[Cancer survival care plan: A challenge in primary health care]

Web-Based Personalized Intervention to Improve Quality of Life and Self-Efficacy of Long-Term Breast Cancer Survivors: Study Protocol for a Randomized Controlled Trial

Long-term breast cancer survivors (>5 years free of disease) may suffer late sequelae of cancer that impact on their quality of life. The use of telehealth for cancer care is recommended but little is known about the effectiveness of digital interventions for long-term cancer survivors. This study aims to evaluate the effectiveness of a web-based personalized intervention based on artificial intelligence instead of usual primary health care to improve the quality of life of long-term survivors of breast cancer and self-efficacy for the management of late sequelae. A randomized controlled trial will be conducted. The sample will consist of long-term breast cancer survivors recruited from primary health centers. Women will be randomly assigned to the intervention group to receive a web-based personalized intervention or to the control group to receive standard primary health care by nurses. Data on quality of life of cancer survivors and self-efficacy for the management of late sequelae of cancer will be collected and assessed at preintervention, and at 3, 6, and 9 months. It is expected that, at the end of the programme, the experimental group will have improved quality of life and improved self-efficacy for the management of late sequelae of cancer.

Are Nursing Interventions Effective in Improving Quality of Life in Cancer Survivors? A Systematic Review

BACKGROUND

Cancer survivors (CSs) have needs that can negatively impact their quality of life (QoL). Oncology nurses play a key role in providing comprehensive care in cancer survivorship, although little is known about their impact on health outcomes.

OBJECTIVE

The aim of this study was to determine the effectiveness of nursing interventions to improve QoL and satisfaction with care of CSs.

METHODS

A systematic review was conducted. PubMed, CINAHL, PsycINFO, and Cochrane databases were searched for experimental studies. The Joanna Briggs Institute Checklist for Randomized Controlled Trials was used to verify the quality of the studies (Prospero reference: CRD42020148294).

RESULTS

Of the 8 clinical trials eligible for inclusion, 5 demonstrated that interventions conducted by nurses improved the overall QoL or some of its domains in CSs. The included studies focused on short-term survival; no studies in long-term CSs were identified. Two studies assessed satisfaction with care of survivors, obtaining positive results.

CONCLUSIONS

Nursing interventions seem to improve the QoL of short-term CSs. However, because of the low number of studies identified, the findings of this systematic review should be interpreted with caution.

IMPLICATIONS FOR PRACTICE

Further studies are necessary to strengthen the implementation of effective nursing intervention in cancer practice. Research should particularly be conducted with long-term CSs as there is lack of data on this specific stage of cancer.

Survivorship care plans in Spain: A need that cannot be postponed

In Spain, as around the world, the number of cancer survivors is increasing. There were an estimated 500,000 cancer survivors in 2010. In spite of recognition that Survivorship Care Plans (SCPs) are needed, their implementation in Spain has been slower than in other countries and only in very recent years some small initiatives have been carried out. This editorial addresses the difficulties to implement SCPs in the Spanish Health Services and which are the opportunities that favour a scenario in which PCPs and oncologists can offer a real patient-centred care to cancer survivors.

[Psychosocial impact of breast cancer in long-term survival: proposal of an integral follow-up care for survivors]

The aim of the article is to show the psychosocial impact of breast cancer in the long-term survival and to promote the idea of implementing a follow-up plan for survivors. A narrative review of published articles on the experience of survival in breast cancer survivors was conducted. Data were organised according to the domains of measurement (physical, psychological and social) of the Quality of Life of Long-term Breast Cancer Survivors Scale (LTQOL-BC). Breast cancer survivors may feel emotionally affected by the physical sequels (mastectomy, lymphedema, early menopause, and infertility), psychological (fear of recurrence and emotional stress) and/or social (family relationships and employment changes). The data are the foundation of a proposal of specific follow-up care for breast cancer survivors.