1
|
Haidari RE, Anota A, Dabakuyo-Yonli TS, Guillemin F, Conroy T, Velten M, Jolly D, Causeret S, Cuisenier J, Graesslin O, Abbas LA, Nerich V. Utility values and its time to deterioration in breast cancer patients after diagnosis and during treatments. Qual Life Res 2022; 31:3077-3085. [PMID: 35590124 DOI: 10.1007/s11136-022-03157-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND The potential effects of breast cancer (BC) on health-related quality of life (HRQoL) should be considered in clinical and policy decision-making, as the economic burden of BC management is currently assessed. In the last decades, time-to-HRQoL score deterioration (TTD) has been proposed as an approach to the analysis of longitudinal HRQoL in oncology. The main objectives of the current study were to investigate the evolution of the utility values in BC patients after diagnosis and during follow-ups and to evaluate the TTD in utility values among women in all stages of BC. METHODS Health-state utility values (HSUV) were assessed using the EuroQol 5-Dimension 3-Level at diagnosis, at the end of the first hospitalization and 3 and 6 months after the first hospitalization. For a given baseline score, HSUV was considered to have deteriorated if this score decreased by ≥ 0.08 points of the EQ-5D utility index score and ≥ 7 points of the EQ visual analogue scale. TTD curves were calculated using the Kaplan-Meier estimation method. RESULTS Overall 381 patients were enrolled between February 2006 and February 2008. The highest proportions of respondents at the baseline and all follow-ups reporting some and extreme problems were in pain discomfort and anxiety/depression dimensions; more than 80% of patients experienced a deterioration in EQ-5D utility index score and EQ VAS score with a median TTD of 3.15 months and 6.24 Months, respectively. CONCLUSIONS BC patients undergoing therapy need psychological support to cope with their discomfort, pain, depression, anxiety, and fear during the process of diagnosis and treatment to improve their QoL.
Collapse
Affiliation(s)
- Rana El Haidari
- INSERM (French Institut of Health and Medical Research), UMR1098 (Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire Et Génique), EFS BFC (Etablissement Français du Sang Bourgogne Franche-Comté), University of Bourgogne Franche-Comté, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire Et Génique, 25000, Besançon, France.
| | - Amelie Anota
- Biostatistics Unit, Department of Clinical Research and Innovation & Department of Human and Social Sciences, Centre Léon Bérard, Lyon, France.,French National Platform Quality of Life and Cancer, Montpellier, France
| | - Tienhan S Dabakuyo-Yonli
- French National Platform Quality of Life and Cancer, Montpellier, France.,Biostatistics and Epidemiology Unit, Centre Georges François Leclerc, 1 rue Professeur Marion, Dijon, France
| | - Francis Guillemin
- French National Platform Quality of Life and Cancer, Montpellier, France.,CHRU Nancy, Inserm, Université de Lorraine, CIC Epidemiologie Clinique, Nancy, France
| | - Thierry Conroy
- Institut de Cancérologie de Lorraine, Medical Oncology Department, 54519, Vandoeuvre-lès-Nancy, France.,Université de Lorraine, APEMAC, Équipe MICS, 54000, Nancy, France
| | - Michel Velten
- French National Platform Quality of Life and Cancer, Montpellier, France.,Department of Epidemiology and Public Health, Faculty of Medicine, University of Strasbourg, 3430, Strasbourg, EA, France.,Department of Epidemiology and Biostatistics, Paul Strauss Comprehensive Cancer Center, Strasbourg, France
| | - Damien Jolly
- French National Platform Quality of Life and Cancer, Montpellier, France.,Clinical Epidemiology Department, Hôpital Robert. Debré, University Hospital, Rue du Général Koenig, 51092, Reims cedex, France
| | - Sylvain Causeret
- Surgery Department, Centre Georges François Leclerc, Dijon, France
| | - Jean Cuisenier
- Surgery Department, Centre Georges François Leclerc, Dijon, France
| | - Olivier Graesslin
- Gynecological and Obstetric Department, Institut Mère Enfant, University Hospital of Reims, URCA (Université de Reims Champagne Ardenne), Reims, France
| | - Linda Abou Abbas
- Faculty of Medical Sciences, Neuroscience Research Center, Lebanese university, Beirut, 1001, Lebanon
| | - Virginie Nerich
- Biostatistics Unit, Department of Clinical Research and Innovation & Department of Human and Social Sciences, Centre Léon Bérard, Lyon, France.,Department of Pharmacy, University Hospital of Besançon, 25030, Besançon, France
| |
Collapse
|
2
|
de Ligt KM, Witteveen A, Siesling S, Steuten LMG. Shifting breast cancer surveillance from current hospital setting to a community based setting: a cost-effectiveness study. BMC Cancer 2018; 18:96. [PMID: 29361911 PMCID: PMC5781302 DOI: 10.1186/s12885-018-3992-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 01/16/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study explores the effectiveness and cost-effectiveness of surveillance after breast cancer treatment provided in a hospital-setting versus surveillance embedded in the community-based National Breast Cancer Screening Program (NBCSP). METHODS Using a decision tree, strategies were compared on effectiveness and costs from a healthcare perspective over a 5-year time horizon. Women aged 50-75 without distant metastases that underwent breast conserving surgery in 2003-2006 were selected from the Netherlands Cancer Registry (n = 14,093). Key input parameters were mammography sensitivity and specificity, risk of loco regional recurrence (LRR), and direct healthcare costs. Primary outcome measure was the proportion true test results (TTR), expressed as the positive and negative predictive value (PPV, NPV). The incremental cost-effectiveness ratio (ICER) is defined as incremental costs per TTR forgone. RESULTS For the NBCSP-strategy, 13,534 TTR (8 positive; 13,526 negative), and 12,923 TTR (387 positive; 12,536 negative) were found for low and high risks respectively. For the hospital-based strategy, 26,663 TTR (13 positive; 26,650 negative) and 24,883 TTR (440 positive; 24,443 negative) were found for low and high risks respectively. For low risks, the PPV and NPV for the NBCSP-based strategy were 3.31% and 99.88%, and 2.74% and 99.95% for the hospital strategy respectively. For high risks, the PPV and NPV for the NBCSP-based strategy were 64.10% and 98.87%, and 50.98% and 99.71% for the hospital-based strategy respectively. Total expected costs of the NBCSP-based strategy were lower than for the hospital-based strategy (low risk: €1,271,666 NBCSP vs €2,698,302 hospital; high risk: €6,939,813 NBCSP vs €7,450,150 hospital), rendering ICERs that indicate cost savings of €109 (95%CI €95-€127) (low risk) and €43 (95%CI €39-€56) (high risk) per TTR forgone. CONCLUSION Despite expected cost-savings of over 50% in the NBCSP-based strategy, it is nearly 50% lower accurate than the hospital-based strategy, compromising the goal of early detection of LRR to an extent that is unlikely to be acceptable.
Collapse
Affiliation(s)
- Kelly M. de Ligt
- Dept. of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Godebaldkwartier 419, 3511 DT Utrecht, the Netherlands
- Dept. of Health Technology and Services Research, MIRA Institute for Biomedical Technology and Techical Medicine, University of Twente, Drienerlolaan 5, 7522 NB Enschede, the Netherlands
| | - Annemieke Witteveen
- Dept. of Health Technology and Services Research, MIRA Institute for Biomedical Technology and Techical Medicine, University of Twente, Drienerlolaan 5, 7522 NB Enschede, the Netherlands
| | - Sabine Siesling
- Dept. of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Godebaldkwartier 419, 3511 DT Utrecht, the Netherlands
- Dept. of Health Technology and Services Research, MIRA Institute for Biomedical Technology and Techical Medicine, University of Twente, Drienerlolaan 5, 7522 NB Enschede, the Netherlands
| | - Lotte M. G. Steuten
- Fred Hutchinson Cancer Research Center, HICOR: Hutchinson Institute for Cancer Outcomes Research, 1100 Fairview Ave. N, Seattle, WA 98109 USA
| |
Collapse
|
3
|
Knobf M, Cooley M, Duffy S, Doorenbos A, Eaton L, Given B, Mayer D, McCorkle R, Miaskowski C, Mitchell S, Sherwood P, Bender C, Cataldo J, Hershey D, Katapodi M, Menon U, Schumacher K, Sun V, Ah D, LoBiondo-Wood G, Mallory G. The 2014–2018 Oncology Nursing Society Research Agenda. Oncol Nurs Forum 2015; 42:450-65. [DOI: 10.1188/15.onf.450-465] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
4
|
Norberg M, Magnusson E, Egberg Thyme K, Åström S, Lindh J, Öster I. Breast cancer survivorship--intersecting gendered discourses in a 5-year follow-up study. Health Care Women Int 2015; 36:617-33. [PMID: 25692802 DOI: 10.1080/07399332.2015.1017640] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
In this article the authors present a follow-up study of women's interview narratives about life 5 to 7 years after a breast cancer operation. The women had taken part in a study during the 6-month postoperation period. Art therapy contributed to well-being, including strengthening personal boundaries. In the new study, interview analysis informed by critical discursive psychology indicated three problematic discourses that the women still struggled with several years after the operation: the female survivor, the "good woman," and individual responsibility. We concluded that many women with a history of breast cancer need support several years after their medical treatment is finished.
Collapse
Affiliation(s)
- Monika Norberg
- a Department of Nursing , Umeå University , Umeå , Sweden
| | | | | | | | | | | |
Collapse
|
5
|
Ahern T, Gardner A, Courtney M. Geographical comparisons of information and support needs of Australian women following the primary treatment of breast cancer: a 10-year replication study. Health Expect 2014; 18:2678-92. [PMID: 25131899 DOI: 10.1111/hex.12242] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2014] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND In 2002, Raupach and Hiller examined the use of and satisfaction with information and support following treatment of breast cancer from a sample of participants in South Australia. In 2013 this study was replicated to include participants Australia wide and analyse comparisons based on geographical location. Statistical comparisons with the original study were also conducted. DESIGN A 10 year replication study using a cross-sectional needs analysis survey. SETTING AND PARTICIPANTS Women aged 18+ years diagnosed with breast cancer between 6 and 30 months ago were sourced from two national databases of women diagnosed with breast cancer. RESULTS A total of 325 participants completed the survey. The Internet was the most commonly used source of information with 70% (n = 229 of 325) of women using the internet for information, a statistically significantly higher percentage compared with the 2002 study. The study found the top four information issues rated as moderately/extremely important by women in 2013 were identical in 2002. A comparison of sources of support used showed that women in outer regional, remote and very remote areas were statistically more likely to use the breast care nurse (BCN) for support (P = 0.044). CONCLUSIONS The study provides useful, up-to-date data about information and support services used by Australian women with breast cancer. Comparisons with the earlier study show some of the needs of women have changed over time, but others have remained the same. Geographic comparisons overall, demonstrate many consistent findings regardless of location, however, the important work of the breast care nurse is an area in need of further research.
Collapse
Affiliation(s)
- Tracey Ahern
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Australia
| | - Anne Gardner
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Australia
| | - Mary Courtney
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Australia
| |
Collapse
|
6
|
Chambers SK, Girgis A, Occhipinti S, Hutchison S, Turner J, McDowell M, Mihalopoulos C, Carter R, Dunn JC. A Randomized Trial Comparing Two Low-Intensity Psychological Interventions for Distressed Patients With Cancer and Their Caregivers. Oncol Nurs Forum 2014; 41:E256-66. [DOI: 10.1188/14.onf.e256-e266] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
7
|
Croft L, Sorkin J, Gallicchio L. Marital status and optimism score among breast cancer survivors. Support Care Cancer 2014; 22:3027-34. [PMID: 24908428 DOI: 10.1007/s00520-014-2308-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Accepted: 05/27/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE There are an increasing number of breast cancer survivors, but their psychosocial and supportive care needs are not well-understood. Recent work has found marital status, social support, and optimism to be associated with quality of life, but little research has been conducted to understand how these factors relate to one another. METHODS Survey data from 722 breast cancer survivors were analyzed to estimate the association between marital status and optimism score, as measured using the Life Orientation Test-Revised. Linear regression was used to estimate the relationship of marital status and optimism, controlling for potential confounding variables and assessing effect modification. RESULTS The results showed that the association between marital status and optimism was modified by time since breast cancer diagnosis. Specifically, in those most recently diagnosed (within 5 years), married breast cancer survivors had a 1.50 higher mean optimism score than unmarried survivors (95 % confidence interval (CI) 0.37, 2.62; p = 0.009). The difference in optimism score by marital status was not present more than 5 years from breast cancer diagnosis. CONCLUSIONS Findings suggest that among breast cancer survivors within 5 years since diagnosis, those who are married have higher optimism scores than their unmarried counterparts; this association was not observed among longer-term breast cancer survivors. Future research should examine whether the difference in optimism score among this subgroup of breast cancer survivors is clinically relevant.
Collapse
Affiliation(s)
- Lindsay Croft
- Department of Epidemiology and Public Health, University of Maryland, Baltimore, Baltimore, MD, USA
| | | | | |
Collapse
|
8
|
Öster I, Tavelin B, Egberg Thyme K, Magnusson E, Isaksson U, Lindh J, Åström S. Art therapy during radiotherapy – A five-year follow-up study with women diagnosed with breast cancer. ARTS IN PSYCHOTHERAPY 2014. [DOI: 10.1016/j.aip.2013.10.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
9
|
Thompson J, Coleman R, Colwell B, Freeman J, Greenfield D, Holmes K, Mathers N, Reed M. Preparing breast cancer patients for survivorship (PREP) – A pilot study of a patient-centred supportive group visit intervention. Eur J Oncol Nurs 2014; 18:10-6. [DOI: 10.1016/j.ejon.2013.10.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Revised: 09/25/2013] [Accepted: 10/10/2013] [Indexed: 11/29/2022]
|
10
|
de Munck L, Kwast A, Reiding D, de Bock GH, Otter R, Willemse PHB, Siesling S. Attending the breast screening programme after breast cancer treatment: a population-based study. Cancer Epidemiol 2013; 37:968-72. [PMID: 24075800 DOI: 10.1016/j.canep.2013.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Revised: 08/27/2013] [Accepted: 09/02/2013] [Indexed: 01/05/2023]
Abstract
INTRODUCTION In the Netherlands, breast cancer patients are treated and followed at least 5 years after diagnosis. Furthermore, all women aged 50-74 are invited biennially for mammography by the nationwide screening programme. The relation between the outpatient follow-up (follow-up visits in the outpatient clinic for 5 years after treatment) and the screening programme is not well established and attending the screening programme as well as outpatient follow-up is considered undesirable. This study evaluates potential factors influencing women to attend the screening programme during their outpatient follow-up (overlap) and the (re-)attendance to the screening programme after 5 years of outpatient follow-up. METHODS Data of breast cancer patients aged 50-74 years, treated for primary breast cancer between 1996 and 2007 were selected from the Netherlands Cancer Registry and linked to the National Breast Cancer Screening Programme in the Northern region. Cox regression analyses were used to study women (re-)attending the screening programme over time, possible overlap with the outpatient follow-up and factors influencing this. RESULTS In total 11227 breast cancer patients were included, of whom 19% attended the screening programme after breast cancer treatment, 4.4% within 5 years and 15.4% after more than 5 years. Factors that independently influenced attendance within 5 years as well as more than 5 years after treatment were: interval tumours (HR 0.77; 95%CI 0.61-0.97 and HR 0.69; 95%CI 0.53-0.88, ref: screen-detected tumours), receiving adjuvant radiotherapy (HR 0.65; 95%CI 0.47-0.90 and HR 0.66; 95%CI 0.47-0.93; ref: none) and diagnosis of in situ tumours (HR 1.67; 95%CI 1.25-2.23 and HR 1.39; 95%CI 1.05-1.85; ref: stage I tumours). Non-screen related tumours (HR 0.41; 95%CI 0.29-0.58) and recent diagnosis (HR 0.89 per year; 95%CI 0.86-0.92) were only associated with attendance within 5 years after treatment. CONCLUSION The interrelation between outpatient follow-up and screening should be improved to avoid overlap and low attendance to the screening programme after outpatient follow-up. Breast cancer patients should be informed that attending the screening programme during the outpatient follow-up is not necessary.
Collapse
Affiliation(s)
- Linda de Munck
- Department of Research, Comprehensive Cancer Centre the Netherlands, P.O. Box 19079, 3501 DB Utrecht, The Netherlands.
| | | | | | | | | | | | | |
Collapse
|
11
|
Kwast A, Drossaert C, Siesling S. Breast cancer follow-up: from the perspective of health professionals and patients. Eur J Cancer Care (Engl) 2013; 22:754-64. [DOI: 10.1111/ecc.12094] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2013] [Indexed: 11/30/2022]
Affiliation(s)
- A.B.G. Kwast
- Department of Research; Comprehensive Cancer Centre the Netherlands; Utrecht the Netherlands
- Epidemiology, Biostatistics and HTA; Radboud University Medical Centre; Nijmegen the Netherlands
| | - C.H.C. Drossaert
- Department of Psychology & Communication of Health & Risk; University of Twente; Enschede the Netherlands
| | - S. Siesling
- Department of Research; Comprehensive Cancer Centre the Netherlands; Utrecht the Netherlands
- Department of Health Technology and Services Research; University of Twente; Enschede the Netherlands
| | | |
Collapse
|
12
|
Klimmek R, Wenzel J. Adaptation of the illness trajectory framework to describe the work of transitional cancer survivorship. Oncol Nurs Forum 2013; 39:E499-510. [PMID: 23107863 DOI: 10.1188/12.onf.e499-e510] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE/OBJECTIVES To examine and refine the Illness Trajectory Framework, and to address transitional cancer survivorship. DATA SOURCES CINAHL®, PubMed, and relevant Institute of Medicine reports were searched for survivors' experiences during the year following treatment. DATA SYNTHESIS Using an abstraction tool, 68 articles were selected from the initial search (N > 700). Abstracted data were placed into a priori categories refined according to recommended procedures for theory derivation, followed by expert review. CONCLUSIONS Derivation resulted in a framework describing the work of transitional cancer survivorship, defined as survivor tasks, performed alone or with others, to carry out a plan of action for managing one or more aspects of life following primary cancer treatment. Theoretically, survivors engage in three reciprocally interactive lines of work: (a) illness-related, (b) biographical, and (c) everyday life work. Adaptation resulted in refinement of these domains and the addition of survivorship care planning under "illness-related work." IMPLICATIONS FOR NURSING Understanding this process of work may allow survivors and those who support them to better prepare for the post-treatment period. This adaptation provides a framework for future testing and development. Validity and utility of this framework within specific survivor populations also should be explored.
Collapse
Affiliation(s)
- Rachel Klimmek
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA.
| | | |
Collapse
|
13
|
Abstract
BACKGROUND Over recent years, several initiatives have impacted on the referral of patients to secondary care, most notably targets for urgent referral in suspected cancer and the patient choice agenda. At the same time, improved long-term survival in cancer has increased numbers attending follow-up, doubts about the effectiveness of specialist follow-up have emerged, and alternative models of follow-up have been tested. AIM The aim of the study was to explore patient and carer perspectives on the flexibility and responsiveness of cancer services. This article focuses on findings relating to referral, subsequent outpatient appointments and cessation of outpatient follow-up. METHODS Issues were explored in a qualitative study using face-to-face interviews with a purposive sample of 54 people affected by cancer. Data were analysed concurrently with data collection, using qualitative analysis software. FINDINGS The study gave rise to a number of salient themes. Links were identified between three of these: choice and responsiveness during referral; the flexibility and responsiveness of outpatient appointment systems; and negotiating cessation of follow-up. It appeared that policy on urgent referrals might be adversely affecting practice relating to appointment systems and the continuance of follow-up. DISCUSSION AND CONCLUSIONS Hospital-based cancer follow-up is being given decreasing priority because of doubts about effectiveness and a target-driven focus on referral. This is impacting on patients, who may value outpatient follow-up as a 'safety net' but have difficulties in obtaining appointments, and may be discharged without negotiation or adequate support. For these reasons, new forms of flexible/responsive aftercare are urgently needed.
Collapse
Affiliation(s)
- Kate Wilson
- School of Nursing Midwifery and Social Work, University of Manchester, Manchester, UK.
| | | | | |
Collapse
|
14
|
Salonen P, Tarkka MT, Kellokumpu-Lehtinen PL, Koivisto AM, Aalto P, Kaunonen M. Effect of social support on changes in quality of life in early breast cancer patients: a longitudinal study. Scand J Caring Sci 2012; 27:396-405. [DOI: 10.1111/j.1471-6712.2012.01050.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|
15
|
Harnett P, Kerridge IH, Jordens CFC, Hobbs K, Mason C, Morrell BM. Beyond evidence: reappraising use of CA-125 as post-therapy surveillance for ovarian cancer. Med J Aust 2012; 196:440-1. [PMID: 22509867 DOI: 10.5694/mja11.10889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2011] [Accepted: 01/31/2012] [Indexed: 11/17/2022]
Affiliation(s)
- Paul Harnett
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, NSW
| | | | | | | | | | | |
Collapse
|
16
|
Braña-Marcos B, Carrera-Martínez D, De La Villa-Santoveña M, Vegas-Pardavilla E, Avanzas Fernández S, Gracia Corbato MT. [Breast cancer survivors: quality of life and prevailing diagnoses]. ENFERMERIA CLINICA 2012; 22:65-75. [PMID: 22365102 DOI: 10.1016/j.enfcli.2011.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Revised: 09/25/2011] [Accepted: 10/04/2011] [Indexed: 12/24/2022]
Abstract
UNLABELLED Knowledge of the Quality of Life (QoL) of surviving patients with breast cancer using an effective tool, and adapting it to nursing language using NANDA taxonomy, is essential to identify their needs and health problems. OBJECTIVES To evaluate the QoL of women diagnosed with breast cancer in 2004 (survivors). To identify the most common health problems, and adapting them to the NANDA taxonomy. METHODOLOGY A cross-sectional descriptive study was conducted using a QoL Survey (EORTC QLQ-C30 and BR23) in breast cancer survivors with the collection of demographic and clinical data (October-December 2009). Descriptive statistics (SPSS 18.0) were performed, as well as an analysis of the responses to questionnaire items, identifying defining characteristics, related factors and actual/potential diagnoses (NANDA taxonomy). RESULTS The study included 140 participants. There was a significant effect on: Sexual Function (23.16 ± 25.85), Sexual Enjoyment (48.3 ± 29.15), Concern for the future (51.63 ± 32.32), insomnia (33.03 ± 33.91) and Concern for hair loss (32.67 ± 33.67). The most prevalent health problems were: inefficient sexual pattern (87.1%), body image disorder (80.7%), anxiety (41.5) and sexual dysfunction (31.7%). The relationship between these, the defining characteristics, the related factors and key questionnaire items for their identification are shown. DISCUSSION The QoL of breast cancer survivors is affected in various fields. The EORTC scale can be used as a focused evaluation of QoL. Evidence is provided on the most prevalent diagnoses in survivors, being a first step towards standardisation of care. Research on nursing interventions aimed at improving the QOL of patients is necessary.
Collapse
|
17
|
Hutchison C, Morrison A, Rice AM, Tait G, Harden S. Provision of information about malignant spinal cord compression: perceptions of patients and staff. Int J Palliat Nurs 2012; 18:61-8. [DOI: 10.12968/ijpn.2012.18.2.61] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Audrey Morrison
- The Beatson West of Scotland Cancer Centre, NHS Greater Glasgow and Clyde, 1053 Great Western Road, Glasgow G12 0YN, Scotland
| | | | - Gemma Tait
- Centre for Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, East Melbourne
| | - Sharon Harden
- Quantics Consulting Ltd, Roslin BioCentre, Logan Building, Roslin
| |
Collapse
|
18
|
Strand E, Nygren I, Bergkvist L, Smedh K. Nurse or surgeon follow-up after rectal cancer: a randomized trial. Colorectal Dis 2011; 13:999-1003. [PMID: 20478003 DOI: 10.1111/j.1463-1318.2010.02317.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
AIM Follow-up programmes consume a large amount of resources with less time for the surgeon to take on new patients. The aim of this randomized study was to compare patient satisfaction, resource utilization and medical safety in patients curatively operated for rectal cancer who were followed up by either a surgeon or a nurse. METHOD The nurse was trained by the colorectal surgeon before the start of the study. Curatively operated patients were asked to give their consent to participate. Randomization was performed by the stoma therapist. After each consultation, the patient completed a questionnaire. RESULTS A total of 110 patients (58 men) age 68 (range 41-87) years were included between 2002 and 2005. Only three patients refused participation. Patient satisfaction was high according to the Visual Analogue Scale (VAS): 9.4 for the surgeon and 9.5 for the nurse (NS). Consultation time was longer for the nurse: 24 vs 15 min (P = 0.001), with more blood samples being taken (29%vs 7%, P = 0.002). Radiological investigations exceeding the routine were made in 11%vs 4% (NS) cases. Surgical assistance was needed in 13 of 182 consultations with the nurse [mean 6 (1-15) min, total 75 min]. Distant metastases were detected in seven patients in the surgeon group and eight in the nurse group (P = 0.953). Total costs of follow-up did not differ. CONCLUSION Patient satisfaction was equally high for the specialist nurse as for the colorectal surgeon. On only a few occasions was surgical assistance necessary and total costs for the follow-up showed no difference. Medical safety appeared uncompromised. Nurse-led follow-up is encouraged.
Collapse
Affiliation(s)
- E Strand
- Colorectal Unit, Department of Surgery and Centre for Clinical Research, Uppsala University, Central Hospital, Västerås, Sweden
| | | | | | | |
Collapse
|
19
|
Catt SL, Anderson JL, Critchley GR. Patients' and staff's experiences of multidisciplinary follow-up for high-grade glioma after radical radiotherapy. PSYCHOL HEALTH MED 2011; 16:357-65. [PMID: 21491343 DOI: 10.1080/13548506.2011.554563] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Meeting the complex needs of patients with high-grade glioma requires multidisciplinary input. How best to provide care after initial treatment ends is contentious. This study explored the experiences of patients and staff at one UK centre where regular multidisciplinary clinics and brain scanning is provided. In-depth interviews conducted with 10 patients and six staff were transcribed and analysed qualitatively. Patients reported: supportive, individualised care with familiar staff; good communication; that regular scanning was reassuring. Staff believed that team follow-up facilitated immediate decision-making and referral, and reduced visits. They felt that patients value seeing their scans. Patients and staff described positive and negative experiences of multidisciplinary follow-up. There is need to investigate the impact of different approaches to ongoing care.
Collapse
Affiliation(s)
- Susan L Catt
- Cancer Research UK, Psychosocial Oncology Group, Brighton and Sussex Medical School, University of Sussex, Brighton, UK.
| | | | | |
Collapse
|
20
|
Voigt B, Grimm A, Lossack M, Klose P, Schneider A, Richter-Ehrenstein C. The breast care nurse: the care specialist in breast centres. Int Nurs Rev 2011; 58:450-3. [PMID: 22092323 DOI: 10.1111/j.1466-7657.2011.00893.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND In Europe, breast cancer is the most common form of cancer in women; 26.5 per cent of all new malignant diseases and 17.5 per cent of all cancer deaths are due to this type of cancer. In Germany, approximately every tenth woman is diagnosed with breast cancer during her lifetime. OBJECTIVE In order to increase the quality of life of breast cancer patients, the European Society of Mastology (EUSOMA) requires the availability of, and an integration of qualified and specialized care into the interdisciplinary team. Thus, in Germany, a new type of job profile for 'breast nurse' as a qualified care specialist has to be established and has to be oriented towards the international standards of a breast care nurse (BCN). METHODS The Charité's Academy of Health--in cooperation with the Interdisciplinary Breast Centre of the Charité--has offered a career advisory service curriculum for the BCN since 2006 in accordance with the EUSOMA guidelines. RESULTS In three courses, 45 BCNs have been trained. In the first refresher seminar in May 2009, the BCNs were given an opportunity to exchange with fellow BCNs their experiences. CONCLUSION We were able to set up a new curriculum to train nurses as BCNs as to improve the quality of care for breast cancer patients and to orientate the training towards the international standards of a BCN qualification.
Collapse
Affiliation(s)
- B Voigt
- Department of Psychosomatics and Psychotherapy, Charité-University Medicine, Berlin, Germany
| | | | | | | | | | | |
Collapse
|
21
|
Catt SL, Anderson JL, Chalmers AJ, Fallowfield LJ. A UK-wide survey of follow-up practices for patients with high-grade glioma treated with radical intent. J Eval Clin Pract 2011; 17:1-6. [PMID: 21143347 DOI: 10.1111/j.1365-2753.2009.01292.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
RATIONALE AND OBJECTIVE High-grade glioma profoundly affects patients and their families. The best ongoing care for patients completing radical treatment is uncertain. To address this issue a UK-wide audit surveying the follow-up practices of multidisciplinary cancer teams was conducted. METHOD An online survey package was used with a paper version available. RESULTS Of 102 clinicians approached 86 replied, a response rate of 84%. Three-monthly outpatient department appointments led by an oncologist and a specialist nurse were the norm, but more controversially, some centres conduct joint clinics with the whole neurosurgical/oncology team present or available. Nurse-led telephone follow-up in place of hospital visits is uncommon. Regular scanning is conducted despite the clinical benefits being contentious. Access to a range of allied services providing supportive care is considered, but the actual levels of need and the efficiency with which they are delivered require further investigation. CONCLUSIONS The picture of UK follow-up practices revealed by this survey demonstrates that research is now needed to determine what preferences patients and families have for follow-up and their satisfaction with these.
Collapse
Affiliation(s)
- Susan L Catt
- Cancer Research UK Psychosocial Oncology Group, Brighton & Sussex Medical School, Brighton, UK.
| | | | | | | |
Collapse
|
22
|
Beaver K, Williamson S, Chalmers K. Telephone follow-up after treatment for breast cancer: views and experiences of patients and specialist breast care nurses. J Clin Nurs 2010; 19:2916-24. [PMID: 20649914 DOI: 10.1111/j.1365-2702.2010.03197.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
AIMS AND OBJECTIVES To explore the views of patients and specialist breast care nurses on telephone follow-up after treatment for breast cancer. BACKGROUND A recent randomised controlled trial demonstrated that nurse-led telephone follow-up led to high levels of patient satisfaction with no physical or psychological detriment. This study aimed to explore in more detail the views of patients randomised to telephone follow-up and the nurses who conducted telephone appointments. DESIGN Qualitative. METHOD Individual interviews with 28 patients and four specialist breast care nurses. Content analysis was used to analyse the interview data. RESULTS Telephone follow-up was convenient for patients and provided continuity of care. Speaking on the telephone was perceived as a more 'normal' activity than attending hospital outpatient clinics. A structured approach was appreciated, instilling feelings of confidence that all questions had been asked and no errors had been made. Specialist nurses emphasised the high level of skill required to deliver the intervention and perceived that the telephone approach was well able to meet the individual needs of patients. CONCLUSIONS Positive views on telephone follow-up were reported. An experienced and skilled practitioner, with effective communication skills, is required to deliver the intervention and a period of training is recommended. Nurse-led telephone interventions have a broader applicability to other disease conditions, although more work is needed to develop appropriate interventions and evaluate their effectiveness. RELEVANCE TO CLINICAL PRACTICE Nurses at advanced levels of practice are uniquely placed to deliver such complex interventions. However, a period of initial training with effective peer support and channels for ongoing feedback are essential for administering an intervention that relies on audio rather than visual cues.
Collapse
Affiliation(s)
- Kinta Beaver
- School of Nursing and Caring Sciences, University of Central Lancashire, Preston, UK.
| | | | | |
Collapse
|
23
|
Roundtree AK, Giordano SH, Price A, Suarez-Almazor ME. Problems in transition and quality of care: perspectives of breast cancer survivors. Support Care Cancer 2010; 19:1921-9. [PMID: 21140173 DOI: 10.1007/s00520-010-1031-6] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2010] [Accepted: 10/18/2010] [Indexed: 11/29/2022]
Abstract
PURPOSE We conducted a qualitative study to explore breast cancer survivors' perceptions and attitudes about their current healthcare utilization, screening, and information needs. METHODS We completed eight focus groups of breast cancer survivors. We included women, adult survivors, with an initial diagnosis of breast cancer in the year 2000, treated, and without a recurrence as per medical record. To analyze transcripts, we used grounded theory methods, wherein unexpected themes and direct answers emerged from consensus between co-coders. RESULTS Focus groups included 33 participants, the majority of whom were white (84.8%), college-educated (66.7%), and covered by private medical insurance (75.7%) or Medicare (27.3%). Participants' perceptions and attitudes about care were framed in terms of personal experiences (including facing barriers to screening, feeling in limbo in the healthcare system, having problems with communication with and between physicians, confusion about symptoms, and using self-prescribe remedies), personal attitudes (including strong opinions about what survivorship means, concerns about recurrence, and changes in self-perception and agency), and social influences (including modeling others' behaviors, changes in social life, and listening to family). CONCLUSION Survivorship attitudes, recurrence fears, memories, and self-perceptions were influential personal factors in addition to self-efficacy. Solutions such as providing a cancer treatment summary might resolve many of the problems by consolidating and making readily available the numerous medical history and recommendations that survivors accrue over time, switching from provider to provider. Clinicians must also implement communication changes in their interactions with patients to enhance positive attitudes and behaviors, and leverage social influences.
Collapse
Affiliation(s)
- Aimee Kendall Roundtree
- The University of Texas MD Anderson Cancer Center, 1400 Pressler St, Unit 1465, Houston, TX 77030, USA
| | | | | | | |
Collapse
|
24
|
Flynn C, Khaouam N, Gardner S, Higgins K, Enepekides D, Balogh J, MacKenzie R, Singh S, Davidson J, Poon I. The Value of Periodic Follow-up in the Detection of Recurrences after Radical Treatment in Locally Advanced Head and Neck Cancer. Clin Oncol (R Coll Radiol) 2010; 22:868-73. [DOI: 10.1016/j.clon.2010.05.016] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2009] [Revised: 04/14/2010] [Accepted: 05/12/2010] [Indexed: 01/20/2023]
|
25
|
Continuity of care for women with breast cancer: a survey of the views and experiences of patients, carers and health care professionals. Eur J Oncol Nurs 2010; 15:419-27. [PMID: 21112249 DOI: 10.1016/j.ejon.2010.10.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2009] [Revised: 10/19/2010] [Accepted: 10/21/2010] [Indexed: 11/22/2022]
Abstract
PURPOSE OF THE RESEARCH The need for continuity of care in the management of women diagnosed with breast cancer is important yet challenging. The aim was twofold; to explore 1) the concept of continuity of care from the perspectives of women diagnosed with breast cancer, their carers and their health care professionals (HCPs), 2) actual experiences amongst these three groups relating to continuity of care. METHODS AND SAMPLE A three-phase cross-sectional survey was conducted involving eight focus group interviews with women who had been diagnosed with breast cancer (n = 47) and structured questionnaires to both carers (n = 33) and HCPs (n = 44). Data were analysed according to three categories of continuity of care; relational, informational and managerial. KEY RESULTS According to the patients: 'Continuity of Care' is the continuous care over time; it involves the relationship between the HCP and the patient. It is not just a follow-up review. The relationship is built on trust, loyalty and constancy. The perception is that the providers of care know you, know your case history and your future care is agreed on.' Across all phases of the study the three categories of continuity of care were identified but there were differences as to the weight different groups placed on them. Continuity of care was reported to be achieved for the majority of the respondents across all three samples however deficiencies in the service were identified. CONCLUSION The results provide an opportunity to improve service; recommendations have been made and steps to implementation taken.
Collapse
|
26
|
Schmid-Büchi S, Halfens RJG, Dassen T, van den Borne B. Psychosocial problems and needs of posttreatment patients with breast cancer and their relatives. Eur J Oncol Nurs 2010; 15:260-6. [PMID: 20089447 DOI: 10.1016/j.ejon.2009.11.001] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2009] [Revised: 11/20/2009] [Accepted: 11/24/2009] [Indexed: 11/18/2022]
Abstract
PURPOSE The study assessed and compared the psychosocial needs of patients with breast cancer and of their relatives, the patients' and relatives' burden of illness, anxiety, depression and distress and assessed the patients' cancer treatment-related symptoms and identified relevant factors influencing patients' and relatives' needs. METHOD Seventy-two patients (n=72) participated with a relative in a cross-sectional mail-survey, 1-22 months after cancer treatment. RESULTS The patients reported needing help with psychological and sexual issues. They suffered from treatment-related symptoms. More treatment-related symptoms and depression were related to the patients' needs for supportive care. Their relatives' needs primarily concerned access to information and communication with health care professionals. Relatives had higher levels of anxiety (25.0% vs. 22.2%), depression (12.5% vs. 8.3%) and distress (40% vs. 34%) than patients. Higher levels of depression, younger age and having a disease themselves were associated with relatives' need for help. CONCLUSION Patients' and relatives' substantial needs and psychological problems require professional support even after completion of the patients' treatment. Continued assessment of the patients' and their relatives' needs and of the patients' symptoms provide the basis for purposeful counselling and education. Rehabilitation programs for patients and their relatives should be developed and implemented in clinical practice.
Collapse
|
27
|
Breast cancer follow up: a randomised controlled trial comparing point of need access versus routine 6-monthly clinical review. Eur J Oncol Nurs 2008; 13:2-8. [PMID: 19119079 DOI: 10.1016/j.ejon.2008.11.005] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2008] [Revised: 11/11/2008] [Accepted: 11/12/2008] [Indexed: 11/21/2022]
Abstract
AIM To examine a model of care for breast cancer patients based on the concept of point of need access and investigate the effectiveness of this model compared to routine 6-monthly clinical reviews. DESIGN A parallel randomised controlled trial was used to examine point of need access to specialist care via the nurse specialist, compared to routine hospital based 6-monthly clinical review at year two post breast cancer diagnosis. A total of 237 patients were recruited to the study. METHODS Outcome measures at baseline, 9 and 18 months included psychological morbidity using the GHQ12 questionnaire, quality of life using the FACT-B plus endocrine subscale, fear and isolation. An analysis of covariance was used to detect changes over time. Recurrences and methods of detection were recorded as secondary outcome measures. RESULTS Two hundred and fourteen patients completed the study. Overall patients were not exposed to risks of increased psychological morbidity (p=0.767) or decline of quality of life (p=0.282) when routine review was discontinued and no significant differences were detected during an 18-month period. Patients not receiving regular review did not feel isolated, and at the end of 18 months did not wish to return to 6-monthly clinical reviews. The presentation of recurrences and short symptom history demonstrate that the recurrences observed were unlikely to have been detected at a routine visit. CONCLUSIONS Point of need access is acceptable to the majority of patients. Although a third of patients may wish to maintain a regular review, patient choice is important. Findings suggest that after 2 years following the diagnosis of breast cancer there is no evidence to support the view that regular clinical review improves psychological morbidity or quality of life. Patients do not appear to be compromised in terms of early detection of recurrence. Point of need access can be provided by suitably trained specialist nurses and provides a fast, responsive management system at a time when patients really need it.
Collapse
|