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Andersen HH, Mikkelsen MK, Obarzanek CE, Paludan C, Nielsen D. Reasons for declining participation in an exercise-based trial among older women with breast cancer receiving systemic anti-cancer treatment - a qualitative interview study. Physiother Theory Pract 2024; 40:1568-1578. [PMID: 36892484 DOI: 10.1080/09593985.2023.2187675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 02/22/2023] [Accepted: 03/01/2023] [Indexed: 03/10/2023]
Abstract
BACKGROUND Breast cancer is the most frequently diagnosed cancer in the world. Exercise is widely recommended for patients with breast cancer during and after treatment. However, there is a lack of studies investigating barriers related to participation in real-world exercise-based trials for older patients with breast cancer. OBJECTIVE To explore reasons for declining participation in an exercise-based trial among older patients with breast cancer during (neo)adjuvant or palliative systemic treatment. METHODS A qualitative study using semi-structured interviews. Patients who declined participation in an exercise-based trial (N = 50) were invited to participate. Semi-structured interviews were conducted with 15 participants. Interviews were audio-recorded, transcribed verbatim and analyzed using thematic analysis. RESULTS Identified main themes: 1) Lack of energy and resources, including two subthemes: 1a) Overwhelmed both mentally and physically, and 1b) The program is too comprehensive; 2) Uncertainty about reactions to chemotherapy; 3) The hospital is not the optimal exercise setting, including two subthemes: 3a) Transportation and time consumption, and 3b) No desire to spend additional time at the hospital; and 4) Staying active in my own way, including two subthemes: 4a) Motivation to exercise, and 4b) Preferences for exercise activities. CONCLUSION Many barriers were identified, including time of recruitment, information overload, symptoms and side effects, and the hospital as the exercise setting due to practical challenges and negative feelings. Participants were motivated to exercise from knowledge about the benefits of exercising. Furthermore, they preferred activities that they were already involved in or had experience with.
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Affiliation(s)
- Høgni Hammershaimb Andersen
- Department of Oncology, Copenhagen University Hospital, Herlev and Gentofte Hospital, Denmark
- Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital, Herlev and Gentofte Hospital, Denmark
| | - Marta Kramer Mikkelsen
- Department of Oncology, Copenhagen University Hospital, Herlev and Gentofte Hospital, Denmark
| | | | - Camilla Paludan
- Institute for Sports and Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Dorte Nielsen
- Department of Oncology, Copenhagen University Hospital, Herlev and Gentofte Hospital, Denmark
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Wang HY, Hang Kwok SW, Liu XL, Wang T, Bressington D, Shen Y, Zhang Q, Huang HQ, Tan JY. Quality of life patient/cancer survivor version in Chinese cancer survivors: A validation study. Asia Pac J Oncol Nurs 2023; 10:100255. [PMID: 37519402 PMCID: PMC10372171 DOI: 10.1016/j.apjon.2023.100255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 06/02/2023] [Indexed: 08/01/2023] Open
Abstract
Objective To validate the Chinese version of the Quality of Life (QoL) Patient/Cancer Survivor Version (QOLCSV-C) for measuring QoL in Chinese cancer survivors. Methods The study followed a seven-step research practice guideline for cross-cultural research instrument validation study including translation, adaptation, and psychometric assessment. A forward- and backward-translation procedure was approached, followed by cultural adaptation and acceptability assessment. For its psychometric properties, its concurrent validity with the Functional Assessment of Cancer Therapy-General (FACT-G) was examined with correlation analysis. The internal consistency (Cronbach's alpha) and item-total and item-subtotal correlations of the QOLCSV-C were obtained. Factor analyses were conducted. Floor and ceiling effects and the discriminant performance of the selected variables on QOLCSV-C score were also examined. Results The QOLCSV-C was translated from the 41-item QOLCSV with four domains: psychological, physical, spiritual and social well-being. The content validity was excellent (CVI = 1.00). Time spent to complete the QOLCSV-C was about 10 min. The QOLCSV-C was found easy to use, appropriate in length, and reflective of their QoL. The strong correlation between QOLCSV-C and FACT-G indicates a satisfactory concurrent validity (Spearman's rho = 0.765, P < 0.001, n = 205). The overall internal consistency of the QOLCSV-C (Cronbach's alpha = 0.888) and the split-half reliability (Spearman-Brown r = 0.918) were excellent. Most of the items show moderate to strong item-total correlation. The exploratory factor analysis revealed a four-factor solution, and confirmatory factor analysis has a satisfactory model fit with indicative items. None of the total scores of QOLCSV-C reveal the floor or ceiling effect. For discriminant performance, variables demonstrating significant between-group differences include sleep quality, pain, fatigue, nausea, physical health, and financial burden. Conclusions The QOLCSV-C is a reliable and valid instrument for measuring the QoL in Chinese cancer survivors. Future studies can explore the factor structure, gender universal or specific items, and significant predictors of QoL of cancer survivors in different cultures.
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Affiliation(s)
- Hai-Ying Wang
- School of Nursing (Brisbane Centre), Faculty of Health, Charles Darwin University, Brisbane, QLD, Australia
| | - Stephen Wai Hang Kwok
- School of Nursing, Faculty of Health, Charles Darwin University, Ellengowan Drive, Casuarina, NT, Australia
| | - Xian-Liang Liu
- School of Nursing (Brisbane Centre), Faculty of Health, Charles Darwin University, Brisbane, QLD, Australia
| | - Tao Wang
- School of Nursing (Brisbane Centre), Faculty of Health, Charles Darwin University, Brisbane, QLD, Australia
| | - Daniel Bressington
- School of Nursing, Faculty of Health, Charles Darwin University, Ellengowan Drive, Casuarina, NT, Australia
| | - Yushan Shen
- Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Qing Zhang
- Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Hou-Qiang Huang
- Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Jing-Yu Tan
- School of Nursing, Faculty of Health, Charles Darwin University, Ellengowan Drive, Casuarina, NT, Australia
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De La Torre S, Spruijt-Metz D, Farias AJ. Survivors' health competence mediates the association between wearable activity tracker use and self-rated health: HINTS analysis. J Cancer Surviv 2022; 16:1268-1278. [PMID: 35001258 DOI: 10.1007/s11764-021-01112-9] [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: 06/08/2021] [Accepted: 09/08/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE Physical activity (PA) plays an important role in achieving positive self-rated health (SRH) among cancer survivors. Wearable activity trackers (WATs) can be effective for self-monitoring and tracking PA. Studies have shown that survivors who use WATs are more likely to engage in more PA. However, few studies have examined the direct and indirect associations between WAT use, PA, and SRH mediated by constructs derived from self-determination theory, perceived health competence, and perceived social relatedness for health. METHODS Data on survivors were analyzed from National Cancer Institute's Health Information National Trend Survey (HINTS) Cycle 1-3 (n = 1,421). Path analysis was used to test the total, direct, and indirect associations. RESULTS Previous WAT use was directly associated with PA level (standardized beta (SB): 0.07, p = 0.005) and indirectly associated with SRH (SB: 0.04, p = 0.005), mediated by perceived health competence and PA. Perceived health competence was directly associated with SRH (SB: 0.51, p < .0001) and PA (SB: 0.20, p < .0001), and perceived social relatedness for health was not significantly associated with PA (SB: 0.005, p = 0.8) or SRH (SB: 0.02, p = 0.31). CONCLUSIONS Overall, these results indicate that perceived health competence significantly mediated the associations between WAT use and SRH; however, WAT use was only directly associated with PA and was not mediated. IMPLICATIONS FOR CANCER SURVIVORS These findings support the notion that WATs may play a role in addressing SRH among cancer survivors through fostering perceived health competence by providing real-time feedback, goal setting, and opportunities for self-monitoring.
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Affiliation(s)
- Steven De La Torre
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Donna Spruijt-Metz
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.,Dornsife Center for Economic and Social Research, Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Albert J Farias
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. .,Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
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van der Kruk SR, Butow P, Mesters I, Boyle T, Olver I, White K, Sabesan S, Zielinski R, Chan BA, Spronk K, Grimison P, Underhill C, Kirsten L, Gunn KM. Psychosocial well-being and supportive care needs of cancer patients and survivors living in rural or regional areas: a systematic review from 2010 to 2021. Support Care Cancer 2021; 30:1021-1064. [PMID: 34392413 PMCID: PMC8364415 DOI: 10.1007/s00520-021-06440-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 07/13/2021] [Indexed: 01/16/2023]
Abstract
Purpose To summarise what is currently known about the psychosocial morbidity, experiences, and needs of people with cancer and their informal caregivers, who live in rural or regional areas of developed countries. Methods Eligible studies dating from August 2010 until May 2021 were identified through several online databases, including MEDLINE, EMBASE, PsychINFO, and RURAL (Rural and Remote Health Database). Results were reported according to the PRISMA guidelines and the protocol was registered on PROSPERO (CRD42020171764). Results Sixty-five studies were included in this review, including 20 qualitative studies, 41 quantitative studies, and 4 mixed methods studies. Qualitative research demonstrated that many unique psychosocial needs of rural people remain unmet, particularly relating to finances, travel, and accessing care. However, most (9/19) quantitative studies that compared rural and urban groups reported no significant differences in psychosocial needs, morbidity, or quality of life (QOL). Five quantitative studies reported poorer psychosocial outcomes (social and emotional functioning) in urban cancer survivors, while three highlighted poorer outcomes (physical functioning, role functioning, and self-reported mental health outcomes) in the rural group. Conclusion Recent research shows that rural people affected by cancer have unique unmet psychosocial needs relating to rurality. However, there was little evidence that rural cancer survivors report greater unmet needs than their urban counterparts. This contrasts to the findings from a 2011 systematic review that found rural survivors consistently reported worse psychosocial outcomes. More population-based research is needed to establish whether uniquely rural unmet needs are due to general or cancer-specific factors.
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Affiliation(s)
- Shannen R. van der Kruk
- Department of Epidemiology, Maastricht University, Maastricht, The Netherlands
- Cancer Research Institute, University of South Australia, Adelaide, SA Australia
- Australian Centre for Precision Health, School of Health Sciences, University of South Australia, Adelaide, SA Australia
| | - Phyllis Butow
- Centre for Medical Psychology and Evidence-Based Decision-Making, The University of Sydney, Sydney, NSW Australia
| | - Ilse Mesters
- Department of Epidemiology, Maastricht University, Maastricht, The Netherlands
| | - Terry Boyle
- Australian Centre for Precision Health, School of Health Sciences, University of South Australia, Adelaide, SA Australia
| | - Ian Olver
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA Australia
| | - Kate White
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW Australia
| | - Sabe Sabesan
- College of Medicine and Dentistry (CMD), James Cook University, QLD, Townsville, Australia
| | - Rob Zielinski
- Central West Cancer Care Centre, Orange Base Hospital, Orange, NSW Australia
- Western Sydney University, Sydney, NSW Australia
| | - Bryan A. Chan
- School of Medicine, Griffith University, Brisbane, QLD Australia
| | - Kristiaan Spronk
- Cancer Research Institute, University of South Australia, Adelaide, SA Australia
- Department of Rural Health, Allied Health and Human Performance, University of South Australia, Adelaide, SA Australia
| | - Peter Grimison
- Department of Medical Oncology, Chris O’Brien Lifehouse, Sydney, NSW Australia
| | | | | | - Kate M. Gunn
- Cancer Research Institute, University of South Australia, Adelaide, SA Australia
- Department of Rural Health, Allied Health and Human Performance, University of South Australia, Adelaide, SA Australia
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"Doing What Only I Can Do": Experiences From Participating in a Multimodal Exercise-Based Intervention in Older Patients With Advanced Cancer-A Qualitative Explorative Study. Cancer Nurs 2021; 45:E514-E523. [PMID: 34294645 PMCID: PMC8849132 DOI: 10.1097/ncc.0000000000000987] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Background Sparse evidence exists regarding the feasibility and patients’ experiences of exercise programs among older cancer populations. Objective The aim of this study was to explore the experiences of older patients with advanced cancer who participated in a 12-week supervised and multimodal exercise program in a hospital setting. Methods Individual interviews were conducted with 18 participants (≥65 years) with advanced cancer who completed the intervention program regardless of compliance rate. In addition, written evaluation questionnaires were collected. Data were analyzed using thematic analysis. Results Three main themes were identified: (1) Motivated to strengthen body and mind, with the subthemes “Doing what only I can do” and “Reaching goals with support from healthcare professionals and peers”; (2) Exercise as an integrated part of the treatment course; and (3) Overcoming undeniable physical limitations. Conclusions The participants experienced several benefits from participation, including physical improvements, increased energy, reduction of symptoms, and improved social engagement. Goal setting, being positively pushed and cheered on, and integration of fun games increased motivation. In contrast, being pushed beyond physical limitations and experiencing severe symptoms were experienced as barriers toward exercising. Adherence to the exercise program was facilitated by coordinating a tailored program with medical appointments and receiving comprehensive support and guidance. Implications for Practice Multimodal exercise programs seem to be beneficial for older patients with advanced cancer and should be coordinated with oncological treatment in combination with targeted support and advice on symptom management.
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Fitch MI, Lockwood G, Nicoll I. Physical, emotional, and practical concerns, help-seeking and unmet needs of rural and urban dwelling adult cancer survivors. Eur J Oncol Nurs 2021; 53:101976. [PMID: 34111722 DOI: 10.1016/j.ejon.2021.101976] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 04/19/2021] [Accepted: 05/03/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE This study explores the influence of residency location on the experiences of cancer survivors. The influence of where individuals live during cancer screening, diagnosis, and treatment has been described in various countries. However, understanding the context of residency on experiences during survivorship has received less attention. METHODS A survey was designed to assess experiences of cancer survivors transitioning to follow-up care. Descriptive statistics were used to contrast physical, emotional, and practical concerns, help-seeking, and unmet needs of rural and urban dwelling respondents. Difference in proportions of greater than 5% were considered clinically meaningful. RESULTS In total, 13,319 respondents completed the survey of which 4646 met the criteria for rural dwelling (e.g., living in villages or towns with 10,000 or less residents or on an acreage, ranch, or farm). Proportions of respondents in rural and urban groups were similar in terms of level of concerns. Differences were observed for help seeking regarding return to work and for difficulty in obtaining help regarding taking care of children and other family members, changes in relationships with family, friends and co-workers, and getting to and from appointments. Unmet needs existed across all domains and were similar in both groups. A larger proportion of rural dwelling respondents experienced unmet needs regarding return to work. CONCLUSIONS [implications]: High proportions of cancer survivors experienced concerns following cancer treatment. However, rural dwelling survivors were more challenged in obtaining help for selected concerns. Implications exist for development of community-based support services in rural settings.
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Affiliation(s)
- Margaret I Fitch
- Bloomberg Faculty of Nursing, University of Toronto, 207 Chisholm Ave., Toronto, Ontario, M4C 4V9, Canada.
| | - Gina Lockwood
- Biostatistician Consultant (Independent), Toronto, Canada.
| | - Irene Nicoll
- Health Care Consultant (Independent), Toronto, Canada.
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Mikkelsen MK, Nielsen DL, Vinther A, Lund CM, Jarden M. Attitudes towards physical activity and exercise in older patients with advanced cancer during oncological treatment - A qualitative interview study. Eur J Oncol Nurs 2019; 41:16-23. [PMID: 31358249 DOI: 10.1016/j.ejon.2019.04.005] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 04/30/2019] [Accepted: 04/30/2019] [Indexed: 01/29/2023]
Abstract
PURPOSE Older patients with cancer are underrepresented in exercise-based trials. To engage older patients in physical activity (PA), it is necessary to consider age-related decline in health, comorbidities and practicalities. The study aim was to explore attitudes towards PA and exercise among older patients with cancer to inform future exercise-based interventions. METHOD Individual interviews (N = 23) were conducted in patients ≥ 65 years with advanced lung, biliary tract and pancreatic cancer receiving palliative oncological treatment. Patients were recruited with a purposive sampling strategy. A semi-structured interview guide focusing on attitudes towards PA and exercise, including barriers, facilitators and motivators, was used. Data on the informants' medical history, demographics and PA level was collected. RESULTS Identified themes were: 1) a general positive perception of physical activity is expressed 2) comorbidities and external circumstances prevent physical activity, 3) fatigue overshadows life, 4) social support is key to short and long-term motivation, 5) fixed conditions keep one focused, 6) familiarity raises confidence and motivation. CONCLUSIONS Even though perceptions of PA were positive among older patients with cancer, most struggled to stay physically active during oncological treatment. Several factors related to cancer and aging were identified as barriers; most profoundly was the overwhelming feeling of fatigue. Improving physical and mental well-being, fixed conditions (e.g. group-based exercise and supervision) and social support were identified as motivators and facilitators. Preferences for PA varied, but activities that were familiar increased motivation. Exercise programs for older patients with cancer must be adjustable to each patient's limitations, needs and personal resources.
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Affiliation(s)
- Marta Kramer Mikkelsen
- Department of Oncology and Hematology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark; Department of Oncology, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev Ringvej 75, 2730, Herlev, Denmark.
| | - Dorte Lisbet Nielsen
- Department of Oncology, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev Ringvej 75, 2730, Herlev, Denmark.
| | - Anders Vinther
- Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev Ringvej 75, 2730, Herlev, Denmark; QD-Research Unit, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev Ringvej 75, 2730, Herlev, Denmark.
| | - Cecilia Margareta Lund
- Department of Medicine, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev Ringvej 75, 2730, Herlev, Denmark.
| | - Mary Jarden
- Department of Oncology and Hematology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark.
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Lemanska A, Poole K, Aning JJ, Griffin BA, Manders R, Saxton JM, Wainwright J, Faithfull S. The Siconolfi step test: a valid and reliable assessment of cardiopulmonary fitness in older men with prostate cancer. Eur Rev Aging Phys Act 2019; 16:1. [PMID: 30651889 PMCID: PMC6327593 DOI: 10.1186/s11556-018-0207-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 12/04/2018] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Assessing fitness and promoting regular physical activity can improve health outcomes and early recovery in prostate cancer. This is however, underutilised in clinical practice. The cardiopulmonary exercise test (CPET) is increasingly being used pre-treatment to measure aerobic capacity and peak oxygen consumption (VO2peak - a gold standard in cardiopulmonary fitness assessment). However, CPET requires expensive equipment and may not always be appropriate. The Siconolfi step test (SST) is simpler and cheaper, and could provide an alternative.The aim of this study was to evaluate the validity and reliability of SST for predicting cardiopulmonary fitness in men with prostate cancer. Men were recruited to this two-centre study (Surrey and Newcastle, United Kingdom) after treatment for locally advanced prostate cancer. They had one or more of three risk factors: elevated blood pressure, overweight (BMI > 25), or androgen deprivation therapy (ADT). Cardiopulmonary fitness was measured using SST and cycle ergometry CPET, at two visits three months apart. The validity of SST was assessed by comparing it to CPET. The VO2peak predicted from SST was compared to the VO2peak directly measured with CPET. The reliability of SST was assessed by comparing repeated measures. Bland-Altman analysis was used to derive limits of agreement in validity and reliability analysis. RESULTS Sixty-six men provided data for both SST and CPET. These data were used for validity analysis. 56 men provided SST data on both visits. These data were used for reliability analysis. SST provided valid prediction of the cardiopulmonary fitness in men > 60 years old. The average difference between CPET and SST was 0.64 ml/kg/min with non-significant positive bias towards CPET (P = 0.217). Bland-Altman 95% limits of agreement of SST with CPET were ± 7.62 ml/kg/min. SST was reliable across the whole age range. Predicted VO2peak was on average 0.53 ml/kg/min higher at Visit 2 than at Visit 1 (P = 0.181). Bland-Altman 95% limits of agreement between repeated SST measures were ± 5.84 ml/kg/min. CONCLUSIONS SST provides a valid and reliable alternative to CPET for the assessment of cardiopulmonary fitness in older men with prostate cancer. Caution is advised when assessing men 60 years old or younger because the VO2peak predicted with SST was significantly lower than that measured with CPET.
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Affiliation(s)
- Agnieszka Lemanska
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Karen Poole
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Jonathan J. Aning
- Department of Urology, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
- Bristol Urological Institute, Southmead Hospital, Westbury-on-trym, Bristol, UK
| | - Bruce A. Griffin
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Ralph Manders
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - John M. Saxton
- Department of Sport, Exercise & Rehabilitation, Northumbria University, Newcastle Upon Tyne, UK
| | - Joe Wainwright
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Sara Faithfull
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
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Wu HJ, Tai CJ, Tai CJ, Chien LY. Symptom severity, symptom interference and use of complementary and alternative medicine among survivors of colorectal and breast cancer after curative treatment in Taiwan. Eur J Cancer Care (Engl) 2018; 28:e12925. [DOI: 10.1111/ecc.12925] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 03/21/2018] [Accepted: 08/22/2018] [Indexed: 01/10/2023]
Affiliation(s)
- Hsiu-Ju Wu
- Department of Oncology; Sijhih Cathay General Hospital; Taipei Taiwan
| | - Chen-Jei Tai
- Department of Obstetrics and Gynecology, School of Medicine, College of Medicine; Taipei Medical University; Taipei Taiwan
- Department of Traditional Chinese Medicine; Taipei Medical University Hospital; Taipei Taiwan
| | - Cheng-Jeng Tai
- Department of Internal Medicine, School of Medicine, College of Medicine; Taipei Medical University; Taipei Taiwan
- Division of Hematology and Oncology, Department of Internal Medicine; Taipei Medical University Hospital; Taipei Taiwan
| | - Li-Yin Chien
- Institute of Community Health Care; National Yang-Ming University; Taipei Taiwan
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Mikkelsen MK, Lund CM, Vinther A, Tolver A, Ragle AM, Johansen JS, Chen I, Engell-Noerregaard L, Larsen FO, Zerahn B, Nielsen DL, Jarden M. Engaging the older cancer patient; Patient Activation through Counseling, Exercise and Mobilization - Pancreatic, Biliary tract and Lung cancer (PACE-Mobil-PBL) - study protocol of a randomized controlled trial. BMC Cancer 2018; 18:934. [PMID: 30261853 PMCID: PMC6161425 DOI: 10.1186/s12885-018-4835-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 09/18/2018] [Indexed: 01/06/2023] Open
Abstract
Background Several intervention studies have demonstrated that exercise training has beneficial effects among cancer patients. However, older cancer patients are underrepresented in clinical trials, and only few exercise-based studies have focused specifically on older patients with cancer. In particular, research investigating the effects of exercise training among older patients with advanced cancer is lacking. The purpose of the current study is to investigate the effect of a 12-week multimodal and exercise-based intervention among older patients (≥65 years) with advanced pancreatic, biliary tract or lung cancer, who are treated with first-line palliative chemotherapy, immunotherapy or targeted therapy. Methods PACE-Mobil-PBL is a two-armed randomized controlled trial. Participants will be randomized 1:1 to an intervention group (N = 50) or a control group (N = 50). Participants in the intervention group will receive standard oncological treatment and a 12-week multimodal intervention, comprised of: (I) supervised exercise training, twice weekly in the hospital setting, (II) home-based walking with step counts and goal-setting, (III) supportive and motivational nurse-led counseling, and (IV) protein supplement after each supervised training session. Participants in the control group will receive standard oncological treatment. The primary outcome is physical function measured by the 30-s chair stand test. Secondary outcomes include measures of feasibility, activity level, physical capacity and strength, symptom burden, quality of life, toxicity to treatment, dose reductions, inflammatory biomarkers, body weight and composition, hospitalizations and survival. Assessments will be conducted at baseline, and after 6, 12 and 16 weeks. Discussion The current study is one of the first to investigate the effect of an exercise-based intervention specifically targeting older patients with advanced cancer. PACE-Mobil-PBL supports the development of health promoting guidelines for older patients with cancer, and the study results will provide new and valuable knowledge in this understudied field. Trial registration The study was prospectively registered at ClinicalTrials.gov on January 26, 2018 (ID: NCT03411200). Electronic supplementary material The online version of this article (10.1186/s12885-018-4835-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Marta Kramer Mikkelsen
- Department of Oncology and Hematology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark. .,Department of Oncology, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev Ringvej 75, 2730, Herlev, Denmark.
| | - Cecilia Margareta Lund
- Department of Oncology, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev Ringvej 75, 2730, Herlev, Denmark.,Department of Medicine, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev Ringvej 75, Herlev, 2730, Denmark
| | - Anders Vinther
- Department of Rehabilitation, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev Ringvej 75, 2730, Herlev, Denmark.,QD-Research Unit, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev Ringvej 75, 2730, Herlev, Denmark
| | - Anders Tolver
- Data Science Laboratory, Department of Mathematical Sciences, University of Copenhagen, 2100 Copenhagen Ø, Denmark
| | - Anne-Mette Ragle
- Department of Rehabilitation, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev Ringvej 75, 2730, Herlev, Denmark
| | - Julia Sidenius Johansen
- Department of Oncology, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev Ringvej 75, 2730, Herlev, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen N, Denmark.,Department of Medicine, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev Ringvej 75, Herlev, 2730, Denmark
| | - Inna Chen
- Department of Oncology, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev Ringvej 75, 2730, Herlev, Denmark
| | - Lotte Engell-Noerregaard
- Department of Oncology, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev Ringvej 75, 2730, Herlev, Denmark
| | - Finn Ole Larsen
- Department of Oncology, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev Ringvej 75, 2730, Herlev, Denmark
| | - Bo Zerahn
- Department of Clinical Physiology and Nuclear Medicine, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev Ringvej 75, 2730, Herlev, Denmark
| | - Dorte Lisbet Nielsen
- Department of Oncology, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev Ringvej 75, 2730, Herlev, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen N, Denmark
| | - Mary Jarden
- Department of Oncology and Hematology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark.,Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, 1014 Copenhagen K, Denmark
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Yoon H, Kim Y, Lim YO, Choi K. Quality of life of older adults with cancer in Korea. SOCIAL WORK IN HEALTH CARE 2018; 57:526-547. [PMID: 29723126 DOI: 10.1080/00981389.2018.1467355] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This study examines the quality of life (QoL) of older adults with cancer (N = 176), by comparing them with age- and gender-matched groups without cancer (N = 176), and investigates factors associated with their QoL. The results of Medical Outcome Study Short Form-36 (MOS SF-36) showed that the study group had significantly lower scores than the noncancer group on all eight scales and on the Physical Component Summary and the Mental Component Summary. Comparison with gender and age groups revealed some differences. Optimism and social support were positively related to QoL while comorbidity, cancer-related concerns, and financial worries were inversely related.
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Affiliation(s)
- Hyunsook Yoon
- a Department of Social Welfare , Hallym University , Chuncheon-si , Gangwon-do , Korea
| | - Yojin Kim
- a Department of Social Welfare , Hallym University , Chuncheon-si , Gangwon-do , Korea
| | - Yeon Ok Lim
- b Hallym University Institute of Aging , Chuncheon-si , Gangwon-do , Korea
| | - Kyoungwon Choi
- c Hallym Youth Welfare Center , Chuncheon-si , Gangwon-do , Korea
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12
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Guldhav KV, Jepsen R, Ytrehus S, Grov EK. Access to information and counselling - older cancer patients' self-report: a cross-sectional survey. BMC Nurs 2017; 16:18. [PMID: 28428732 PMCID: PMC5397690 DOI: 10.1186/s12912-017-0211-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 04/11/2017] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND An increasingly older population, improved diagnostics and treatment increase the number of older cancer survivors, thus more than 60% of those affected by cancer are over the age of 65. Symptom relief and the prevention of functional impairment are important tasks for home care nursing, considering that patients can live a long time with their cancer disease and related side effects. The aim of this study was to investigate the extent to which cancer patients over the age of 65 reported access to information and counselling from home care nursing services, including those offered by the cancer coordinator. METHODS A cross-sectional survey was used. The survey consisted of 174 cancer patients from two regions in Norway living at home (101 women; 66-92 years). The questionnaire contained questions of various sequences including information and advices given and data on access to and use of home health care services. The questions focused on the extent to which home health care services provided the following: 1) information about the disease and treatment, 2) information about consequences and complications of the cancer disease, 3) nutritional advice and 4) advice on physical activity. Demographic, clinical and organizational variables were used. SPSS program version 22 was employed to perform descriptive and inferential statistics including correlation and logistic regression analysis. For ethical reasons, patients who were dying, delirious or with presence of cognitive impairment (any kind of dementia) were excluded. RESULTS The results showed that a majority (67-77%) of the respondents reported low levels of information and counselling offered. Low levels represents in this study medium, small and very small degree (Likert scale). Women, those above 85 years of age and patients with a gynecological or hematological cancer diagnosis experienced less access to information and counselling. Respondents facing availability of a cancer coordinator reported significantly higher access to information about the disease and treatment (p = 0.03), nutritional advice (p = 0.04) and advice on physical activity (p = 0.04) compared to those who only had contact with a home health care nurse or home health care assistant. CONCLUSIONS The results indicated that the availability of a cancer coordinator facilitated personalized information and counselling for older cancer patients.
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Affiliation(s)
| | - Randi Jepsen
- Nykøbing Falster Hospital, Region Sjælland, Fjordvej 15, DK-4800 Nykøbing F., Denmark
- Faculty of Health Studies, Sogn og Fjordane University College, PO Box 523, 6803 Førde, Norway
| | - Siri Ytrehus
- Faculty of Health Studies, Sogn og Fjordane University College, PO Box 523, 6803 Førde, Norway
| | - Ellen Karine Grov
- Faculty of Health Studies, Sogn og Fjordane University College, PO Box 523, 6803 Førde, Norway
- Oslo and Akershus University College of Applied Sciences Faculty of Health, Institute of Nursing and Health Promotion, PO Box 4, St. Olavs plass, 0130 Oslo, Norway
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13
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The complex health profile of long-term cancer survivors: prevalence and predictors of comorbid conditions. J Cancer Surviv 2014; 9:239-51. [PMID: 25319681 DOI: 10.1007/s11764-014-0403-1] [Citation(s) in RCA: 156] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Accepted: 09/19/2014] [Indexed: 12/24/2022]
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14
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Nützel A, Dahlhaus A, Fuchs A, Gensichen J, König HH, Riedel-Heller S, Maier W, Schäfer I, Schön G, Weyerer S, Wiese B, Scherer M, van den Bussche H, Bickel H. Self-rated health in multimorbid older general practice patients: a cross-sectional study in Germany. BMC FAMILY PRACTICE 2014; 15:1. [PMID: 24387712 PMCID: PMC3923097 DOI: 10.1186/1471-2296-15-1] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Accepted: 12/17/2013] [Indexed: 11/17/2022]
Abstract
Background With increasing life expectancy the number of people affected by multimorbidity rises. Knowledge of factors associated with health-related quality of life in multimorbid people is scarce. We aimed to identify the factors that are associated with self-rated health (SRH) in aged multimorbid primary care patients. Methods Cross-sectional study with 3,189 multimorbid primary care patients aged from 65 to 85 years recruited in 158 general practices in 8 study centers in Germany. Information about morbidity, risk factors, resources, functional status and socio-economic data were collected in face-to-face interviews. Factors associated with SRH were identified by multivariable regression analyses. Results Depression, somatization, pain, limitations of instrumental activities (iADL), age, distress and Body Mass Index (BMI) were inversely related with SRH. Higher levels of physical activity, income and self-efficacy expectation had a positive association with SRH. The only chronic diseases remaining in the final model were Parkinson’s disease and neuropathies. The final model accounted for 35% variance of SRH. Separate analyses for men and women detected some similarities; however, gender specific variation existed for several factors. Conclusion In multimorbid patients symptoms and consequences of diseases such as pain and activity limitations, as well as depression, seem to be far stronger associated with SRH than the diseases themselves. High income and self-efficacy expectation are independently associated with better SRH and high BMI and age with low SRH. Trial registration MultiCare Cohort study registration:ISRCTN89818205.
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Affiliation(s)
- Anna Nützel
- Department of Psychiatry and Psychotherapy, Technical University of Munich, Munich, Germany.
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Puts M, Monette J, Girre V, Sourial N, Wolfson C, Monette M, Batist G, Bergman H. The relationship of self-rated health with functional status, toxicity and mortality: Results of a prospective pilot study of older patients with newly-diagnosed cancer. J Geriatr Oncol 2013; 4:319-26. [DOI: 10.1016/j.jgo.2013.07.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Revised: 03/13/2013] [Accepted: 07/17/2013] [Indexed: 12/01/2022]
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Porter KE. "Chemo brain"--is cancer survivorship related to later-life cognition? Findings from the health and retirement study. J Aging Health 2013; 25:960-81. [PMID: 23965309 DOI: 10.1177/0898264313498417] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Studies have shown a correlation between cancer and cognition referred to as "chemo brain." This study investigated the relationship between cancer and later-life cognition using nationally representative data. METHOD Analysis of the 2006 Health and Retirement Study investigated the (a) effects of cancer survivorship on the total cognition score using linear regression in adults age 65+ (n = 9,814) and (b) the effects of cancer treatment on the total recall index using linear regression in adults age 50+ (n = 657). RESULTS Total cognition score is not associated with cancer survivorship. The association between long-term cancer survivorship and cognition score was significant (p < .05; b = .276). Total recall index is not associated with chemotherapy. DISCUSSION These results support other research suggesting that chemo brain may be biased by expectation as well as favored by research that relies upon self-reported cognitive measures versus cognitive testing. The study was limited by the cross-sectional design.
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Chronic Diseases among Older Cancer Survivors. J Cancer Epidemiol 2012; 2012:206414. [PMID: 22956953 PMCID: PMC3432539 DOI: 10.1155/2012/206414] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2012] [Revised: 04/30/2012] [Accepted: 05/21/2012] [Indexed: 01/07/2023] Open
Abstract
Objective. To compare the occurrence of pre-existing and subsequent comorbidity among older cancer patients (≥60 years) with older non-cancer patients. Material and Methods. Each cancer patient (n = 3835, mean age 72) was matched with four non-cancer patients in terms of age, sex, and practice. The occurrence of chronic diseases was assessed cross-sectionally (lifetime prevalence at time of diagnosis) and longitudinally (incidence after diagnosis) for all cancer patients and for breast, prostate, and colorectal cancer patients separately. Cancer and non-cancer patients were compared using logistic and Cox regression analysis. Results. The occurrence of the most common pre-existing and incident chronic diseases was largely similar in cancer and non-cancer patients, except for pre-existing COPD (OR 1.21, 95% CI 1.06–1.37) and subsequent venous thrombosis in the first two years after cancer diagnosis (HR 4.20, 95% CI 2.74–6.44), which were significantly more frequent (P < 0.01) among older cancer compared to non-cancer patients. Conclusion. The frequency of multimorbidity in older cancer patients is high. However, apart from COPD and venous thrombosis, the incidence of chronic diseases in older cancer patients is similar compared to non-cancer patients of the same age, sex, and practice.
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Wikman A, Djärv T, Johar A, Lagergren P. Health-related quality of life does not differ between short-term, long-term and very long-term cancer survivors in the Swedish general population. Psychooncology 2012; 22:1369-74. [PMID: 22888065 DOI: 10.1002/pon.3147] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2012] [Revised: 07/09/2012] [Accepted: 07/10/2012] [Indexed: 11/12/2022]
Abstract
BACKGROUND Time since cancer diagnosis is rarely accounted for in population-based studies of health-related quality of life (HRQL) among cancer survivors. Therefore, this study aimed to assess the relationship between time since cancer diagnosis and impairments in HRQL among short-term, long-term and very long-term cancer survivors in the general population. METHODS A cross-sectional population-based survey of 4910 Swedish adults aged 40-79 years was conducted between April and June 2008. Three hundred and nineteen cases of cancer were identified, and 4591 participants reported no cancer. Analysis of co-variance (95% confidence intervals), adjusting for age, gender, education, marital status and non-cancer co-morbidity, was performed to compare HRQL ratings, as measured by the European Organisation for Research and Treatment of Cancer QLQ-C30, between short-term (<5 years since diagnosis [YSD]), long-term (5-10 YSD) and very long-term (>10 YSD) cancer survivors, and with that of a no-cancer control group. RESULTS No significant differences were observed between the survivor groups across the HRQL scales, with the exception of fatigue and appetite loss, which were greater among the short-term survivors compared with the very long-term survivors. For the majority of the HRQL scales, ratings were significantly poorer in the short-term survivors compared with controls. Long-term survivors had significantly reduced global quality of life, physical function, social function and fatigue, compared with controls. Differences observed between groups were largely of limited clinical significance. HRQL of very long-term survivors did not differ from controls. CONCLUSIONS Although HRQL was similar between short-term, long-term and very long-term survivors, when compared with the background population, findings suggest that some functional impairments and symptoms are present even at 5-10 YSD.
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Affiliation(s)
- Anna Wikman
- Department of Molecular Medicine and Surgery, Unit of Upper Gastrointestinal Research, Karolinska Institutet, Stockholm, Sweden.
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