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Leibring I, Kihlgren A, Anderzén Carlsson A. Fear, coping and support- from the perspective of children aged 10-17-year old having acute lymphoblastic leukemia. Int J Qual Stud Health Well-being 2024; 19:2310147. [PMID: 38324664 PMCID: PMC10851796 DOI: 10.1080/17482631.2024.2310147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 01/22/2024] [Indexed: 02/09/2024] Open
Abstract
PURPOSE To describe experiences of fear, coping, and support in 10-17-year-old children under treatment for acute lymphoblastic leukaemia (ALL). METHODS A longitudinal descriptive qualitative design was adopted. Ten children participated in one to three interviews each (24 interviews in all). Interviews were analysed using a matrix-based qualitative method. RESULTS The variety of fears described related to uncertainty, pain and medical procedures, bodily changes and loss of control, complications, professionals' attitudes, affected school results, and social isolation. Children used various strategies to deal with fear: some more general, to cope with the whole situation, and others more related to specific events such as treatment and tests. The most reported strategies we labelled Accepting the situation, Positive thinking, and Being an active agent. Less favourable strategies were also reported. Health care professionals, families, and friends offered valuable, but different kinds of, support. CONCLUSIONS Children aged 10 to 17 undergoing treatment for ALL experience various fears. Each experience is individual and changes over time, but there are common patterns. Most children used problem-solving or emotional-regulation strategies, but withdrawal was also reported. Even children who can deal with fear need support from their health care professionals, families, and friends.
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Affiliation(s)
- Ingela Leibring
- Faculty of Health, Science and Technology, Institution for Health, Karlstad University, Karlstad, Sweden
| | - Annica Kihlgren
- Faculty of Health and Medicine, School of Health Sciences, Örebro University, Örebro, Sweden
| | - Agneta Anderzén Carlsson
- Faculty of Medicine and Health, University Health Care Research Center, Örebro University, Örebro, Sweden
- Faculty of Health and Social Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
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Court RJ, Swallow V, El-Yousfi S, Gray-Burrows K, Sotir F, Wheeler G, Kellar I, Lee JM, Mitchell R, Mlynarczyk W, Ramavath A, Dimitri P, Phillips B, Prodgers L, Pownall M, Kowalczyk M, Branchflower J, Powell L, Bhanbhro S, Weighall A, Martin-Kerry J. Children and young people's preferences and needs when using health technology to self-manage a long-term condition: a scoping review. Arch Dis Child 2024:archdischild-2023-326044. [PMID: 39142825 DOI: 10.1136/archdischild-2023-326044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 05/27/2024] [Indexed: 08/16/2024]
Abstract
BACKGROUND The use of patient-facing health technologies to manage long-term conditions (LTCs) is increasing; however, children and young people (CYP) may have preferences about health technologies which they interact or engage with, that influence their decision to use these technologies. AIMS To identify CYP's reported preferences about health technologies to self-manage LTCs. METHODS We undertook a scoping review, searching MEDLINE, PsycINFO and CINAHL in July 2021. Searches were limited to papers published between January 2015 and July 2021. We included any health technologies used to manage physical and mental LTCs. Qualitative content analysis of study data was undertaken to categorise data into themes and quantitative data were described and visually represented. We engaged CYP with LTCs to support the review design, interpretation of findings and development of recommendations. RESULTS 161 journal articles were included, describing preferences of CYP. Most included studies were undertaken in high-income countries. CYP's main preferences and needs were: design and functionality; privacy and sharing; customisation and personalisation of the technology; and interaction options within the technology. CONCLUSIONS This review highlights important preferences and needs that CYP may have before using technologies to self-manage their LTC. These should be considered when developing technology for this population. Future research should involve CYP throughout the development of the technologies, from identifying their unmet needs through to final design, development, evaluation and implementation of the intervention.
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Affiliation(s)
- Rosemary Jane Court
- Nursing and Midwifery, Sheffield Hallam University College of Health Wellbeing and Life Sciences, Sheffield, UK
| | - Veronica Swallow
- College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Sheffield, UK
| | - Sarab El-Yousfi
- School of Clinical Dentistry, The University of Sheffield, Sheffield, UK
| | - Kara Gray-Burrows
- School of Dentistry, University of Leeds Faculty of Medicine and Health, Leeds, UK
| | - Fiona Sotir
- School of Clinical Dentistry, The University of Sheffield, Sheffield, UK
| | - Gemma Wheeler
- NIHR MedTech & In Vitro Diagnostics Co-operative Sheffield Children's Hospital, NIHR Sheffield CRF, Sheffield, UK
| | - Ian Kellar
- Department of Psychology, The University of Sheffield, Sheffield, UK
| | - Jia Mang Lee
- Hull York Medical School, University of York, York, UK
| | - Robyn Mitchell
- Patient and Public Involvement (PPI) Group Member, University of York, York, UK
| | - Wiktoria Mlynarczyk
- Patient and Public Involvement (PPI) Group Member, University of York, York, UK
| | - Arnav Ramavath
- Patient and Public Involvement (PPI) Group Member, University of York, York, UK
| | - Paul Dimitri
- NIHR Children and Young People MedTech Cooperative, Sheffield Children's Hospital NHS Foundation Trust, Sheffield, UK
| | - Bob Phillips
- Leeds Children's Hospital, Leeds, UK
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Lucy Prodgers
- School of Psychology, University of Leeds, Leeds, UK
| | | | | | - Jacob Branchflower
- NIHR MedTech & In Vitro Diagnostics Co-operative Sheffield Children's Hospital, NIHR Sheffield CRF, Sheffield, UK
| | - Lauren Powell
- School of Education, The University of Sheffield, Sheffield, UK
| | - Sadiq Bhanbhro
- Health Research Institute, Sheffield Hallam University, Sheffield, UK
| | - Anna Weighall
- School of Education, The University of Sheffield, Sheffield, UK
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Shin A, Banubakode S, Taveras Alam S, Gonzalez AO. Evaluating the Readability of Online Blood Cancer Education Materials Across Different Readability Measures. Cureus 2024; 16:e58488. [PMID: 38765438 PMCID: PMC11101262 DOI: 10.7759/cureus.58488] [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] [Accepted: 04/17/2024] [Indexed: 05/22/2024] Open
Abstract
Introduction The National Institutes of Health and the American Medical Association recommend patient education materials (EMs) be at or below the sixth-grade reading level. The American Cancer Society, Leukemia & Lymphoma Society, and National Comprehensive Cancer Network have accurate blood cancer EMs. Methods One hundred one (101) blood cancer EMs from the above organizations were assessed using the following: Flesch Reading Ease Formula (FREF), Flesch-Kincaid Grade Level (FKGL), Gunning Fog Index (GFI), Simple Measure of Gobbledygook Index (SMOG), and the Coleman-Liau Index (CLI). Results Only 3.96% of patient EMs scored at or below the seventh-grade reading level in all modalities. Healthcare professional education materials (HPEMs) averaged around the college to graduate level. For leukemia and lymphoma patient EMs, there were significant differences for FKGL vs. SMOG, FKGL vs. GFI, FKGL vs. CLI, SMOG vs. CLI, and GFI vs. CLI. For HPEMs, there were significant differences for FKGL vs. GFI and GFI vs. CLI. Conclusion The majority of patient EMs were above the seventh-grade reading level. A lack of easily readable patient EMs could lead to a poor understanding of disease and, thus, adverse health outcomes. Overall, patient EMs should not replace physician counseling. Physicians must close the gaps in patients' understanding throughout their cancer treatment.
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Affiliation(s)
- Ashley Shin
- Division of Hematology/Oncology, McGovern Medical School at UTHealth Houston, Houston, USA
| | - Surbhi Banubakode
- Division of Hematology/Oncology, McGovern Medical School at UTHealth Houston, Houston, USA
| | - Sara Taveras Alam
- Division of Hematology/Oncology, McGovern Medical School at UTHealth Houston, Houston, USA
| | - Anneliese O Gonzalez
- Division of Hematology/Oncology, McGovern Medical School at UTHealth Houston, Houston, USA
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Tremolada M, Taverna L, Vietina F, Incardona RM, Pierobon M, Bonichini S, Biffi A, Bisogno G. Adolescents and young adults with oncohematological disease: use of social networks, impact of SARS-COV-2, and psychosocial well-being. Front Psychiatry 2023; 14:1239131. [PMID: 38025461 PMCID: PMC10646548 DOI: 10.3389/fpsyt.2023.1239131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 10/10/2023] [Indexed: 12/01/2023] Open
Abstract
Objective Adolescents and young adults (AYA) with oncohematological diseases could have important psychosocial difficulties that could be worsened by the effects of the COVID19 pandemic. At this developmental stage, it is also important to assess the use of social networks (SNs). This study aims to investigate the type of social network use and the consequences of the COVID19 period. These patients are compared with matched healthy peers. Methods After the informant consent signature, the adolescents completed a series of self-report questionnaires on the use of SNs, on communication preferences, on social anxiety and on Covid19 impact through the online platform of LimeSurvey. Most of the adolescents belonged to the 18-20 age group (42.5%), were female (62%) and mainly off therapy (72%). Results Adolescents spent more than 2 h/day on Instagram and 1 h and half on Whatsapp, while Tik Tok use was on average 1 h/day, especially used by younger patients (r = -0.33, p = 0.023). Males used Twitch (t45 = -2.06, p = 0.05) and Youtube (t45 = -2.18, p = 0.03) for longer than females. AYA in therapy used more Tik Tok (U = 137.50; p = 0.03), Ask/Tellonym (U = 172.50; p = 0.05) and Twitch (U = 144; p = 0.017) than those off therapy. Healthy AYA showed lower levels of exposure (Z = -4.17; p = 0.00001) and impact (Z = -5.12; p = 0.00001) to Covid19, while the level of social anxiety is comparable and is in the normal range in both groups. Discussion Some clinical considerations and suggestions could be given based on these empirical results to health professionals in the care of AYA cancer patients.
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Affiliation(s)
- Marta Tremolada
- Department of Developmental Psychology and Socialization, School of Psychology, University of Padua, Padua, Italy
- Pediatric Hematology, Oncology and Stem Cell Transplant Center, Department of Woman’s and Child’s Health, University of Padua, Padua, Italy
| | - Livia Taverna
- Faculty of Education, Free University of Bozen-Bolzano, Bolzano, Italy
| | - Francesco Vietina
- Pediatric Hematology, Oncology and Stem Cell Transplant Center, Department of Woman’s and Child’s Health, University of Padua, Padua, Italy
| | - Roberta Maria Incardona
- Pediatric Hematology, Oncology and Stem Cell Transplant Center, Department of Woman’s and Child’s Health, University of Padua, Padua, Italy
| | - Marta Pierobon
- Pediatric Hematology, Oncology and Stem Cell Transplant Center, Department of Woman’s and Child’s Health, University of Padua, Padua, Italy
| | - Sabrina Bonichini
- Department of Developmental Psychology and Socialization, School of Psychology, University of Padua, Padua, Italy
| | - Alessandra Biffi
- Pediatric Hematology, Oncology and Stem Cell Transplant Center, Department of Woman’s and Child’s Health, University of Padua, Padua, Italy
| | - Gianni Bisogno
- Pediatric Hematology, Oncology and Stem Cell Transplant Center, Department of Woman’s and Child’s Health, University of Padua, Padua, Italy
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Daniels S, Willard VW. Social media interactions after diagnosis: Social experiences of adolescents and young adults (AYA) with cancer. J Psychosoc Oncol 2023; 42:351-364. [PMID: 37651311 DOI: 10.1080/07347332.2023.2249876] [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] [Indexed: 09/02/2023]
Abstract
PURPOSE Cancer disrupts the social lives of adolescents and young adults (AYA). Social media may be a resource to engage with social networks, seek entertainment, and receive social support. However, some aspects of social media engagement may be emotionally burdensome and sensitive for AYA to navigate. The aim of this qualitative study was to contextualize the impact of cancer on AYA social media interaction. METHODS Eight AYA ages 15-21 years and recently diagnosed with cancer participated in a semi-structured interview. AYA were asked about their social media interactions, engagement habits, and online cancer-related disclosure. Interviews averaged 36 min in length and were de-identified and transcribed verbatim and analyzed using thematic analysis. RESULTS Four salient themes emerged from the data: (1) AYA engage in active and passive social media use depending on the platform, (2) AYA social media habits change due to treatment experiences, (3) AYA evaluate and protect their self-image, privacy, and time, and (4) AYA access social support online and interpret its meaning in different ways. AYA reported using social media, but many altered their frequency and type of interaction after diagnosis. Some were comfortable sharing about cancer and continued to interact actively online; others felt protective and vulnerable, transitioning to media consumption, or withdrawing from use. While social media provided space to receive direct and indirect social support, AYA interpreted the meaning of support in complex ways. CONCLUSIONS Social media may serve a variety of socio-emotional needs, but not all AYA will benefit from the same types of social media interaction. This study highlights the importance of talking to AYA with cancer about their social media interactions during treatment to better support their coping and adjustment.
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Affiliation(s)
- Sarah Daniels
- St. Jude Children's Research Hospital, Memphis, TN, USA
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6
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Poudel PG, Bauer HE, Srivastava DK, Krull KR, Hudson MM, Robison LL, Wang Z, Huang IC. Online Platform to Assess Complex Social Relationships and Patient-Reported Outcomes Among Adolescent and Young Adult Cancer Survivors. JCO Clin Cancer Inform 2021; 5:859-871. [PMID: 34415790 DOI: 10.1200/cci.21.00044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
PURPOSE Social integration and relationship issues have been understudied among adolescent and young adult (AYA) cancer survivors. This study compared social relationships (social networks, support, and isolation) between AYA cancer survivors and noncancer controls, and identified social integration mechanisms through which the cancer experience influences patient-reported outcomes (PROs). MATERIALS AND METHODS One hundred two AYA cancer survivors and 102 age, sex, and race-matched noncancer controls from a national Internet panel completed an online survey to identify up to 25 of closest friends and relatives whom they have contacted within the past 2 years. Participants' interpersonal connections were used to create a social network index. The Duke-UNC Functional Social Support Questionnaire, UCLA Loneliness Scale, and PROMIS-29 Profile were used to measure social support, perceived isolation or loneliness, and PROs (physical functioning, pain interference, fatigue, anxiety, and depression domains), respectively. Path analysis tested effects of cancer experience on PROs using serial social relationship variables as mediators. RESULTS Compared with controls, survivors of lymphoma, leukemia, and solid tumor had better social networks; however, survivors of solid tumor and central nervous system malignancies had higher perceived loneliness (all P values < .05). Cancer experience was directly associated with poor PROs (P values < .05 for all domains except fatigue) and indirectly associated through the social network-support-loneliness pathway (all P values < .05). Survivors with higher loneliness had lower physical functioning and higher pain interference, fatigue, anxiety, and depression versus controls with lower loneliness (all P values < .05). CONCLUSION Compared with controls, survivors were more socially connected but experienced greater loneliness, which was associated with poorer PROs. Screening social integration issues during follow-up care and providing appropriate interventions are warranted.
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Affiliation(s)
- Pragya G Poudel
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN
| | - Hailey E Bauer
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN
| | - D Kumar Srivastava
- Department of Biostatistics, St Jude Children's Research Hospital, Memphis, TN
| | - Kevin R Krull
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN.,Department of Psychology, St Jude Children's Research Hospital, Memphis, TN
| | - Melissa M Hudson
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN.,Department of Oncology, St Jude Children's Research Hospital, Memphis, TN
| | - Leslie L Robison
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN
| | - Zhaoming Wang
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN.,Department of Computational Biology, St Jude Children's Research Hospital, Memphis, TN
| | - I-Chan Huang
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN
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7
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Daniels SR, Yang CC, Toohey SJ, Willard VW. Perspectives on Social Media from Adolescents and Young Adults with Cancer. J Pediatr Oncol Nurs 2021; 38:225-232. [PMID: 33729902 DOI: 10.1177/1043454221992319] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Adolescents and young adults (AYAs) with cancer use social media in unique ways throughout treatment. The purpose of this article is to describe the social media experiences of AYAs with cancer as a means of exploring the potential impact of social media on AYA psychosocial development after diagnosis and throughout cancer treatment. Methods: Seven AYAs treated for cancer, aged 15-20 years, completed a semi-structured interview regarding their social media preferences and habits. Each interview was transcribed verbatim and de-identified. Data were coded and themes were identified via latent thematic analysis. Results: Four themes emerged regarding social media experiences for AYAs with cancer: (1) changes in audience and feedback after diagnosis; (2) attitudes about body image and peer support; (3) control over personal, familial, and societal messages about illness; and (4) maintaining normalcy despite hospital stressors. Discussion: Social media appear especially useful for promoting social and identity development as AYAs undergo cancer treatment. Specifically, social media provide spaces to negotiate body image and sense of self, to manage peer relationships, to reclaim control and independence, and to maintain normalcy. Understanding these experiences will prepare healthcare providers and caregivers to assess ongoing psychosocial development and adjustment throughout cancer treatment.
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Affiliation(s)
- Sarah R Daniels
- 5417Child Life Program, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Chia-Chen Yang
- School of Educational Foundations, Leadership and Aviation, 33086Oklahoma State University, Stillwater, OK, USA
| | - Samantha J Toohey
- 5417Child Life Program, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Victoria W Willard
- Department of Psychology, 5417St. Jude Children's Research Hospital, Memphis, TN, USA
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8
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David CL, Lowrey L. A qualitative investigation assessing whether implementing a Teenage Young Adult information evening, within a radiotherapy department, would improve the information support and treatment pathway for 18-24-year-old cancer patients. Radiography (Lond) 2021; 27:847-853. [PMID: 33589304 DOI: 10.1016/j.radi.2021.01.005] [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: 09/01/2020] [Revised: 01/11/2021] [Accepted: 01/17/2021] [Indexed: 10/22/2022]
Abstract
INTRODUCTION This study evaluated the current information services provided to 10 Teenage Young Adult (TYA) oncology patients within a single radiotherapy department through retrospective patient views. Additionally, the participants provided valuable perspectives on the aptness and merit of implementing a dedicated information evening within the radiotherapy department. METHODS Focus group sessions and open-ended questionnaires were used as the primary data collection tools for this study, producing rich and informative data. The transcriptions from the focus groups, along with the questionnaire responses were then analysed using coding techniques, resulting in 6 distinct themes. RESULTS The participants felt they received adequate information about their radiotherapy treatment and its side effects. However, participants did report some gaps within the service provision that need to be addressed to improve treatment pathways in future. Furthermore, the information was always supplied in paper format which was often undesirable to the cohort with a more interactive format preferred. The participants disclosed very strong feelings of being different to "usual cancer patients" and displayed a desire for more opportunities to meet other TYA patients to be provided within their pathway. CONCLUSION AND IMPLICATIONS FOR PRACTICE The findings of this study suggest that the implementation of a dedicated TYA open evening would improve the information support and treatment pathway for 18-24-year-old cancer patients. The evening could offer a wanted opportunity where TYA patients could meet each other and additionally, treatment information and age appropriate support information could be provided in a different and more suitable format than current paper-based literature.
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Affiliation(s)
- C L David
- Radiotherapy Department, Basement P-2, University College Hospital, 235 Euston Road, London, NW1 2BU, UK.
| | - L Lowrey
- Kingston and St George's Joint Faculty, Health, Social Care and Education, Bay 18/desk 21 6th, Floor Hunter Wing, Cranmer Terrace, London, SW17 0RE, UK
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9
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Telles CM. A scoping review of literature: What has been studied about adolescents and young adults (AYAs) with cancer? Cancer Treat Res Commun 2021; 27:100316. [PMID: 33545568 DOI: 10.1016/j.ctarc.2021.100316] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 01/12/2021] [Accepted: 01/14/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE To map, organize and analyze the articles published in the last five years about AYAs with cancer. METHODS CAPES database and Google Scholar were searched to identify relevant studies from 2015 to February 2020. Eligible articles included empirical or theoretical research, quantitative and/or qualitative studies, targeted AYAs with cancer, addressed different topics related to AYAs such as unmet needs, hospital challenges, interventions or tools based on evidence, as well as political and socioeconomic aspects. RESULTS Of the 161 articles analyzed, 74 (46%) discussed the health system, including hospital dynamics, treatment and interventions during treatment; 63 (39.1%) discussed aspects or interventions that influence the quality of life and mental health of AYAs with cancer; 14 (8.7%) discussed issues related to sexual health; and 10 (6.2%) addressed social, economic and demographic problems of AYAs with cancer. Three types of purposes have been identified in the articles: 118 (73.3%) investigated variables in areas related to AYAs with cancer, aiming to increase the understanding of the phenomenon and the needs of AYAs; 18 (11.2%) intervened on the needs of AYAs with cancer through pilot studies or evidence-based interventions; and 22 (13.7%) aimed to evaluate an intervention previously performed or to evaluate an intervention based on evidence. CONCLUSION There is still much to be researched within the last two categories. In the last three years, these categories have been growing gradually and on a small scale.
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Affiliation(s)
- Camila M Telles
- Graduating in Psychology - Senior year, Positivo University - Curitiba, Paraná, Brazil (Student); Teen Cancer America - Los Angeles, California, the United States of America (Intern Pro Cancer).
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10
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Ernst M, Brähler E, Wild PS, Faber J, Merzenich H, Beutel ME. Loneliness predicts suicidal ideation and anxiety symptoms in long-term childhood cancer survivors. Int J Clin Health Psychol 2020; 21:100201. [PMID: 33363584 PMCID: PMC7753031 DOI: 10.1016/j.ijchp.2020.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 10/30/2020] [Indexed: 01/06/2023] Open
Abstract
Long-term childhood cancer survivors (CCS) are at risk for adverse late effects. However, not all of them are well understood. The present study addressed loneliness, a previously under-researched mental health risk in cancer survivor populations. We assessed the prevalence of loneliness and its impact on psychological symptoms over time. Method: A registry-based sample of N = 633 adult long-term CCS underwent medical and psychological assessments and took part in a follow-up survey 2.5 years later. Psychological symptoms (somatic, anxiety, depression symptoms, and suicidal ideation) were measured using the Patient Health Questionnaire. We calculated linear regression models of symptoms at follow-up to investigate the impact of loneliness over time (controlling for symptoms at baseline and relevant confounders). Results: Loneliness was reported by 17.70% of CCS. In multivariate linear regression analyses, loneliness was still predictive of more severe anxiety symptoms and suicidal ideation over two years later. Loneliness did not predict somatic and depression symptoms at follow-up (which increased with age). Conclusions: Loneliness affected a significant number of CCS and was a risk factor for persistent anxiety symptoms and suicidal ideation. The extent to which young cancer patients’ re-integration into society is successful could thus have important implications for well-being in adulthood.
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Affiliation(s)
- Mareike Ernst
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Germany
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Germany
| | - Philipp S Wild
- Preventive Cardiology and Preventive Medicine-Department of Cardiology, University Medical Center Mainz, Germany.,Center for Thrombosis and Hemostasis, University Medical Center Mainz, Germany.,DZHK German Center for Cardiovascular Research, Partner Site Rhine-Main, Mainz, Germany
| | - Jörg Faber
- Department of Pediatric Hematology/Oncology/Hemostaseology, Center for Pediatric and Adolescent Medicine, University Medical Center Mainz, Germany
| | - Hiltrud Merzenich
- Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center Mainz, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Germany
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11
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Blower S, Swallow V, Maturana C, Stones S, Phillips R, Dimitri P, Marshman Z, Knapp P, Dean A, Higgins S, Kellar I, Curtis P, Mills N, Martin-Kerry J. Children and young people's concerns and needs relating to their use of health technology to self-manage long-term conditions: a scoping review. Arch Dis Child 2020; 105:1093-1104. [PMID: 32444448 PMCID: PMC7588410 DOI: 10.1136/archdischild-2020-319103] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 04/22/2020] [Accepted: 04/24/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND The use of patient-facing health technologies to manage long-term conditions is increasing; however, children and young people may have particular concerns or needs before deciding to use different health technologies. AIMS To identify children and young people's reported concerns or needs in relation to using health technologies to self-manage long-term conditions. METHODS A scoping review was conducted. We searched MEDLINE, PsycINFO and CINAHL in February 2019. Searches were limited to papers published between January 2008 and February 2019. We included any health technology used to manage long-term conditions. A thematic synthesis of the data from the included studies was undertaken. We engaged children with long-term conditions (and parents) to support review design, interpretation of findings and development of recommendations. RESULTS Thirty-eight journal articles were included, describing concerns or needs expressed by n=970 children and/or young people aged 5-18 years. Most included studies were undertaken in high-income countries with children aged 11 years and older. Studies examined concerns with mobile applications (n=14), internet (n=9), social media (n=3), interactive online treatment programmes (n=3), telehealth (n=1), devices (n=3) or a combination (n=5). Children and young people's main concerns were labelling and identity; accessibility; privacy and reliability; and trustworthiness of information. DISCUSSION This review highlights important concerns that children and young people may have before using technology to self-manage their long-term condition. In future, research should involve children and young people throughout the development of technology, from identifying their unmet needs through to design and evaluation of interventions.
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Affiliation(s)
- Sarah Blower
- Department of Health Sciences, University of York, York, UK
| | - Veronica Swallow
- College of Health, Wellbeing & Life Sciences, Sheffield Hallam University, Sheffield, South Yorkshire, UK
| | - Camila Maturana
- York Trials Unit, University of York, York, North Yorkshire, UK
| | - Simon Stones
- School of Healthcare, University of Leeds, Leeds, West Yorkshire, UK
| | - Robert Phillips
- Centre for Reviews and Dissemination, University of York, York, North Yorkshire, UK
| | - Paul Dimitri
- NIHR Children and Young People MedTech Cooperative, Sheffield Children's Hospital NHS Foundation Trust, Sheffield, Sheffield, UK
| | - Zoe Marshman
- School of Clinical Dentistry, The University of Sheffield, Sheffield, Sheffield, UK
| | - Peter Knapp
- Department of Health Sciences and Hull York Medical School, University of York, York, North Yorkshire, UK
| | - Alexandra Dean
- York Trials Unit, University of York, York, North Yorkshire, UK
| | | | - Ian Kellar
- School of Psychology, University of Leeds, Leeds, West Yorkshire, UK
| | - Penny Curtis
- School of Nursing and Midwifery, The University of Sheffield, Sheffield, Sheffield, UK
| | - Nathaniel Mills
- NIHR Children and Young People MedTech Co-operative and NIHR Devices for Dignity MedTech Co-operative, Sheffield Children's NHS Trust, Sheffield, UK
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12
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Pulewka K, Strauss B, Hochhaus A, Hilgendorf I. Clinical, social, and psycho-oncological needs of adolescents and young adults (AYA) versus older patients following hematopoietic stem cell transplantation. J Cancer Res Clin Oncol 2020; 147:1239-1246. [PMID: 33052515 PMCID: PMC7954716 DOI: 10.1007/s00432-020-03419-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 10/03/2020] [Indexed: 11/30/2022]
Abstract
Purpose To analyze demand for information and advice as well as medical, psychological, and social needs of adolescents and young adults (AYAs) and older patients (non-AYA) after hematopoietic stem cell transplantation (HSCT). Methods A questionnaire was sent to 100 HSCT recipients comprising n = 50 AYAs (aged 19–39 years) and n = 50 non-AYAs (> 39 years). The questionnaire covered the categories: (a) patient characteristics; (b) need for advice, on medical, psychological, and social care topics; (c) medical, psychological, and social needs, and (d) preferred forms and channels of information. Results The return rate was 65%. 62.5% of patients indicated medical needs; 41.1% psychological needs, and 64.9% had needs concerning social issues. Among medical aspects, aftercare was important to both groups. Nutrition was of highest interest for AYA, while non-AYAs identified fatigue and vaccination as their most pressing concerns. Body shape/sexuality and relaxation techniques were the most common psychological issues for AYA, while coping strategies were important for both cohorts. Family, relationship and friends were of less interest in both groups. Rehabilitation and premature retirement were of highest interest for both cohorts. The preferred mode of communicating advice was one-to-one conversation in a quiet environment as opposed to informational sessions. Conclusion Despite well-established aftercare programs following HSCT, many patients describe unmet needs regarding medical, psychological, and social policy issues. AYA and non-AYA differ in informational needs after HSCT, and, therefore, age-appropriate informational materials are necessary. Particularly AYA may profit from information covering body-shape/sexuality and nutrition, while both cohorts require information covering coping strategies and aftercare.
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Affiliation(s)
- Kristin Pulewka
- Institut für Psychosoziale Medizin, Psychotherapie und Psychoonkologie, Universitätsklinikum Jena, Jena, Germany.,Klinik für Innere Medizin II, Abteilung Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Am Klinikum 1, 07740, Jena, Germany
| | - Bernhard Strauss
- Institut für Psychosoziale Medizin, Psychotherapie und Psychoonkologie, Universitätsklinikum Jena, Jena, Germany
| | - Andreas Hochhaus
- Klinik für Innere Medizin II, Abteilung Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Am Klinikum 1, 07740, Jena, Germany
| | - Inken Hilgendorf
- Klinik für Innere Medizin II, Abteilung Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Am Klinikum 1, 07740, Jena, Germany.
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13
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De Clercq E, Rost M, Gumy-Pause F, Diesch T, Espeli V, Elger BS. Moving Beyond the Friend-Foe Myth: A Scoping Review of the Use of Social Media in Adolescent and Young Adult Oncology. J Adolesc Young Adult Oncol 2020; 9:561-571. [DOI: 10.1089/jayao.2019.0168] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Eva De Clercq
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| | - Michael Rost
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| | - Fabienne Gumy-Pause
- Département de l'Enfant et de l'Adolescent, Onco-hématologie pédiatrique, Hôpitaux Universitaires de Genève, Geneve, Switzerland
| | - Tamara Diesch
- Onkologie/Hämatologie, Universitäts-Kinderspital Basel, Basel, Switzerland
| | - Vittoria Espeli
- Oncologia medica, Istituto Oncologico della Svizzera Italiana, Bellinzona, Switzerland
| | - Bernice S. Elger
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
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14
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De Clercq E, Rost M, von der Weid N, Ansari M, Elger BS. To be or not to be in the social media arena? The perspective of healthcare providers working within adolescent and young adult oncology in Switzerland. Int J Adolesc Med Health 2020; 34:417-429. [PMID: 32860667 DOI: 10.1515/ijamh-2020-0137] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 07/28/2020] [Indexed: 12/23/2022]
Abstract
Background Given that social media is quickly penetrating clinical practice, it is essential to explore how these technologies can be used to improve patient-centered care. This is particularly important for healthcare professionals caring for adolescents and young adults (AYA), amid whom the use of social media is nearly universal and whose medical and psychosocial needs are often underestimated by the pediatric or adult oncology settings in which they are treated. Objectives To examine the perspectives of various medical professionals on the emerging role of social media in AYA oncology. Methods Three focus groups were performed with Swiss healthcare professionals involved in the care of AYA patients with cancer. The focus groups were analyzed using thematic coding. Results Healthcare professionals caring for AYA cancer patients in Switzerland are reluctant to step into the social media sphere because they find it difficult to navigate professional boundaries in an unfamiliar space where different contexts collapse. Nurses and younger healthcare professionals who tend to have a more intimate relationship with AYA, often lack virtual mentorship to know how to maintain online professionalism. Adolescents and young adults cancer-related social media presence was unknown to our participants which resulted in missed occasions to inform, educate and care for this often underserved population of cancer patients. Conclusions More practical guidance is needed to help healthcare professionals with how to integrate social media into clinical practice. Setting up fruitful collaborations between medical institutions and existing AYA support groups online might be the best way forward.
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Affiliation(s)
- Eva De Clercq
- University of Basel, Institute for Biomedical Ethics, Basel, Switzerland
| | - Michael Rost
- University of Basel, Institute for Biomedical Ethics, Basel, Switzerland
| | | | - Marc Ansari
- Hôpitaux Universitaires de Genève, Département de l'Enfant et de l'Adolescent, Onco-hématologie pédiatrique, Genève, Switzerland
| | - Bernice S Elger
- University of Basel, Institute for Biomedical Ethics, Basel, Switzerland
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15
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Vandermorris A, Sampson L, Korenblum C. Promoting adherence in adolescents and young adults with cancer to optimize outcomes: A developmentally oriented narrative review. Pediatr Blood Cancer 2020; 67:e28128. [PMID: 31886630 DOI: 10.1002/pbc.28128] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 11/10/2019] [Accepted: 11/25/2019] [Indexed: 01/03/2023]
Abstract
Adherence is a critical consideration in ongoing efforts to improve outcomes among adolescents and young adults (AYAs) with cancer. In this narrative review, we embed existing conceptualizations of adherence within a developmental context to provide a novel vantage point from which to examine this important issue. Applying this developmentally oriented framework, we summarize the most current literature on strategies to enhance adherence in the AYA population. A developmentally informed approach to working with AYAs can elucidate unique strengths and vulnerabilities of this population and offer a new perspective on opportunities to respond to biopsychosocial barriers to adherence in a strengths-based, collaborative manner.
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Affiliation(s)
- Ashley Vandermorris
- Division of Adolescent Medicine, Department of Paediatrics, SickKids Hospital and University of Toronto, Toronto, Canada
| | - Lorna Sampson
- Department of Paediatrics, University of Toronto, Toronto, Canada
| | - Chana Korenblum
- Princess Margaret Cancer Centre, University Health Network, Division of Adolescent Medicine, Department of Paediatrics, SickKids Hospital and University of Toronto, Toronto, Canada
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16
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Pereira LM, Piela G, DiCola K. Thematic content of video narratives in patients and survivors of adolescent cancer. Psychooncology 2020; 29:759-765. [PMID: 31997415 DOI: 10.1002/pon.5340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 01/16/2020] [Accepted: 01/18/2020] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Modern day adolescents and young adults (AYAs) connect with their peers via a number of increasingly novel ways, many of which involve social media. These online relationships are often translated offline to increase one's social standing and quality of in-person relationships. However, when an AYA is diagnosed with a chronic medical condition, like cancer, in-person relationships with peers become difficult and the online component of socialization is all that is left. Video testimonials are a way that some AYAs have chosen to reach out to their peers; however, little is known about what AYAs are saying in these videos and how they are using them to connect with peers on a more intimate level. METHODS This study examined the content of video testimonials of n = 25 AYA cancer patients and survivors. Transcripts of videos were coded by a team of researchers to identify themes and overall tone. RESULTS Results suggested that films focused on struggles AYAs faced during their cancer journeys with a number of themes emerging; additionally, a hopeful tone was seen around the overall impact that cancer had on the patient's life. CONCLUSIONS It may be the case that video testimonials are an effective way to allow AYA patients with a cancer history to explore their thoughts about their illness experience and fill an important social gap not available to them as they undergo treatment.
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Affiliation(s)
- Lila M Pereira
- Department of Pediatric Hematology, Oncology, and Stem Cell Transplantation, New York Medical College, Valhalla, New York
| | - Gabrielle Piela
- Department of Psychology, Pace University, New York, New York
| | - Katie DiCola
- Department of Psychology, Mercy College, New York, New York
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17
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Lima VFD, Mazza VDA, Scochi CGS, Gonçalves LS. Online information use on health/illness by relatives of hospitalized premature infants. Rev Bras Enferm 2019; 72:79-87. [DOI: 10.1590/0034-7167-2018-0030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 02/01/2019] [Indexed: 01/13/2023] Open
Abstract
ABSTRACT Objective: To analyze the use of online information on health/illness by relatives of premature infants admitted to the Neonatal Intensive Care Unit. Method: Exploratory, qualitative study conducted at a Neonatal Intensive Care Unit from a University Hospital in the state capital of southern Brazil, with 33 relatives of hospitalized premature infants. The data were collected through a semi-structured interview and were submitted to thematic analysis, with the aid of the software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires (IRAMUTEQ®). Results: From the data analysis, two thematic categories emerged: Online information on health/illness researched by relatives; and Online sources of information consulted by relatives. Final considerations: Health professionals need to consider the use of online information by relatives in the care process, adding it in their practice in relation to the informational needs presented, and stimulating spaces for dialogue about the data found.
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18
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Domínguez M, Sapiña L. From sweeteners to cell phones-Cancer myths and beliefs among journalism undergraduates. Eur J Cancer Care (Engl) 2019; 29:e13180. [PMID: 31583776 DOI: 10.1111/ecc.13180] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Revised: 02/19/2019] [Accepted: 09/17/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The media are an important source of health information that can help people make their own medical decisions. However, medical news can also transmit biases produced by different factors, such as the previously held beliefs of journalists. This study identifies which cancer myths are more popular among future journalists and whether their beliefs are related to their chosen source of health information. METHODS A survey was conducted among journalism undergraduates (N = 249) to determine which cancer myths existed and how widespread they were. The survey included a list with different sources of health information and eight questions regarding cancer-related myths. RESULTS The most extensive myths among the undergraduate respondents were that sweeteners (40.2%) and cell phones (48.2%) produce cancer and that a patient's good or bad attitude can determine the outcome of such an illness (52.2%). Respondents who relied on their family and friends as a source of health information were more prone to believe in cancer myths. CONCLUSION This research focuses on future journalists as a group of special interest for improving knowledge about cancer. Future campaigns to debunk cancer misconceptions should pay attention to the role played by family and friends as agents of health information transmittance.
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Affiliation(s)
- Martí Domínguez
- Department of the Theory of Language and Communication Sciences, Faculty of Philology, Translation and Communication, University of Valencia, Valencia, Spain
| | - Lucía Sapiña
- The Two Cultures Observatory, University of Valencia, Valencia, Spain
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19
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Levin NJ, Zebrack B, Cole SW. Psychosocial issues for adolescent and young adult cancer patients in a global context: A forward-looking approach. Pediatr Blood Cancer 2019; 66:e27789. [PMID: 31058418 PMCID: PMC10599653 DOI: 10.1002/pbc.27789] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 04/12/2019] [Accepted: 04/19/2019] [Indexed: 02/01/2023]
Abstract
The first decade of adolescent and young adult (AYA) oncology psychosocial care and research (2005-2015) was driven by a normative, developmental framework that assumed a generalizable life experience for AYAs that is distinct from both younger children and older adults. As we proceed through a second decade, new considerations emerge regarding diversity of life experiences as occurring within and influenced by a complex global context. The purpose of this paper is to review and provide commentary on the impact of global and contextual conditions on AYAs. We expound upon the effects of precarious labor conditions, changing timetables and priorities for developmental tasks, sexual and gender plurality, and expanding cultural diversity. We discuss the implications of social genomics and technology and social media for enhancing precision psychosocial medicine. To build a forward-looking approach, this paper calls for tailored, multilevel treatments that consider variability of AYAs within the social and global contexts in which they live.
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Affiliation(s)
- Nina Jackson Levin
- School of Social Work and Department of Anthropology, University of Michigan, Ann Arbor, Michigan
| | - Bradley Zebrack
- School of Social Work, University of Michigan, Ann Arbor, Michigan
| | - Steve W. Cole
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
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20
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Abstract
The internet and social media have changed the way society communicates, requiring the nursing workforce to develop effective digital literacy skills and attain levels of e-professionalism. The internet provides a unique environment that both connects and disrupts with powerful and unpredictable consequences for healthcare. A networked nursing workforce can influence and create collaborative communities of practice that will develop and shape healthcare. Nurse education must engage with technology and social media to provide a future-ready workforce capable of delivering future eHealth reforms.
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Affiliation(s)
- Paul Ross
- a Critical Care Registered Nurse, Alfred Intensive Care Unit , 55 Commercial Road, Melbourne , VIC 3181 , Australia.,b School of Nursing and Midwifery, La Trobe University , 99 Commercial Road, Melbourne , 3004 , VIC , Australia
| | - Rachel Cross
- b School of Nursing and Midwifery, La Trobe University , 99 Commercial Road, Melbourne , 3004 , VIC , Australia
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21
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Gessler D, Juraskova I, Sansom‐Daly UM, Shepherd HL, Patterson P, Muscat DM. Clinician‐patient‐family decision‐making and health literacy in adolescents and young adults with cancer and their families: A systematic review of qualitative studies. Psychooncology 2019; 28:1408-1419. [DOI: 10.1002/pon.5110] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 05/03/2019] [Accepted: 05/13/2019] [Indexed: 11/05/2022]
Affiliation(s)
- Danielle Gessler
- School of PsychologyThe University of Sydney Sydney New South Wales Australia
- Centre for Medical Psychology and Evidence‐Based Decision‐Making (CeMPED)The University of Sydney Sydney New South Wales Australia
- Psycho‐Oncology Cooperative Research Group (PoCoG), School of PsychologyThe University of Sydney Sydney New South Wales Australia
| | - Ilona Juraskova
- School of PsychologyThe University of Sydney Sydney New South Wales Australia
- Centre for Medical Psychology and Evidence‐Based Decision‐Making (CeMPED)The University of Sydney Sydney New South Wales Australia
- Psycho‐Oncology Cooperative Research Group (PoCoG), School of PsychologyThe University of Sydney Sydney New South Wales Australia
| | - Ursula M. Sansom‐Daly
- Behavioural Sciences Unit, Kids Cancer CentreSydney Children's Hospital Randwick New South Wales Australia
- School of Women's and Children's HealthUNSW Sydney Sydney New South Wales Australia
- Sydney Youth Cancer ServicePrince of Wales Hospital Randwick New South Wales Australia
| | - Heather L. Shepherd
- School of PsychologyThe University of Sydney Sydney New South Wales Australia
- Centre for Medical Psychology and Evidence‐Based Decision‐Making (CeMPED)The University of Sydney Sydney New South Wales Australia
- Psycho‐Oncology Cooperative Research Group (PoCoG), School of PsychologyThe University of Sydney Sydney New South Wales Australia
| | - Pandora Patterson
- Cancer Nursing Research UnitThe University of Sydney Sydney New South Wales Australia
- Research, Evaluation, and Social Policy Unit, CanTeen Australia Newtown New South Wales Australia
| | - Danielle Marie Muscat
- Sydney Health Literacy Lab, School of Public Health, Faculty of Medicine and HealthThe University of Sydney Sydney New South Wales Australia
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22
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Brütting J, Steeb T, Reinhardt L, Berking C, Meier F. Exploring the Most Visible German Websites on Melanoma Immunotherapy: A Web-Based Analysis. JMIR Cancer 2018; 4:e10676. [PMID: 30545808 PMCID: PMC6315239 DOI: 10.2196/10676] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 06/06/2018] [Accepted: 06/19/2018] [Indexed: 01/06/2023] Open
Abstract
Background Patients diagnosed with melanoma frequently search the internet for treatment information, including novel and complex immunotherapy. However, health literacy is limited among half of the German population, and no assessment of websites on melanoma treatment has been performed so far. Objective The aim of this study was to identify and assess the most visible websites in German language on melanoma immunotherapy. Methods In accordance with the common Web-based information-seeking behavior of patients with cancer, the first 20 hits on Google, Yahoo, and Bing were searched for combinations of German synonyms for “melanoma” and “immunotherapy” in July 2017. Websites that met our predefined eligibility criteria were considered for assessment. Three reviewers independently assessed their quality by using the established DISCERN tool and by checking the presence of quality certification. Usability and reliability were evaluated by the LIDA tool and understandability by the Patient Education Materials Assessment Tool (PEMAT). The Flesch Reading Ease Score (FRES) was calculated to estimate the readability. The ALEXA and SISTRIX tools were used to investigate the websites’ popularity and visibility. The interrater agreement was determined by calculating Cronbach alpha. Subgroup differences were identified by t test, U test, or one-way analysis of variance. Results Of 480 hits, 45 single websites from 30 domains were assessed. Only 2 website domains displayed a German quality certification. The average assessment scores, mean (SD), were as follows: DISCERN, 48 (7.6); LIDA (usability), 40 (2.0); LIDA (reliability), 10 (1.6); PEMAT, 69% (16%); and FRES, 17 (14), indicating mediocre quality, good usability, and understandability but low reliability and an even very low readability of the included individual websites. SISTRIX scores ranged from 0 to 6872 and ALEXA scores ranged from 17 to 192,675, indicating heterogeneity of the visibility and popularity of German website domains providing information on melanoma immunotherapy. Conclusions Optimization of the most accessible German websites on melanoma immunotherapy is desirable. Especially, simplification of the readability of information and further adaption to reliability criteria are required to support the education of patients with melanoma and laypersons, and to enhance transparency.
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Affiliation(s)
- Julia Brütting
- Department of Dermatology, Dresden University Hospital and Medical Faculty Carl Gustav Carus, Technical University of Dresden, Dresden, Germany
| | - Theresa Steeb
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | - Lydia Reinhardt
- Department of Dermatology, Dresden University Hospital and Medical Faculty Carl Gustav Carus, Technical University of Dresden, Dresden, Germany
| | - Carola Berking
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | - Friedegund Meier
- Department of Dermatology, Dresden University Hospital and Medical Faculty Carl Gustav Carus, Technical University of Dresden, Dresden, Germany
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Lea S, Martins A, Morgan S, Cargill J, Taylor RM, Fern LA. Online information and support needs of young people with cancer: a participatory action research study. ADOLESCENT HEALTH MEDICINE AND THERAPEUTICS 2018; 9:121-135. [PMID: 30310338 PMCID: PMC6167089 DOI: 10.2147/ahmt.s173115] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Purpose The Internet is a fully integrated part of young people’s life and it is pivotal that online resources are developed to maximize the potential of the Internet to support those living with and beyond cancer. We sought to understand how young people with a cancer diagnosis use the Internet and to what extent information and support needs are met by existing online resources. Patients and methods This was a participatory action research study involving 21 young people participating in workshops and individual interviews. Participants aged 13–24 years were diagnosed with a range of cancers. Young people were on treatment or had completed treatment; some had experienced relapse. Workshops consisted of participatory methods including focus group discussions, interactive activities, and individual thought, encompassing online resources used; when, how and what they were searching for, whether resources were helpful and how they could be improved. Results Young people reported using communication platforms, entertainment sites, social media, medical websites, charity websites, and search engines to find information and support. Different online use and needs were described throughout their cancer timeline and online use was generally driven by negative emotions. Seven factors influenced access and engagement: 1) where young people were on their cancer timeline; 2) external influencing factors, such as family and environments; 3) emotional drivers; 4) what young people search for online; 5) resources, websites, and digital platforms used by young people; 6) availability, accessibility, and assessment of online information and resources; 7) emotional responses to using online resources. Conclusion The way young people access and engage with online resources is complex with multiple influencing factors including powerful emotional drivers and responses to Internet searching. There is a need to develop resources that support the holistic needs of young people and this should be done in collaboration with young people.
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Affiliation(s)
- Sarah Lea
- Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK,
| | - Ana Martins
- Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK,
| | - Sue Morgan
- Teenage Cancer Trust Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Jamie Cargill
- TYA Cancer Service South West, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Rachel M Taylor
- Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK,
| | - Lorna A Fern
- Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK,
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24
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Janin MMH, Ellis SJ, Wakefield CE, Fardell JE. Talking About Cancer Among Adolescent and Young Adult Cancer Patients and Survivors: A Systematic Review. J Adolesc Young Adult Oncol 2018; 7:515-524. [PMID: 29851370 DOI: 10.1089/jayao.2017.0131] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Communication plays an essential role in social relationships. Yet it is unclear how young cancer patients and survivors communicate with peers, and whether this contributes to increased rates of social difficulties. We aimed to analyze how childhood cancer patients and survivors communicate about their cancer with family and peers. We systematically searched Medline, Embase and PsycINFO for peer-reviewed studies on cancer-related communication among patients and survivors (any cancer, <25 years at diagnosis). We screened 309 articles, and included 6 qualitative studies. Studies were assessed using a standardized quality assessment tool. Participants were adolescents and young adults, 16-34 years of age at the time of study. Included studies related to different forms of cancer-related communication, benefits, and challenges. We found that cancer-related communication was an individual, complex process, addressing medical, existential, and emotional aspects of cancer. Communication occurred on a spectrum with variation in who information was shared with, as well as differences in the frequency at which information was shared, and the amount and type of information shared. Communication often occurred at uncertain or significant times for participants, or was initiated by others. Communicating about cancer yielded benefits as a coping strategy, prompted social support, and appeared central to significant relationships. Barriers to communication, including fear of stigma and poor peer reactions, hindered willingness to disclose. The number of studies analyzing this topic was limited. Communicating about cancer is a significant yet complex process for young patients and survivors. Further research is needed to complement the existing literature and to establish the evidence base for the development of future effective interventions promoting social and communication skills.
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Affiliation(s)
- Madeleine Marie Hortense Janin
- 1 Kids Cancer Center, Sydney Children's Hospital , Randwick, Australia .,2 School of Women's and Children's Health, Discipline of Pediatrics, UNSW Medicine, University of New South Wales , Sydney, Australia
| | - Sarah Jane Ellis
- 1 Kids Cancer Center, Sydney Children's Hospital , Randwick, Australia .,2 School of Women's and Children's Health, Discipline of Pediatrics, UNSW Medicine, University of New South Wales , Sydney, Australia
| | - Claire Elizabeth Wakefield
- 1 Kids Cancer Center, Sydney Children's Hospital , Randwick, Australia .,2 School of Women's and Children's Health, Discipline of Pediatrics, UNSW Medicine, University of New South Wales , Sydney, Australia
| | - Joanna Elizabeth Fardell
- 1 Kids Cancer Center, Sydney Children's Hospital , Randwick, Australia .,2 School of Women's and Children's Health, Discipline of Pediatrics, UNSW Medicine, University of New South Wales , Sydney, Australia
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25
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Gibson F, Pearce S, Fern L, Martins A, Kelly D. Improving the identification of cancer in young people: A scoping review. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/23809000.2017.1307089] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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