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Derry-Vick HM, Heathcote LC, Glesby N, Stribling J, Luebke M, Epstein AS, Prigerson HG. Scanxiety among Adults with Cancer: A Scoping Review to Guide Research and Interventions. Cancers (Basel) 2023; 15:1381. [PMID: 36900174 PMCID: PMC10000102 DOI: 10.3390/cancers15051381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/14/2023] [Accepted: 02/17/2023] [Indexed: 02/24/2023] Open
Abstract
Background: Scan-related anxiety ("scanxiety") is distressing to people living with and beyond cancer. We conducted a scoping review to promote conceptual clarity, identify research practices and gaps, and guide intervention strategies for adults with a current or prior cancer diagnosis. Methods: Following a systematic search, we screened 6820 titles and abstracts, evaluated 152 full-text articles, and selected 36 articles. Definitions, study designs, measurement methods, correlates, and consequences of scanxiety were extracted and summarized. Results: The reviewed articles included individuals living with current cancer (n = 17) and those in the post-treatment phase (n = 19), across a breadth of cancer types and disease stages. In five articles, authors explicitly defined scanxiety. Multiple components of scanxiety were described, including those related to scan procedures (e.g., claustrophobia, physical discomfort) and scan results (e.g., implications for disease status and treatment), suggesting varied intervention approaches may be needed. Twenty-two articles used quantitative methods, nine used qualitative methods, and five used mixed methods. In 17 articles, symptom measures specifically referenced cancer scans; 24 included general measures without reference to scans. Scanxiety tended to be higher among those with lower education levels, less time since diagnosis, and greater baseline anxiety levels (three articles each). Although scanxiety often decreased immediately pre- to post-scan (six articles), participants reported the waiting period between scan and results to be particularly stressful (six articles). Consequences of scanxiety included poorer quality of life and somatic symptoms. Scanxiety promoted follow-up care for some patients yet hindered it for others. Conclusions: Scanxiety is multi-faceted, heightened during the pre-scan and scan-to-results waiting periods, and associated with clinically meaningful outcomes. We discuss how these findings can inform future research directions and intervention approaches.
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Affiliation(s)
- Heather M. Derry-Vick
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ 07110, USA
- Hackensack Meridian School of Medicine, Nutley, NJ 07110, USA
| | - Lauren C. Heathcote
- Health Psychology Section, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE1 9RT, UK
| | | | | | - Matthew Luebke
- Hackensack Meridian School of Medicine, Nutley, NJ 07110, USA
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Blödt S, Müller-Nordhorn J, Seifert G, Holmberg C. Trust, medical expertise and humaneness: A qualitative study on people with cancer' satisfaction with medical care. Health Expect 2021; 24:317-326. [PMID: 33528878 PMCID: PMC8077133 DOI: 10.1111/hex.13171] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 10/21/2020] [Accepted: 11/05/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Understanding peoples' evaluations of their health care is important to ensure appropriate health-care services. OBJECTIVES To understand what factors influence peoples' satisfaction with care and how interpersonal trust is established between doctors and cancer patients in Germany. DESIGN A narrative interview study that included women with a diagnosis of breast cancer and men with a diagnosis of prostate cancer. A question-focused analysis was conducted. SETTING AND PARTICIPANTS Interviewees were sought across Germany through self-help organizations, clinics, rehabilitation facilities, physicians and other health-care professionals, in order to develop modules on experiencing cancer for the website krankheitserfahrungen.de (illness experiences.de). RESULTS Satisfaction was related to the perception of having a knowledgeable and trusted physician. Trust was developed through particular interactions in which 'medical expertise' and 'humaneness' were enacted by physicians. Humaneness represents the ability of physicians to personalize medical expertise and thereby to convey working in the individual's best interest and to treat the patient as an individual and unique human being. This was fostered through contextual and relational factors including among others setting, time, information transfer, respect, availability, profoundness, sensitivity and understanding. CONCLUSION It was the ability to make oneself known to and know the patient in particular ways that allowed for satisfying care experiences by establishing interpersonal trust. This suggests the importance of conceptualizing the doctor-patient relationship as a fundamentally reciprocal human interaction of caregiving and care-receiving. At the core of the satisfying care experiences lies a doctor-patient relationship with a profoundly humane quality.
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Affiliation(s)
- Susanne Blödt
- Institute of Social Medicine and Epidemiology, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany
| | - Jacqueline Müller-Nordhorn
- Institute of Public Health of the Charité - Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Georg Seifert
- Department of Pediatrics, Division of Oncology and Hematology, Charité - Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.,Faculdade de Medicina, Departamento de Pediatria, Instituto de Tratamento do Câncer Infantil (ITACI), Universidade de São Paulo, São Paulo, Brazil
| | - Christine Holmberg
- Institute of Social Medicine and Epidemiology, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany.,Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Potsdam, Germany
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3
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McGeechan GJ, Byrnes K, Campbell M, Carthy N, Eberhardt J, Paton W, Swainston K, Giles EL. A systematic review and qualitative synthesis of the experience of living with colorectal cancer as a chronic illness. Psychol Health 2021; 37:350-374. [PMID: 33499649 DOI: 10.1080/08870446.2020.1867137] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Advances in detection and treatment mean that over 50% of people diagnosed with colorectal cancer can expect to live for more than ten years following treatment. Studies show that colorectal cancer patients can experience numerous physical and psychological late effects. The aim of this study was to conduct a systematic review and qualitative synthesis on the experiences of living with colorectal cancer as a chronic illness. METHODS Electronic searches of online databases were undertaken of peer reviewed and grey literature. Forty-seven papers were eligible for inclusion in the review, capturing the experiences of over 700 participants, the findings from which were analysed using thematic synthesis. RESULTS Three higher order concepts were identified which were prevalent across studies and countries and which related to the supportive care needs of patients; common physical and psychological late effects of cancer; and methods of psychosocial adjustment to living with and beyond colorectal cancer. CONCLUSION The results are considered in the context of existing theoretical approaches to chronic illness and the need to develop a theoretical approach which fully encapsulates the experience of living with colorectal cancer as a chronic illness in order to inform interventions to support patient adjustment.
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Affiliation(s)
- Grant J McGeechan
- Centre for Applied Psychological Science, Teesside University, Middlesbrough, UK
| | - Kate Byrnes
- Centre for Public Health, Teesside University, Middlesbrough, UK
| | - Miglena Campbell
- Centre for Applied Psychological Science, Teesside University, Middlesbrough, UK
| | - Nikki Carthy
- Centre for Applied Psychological Science, Teesside University, Middlesbrough, UK
| | - Judith Eberhardt
- Centre for Applied Psychological Science, Teesside University, Middlesbrough, UK
| | - Wendy Paton
- Centre for Applied Psychological Science, Teesside University, Middlesbrough, UK
| | - Katherine Swainston
- Centre for Applied Psychological Science, Teesside University, Middlesbrough, UK
| | - Emma L Giles
- Centre for Public Health, Teesside University, Middlesbrough, UK
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Qaderi SM, Swartjes H, Custers JAE, de Wilt JHW. Health care provider and patient preparedness for alternative colorectal cancer follow-up; a review. Eur J Surg Oncol 2020; 46:1779-1788. [PMID: 32571636 DOI: 10.1016/j.ejso.2020.06.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 05/06/2020] [Accepted: 06/11/2020] [Indexed: 12/15/2022] Open
Abstract
Follow-up after curative treatment for colorectal cancer (CRC) puts pressure on outpatient services due to the growing number of CRC survivors. The aim of this state-of-the-art review was to evaluate setting, manner and provider of follow-up. Moreover, perceptions of CRC survivors and health care providers regarding standard and alternative follow-up were examined. After a comprehensive literature search of the PubMed database, 69 articles were included reporting on CRC follow-up in the hospital, primary care and home setting. Hospital-based follow-up is most common and has been provided by surgeons, medical oncologists, and gastroenterologists, as well as nurses. Primary care-based follow-up has been provided by general practitioners or nurses. Even though most hospital- or primary care-based follow-up care requires patients to visit the clinic, telephone-based care has proven to be a feasible alternative. Most patients perceived follow-up as positive; valuing screening and detection for disease recurrence and appreciating support for physical and psychosocial symptoms. Hospital-based follow-up performed by the medical specialist or nurse is highly preferred by patients and health care providers. However, willingness of both patients and health care providers for alternative, primary care or remote follow-up exists. Nurse-led and GP-led follow-up have proven to be cost-effective alternatives compared to specialist-led follow-up. If proven safe and acceptable, remote follow-up can become a cost-effective alternative. To decrease the personal and financial burden of follow-up for a growing number of colorectal cancer survivors, a more acceptable, flexible and dynamic care follow-up mode consisting of enhanced communication and role definitions among clinicians is warranted.
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Affiliation(s)
- S M Qaderi
- Department of Surgical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands.
| | - H Swartjes
- Department of Surgical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - J A E Custers
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - J H W de Wilt
- Department of Surgical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
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Cervantes-Ortega M, Du S, Biegler KA, Al-Majid S, Davis KC, Chen Y, Kobsa A, Mukamel DB, Sorkin DH. Participatory decision-making for cancer care in a high-risk sample of low income Mexican-American breast cancer survivors: The role of acculturation. ACTA ACUST UNITED AC 2020; 6:35-43. [PMID: 33898743 DOI: 10.5430/ijh.v6n2p35] [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: 11/06/2022]
Abstract
Background Despite declining cancer incidence and mortality rates, Latina patients continue to have lower 5-year survival rates compared to their non-Hispanic white counterparts. Much of this difference has been attributed to lack of healthcare access and poorer quality of care. Research, however, has not considered the unique healthcare experiences of Latina patients. Methods Latina women with prior diagnoses of stage 0-III breast cancer were asked to complete a cross-sectional survey assessing several socio-demographic factors along with their experiences as cancer patients. Using a series of linear regression models in a sample of 68 Mexican-American breast cancer survivors, we examined the extent to which patients' ratings of provider interpersonal quality of care were associated with patients' overall healthcare quality, and how these associations varied by acculturation status. Results Findings for Latina women indicated that both participatory decision-making (PDM) (β = 0.62, p < .0001) and trust (β = 0.53, p = .02) were significantly associated with patients' ratings of healthcare quality. The interaction between acculturation and PDM further suggested that participating in the decision-making process mattered more for less acculturated than for more acculturated patients (β = -0.51, p ≤ .01). Conclusions The variation across low and high acculturated Latinas in their decision-making process introduces a unique challenge to health care providers. Further understanding the relationship between provider-patient experiences and ratings of overall healthcare quality is critical for ultimately improving health outcomes.
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Affiliation(s)
| | - Senxi Du
- Keck School of Medicine, University of Southern California, Los Angeles, USA
| | - Kelly A Biegler
- Department of Medicine, University of California Irvine, Irvine, USA
| | - Sadeeka Al-Majid
- School of Nursing, California State University Fullerton, Fullerton, USA
| | - Katelyn C Davis
- Department of Medicine, University of California Irvine, Irvine, USA
| | - Yunan Chen
- Department of Informatics, University of California Irvine, Irvine, USA
| | - Alfred Kobsa
- Department of Informatics, University of California Irvine, Irvine, USA.,Department of Computer Science, University of California Irvine, Irvine, USA
| | - Dana B Mukamel
- Department of Medicine, University of California Irvine, Irvine, USA
| | - Dara H Sorkin
- Department of Medicine, University of California Irvine, Irvine, USA
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Berian JR, Cuddy A, Francescatti AB, O'Dwyer L, Nancy You Y, Volk RJ, Chang GJ. A systematic review of patient perspectives on surveillance after colorectal cancer treatment. J Cancer Surviv 2017; 11:542-552. [PMID: 28639159 PMCID: PMC5744251 DOI: 10.1007/s11764-017-0623-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Accepted: 05/30/2017] [Indexed: 12/18/2022]
Abstract
PURPOSE Surveillance after colorectal cancer (CRC) treatment is routine, but intensive follow-up may offer little-to-no overall survival benefit. Given the growing population of CRC survivors, we aimed to systematically evaluate the literature for the patient perspective on two questions: (1) How do CRC patients perceive routine surveillance following curative treatment and what do they expect to gain from their surveillance testing or visits? (2) Which providers (specialists, nursing, primary care) are preferred by CRC survivors to guide post-treatment surveillance? METHODS Systematic searches of PubMed MEDLINE, Embase, the CENTRAL Register of Controlled Trials, CINAHL, and PsycINFO were conducted. Studies were screened for inclusion by two reviewers, with discrepancies adjudicated by a third reviewer. Data were abstracted and evaluated utilizing validated reporting tools (CONSORT, STROBE, CASP) appropriate to study design. RESULTS Citations (3691) were screened, 91 full-text articles reviewed, and 23 studies included in the final review: 15 quantitative and 8 qualitative. Overall, 12 studies indicated CRC patients perceive routine surveillance positively, expecting to gain reassurance of continued disease suppression. Negative perceptions described in six studies included anxiety and dissatisfaction related to quality of life or psychosocial issues during follow-up. Although 5 studies supported specialist-led care, 9 studies indicated patient willingness to have follow-up with non-specialist providers (primary care or nursing). CONCLUSIONS Patients' perceptions of follow-up after CRC are predominantly positive, although unmet needs included psychosocial support and quality of life. IMPLICATIONS FOR CANCER SURVIVORS Survivors perceived follow-up as reassuring, however, surveillance care should be more informative and focused on survivor-specific needs.
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Affiliation(s)
- Julia R Berian
- Division of Research and Optimal Patient Care, American College of Surgeons, 633 N. St Clair St., 22nd Floor, Chicago, IL, 60611, USA
- Department of Surgery, University of Chicago Medical Center, 5841 S. Maryland Ave, Chicago, IL, 60637, USA
| | - Amanda Cuddy
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, P.O. Box 301402, Houston, TX, 77230, USA
| | - Amanda B Francescatti
- Division of Research and Optimal Patient Care, American College of Surgeons, 633 N. St Clair St., 22nd Floor, Chicago, IL, 60611, USA
| | - Linda O'Dwyer
- Galter Health Sciences Library, Northwestern University, 303 E. Chicago Avenue, Chicago, IL, 60611, USA
| | - Y Nancy You
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, P.O. Box 301402, Houston, TX, 77230, USA
| | - Robert J Volk
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, 77230, USA
| | - George J Chang
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, P.O. Box 301402, Houston, TX, 77230, USA.
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, 77230, USA.
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7
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Ernstmann N, Wirtz M, Nitzsche A, Gross SE, Ansmann L, Gloede TD, Jung J, Pfaff H, Baumann W, Schmitz S, Neumann M. Patients' Trust in Physician, Patient Enablement, and Health-Related Quality of Life During Colon Cancer Treatment. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2017; 32:571-579. [PMID: 28110419 DOI: 10.1007/s13187-017-1166-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
In cancer care, where patients and their families experience significant emotional distress and patients have to deal with complex medical information, patient centeredness is an important aspect of quality of care. The aim of this study is to examine the impact of patients' trust in their oncologists and patients' enablement on changes in health-related quality of life of colon cancer patients during follow-up care. We conducted a prospective study in a representative sample of private practices of German oncologists (N = 44). Patients (N = 131) filled out a standardized questionnaire prior to their first consultation (T0), directly after the first consultation (T1) and after two months (T2). Data were analyzed by structural equation modeling. Significant associations were found between trust in physician and changes in physical functioning between T1 and T2, and between trust in physician and patient enablement. Patient enablement is significantly associated with changes in physical functioning between T1 and T2. The results underline the importance of building a close and trustful patient-physician relationship in the oncology encounter. A central mechanism of the association between the quality of the relationship and health outcomes seems to be patient enablement. To enable patients to cope with their situation by making them understand their diagnosis, treatments, and side effects can impact health-related quality of life in physical domains.
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Affiliation(s)
- Nicole Ernstmann
- Center for Health Communication and Health Services Research (CHSR), Department for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany.
| | - Markus Wirtz
- Department for Research Methodology, University of Education, Kunzenweg 21, 79117, Freiburg, Germany
| | - Anika Nitzsche
- Institute for Medical Sociology, Health Services Research and Rehabilitation Science (IMVR), University of Cologne, Eupener Strasse 129, 50933, Cologne, Germany
| | - Sophie E Gross
- Institute for Medical Sociology, Health Services Research and Rehabilitation Science (IMVR), University of Cologne, Eupener Strasse 129, 50933, Cologne, Germany
| | - Lena Ansmann
- Institute for Medical Sociology, Health Services Research and Rehabilitation Science (IMVR), University of Cologne, Eupener Strasse 129, 50933, Cologne, Germany
| | - Tristan D Gloede
- Institute for Medical Sociology, Health Services Research and Rehabilitation Science (IMVR), University of Cologne, Eupener Strasse 129, 50933, Cologne, Germany
| | - Julia Jung
- Institute for Medical Sociology, Health Services Research and Rehabilitation Science (IMVR), University of Cologne, Eupener Strasse 129, 50933, Cologne, Germany
| | - Holger Pfaff
- Institute for Medical Sociology, Health Services Research and Rehabilitation Science (IMVR), University of Cologne, Eupener Strasse 129, 50933, Cologne, Germany
| | - Walter Baumann
- Scientific Institute of Office-Based Haematologists and Oncologists, WINHO , Vor den Siebenburgen 2, 50676, Cologne, Germany
| | - Stephan Schmitz
- Professional Organization of Office-Based Haematologists and Oncologists e.V. (BNHO), Sachsenring 69, 50677, Cologne, Germany
| | - Melanie Neumann
- Institute for Integrative Medicine, Department for Psychology/Psychotherapy, Department for Medicine, Faculty of Health, Witten/Herdecke University, Gerhard-Kienle-Weg 4, 58313, Herdecke, Germany
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Abstract
Cancer is fundamentally a genetic disease caused by mutational or epigenetic alterations in DNA. There has been a remarkable expansion of the molecular understanding of colonic carcinogenesis in the last 30 years and that understanding is changing many aspects of colorectal cancer care. It is becoming increasingly clear that there are genetic subsets of colorectal cancer that have different risk factors, prognosis, and response to treatment. This article provides a general update on colorectal cancer and highlights the ways that genetics is changing clinical care.
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Affiliation(s)
- Joshua C Obuch
- Division of Gastroenterology & Hepatology, Department of Medicine, University of Colorado, School of Medicine, 12631 E. 17th Avenue, MS B-158, Aurora, CO 80045, USA
| | - Dennis J Ahnen
- University of Colorado, School of Medicine, 12631 E. 17th Avenue, MS B-158, Aurora, CO 80045, USA.
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