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Vena JA, Copel LC. A Meta-Ethnography of the Experiences of Adults with Lymphoma During Acute and Chronic Survivorship. Semin Oncol Nurs 2021; 37:151142. [PMID: 33773881 DOI: 10.1016/j.soncn.2021.151142] [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: 10/21/2020] [Revised: 02/01/2021] [Accepted: 02/10/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The acute and chronic phases of cancer survivorship are the periods of treatment, post-treatment, and early remission. During acute and chronic survivorship, adults with lymphoma have reported both positive and negative changes in health-related quality of life. This meta-ethnography aims to appraise the experiences of adults with lymphoma at the acute and chronic survivorship phases. DATA SOURCES This qualitative review used the established meta-ethnography framework from Noblit and Hare and is outlined following the meta-ethnography reporting guidance (eMERGe). A systematic literature search using four unique databases was completed, including the Cumulative Index to Nursing and Allied Health Literature, PubMed, Ovid Emcare, and Clarivate Web of Science. CONCLUSION In total, nine research studies were included in this review. Study characteristics and sample evidence were extracted from the included studies to produce the synthesis. The review and synthesis formed three main themes and six subthemes that reflect the challenges of cancer treatment and post-treatment, the communication and support from others, and how lymphoma patients reframe and reprioritize during and following treatment. IMPLICATIONS FOR NURSING PRACTICE This meta-ethnography provides a comprehensive analysis of adults' experiences with lymphoma at the acute and chronic survivorship phases. Several approaches for the management and care of lymphoma patients were found in this review, including integrating patient support groups from diagnosis through post-treatment, tailored psychological health care services, personalized care and delivery pathways at post-treatment, and the promotion of strategies to cope with cancer in remission. Additional research should examine younger and older adults to discover age-related issues in lymphoma populations in addition to disparities among minority patients with lymphoma and those from low socioeconomic backgrounds.
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Affiliation(s)
- Joseph A Vena
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, PA.
| | - Linda C Copel
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, PA
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Tanzi S, De Panfilis L, Costantini M, Artioli G, Alquati S, Di Leo S. Development and preliminary evaluation of a communication skills training programme for hospital physicians by a specialized palliative care service: the 'Teach to Talk' programme. BMC MEDICAL EDUCATION 2020; 20:363. [PMID: 33059642 PMCID: PMC7560022 DOI: 10.1186/s12909-020-02275-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 10/01/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND There is widespread agreement about the importance of communication skills training (CST) for healthcare professionals caring for cancer patients. Communication can be effectively learned and improved through specific CST. Existing CSTs have some limitations with regard to transferring the learning to the workplace. The aim of the study is developing, piloting, and preliminarily assessing a CST programme for hospital physicians caring for advanced cancer patients to improve communication competences. METHODS This is a Phase 0-I study that follows the Medical Research Council framework; this paper describes the following sections: a literature review on CST, the development of the Teach to Talk training programme (TtT), the development of a procedure for assessing the quality of the implementation process and assessing the feasibility of the implementation process, and the pilot programme. The study was performed at a 900-bed public hospital. The programme was implemented by the Specialized Palliative Care Service. The programme was proposed to 19 physicians from 2 departments. RESULTS The different components of the training course were identified, and a set of quality indicators was developed. The TtT programme was implemented; all the physicians attended the lesson, videos, and role-playing sessions. Only 25% of the physicians participated in the bedside training. It was more challenging to involve Haematology physicians in the programme. CONCLUSIONS The programme was completed as established for one of the two departments in which it was piloted. Thus, in spite of the good feedback from the trainees, a re-piloting of a different training program will be developed, considering in particular the bed side component. The program should be tailored on specific communication attitude and believes, probably different between different specialties.
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Affiliation(s)
- S Tanzi
- Palliative Care Unit, Azienda USL- IRCCS Reggio Emilia, Reggio Emilia, Italy.
- Clinical and Experimental Medicine PhD Programme, University of Modena and Reggio Emilia, Modena, Italy.
| | - L De Panfilis
- Unit of Bioethics, Azienda USL- IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - M Costantini
- Scientific Directorate, Azienda USL-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - G Artioli
- Palliative Care Unit, Azienda USL- IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - S Alquati
- Palliative Care Unit, Azienda USL- IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - S Di Leo
- Psycho-oncology Unit, Azienda USL-IRCCS Reggio Emilia, Reggio Emilia, Italy
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Abstract
BACKGROUND Survivors of lymphoma experience multiple challenges after treatment. However, a lack of knowledge of in-depth experiences of lymphoma survivors in early aftercare persists. OBJECTIVE To gain an in-depth understanding of the experiences of lymphoma survivors in early aftercare who have received an aftercare consultation based on evidence-based guideline recommendations, with an advanced practice nurse. METHODS This study used a narrative design. We recruited lymphoma survivors after a best-practice aftercare consultation with an advanced practice nurse. A total of 22 lymphoma survivors and 9 partners participated. Data were collected through narrative interviews and analyzed according to thematic narrative analysis. RESULTS Six themes emerged: living and dealing with health consequences, coping with work and financial challenges, having a positive outlook and dealing with uncertainty, deriving strength from and experiencing tensions in relationships, getting through tough times in life, and receiving support from healthcare professionals. CONCLUSIONS The stories of lymphoma survivors in early aftercare revealed their experiences of how they coped with a range of challenges in their personal lives. Choosing an aftercare trajectory based on an aftercare consultation that encourages patients to think about their issues, goals, and possible aftercare options may be useful for their transition from treatment to survivorship. IMPLICATIONS FOR PRACTICE Survivors' social support and self-management capabilities are important aspects to be addressed in cancer care. An aftercare consultation involving shared goal setting and care planning may help nurses provide personalized aftercare.
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Parker PA, Banerjee SC, Matasar MJ, Bylund CL, Schofield E, Li Y, Jacobsen PB, Astrow AB, Leventhal H, Horwitz S, Kissane D. Cancer worry and empathy moderate the effect of a survivorship-focused intervention on quality of life. Psychooncology 2020; 29:1012-1018. [PMID: 32128909 DOI: 10.1002/pon.5371] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 02/13/2020] [Accepted: 02/26/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE This study examined the impact of a survivorship planning consultation (SPC) for patients with Hodgkin's lymphoma and diffuses large B-cell lymphoma on quality of life (QOL). We specifically assessed two potential moderators, cancer worry and perceived empathy, of the intervention effects on QOL. METHODS This cluster randomized, four-site trial examined the efficacy of a SPC; physicians received communication skills training and applied these skills in a survivorship-focused office visit using a care plan vs a control arm in which physicians were trained to and subsequently provided a time-controlled, manualized wellness rehabilitation consultation focused only on discussion of healthy nutrition and exercise. We examined the effect of the intervention on patients' QOL and examined potential moderators-cancer worry and perceived physician empathy. RESULTS Forty-two physicians and 198 patients participated. There was no main effect of the intervention on any of the QOL dimensions (ps > 0.10). However, cancer worry was a significant moderator of the effects of the intervention on three QOL domains (physical P = .04; social P = .04; spiritual P = .01) and perceived empathy was a significant moderator of QOL (physical P = .004; psychological P = .04; social P = .01). Specifically, the beneficial effects of the intervention were more pronounced among patients who initially reported higher levels of cancer worry and lower levels of physician empathy. CONCLUSIONS This study identified two factors, perceived empathy and cancer worry, that were found to impact the QOL of patients who participated in this communication-based survivorship intervention.
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Affiliation(s)
- Patricia A Parker
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.,Department of Psychiatry, Weill Cornell Medical College, New York, New York, USA
| | - Smita C Banerjee
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.,Department of Psychiatry, Weill Cornell Medical College, New York, New York, USA
| | - Matthew J Matasar
- Department of Medicine, Weill Cornell Medical College, New York, New York, USA.,Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
| | - Carma L Bylund
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.,STEM Translational Communication Center, University of Florida, Gainesville, Florida, USA
| | - Elizabeth Schofield
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
| | - Yuelin Li
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.,Department of Psychiatry, Weill Cornell Medical College, New York, New York, USA
| | - Paul B Jacobsen
- Division of Cancer Control & Population Sciences, National Cancer Institute, Bethesda, Maryland, USA
| | - Alan B Astrow
- Department of Medicine, New York Methodist Hospital, Hematology and Oncology, Weill Cornell Medical College, New York, New York, USA
| | - Howard Leventhal
- Department of Psychology, Rutgers University, New Brunswick, New Jersey, USA
| | - Steven Horwitz
- Department of Medicine, Weill Cornell Medical College, New York, New York, USA.,Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
| | - David Kissane
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.,Department of Psychiatry, Weill Cornell Medical College, New York, New York, USA.,University of Notre Dame Australia, School of Medicine, and the Cunningham Centre for Palliative Care Research, St Vincent's Hospital, Sydney, Australia
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COMSKIL Communication Training in Oncology-Adaptation to German Cancer Care Settings. Recent Results Cancer Res 2019; 210:191-205. [PMID: 28924687 DOI: 10.1007/978-3-319-64310-6_12] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Medical communication is a skill which can be learned and taught and which can substantially improve treatment outcomes, especially if patients' communication preferences are taken into account. Here, we give an overview of communication training research and outline the COMSKIL program as a state-of-the-art communication skills training in oncology. COMSKIL has a solid theoretical foundation and teaches core elements of medical communication in up to ten fully operationalized modules. These address typical situations ranging from breaking bad news to responding to difficult emotions, shared decision-making, and communicating via interpreters.
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Donohue S, Haine JE, Li Z, Trowbridge ER, Kamnetz SA, Feldstein DA, Sosman JM, Wilke LG, Sesto ME, Tevaarwerk AJ. The Impact of a Primary Care Education Program Regarding Cancer Survivorship Care Plans: Results from an Engineering, Primary Care, and Oncology Collaborative for Survivorship Health. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2019; 34:154-160. [PMID: 28932992 PMCID: PMC5860986 DOI: 10.1007/s13187-017-1281-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Survivorship care plans (SCPs) have been recommended as tools to improve care coordination and outcomes for cancer survivors. SCPs are increasingly being provided to survivors and their primary care providers. However, most primary care providers remain unaware of SCPs, limiting their potential benefit. Best practices for educating primary care providers regarding SCP existence and content are needed. We developed an education program to inform primary care providers of the existence, content, and potential uses for SCPs. The education program consisted of a 15-min presentation highlighting SCP basics presented at mandatory primary care faculty meetings. An anonymous survey was electronically administered via email (n = 287 addresses) to evaluate experience with and basic knowledge of SCPs pre- and post-education. A total of 101 primary care advanced practice providers (APPs) and physicians (35% response rate) completed the baseline survey with only 23% reporting prior receipt of a SCP. Only 9% could identify the SCP location within the electronic health record (EHR). Following the education program, primary care physicians and APPs demonstrated a significant improvement in SCP knowledge, including improvement in their ability to locate one within the EHR (9 vs 59%, p < 0.0001). A brief educational program containing information about SCP existence, content, and location in the EHR increased primary care physician and APP knowledge in these areas, which are prerequisites for using SCP in clinical practice.
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Affiliation(s)
| | - James E Haine
- Department of Medicine, Division of Internal Medicine, University of Wisconsin, Madison, WI, USA
| | - Zhanhai Li
- Biostatistics, University of Wisconsin, Madison, WI, USA
| | - Elizabeth R Trowbridge
- Department of Medicine, Division of Internal Medicine, University of Wisconsin, Madison, WI, USA
| | - Sandra A Kamnetz
- Department of Family and Community Health, University of Wisconsin, Madison, WI, USA
| | - David A Feldstein
- Department of Medicine, Division of Internal Medicine, University of Wisconsin, Madison, WI, USA
| | - James M Sosman
- Department of Medicine, Division of Internal Medicine, University of Wisconsin, Madison, WI, USA
| | - Lee G Wilke
- Department of Surgery, University of Wisconsin, Madison, WI, USA
- University of Wisconsin Carbone Cancer Center, Madison, WI, USA
| | - Mary E Sesto
- University of Wisconsin Carbone Cancer Center, Madison, WI, USA
- Department of Industrial and Systems Engineering, University of Wisconsin, Madison, WI, USA
| | - Amye J Tevaarwerk
- University of Wisconsin Carbone Cancer Center, Madison, WI, USA.
- Department of Medicine, Division of Hematology/Oncology, University of Wisconsin, 1111 Highland Ave, WIMR 6037, Madison, WI, 53705, USA.
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Parker PA, Banerjee SC, Matasar MJ, Bylund CL, Rogers M, Franco K, Schofield E, Li Y, Levin TT, Jacobsen PB, Astrow AB, Leventhal H, Horwitz S, Kissane D. Efficacy of a survivorship-focused consultation versus a time-controlled rehabilitation consultation in patients with lymphoma: A cluster randomized controlled trial. Cancer 2018; 124:4567-4576. [PMID: 30335188 DOI: 10.1002/cncr.31767] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 08/21/2018] [Accepted: 08/21/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Survivors of cancer often describe a sense of abandonment after treatment along with heightened uncertainty and limited knowledge of what lies ahead. This study examined the efficacy of a survivorship care plan (SCP) intervention to help physicians to address survivorship issues through communication skills training plus a new consultation focused on the use of an SCP for patients with Hodgkin lymphoma and diffuse large B-cell lymphoma. METHODS This 4-site cluster randomized trial examined the efficacy of a survivorship planning consultation (SPC) in patients who achieved complete remission after the completion of first-line therapy (for the SPC, physicians received communication skills training and, using an SCP, applied those skills in a survivorship-focused office visit) versus a control arm in which physicians were trained in and subsequently provided a time-controlled, manualized wellness rehabilitation consultation (WRC) focused only on discussion of healthy nutrition and exercise as rehabilitation after chemotherapy. The primary outcomes for patients were changes in knowledge about lymphoma and adherence to physicians' recommendations for vaccinations and cancer screenings. RESULTS Forty-two physicians and 198 patients participated across the 4 sites. Patients whose physicians were in the SPC arm had greater knowledge about their lymphoma (P = .01) and showed greater adherence to physician recommendations for influenza vaccinations (P = .02) and colonoscopy (P = .02) than patients whose physicians were in the WRC arm. CONCLUSIONS A dedicated consultation using an SCP and supported by communication skills training may enhance patients' knowledge and adherence to some health promotion recommendations.
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Affiliation(s)
- Patricia A Parker
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York
- Department of Psychiatry, Weill Cornell Medical College, New York
| | - Smita C Banerjee
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York
- Department of Psychiatry, Weill Cornell Medical College, New York
| | - Matthew J Matasar
- Department of Medicine, Weill Cornell Medical College, New York
- Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York
| | - Carma L Bylund
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York
- STEM Translational Communication Center, University of Florida, Gainesville
| | - Madeline Rogers
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York
| | - Kara Franco
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York
| | - Elizabeth Schofield
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York
| | - Yuelin Li
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York
- Department of Psychiatry, Weill Cornell Medical College, New York
| | - Tomer T Levin
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York
- Department of Psychiatry, Weill Cornell Medical College, New York
| | - Paul B Jacobsen
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| | - Alan B Astrow
- Department of Medicine, New York Methodist Hospital, New York
- Hematology and Oncology, Weill Cornell Medical College, New York
| | - Howard Leventhal
- Department of Psychology, Rutgers University, New Brunswick, New Jersey
| | - Steven Horwitz
- Department of Medicine, Weill Cornell Medical College, New York
- Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York
| | - David Kissane
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York
- Department of Psychiatry, Weill Cornell Medical College, New York
- Department of Psychiatry, Monash University, Clayton, Victoria, Australia
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Strekalova YA, Hawkins KE, Drusbosky LM, Cogle CR. Using social media to assess care coordination goals and plans for leukemia patients and survivors. Transl Behav Med 2018; 8:481-491. [PMID: 29800400 DOI: 10.1093/tbm/ibx075] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Care coordination has been shown to have a positive effect on the management of chronic disease. Specific to the management of leukemia, coordination may occur between primary care physician, medical and radiation oncologists, surgeons, cardiologists, and genetics specialists. Experiencing gaps in communication and care coordination, many health consumers seek instrumental support in their social circles, including online forums and networks. The goal of this theory-guided study was to provide an in-depth assessment of how individuals use online forums to deliberate about their goals and plans for leukemia care coordination. Guided by the planning theory of communication, the data were collected from the American Cancer Society Cancer Survivors Network and included 125 original posts and 1,248 responses. Thematic analysis and axial coding were applied to analyze the data. Goal-related themes included overcoming the diffusion of care coordination and achieving health management cohesion. Planning themes included social health management, communication self-efficacy, and role deliberation. Online patient forums provide an interactive platform for patients and caregivers to engage in active conversations, which in turn can serve as identifiers of care coordination needs. Communication with those who share similar experiences allows cancer patients and survivors to accumulate functional health literacy, gain communication self-efficacy, and articulate a care coordination role acceptable to them.
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Affiliation(s)
- Yulia A Strekalova
- College of Journalism and Communications, University of Florida, Gainesville, FL, USA
| | - Kimberly E Hawkins
- Division of Hematology & Oncology, Department of Medicine, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Leylah M Drusbosky
- Division of Hematology & Oncology, Department of Medicine, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Cristopher R Cogle
- Division of Hematology & Oncology, Department of Medicine, College of Medicine, University of Florida, Gainesville, FL, USA
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Economou D, Reb A. Communication Concerns When Transitioning to Cancer Survivorship Care. Semin Oncol Nurs 2017; 33:526-535. [DOI: 10.1016/j.soncn.2017.10.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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