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Justesen RM, Ikander TM, Thomsen TG, Dieperink KB. Nursing Roles in Cancer Rehabilitation: An Integrative Review. Cancer Nurs 2023:00002820-990000000-00141. [PMID: 37158677 DOI: 10.1097/ncc.0000000000001243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
BACKGROUND Because of cancer survivors' increased need for help and support, cancer rehabilitation should be an essential part of cancer treatment, where focusing on patients' individual needs is essential. OBJECTIVE To provide an overview of existing evidence about nurses' roles and participation in cancer rehabilitation, based on both nurses' and patients' perspectives. METHODS A systematic search was conducted in PubMed, CINAHL, EMBASE and Cochrane databases for studies published from January 2001-January 2022. Whittemore and Knafl's methodology for data extraction and synthesis was used, and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines were followed. The review was registered in PROSPERO (CRD42021223683). RESULTS Ten qualitative studies and 7 quantitative studies were included, encompassing 306 patients and 1847 clinicians (1164 nurses). Three nursing roles emerged: (1) relationship-forming, in which nurses described ongoing involvement in patients' rehabilitation and patients described nurses as trusted partners; (2) coordinating, in which nurses described a lack of time and resources and a focus on medical treatment, and patients described nurses as expert coordinators; and (3) follow-up, in which patients described nurses as good communicators and trusted partners in their follow-up, and nurses described their natural interest in patients' rehabilitation outcomes during follow-up. CONCLUSIONS Patients were comfortable with nurses as trusted partners during cancer rehabilitation. Significant barriers such as lack of time, resources, and education about rehabilitation may negatively influence rehabilitation planning, implementation, and monitoring. IMPLICATIONS FOR PRACTICE Clinicians can use the findings to improve cancer rehabilitation with the nurse as a central provider and conduct further research on the coordinating and follow-up roles.
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Affiliation(s)
- Rikke M Justesen
- Author Affiliations: Department of Clinical Research, University of Southern Denmark (Ms Justesen and Drs Ikander, Dieperink, and Thomsen); Research Unit of Oncology, Odense University Hospital (Dr Dieperink), Odense; Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Køge (Dr Thomsen); and REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Nyborg (Dr Ikander), Denmark
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Quality of care and quality of life as experienced by patients with advanced cancer of a rare tumour type: results of the multicentre observational eQuiPe study. J Cancer Surviv 2023:10.1007/s11764-022-01323-8. [PMID: 36595186 DOI: 10.1007/s11764-022-01323-8] [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: 11/03/2022] [Accepted: 12/15/2022] [Indexed: 01/04/2023]
Abstract
PURPOSE Patients with a rare cancer face difficulties during their disease trajectory, such as delayed diagnosis and lack of expert care. However, little is known about their perceived quality of care (QoC) and quality of life (QoL) in the advanced disease stage. We aimed to assess the QoC and QoL as experienced by patients with advanced rare cancers compared to patients with advanced common cancers. METHODS In this cross-sectional study, baseline data of patients with advanced cancer from the multicentre, longitudinal, observational eQuipe study were analysed. Multivariable linear regression analyses were conducted to assess differences in experienced QoC (continuity of care, continuity of information, and satisfaction with care) and QoL (functioning, symptoms, overall QoL, and social wellbeing) between advanced rare and common cancer patients. RESULTS Of the 1087 included patients, 106 (9.8%) had a rare cancer type. In comparison to patients with advanced common cancers, patients with advanced rare cancers experienced significantly lower continuity of care (77.8 vs. 71.1 respectively, p = 0.011) and social functioning (78.8 vs. 72.6 respectively, p = 0.012). No differences were found regarding continuity of information, satisfaction with care, overall QoL, and social wellbeing. CONCLUSIONS Patients with advanced rare cancers experience less continuity of care, and the impact of the disease on social and family life seems higher compared to patients with advanced common cancers. IMPLICATIONS FOR CANCER SURVIVORS To enhance the QoC and QoL of patients with advanced rare cancers, supportive care should mainly focus on improving continuity of care and patients' social functioning.
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Bardon C, Guillemette A, Rioux ME, Rivard M. Group intervention programs and their impact on well-being and quality-of-life for adults living with a rare or orphan disease - realist review of literature. Disabil Rehabil 2022:1-11. [PMID: 35979809 DOI: 10.1080/09638288.2022.2104943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE Adults living with a rare or orphan diseases (ROD) experience common psychosocial difficulties that are often poorly addressed in usual care. This realist literature review aims to inform the development, evaluation and implementation of evidence based group therapy programs adapted to shared needs of patients living with various ROD. METHOD The review is based on an analysis of Context-Mechanism-Outcome configurations. It included 21 primary studies published between 2010 and April 2022 and used a PRISMA process for study selection and inclusion. RESULTS Our results show that group psychosocial interventions can help reduce perception of symptoms and psychological impacts of disease, improve social functioning and support and quality of life in patients. CONCLUSION Group therapy programs seem promising for ROD-patients and should be considered within comprehensive treatment and support plans. However, more comprehensive studies of group therapies in context should aim to identify core active components of these interventions with ROD-patients. Implications for Rehabilitation:Rare or Orphan Diseases are varied, difficult to diagnose and have a major impact on all aspects of the patients' lives (physical, emotional, psychological, social, professional).Psychosocial support is a key but underdeveloped component to support the recovery trajectory for these patients.In this review of group interventions, we identified a few promising practices adaptable to patients living with Rare or Orphan Diseases (Acceptance and commitment therapy, cognitive behavioural therapies, psychoeducational programs).Patients who received psychosocial group interventions are likely to experience improvement in their quality of life.
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Affiliation(s)
- Cécile Bardon
- Psychologie, Université du Québec à Montréal, Montréal, Canada
| | | | - Marie-Eve Rioux
- Psychologie, Université du Québec à Montréal, Montréal, Canada
| | - Mélina Rivard
- Psychologie, Université du Québec à Montréal, Montréal, Canada
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de Heus E, Engelen V, Dingemans I, Richel C, Schrieks M, van der Zwan JM, Besselink MG, van Berge Henegouwen MI, van Herpen CML, Duijts SFA. Differences in health care experiences between rare cancer and common cancer patients: results from a national cross-sectional survey. Orphanet J Rare Dis 2021; 16:249. [PMID: 34074302 PMCID: PMC8170927 DOI: 10.1186/s13023-021-01886-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 05/21/2021] [Indexed: 11/15/2022] Open
Abstract
Background Patients with rare cancers face challenges in the diagnostic and treatment phase, and in access to clinical expertise. Since studies on health care experiences of these patients in comparison to patients with more common cancers are scarce, we aimed to explore these differences. Methods Data were cross-sectionally collected among (former) adult cancer patients through a national online survey in the Netherlands (October 2019). Descriptive statistics were reported and subgroups (rare vs. common patients) were compared. Results In total, 7343 patients (i.e., 1856 rare and 5487 common cancer patients) participated. Rare cancer patients were more often diagnosed and treated in different hospitals compared to common cancer patients (67% vs. 59%, p < 0.001). Rare cancer patients received treatment more often in a single hospital (60% vs. 57%, p = 0.014), but reported more negative experiences when treated in multiple hospitals than common cancer patients (14% vs. 9%, p < 0.001). They also more often received advise from their physician about the hospital to go to for a second opinion (50% vs. 36%, p < 0.001), were more likely to choose a hospital specialized in their cancer type (33% vs. 22%, p < 0.001), and were more willing to travel as long as necessary to receive specialized care than common cancer patients (55% vs. 47%, p < 0.001). Conclusions Rare and common cancer patients differ in their health care experiences. Health care for rare cancer patients can be further improved by proper referral to centers of expertise and building a clinical network specifically for rare cancers. Supplementary Information The online version contains supplementary material available at 10.1186/s13023-021-01886-2.
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Affiliation(s)
- Eline de Heus
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Godebaldkwartier 419, 3511 DT, Utrecht, The Netherlands. .,Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Vivian Engelen
- Dutch Federation of Cancer Patients Organisations (Nederlandse Federatie Van Kankerpatiëntenorganisaties, NFK), Utrecht, The Netherlands
| | - Irene Dingemans
- Dutch Federation of Cancer Patients Organisations (Nederlandse Federatie Van Kankerpatiëntenorganisaties, NFK), Utrecht, The Netherlands
| | - Carol Richel
- Dutch Breast Cancer Association (Borstkankervereniging Nederland, BVN), Utrecht, The Netherlands
| | - Marga Schrieks
- Dutch Federation of Cancer Patients Organisations (Nederlandse Federatie Van Kankerpatiëntenorganisaties, NFK), Utrecht, The Netherlands
| | - Jan Maarten van der Zwan
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Godebaldkwartier 419, 3511 DT, Utrecht, The Netherlands
| | - Marc G Besselink
- Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Mark I van Berge Henegouwen
- Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Carla M L van Herpen
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Saskia F A Duijts
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Godebaldkwartier 419, 3511 DT, Utrecht, The Netherlands.,Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Bravery B, Loughnan S, Murphy M. Depression treatment research in people with cancer does not reflect cancer prevalence: findings from a systematic review. EVIDENCE-BASED MENTAL HEALTH 2020; 23:155-160. [PMID: 32788165 PMCID: PMC10231615 DOI: 10.1136/ebmental-2020-300145] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 07/06/2020] [Accepted: 07/10/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND One in six people with cancer will develop depression at some point in their care. Untreated depression affects quality of life, cancer care satisfaction and healthcare expenditure. Treatments for this vulnerable heterogenous population should be evidence based and specific. A common sentiment is that psychiatric research does not reflect the prevalence of patients with cancer and comorbid depression and is biased towards certain cancers, but this has not been empirically shown. STUDY SELECTION AND ANALYSIS A systematic review of studies on psychological and pharmacological treatments for depression in people with cancer was conducted. Of 4621 papers identified from a search of PubMed and PsycINFO up to 27 June 2020, 84 met inclusion criteria (eg, adults with cancer; depression diagnosis; treatment study) and comprised 6048 participants with depression with cancer. FINDINGS Cancer types are not proportionally represented in depression research in accordance with their incidence. Breast cancer is over-represented (relative frequency in research 49.3%, but 11.7% of global cancer). Cancers of the head and neck and bone and soft tissue were close to parity. All other cancers are under-represented. Representativeness varied 40-fold across different cancers. CONCLUSIONS The evidence base for depression treatments is dominated by a single cancer. Given heterogeneity in cancer populations (eg, stage of illness; psychological impact; cancer treatments), it is possible that depression treatments may not have the same benefits and harms across all cancers, impeding the ability to offer people with different cancers the best depression treatment. While the dominant opinion within this research field is that a cancer bias exists, this is the first study to demonstrate as such.
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Affiliation(s)
- Benjamin Bravery
- School of Medicine, The University of Notre Dame Australia, Darlinghurst, New South Wales, Australia
| | - Siobhan Loughnan
- Clinical Research Unit for Anxiety and Depression (CRUfAD) at St Vincent's Hospital, UNSW, Darlinghurst, New South Wales, Australia
| | - Michael Murphy
- Clinical Research Unit for Anxiety and Depression (CRUfAD) at St Vincent's Hospital, UNSW, Darlinghurst, New South Wales, Australia
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Smrke A, Younger E, Wilson R, Husson O, Farag S, Merry E, Macklin-Doherty A, Cojocaru E, Arthur A, Benson C, Miah AB, Zaidi S, Gennatas S, Jones RL. Telemedicine During the COVID-19 Pandemic: Impact on Care for Rare Cancers. JCO Glob Oncol 2020; 6:1046-1051. [PMID: 32639877 PMCID: PMC7392777 DOI: 10.1200/go.20.00220] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
PURPOSE Many patients with cancer, often those with rare cancers such as sarcomas, travel long distances to access expert care. The COVID-19 pandemic necessitated widespread changes in delivery of cancer care, including rapid adoption of telemedicine-based care. We aimed to evaluate the impact of telemedicine on patients, clinicians, and care delivery at the Royal Marsden Hospital (RMH) Sarcoma Unit during the pandemic. METHODS Data were extracted from patient records for all planned outpatient appointments at the RMH Sarcoma Unit from March 23 to April 24, 2020. Patients and clinicians completed separate questionnaires to understand their experiences. RESULTS Of 379 planned face-to-face appointments, 283 (75%) were converted to telemedicine. Face-to-face appointments remained for patients who needed urgent start of therapy or performance status assessment. Patients lived on average > 1.5 hours from RMH. Patient satisfaction (n = 108) with telemedicine was high (mean, 9/10), and only 48% (n = 52/108) would not want to hear bad news using telemedicine. Clinicians found telemedicine efficient, with no associated increased workload, compared with face-to-face appointments. Clinicians indicated lack of physical examination did not often affect care provision when using telemedicine. Most clinicians (n = 17; 94%) believed telemedicine use was practice changing; congruently, 80% (n = 86/108) of patients desired some telemedicine as part of their future care, citing reduced cost and travel time. CONCLUSION Telemedicine can revolutionize delivery of cancer care, particularly for patients with rare cancers who often live far away from expert centers. Our study demonstrates important patient and clinician benefits; assessment of longer-term impact on patient outcomes and health care systems is needed.
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Affiliation(s)
- Alannah Smrke
- The Royal Marsden Hospital NHS Trust, London, United Kingdom
| | - Eugenie Younger
- The Royal Marsden Hospital NHS Trust, London, United Kingdom
| | - Roger Wilson
- Sarcoma Patients Euronet e.V./Association, Wölfersheim, Germany
| | - Olga Husson
- Institute of Cancer Research, London, United Kingdom
| | - Sheima Farag
- The Royal Marsden Hospital NHS Trust, London, United Kingdom
| | - Eve Merry
- The Royal Marsden Hospital NHS Trust, London, United Kingdom
| | - Aislinn Macklin-Doherty
- The Royal Marsden Hospital NHS Trust, London, United Kingdom.,Institute of Cancer Research, London, United Kingdom
| | - Elena Cojocaru
- The Royal Marsden Hospital NHS Trust, London, United Kingdom
| | - Amani Arthur
- The Royal Marsden Hospital NHS Trust, London, United Kingdom.,Institute of Cancer Research, London, United Kingdom
| | | | - Aisha B Miah
- The Royal Marsden Hospital NHS Trust, London, United Kingdom.,Institute of Cancer Research, London, United Kingdom
| | - Shane Zaidi
- The Royal Marsden Hospital NHS Trust, London, United Kingdom
| | | | - Robin L Jones
- The Royal Marsden Hospital NHS Trust, London, United Kingdom.,Institute of Cancer Research, London, United Kingdom
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Design and development of a disease-specific quality of life tool for patients with aplastic anaemia and/or paroxysmal nocturnal haemoglobinuria (QLQ-AA/PNH)-a report on phase III. Ann Hematol 2019; 98:1547-1559. [PMID: 31115593 PMCID: PMC6591198 DOI: 10.1007/s00277-019-03681-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 03/28/2019] [Indexed: 12/20/2022]
Abstract
To date, instruments to measure quality of life (QoL) specifically for patients with acquired aplastic anaemia (AA) and paroxysmal nocturnal haemoglobinuria (PNH) are lacking altogether. As a consequence, this issue is either underevaluated or alternatively, instruments originally designed for cancer patients are being used. We therefore started to systematically develop a AA/PNH-specific QoL (QLQ-AA/PNH) instrument in these ultra-rare diseases according to European Organisation for Research and Treatment of Cancer (EORTC) guidelines. While phases I and II of the process have previously been published, we now report on the resulting instrument (phase III of this process). As part of the phase III of the evaluation process, we approached patients through physicians, patient support groups, and patient conferences. After participants completed the preliminary questionnaire and reported socio-demographic data, they were interviewed in person or via phone with a debriefing interview to find out whether the items were relevant, easy to understand, and acceptable to patients and whether there was anything missing in the questionnaire. We hypothesised what items could be combined into a scale and calculated Cronbach’s alpha to define its preliminary internal consistency. After definition of a priori criteria to keep or delete items, a group of six experts met in person, discussed the results, and decided on in- or exclusion. A total of 48 patients were enrolled, 21 of those suffered from AA (44%), 13 from PNH (27%), and 14 from AA/PNH syndrome (29%). The median time to complete the 69 items was 10 min (range 5–20), mean time 11 min. The compliance criterion (> 95% completion) was fulfilled by 57 items. Twenty-three items were mentioned as especially relevant by ≥ 2% of the patients. Cronbach’s alpha of the hypothesised scales ranged from 0.63 (social support) to 0.92 (fear of progression and illness intrusiveness). Finally, 47 items were kept; 16 were deleted, and 5 were changed, while 1 item expanded. This resulted in 54 items in total. As no issues were mentioned to lacking by a minimum of five patients, no items were added to the questionnaire. After completion, the AA/PNH-QoL tool (QLQ-AA/PNH) was translated according to EORTC guidelines into English, French, and Italian. For patients with PNH and AA until now, the standard assessment for QoL was to use the EORTC Quality of Life Questionnaire (QLQ-C30) or the Functional Assessment of Chronic Illness Therapy Fatigue Instrument (FACIT-Fatigue). We herewith present a new instrument aimed to be better tailored to the needs of PNH and AA patients. The anticipated fourth development phase will be performed for psychometric validation; however, we already explored the internal consistency of the hypothesised scales and found the results to be very good. Hence, the new QLQ-AA/PNH with 54 items can be used in trials and clinical studies from now on, according to EORTC strategy even if the scoring algorithm at this point is preliminary and the QLQ-AA/PNH might change slightly after phase IV. This is important, as there are no other disease-specific instruments available for AA/PNH patients right now.
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Leyden J, Pavlakis N, Chan D, Michael M, Clarke S, Khasraw M, Price T. Patient-reported experience of the impact and burden of neuroendocrine tumors: Oceania patient results from a large global survey. Asia Pac J Clin Oncol 2017; 14:256-263. [DOI: 10.1111/ajco.12785] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 07/25/2017] [Indexed: 12/14/2022]
Affiliation(s)
- John Leyden
- The Unicorn Foundation; Mosman NSW Australia
| | - Nick Pavlakis
- Department of Medical Oncology; Royal North Shore Hospital; St Leonards NSW Australia
| | - David Chan
- Department of Medical Oncology; Royal North Shore Hospital; St Leonards NSW Australia
| | | | - Stephen Clarke
- Department of Medical Oncology; Royal North Shore Hospital; St Leonards NSW Australia
| | - Mustafa Khasraw
- Department of Medical Oncology; Royal North Shore Hospital; St Leonards NSW Australia
| | - Timothy Price
- Queen Elizabeth Hospital and University of Adelaide; Adelaide SA Australia
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Patient-Reported Experience of Diagnosis, Management, and Burden of Neuroendocrine Tumors: Results From a Large Patient Survey in the United States. Pancreas 2017; 46:639-647. [PMID: 28328615 PMCID: PMC5404397 DOI: 10.1097/mpa.0000000000000818] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES The aim of this survey was to examine the experience of patients with neuroendocrine tumors (NETs) to raise awareness of the NET-related burden and identify unmet needs. Here, we report data from patients in the United States. METHODS Patients with NETs participated in a 25-minute anonymous survey, conducted primarily online from February to May 2014. Survey questions captured information on sociodemographics, clinical characteristics, NET diagnostic experience, disease impact/management, interaction with medical teams, and NETs knowledge/awareness. RESULTS Of 1928 patients who participated globally, the largest percentage was from the United States (39%). Approximately 50% of US patients reported being diagnosed with other conditions before receiving their NET diagnosis, which for 34% took 5 years or more. Patients experienced many symptoms on a daily basis as a result of NETs, which had a substantial negative impact on their work and daily lives. Numerous improvements were suggested by patients, including better access to NET-specific treatments and medical teams/centers and better education for the management of disease-related and treatment-related symptoms. CONCLUSIONS This survey demonstrated the significant burden of NETs on patients' lives and identified key areas for improvement in diagnosis and long-term management, including better access to NET-specific treatments and specialist medical teams/centers.
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Lowry PA, Freeman ML, Russell JS. Nursing Management of Advanced Merkel Cell Carcinoma. Oncol Nurs Forum 2016; 43:680-683. [PMID: 27768129 DOI: 10.1188/16.onf.680-683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Merkel cell carcinoma (MCC) is a rare and lethal skin cancer with few known treatment options. Management of this disease is challenging, and oncology nurses must understand the medical, physical, and psychosocial burden that MCC places on the patient and family caregivers. Patients must navigate a complex medical and insurance network that often fails to support patients with rare cancers. Nurses must advocate for these patients to ensure quality comprehensive cancer care.
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Takeuchi T, Muraoka K, Yamada M, Nishio Y, Hozumi I. Living with idiopathic basal ganglia calcification 3: a qualitative study describing the lives and illness of people diagnosed with a rare neurological disease. SPRINGERPLUS 2016; 5:1713. [PMID: 27777849 PMCID: PMC5050183 DOI: 10.1186/s40064-016-3390-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 09/26/2016] [Indexed: 01/30/2023]
Abstract
PURPOSE Idiopathic basal ganglia calcification (IBGC) is a rare, intractable disease with unknown etiology. IBGC3 is a familial genetic disease defined by genetic mutations in the major causative gene (SLC20A2). People with IBGC3 experience distress from the uncommon nature of their illness and uncertainty about treatment and prognoses. The present study aimed to describe the lives and illness of people with IBGC3. METHODS Participants were recruited from patients aged 20 years or older enrolled in a genetic study, who were diagnosed with IBGC3 and wanted to share their experiences. In-depth semi-structured interviews were conducted with six participants. Interviews were conducted between December 2012 and February 2014, and were recorded and transcribed verbatim. Qualitative data analysis was performed to identify categories and subcategories. Efforts were made to ensure the credibility, transferability, dependability, conformability, and validity of the data. RESULTS Six thematic categories, 17 subcategories, and 143 codes emerged. The six categories were: (1) Frustration and anxiety with progression of symptoms without a diagnosis; (2) Confusion about diagnosis with an unfamiliar disease; (3) Emotional distress caused by a genetic disease; (4) Passive attitude toward life, being extra careful; (5) Taking charge of life, becoming active and engaged; and (6) Requests for healthcare. CONCLUSIONS The qualitative data analysis indicated a need for genetic counseling, access to disease information, establishment of peer and family support systems, mental health services, and improvement in early intervention and treatment for the disease.
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Affiliation(s)
- Tomiko Takeuchi
- Department of Gerontological Nursing, Toyama University, Toyama, Japan
| | - Koko Muraoka
- Department of Adult Health Nursing, Toho University, Tokyo, Japan
| | - Megumi Yamada
- Department of Neurology and Geriatrics, Gifu University, Gifu, Japan
| | - Yuri Nishio
- Laboratory of English Studies, Gifu Pharmaceutical University, Gifu, Japan
| | - Isao Hozumi
- Laboratory of Medical Therapeutics and Molecular Therapeutics, Gifu Pharmaceutical University, Gifu, Japan
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Involvement of patients with lung and gynecological cancer and their relatives in psychosocial cancer rehabilitation: a narrative review. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2016; 8:127-43. [PMID: 25142155 DOI: 10.1007/s40271-014-0076-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Getting cancer is stressful for most patients and their relatives, and research has shown that psychosocial support is needed. Still, cancer care fails to appropriately address psychosocial problems associated with cancer. Research on this topic is often seen from the perspective of either the patient or the relative, even though it is suggested that psychosocial support is beneficial for the patient and the relative as a pair. Furthermore, research on the need for psychosocial support rarely involves patients with gynecological and lung cancer and their relatives, even though they often suffer from isolation and stigmatization. The aim of this review was therefore to summarize knowledge about psychosocial support with regard to individual needs, involvement of significant others, and providers of psychosocial support focusing on this specific population. METHOD A narrative review procedure was chosen. This method is a specific kind of review, which summarizes, explains, and interprets evidence on a selected topic. The review process was structured according to typical scholarly articles with attention to the search and review process. RESULTS A total of 16 studies were included in the review. The studies were divided into two main categories: (1) studies focusing on needs for psychosocial support; and (2) studies focusing on interventions. The needs studies were analyzed, and three themes emerged: the needs of the patient and the significant other across the cancer trajectory; the needs of the significant other as a carer; and needs and ongoing and tailored support. The intervention studies were directed toward the patient and the relative, the patient, or the relative. Five interventions comprising various forms of support that were purely supportive and were carried out by healthcare professionals were identified. CONCLUSION There were overlaps between the needs of the patient and the relative, but there were also distinctive characteristics of the needs in the two groups. The needs varied during the cancer trajectory, and we therefore recommend that support be offered continuously. It was also evident that the relatives should be involved in the patients' care and that the involvement was beneficial for both the patient and the relative.
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Singh S, Granberg D, Wolin E, Warner R, Sissons M, Kolarova T, Goldstein G, Pavel M, Öberg K, Leyden J. Patient-Reported Burden of a Neuroendocrine Tumor (NET) Diagnosis: Results From the First Global Survey of Patients With NETs. J Glob Oncol 2016; 3:43-53. [PMID: 28717741 PMCID: PMC5493232 DOI: 10.1200/jgo.2015.002980] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Purpose Despite the considerable impact of neuroendocrine tumors (NETs) on patients’ daily lives, the journey of the patient with a NET has rarely been documented, with published data to date being limited to small qualitative studies. NETs are heterogeneous malignancies with nonspecific symptomology, leading to extensive health care use and diagnostic delays that affect survival. A large, international patient survey was conducted to increase understanding of the experience of the patient with a NET and identify unmet needs, with the aim of improving disease awareness and care worldwide. Methods An anonymous, self-reported survey was conducted (online or on paper) from February to May 2014, recruiting patients with NETs from > 12 countries as a collaboration between the International Neuroendocrine Cancer Alliance and Novartis Pharmaceuticals. Survey questions captured information on sociodemographics, clinical characteristics, NET diagnostic experience, disease impact/management, interaction with medical teams, NET knowledge/awareness, and sources of information. This article reports the most relevant findings on patient experience with NETs and the impact of NETs on health care system resources. Results A total of 1,928 patients with NETs participated. A NET diagnosis had a substantially negative impact on patients’ personal and work lives. Patients reported delayed diagnosis and extensive NET-related health care resource use. Patients desired improvement in many aspects of NET care, including availability of a wider range of NET-specific treatment options, better access to NET experts or specialist centers, and a more knowledgeable, better-coordinated/-aligned NET medical team. Conclusion This global patient-reported survey demonstrates the considerable burden of NETs with regard to symptoms, work and daily life, and health care resource use, and highlights considerable unmet needs. Further intervention is required to improve the patient experience among those with NETs.
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Affiliation(s)
- Simron Singh
- , University of Toronto, Toronto, Ontario, Canada; and , Uppsala University Hospital, Uppsala, Sweden; , Montefiore Einstein Center for Cancer Care, Bronx, NY; , Mount Sinai School of Medicine, New York, NY; , NET Patient Foundation, Hockley Heath, United Kingdom; , APOZ & Friends, Sofia, Bulgaria; , The Carcinoid Cancer Foundation, Inc., White Plains, NY; , Charité Universitätsmedizin Berlin, Berlin, Germany; and , The Unicorn Foundation, Mosman, New South Wales, Australia
| | - Dan Granberg
- , University of Toronto, Toronto, Ontario, Canada; and , Uppsala University Hospital, Uppsala, Sweden; , Montefiore Einstein Center for Cancer Care, Bronx, NY; , Mount Sinai School of Medicine, New York, NY; , NET Patient Foundation, Hockley Heath, United Kingdom; , APOZ & Friends, Sofia, Bulgaria; , The Carcinoid Cancer Foundation, Inc., White Plains, NY; , Charité Universitätsmedizin Berlin, Berlin, Germany; and , The Unicorn Foundation, Mosman, New South Wales, Australia
| | - Edward Wolin
- , University of Toronto, Toronto, Ontario, Canada; and , Uppsala University Hospital, Uppsala, Sweden; , Montefiore Einstein Center for Cancer Care, Bronx, NY; , Mount Sinai School of Medicine, New York, NY; , NET Patient Foundation, Hockley Heath, United Kingdom; , APOZ & Friends, Sofia, Bulgaria; , The Carcinoid Cancer Foundation, Inc., White Plains, NY; , Charité Universitätsmedizin Berlin, Berlin, Germany; and , The Unicorn Foundation, Mosman, New South Wales, Australia
| | - Richard Warner
- , University of Toronto, Toronto, Ontario, Canada; and , Uppsala University Hospital, Uppsala, Sweden; , Montefiore Einstein Center for Cancer Care, Bronx, NY; , Mount Sinai School of Medicine, New York, NY; , NET Patient Foundation, Hockley Heath, United Kingdom; , APOZ & Friends, Sofia, Bulgaria; , The Carcinoid Cancer Foundation, Inc., White Plains, NY; , Charité Universitätsmedizin Berlin, Berlin, Germany; and , The Unicorn Foundation, Mosman, New South Wales, Australia
| | - Maia Sissons
- , University of Toronto, Toronto, Ontario, Canada; and , Uppsala University Hospital, Uppsala, Sweden; , Montefiore Einstein Center for Cancer Care, Bronx, NY; , Mount Sinai School of Medicine, New York, NY; , NET Patient Foundation, Hockley Heath, United Kingdom; , APOZ & Friends, Sofia, Bulgaria; , The Carcinoid Cancer Foundation, Inc., White Plains, NY; , Charité Universitätsmedizin Berlin, Berlin, Germany; and , The Unicorn Foundation, Mosman, New South Wales, Australia
| | - Teodora Kolarova
- , University of Toronto, Toronto, Ontario, Canada; and , Uppsala University Hospital, Uppsala, Sweden; , Montefiore Einstein Center for Cancer Care, Bronx, NY; , Mount Sinai School of Medicine, New York, NY; , NET Patient Foundation, Hockley Heath, United Kingdom; , APOZ & Friends, Sofia, Bulgaria; , The Carcinoid Cancer Foundation, Inc., White Plains, NY; , Charité Universitätsmedizin Berlin, Berlin, Germany; and , The Unicorn Foundation, Mosman, New South Wales, Australia
| | - Grace Goldstein
- , University of Toronto, Toronto, Ontario, Canada; and , Uppsala University Hospital, Uppsala, Sweden; , Montefiore Einstein Center for Cancer Care, Bronx, NY; , Mount Sinai School of Medicine, New York, NY; , NET Patient Foundation, Hockley Heath, United Kingdom; , APOZ & Friends, Sofia, Bulgaria; , The Carcinoid Cancer Foundation, Inc., White Plains, NY; , Charité Universitätsmedizin Berlin, Berlin, Germany; and , The Unicorn Foundation, Mosman, New South Wales, Australia
| | - Marianne Pavel
- , University of Toronto, Toronto, Ontario, Canada; and , Uppsala University Hospital, Uppsala, Sweden; , Montefiore Einstein Center for Cancer Care, Bronx, NY; , Mount Sinai School of Medicine, New York, NY; , NET Patient Foundation, Hockley Heath, United Kingdom; , APOZ & Friends, Sofia, Bulgaria; , The Carcinoid Cancer Foundation, Inc., White Plains, NY; , Charité Universitätsmedizin Berlin, Berlin, Germany; and , The Unicorn Foundation, Mosman, New South Wales, Australia
| | - Kjell Öberg
- , University of Toronto, Toronto, Ontario, Canada; and , Uppsala University Hospital, Uppsala, Sweden; , Montefiore Einstein Center for Cancer Care, Bronx, NY; , Mount Sinai School of Medicine, New York, NY; , NET Patient Foundation, Hockley Heath, United Kingdom; , APOZ & Friends, Sofia, Bulgaria; , The Carcinoid Cancer Foundation, Inc., White Plains, NY; , Charité Universitätsmedizin Berlin, Berlin, Germany; and , The Unicorn Foundation, Mosman, New South Wales, Australia
| | - John Leyden
- , University of Toronto, Toronto, Ontario, Canada; and , Uppsala University Hospital, Uppsala, Sweden; , Montefiore Einstein Center for Cancer Care, Bronx, NY; , Mount Sinai School of Medicine, New York, NY; , NET Patient Foundation, Hockley Heath, United Kingdom; , APOZ & Friends, Sofia, Bulgaria; , The Carcinoid Cancer Foundation, Inc., White Plains, NY; , Charité Universitätsmedizin Berlin, Berlin, Germany; and , The Unicorn Foundation, Mosman, New South Wales, Australia
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Loggers ET, Prigerson HG. The End-of-Life Experience of Patients With Rare Cancers and Their Caregivers. Rare Tumors 2014; 6:5281. [PMID: 24711910 PMCID: PMC3977173 DOI: 10.4081/rt.2014.5281] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Accepted: 02/06/2014] [Indexed: 02/03/2023] Open
Abstract
Little is known about the end-of-life (EOL) experience of patients with rare cancers (PRC) or their caregivers. From September 2002 to August 2008, 618 stage IV cancer patients [195 PRC and 423 patients with common cancers (PCC)] and their caregivers participated in an interview-based cohort study. Patients were interviewed about EOL preferences, planning, medical care, and followed until death. Interviews with caregivers at baseline assessed caregiver mental and physical health; and postmortem, assessed EOL patient care. PRC were four times more likely than PCC to be receiving both radiation and chemotherapy at study entry (10.3% vs 3.3%, respectively, adjusted odds ratio 4.31, P=0.003). PRC's caregivers were more likely to report declining health (22.1% vs 15.7%, P=0.05) and marginally more likely to report using mental health services to cope than PCC's caregivers. PRC were as likely to acknowledge their illness was terminal, have EOL discussions, and participate in advance care planning as PCC. Future research should investigate terminal care for PRC and how providing care affects caregivers' physical and mental health.
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Affiliation(s)
- Elizabeth Trice Loggers
- Group Health Research Institute, Group Health Cooperative, Seattle, WA, USA
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Holly G. Prigerson
- Center for Psychosocial Epidemiology and Outcomes, Dana-Farber Cancer Institute, Boston, MA, USA
- Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA, USA
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15
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Feinberg Y, Law C, Singh S, Wright F. Patient experiences of having a neuroendocrine tumour: A qualitative study. Eur J Oncol Nurs 2013; 17:541-5. [DOI: 10.1016/j.ejon.2013.02.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Revised: 02/05/2013] [Accepted: 02/17/2013] [Indexed: 11/29/2022]
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Kent EE, Mitchell SA, Oakley-Girvan I, Arora NK. The importance of symptom surveillance during follow-up care of leukemia, bladder, and colorectal cancer survivors. Support Care Cancer 2013; 22:163-72. [PMID: 24018909 DOI: 10.1007/s00520-013-1961-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Accepted: 08/27/2013] [Indexed: 12/29/2022]
Abstract
PURPOSE We examined cancer survivors' experience of bothersome symptoms, association of symptom bother with health-related quality of life (HRQOL), survivors' perception of symptom care, and their symptom-related information needs. METHODS Using self-report survey measures, survivors of leukemia, bladder, or colorectal cancer who were 2-5 years post-diagnosis and received follow-up care in the past year (N = 623) provided information about the presence of bothersome symptoms, symptom-related information needs, adequacy of symptom-related care, and their physical and mental HRQOL. Multivariable statistical analyses were conducted to identify correlates of symptom bother, inadequate care, and symptom information needs and to examine the association between symptom bother and HRQOL. RESULTS Twenty-eight percent of the 606 respondents experienced symptom bother in the past year (46 % of leukemia, 24 % of bladder, and 26 % of colorectal cancer survivors). Younger survivors, those of Hispanic ethnicity, with low income, those with recurrent cancer, and chemotherapy recipients were more likely to report symptom bother (all p < 0.05). Symptom bother was associated with lower physical and mental HRQOL (p < 0.001). While 92 % of survivors with symptoms discussed them with their follow-up care physician, 52 % of these reported receiving inadequate symptom care. Survivors reporting inadequate symptom care were 2.5 times as likely to identify symptom information needs compared to those who received adequate care (p < 0.05). CONCLUSIONS One in four cancer survivors report symptoms 2-5 years post-diagnosis, and only half of these survivors receive adequate care to address those symptoms. Research that refines and tests symptom care interventions for this population is warranted.
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Affiliation(s)
- Erin E Kent
- Outcomes Research Branch, Applied Research Program, Division of Cancer Control and Population Science, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA,
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17
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EVANS J, ZIEBLAND S, PETTITT A. Incurable, invisible and inconclusive: watchful waiting for chronic lymphocytic leukaemia and implications for doctor-patient communication. Eur J Cancer Care (Engl) 2011; 21:67-77. [DOI: 10.1111/j.1365-2354.2011.01278.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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