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Wang C, Liao Z, Li Z, Wang Y, Wu Y, Hu R. Identifying barriers to resilience from the perspective of young and middle-aged patients with lymphoma: A qualitative exploration. Eur J Oncol Nurs 2023; 64:102348. [PMID: 37290165 DOI: 10.1016/j.ejon.2023.102348] [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: 12/24/2022] [Revised: 05/01/2023] [Accepted: 05/02/2023] [Indexed: 06/10/2023]
Abstract
PURPOSE This study aimed to understand and identify barriers to resilience in young and middle-aged patients with lymphoma in the context of Chinese culture. METHODS A qualitative descriptive study was employed. Face-to-face, semi-structured, and in-depth individual interviews were conducted between May and July 2022. Purposive and differential sampling was used to select eligible participants. Conventional content analysis was used to analyze qualitative data and identify categories and subcategories. This study followed the COREQ checklist. RESULTS Twenty patients aged 28-59 years completed the interviews. Three categories involving thirteen subcategories were identified from the interview data: (1) internal barriers-derived from individual cognitive, emotional, behavioral, spiritual, and physical distress, resulting in internal negative constructs, and reducing the motivation to overcome adversity; (2) unbalanced family functioning-families threatened by disease are incapable of maintaining normal functioning and fail to act effectively when facing crises; and (3) absent social support-insufficient or unavailable shielding protection from social support further inhibits resilience among patients with lymphoma. CONCLUSIONS This study identified various barriers to the resilience of young and middle-aged patients with lymphoma in the context of Chinese culture. In addition to the patient's internal barriers of resilience, specific family and socio-cultural barriers should also be emphasized by healthcare professionals. Multidisciplinary and family-centered resilience intervention should be developed to help such patients cope with, adapt to the disease, and achieve good psychosocial returns.
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Affiliation(s)
- Chunfeng Wang
- The School of Nursing, Fujian Medical University, Fujian Province, China
| | - Zhenling Liao
- The School of Nursing, Fujian Medical University, Fujian Province, China
| | - Zhangjie Li
- The School of Nursing, Fujian Medical University, Fujian Province, China
| | - Ying Wang
- The School of Nursing, Fujian Medical University, Fujian Province, China
| | - Yong Wu
- Department of Hematology, Fujian Medical University Union Hospital, Fujian Province, China.
| | - Rong Hu
- The School of Nursing, Fujian Medical University, Fujian Province, China.
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Yu TC, Yu SC, Wang RC, Lai SF, Teng CLJ, Lin JW, Lin WL, Huang TC. Investigating early progression of Hodgkin lymphoma in a two-center analysis. J Formos Med Assoc 2022; 121:1215-1222. [PMID: 35022156 DOI: 10.1016/j.jfma.2021.12.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 12/23/2021] [Accepted: 12/27/2021] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND/PURPOSE The early progression of disease (POD) of Hodgkin lymphoma (HL) leads to a poor prognosis. To identify risk factors for early POD, this retrospective two-center cohort analysis was conducted. METHODS Medical records of HL patients between 1998 and 2020 from two referral centers were reviewed. RESULTS Two-hundred and sixty-nine patients were analyzed. The distribution of early vs. advanced stages was 51.1 vs. 48.9%, respectively. The 5-year progression free survival (PFS) was 63%, and the overall survival (OS) was 87% with a median follow-up of 52.0 months. The complete remission (CR) rate was 85.7%. Disease progression or relapsed disease occurred in 33.9% (n = 85) of patients while 17.0% of this cohort had early POD within 12 months of induction therapy. Patients with early POD had a worse median OS than those without (p < 0.001). Failure to achieve post-induction CR and high international prognostic score (IPS, 3-7) were independent risk factors for early POD. Compared with chemotherapy alone, consolidative radiotherapy after induction chemotherapy was associated with a lower risk of early POD (21.3% vs. 6.2%, p = 0.006). CONCLUSION High IPS was an independent risk factor for early POD, which was less observed in those with consolidative radiotherapy.
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Affiliation(s)
- Ta-Chuan Yu
- Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan
| | - Shan-Chi Yu
- Department and Graduate Institute of Pathology, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan
| | - Ren-Ching Wang
- Department of Pathology and Laboratory Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Nursing, College of Nursing, HungKuang University, Taichung, Taiwan
| | - Shih-Fan Lai
- Division of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Chieh-Lin Jerry Teng
- Division of Hematology/Medical Oncology, Department of Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Life Science, Tunghai University, Taichung, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Jing-Wei Lin
- Department of Radiation Oncology, Chiayi Branch, Taichung Veterans General Hospital, Chiayi, Taiwan
| | - Wan-Ling Lin
- Department of Nuclear Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan
| | - Tai-Chung Huang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
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Jerry Teng CL, Tan TD, Pan YY, Lin YW, Lien PW, Chou HC, Chen PH, Lin FJ. Prognostic Factors for Clinical Outcomes in Patients with Newly Diagnosed Advanced-stage Hodgkin Lymphoma: A Nationwide Retrospective Study. Cancer Control 2022; 29:10732748221124865. [PMID: 36134681 PMCID: PMC9511302 DOI: 10.1177/10732748221124865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Introduction While Hodgkin lymphoma (HL) is mostly curable, outcomes for advanced-stage HL remain unsatisfactory. The International Prognostic Score and its modifications were developed to predict HL prognosis; however, more straightforward prognostic factors are needed. This study aimed to identify simpler prognostic factors for advanced-stage newly diagnosed HL (NDHL). Methods This retrospective study used the Taiwan National Health Insurance Research Database and the Taiwan Cancer Registry. Patients with advanced-stage NDHL receiving ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) or ABVD-like regimens between 2009 and 2016 were enrolled. Cox proportional hazards models were used to identify prognostic factors for the time to next treatment (TTNT) and overall survival (OS). We used the time-dependent area under the receiver operating characteristic curve (AUROC) to evaluate model performance. Results The study included 459 patients with advanced-stage NDHL. A bimodal age distribution (peaks 20-44 and >65 years) was observed. Over a median follow-up of 4.7 years, the complete remission and OS rates were 52% and 76%, respectively. Age ≥60 years (adjusted hazard ratio [aHR]: 1.73, 95% confidence interval [CI]: 1.23-2.43), extranodal involvement (1.40, 1.05-1.87), B symptoms (1.53, 1.13-2.06), and Charlson Comorbidity Index (CCI) ≥1 (1.49, 1.08-2.06) were significantly associated with a shorter TTNT. The time-dependent AUROC was .65. With a time-dependent AUROC of .81, age ≥60 years (4.55, 2.90-7.15) and CCI ≥1 (1.86, 1.18-2.91) were risk factors for worse OS. Conclusion Older age and more comorbidities were risk factors for an inferior OS in advanced-stage NDHL, while older age, extranodal involvement, B-symptoms, and higher CCI were significantly associated with disease relapse.
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Affiliation(s)
- Chieh-Lin Jerry Teng
- Division of Hematology/Medical Oncology, Department of Medicine, 40293Taichung Veterans General Hospital, Taichung, Taiwan.,Department of Life Science, Tunghai University, Taichung, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan.,Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan.,Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Tran-Der Tan
- Department of Hematology and Medical Oncology, 59087Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan
| | - Yun-Yi Pan
- Graduate Institute of Clinical Pharmacy, College of Medicine, 33561National Taiwan University, Taipei, Taiwan
| | - Yu-Wen Lin
- Graduate Institute of Clinical Pharmacy, College of Medicine, 33561National Taiwan University, Taipei, Taiwan
| | - Pei-Wen Lien
- Takeda Pharmaceuticals Taiwan, Ltd., Taipei, Taiwan
| | | | | | - Fang-Ju Lin
- Graduate Institute of Clinical Pharmacy, College of Medicine, 33561National Taiwan University, Taipei, Taiwan.,School of Pharmacy, College of Medicine, 33561National Taiwan University, Taipei, Taiwan.,Department of Pharmacy, 33561National Taiwan University Hospital, Taipei, Taiwan
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