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Leibring I, Kihlgren A, Anderzén Carlsson A. Fear, coping and support- from the perspective of children aged 10-17-year old having acute lymphoblastic leukemia. Int J Qual Stud Health Well-being 2024; 19:2310147. [PMID: 38324664 PMCID: PMC10851796 DOI: 10.1080/17482631.2024.2310147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 01/22/2024] [Indexed: 02/09/2024] Open
Abstract
PURPOSE To describe experiences of fear, coping, and support in 10-17-year-old children under treatment for acute lymphoblastic leukaemia (ALL). METHODS A longitudinal descriptive qualitative design was adopted. Ten children participated in one to three interviews each (24 interviews in all). Interviews were analysed using a matrix-based qualitative method. RESULTS The variety of fears described related to uncertainty, pain and medical procedures, bodily changes and loss of control, complications, professionals' attitudes, affected school results, and social isolation. Children used various strategies to deal with fear: some more general, to cope with the whole situation, and others more related to specific events such as treatment and tests. The most reported strategies we labelled Accepting the situation, Positive thinking, and Being an active agent. Less favourable strategies were also reported. Health care professionals, families, and friends offered valuable, but different kinds of, support. CONCLUSIONS Children aged 10 to 17 undergoing treatment for ALL experience various fears. Each experience is individual and changes over time, but there are common patterns. Most children used problem-solving or emotional-regulation strategies, but withdrawal was also reported. Even children who can deal with fear need support from their health care professionals, families, and friends.
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Affiliation(s)
- Ingela Leibring
- Faculty of Health, Science and Technology, Institution for Health, Karlstad University, Karlstad, Sweden
| | - Annica Kihlgren
- Faculty of Health and Medicine, School of Health Sciences, Örebro University, Örebro, Sweden
| | - Agneta Anderzén Carlsson
- Faculty of Medicine and Health, University Health Care Research Center, Örebro University, Örebro, Sweden
- Faculty of Health and Social Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
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Cunningham JM, Ferraro K, Durfee J, Indovina KA. Social Determinants of Health Impacting the Experience of Young Adults With Cancer at a Single Community Urban Hospital: A Retrospective Cohort Study. J Patient Exp 2024; 11:23743735241255450. [PMID: 38765223 PMCID: PMC11100384 DOI: 10.1177/23743735241255450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2024] Open
Abstract
Adolescent and young adult (AYA) cancer patients receive palliative medicine consultation at a late stage and face diagnostic delays. Failure to address social determinants of health (SDOH) and AYA-specific needs can adversely impact patient experience. This retrospective observational cohort study used data from chart review to assess the frequency of SDOH impacting AYA patients and setting of initial diagnosis at a US urban safety-net hospital. The association of SDOH variables with delays in treatment, loss of follow-up, and no-shows was tested using Chi-square and t-tests. One hundred seventy five patient charts were reviewed. Sixty-two percent were diagnosed in acute care settings. Substance use disorders, financial, employment, and insurance issues were associated with delayed treatment, with weak to moderate effect sizes. Mental health diagnoses, substance use disorder, homelessness, and financial burdens were associated with patient no-shows, with moderate to large effect sizes. Twenty-five percent of patients received palliative medicine consultation; 70% of these occurred at end of life. This study demonstrates the impact of SDOH on AYA cancer care and the need for policy allowing for intervention on SDOH.
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Affiliation(s)
- John M Cunningham
- Division of Hospital Medicine, University of Texas Health at San Antonio, San Antonio, TX, USA
| | - Kelly Ferraro
- Division of Hospital Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Division of Palliative Medicine, Denver Health and Hospital Authority, Denver, CO, USA
| | - Joshua Durfee
- Center for Health Systems Research, Denver Health and Hospital Authority, Denver, CO, USA
| | - Kimberly A Indovina
- Division of Hospital Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Division of Palliative Medicine, Denver Health and Hospital Authority, Denver, CO, USA
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Larsen EH, Wahl AK, Ruud E, Mellblom AV, Ålykkja A, Lie HC. Adolescent Cancer Survivors and Their Parents' Experiences With the Transition Off Treatment to Survivorship: A Qualitative Interview Study. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2024; 41:172-187. [PMID: 38656765 DOI: 10.1177/27527530231214528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Background: Transitioning from active cancer treatment to survivorship represents a vulnerable yet underresearched phase for adolescents and their families. Knowledge of their support needs, the challenges they experience, and how they manage them are useful to inform tailored follow-up care. Thus, we aimed to explore their transition experiences. Method: We interviewed 15 adolescents (12-19 years) who had transitioned off of treatment 1 to 47 months prior at Oslo University Hospital's Department of Paediatric Haematology and Oncology and their biological parents (n = 16). The interviews were analyzed using inductive, reflexive thematic analysis inspired by Braun and Clarke. NVivo-12 was used for data management. Results: Four main themes were identified: (a) consequences of cancer beyond transition, (b) transition back to normalcy, (c) survivorship competence, and (d) changes in roles and relationships. The families described happiness and relief but also said that the lingering effects of cancer treatment had a profound impact on day-to-day living. The adolescents expressed closeness with and dependency on their parents, and they perceived family and friends as essential for social readjustment. Discussion: Although adolescent survivors and their parents described a wide variety of strategies for returning to "normalcy," their perspectives also illustrate ongoing psychosocial and educational support needs that changed over time. Our findings indicate a need for improved preparation for and support through the transition. Nurses are well positioned to provide continuous and structured transition support tailored to the needs of the individual survivors and their families.
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Affiliation(s)
- Elna Hamilton Larsen
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Blindern, Oslo, Norway
- Department of Paediatric Haematology and Oncology, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Rikshospitalet, Nydalen, Oslo, Norway
| | - Astrid Klopstad Wahl
- Department of Interdisciplinary Health Sciences, Faculty of Medicine, University of Oslo, Blindern, Oslo, Norway
| | - Ellen Ruud
- Department of Paediatric Haematology and Oncology, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Rikshospitalet, Nydalen, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Blindern, Oslo, Norway
| | - Anneli Viktoria Mellblom
- Regional Centre for Child and Adolescent Mental Health Eastern and Southern Norway (RBUP), Nydalen, Oslo, Norway
| | - Anette Ålykkja
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Blindern, Oslo, Norway
- Department of Paediatric Haematology and Oncology, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Rikshospitalet, Nydalen, Oslo, Norway
| | - Hanne Cathrine Lie
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Blindern, Oslo, Norway
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Critoph DJ, Cable M, Farmer J, Hatcher HM, Kuhn I, Taylor RM, Smith LAM. Is there scope to do better? Clinical communication with adolescents and young adults with cancer-A scoping review. Psychooncology 2024; 33:e6317. [PMID: 38573227 DOI: 10.1002/pon.6317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 01/05/2024] [Accepted: 02/24/2024] [Indexed: 04/05/2024]
Abstract
INTRODUCTION How to communicate effectively with adolescent and young adults with cancer (AYACs) is a research priority. In a UK-wide survey of young people with cancer's research priorities, communication was a striking cross-cutting theme. It is increasingly recognised that AYACs have experiences and communication needs that differ significantly from those of younger children and older adults. The purpose of this review is to explore the features of effective clinical communication with AYACs. METHODS A literature search was undertaken to identify and map the available evidence using a broad scope to get an overview of the pertinent literature, identify knowledge gaps and clarify concepts. The searches yielded 5825 records, generating 4040 unique articles. These were screened and 71 full articles were read by four researchers with disagreements resolved by discussion leaving 29 included articles. Narrative synthesis was undertaken in relation to each of the research questions. RESULTS Three key themes were identified: being an adolescent/young adult, supporters, and healthcare professionals (HCPs). AYACs need to feel that HCPs understand their unique perspective. They want to be involved, this changes over time and in different contexts. Supporters are a central tenet, are most often parents and undertake several roles which are not always universally supportive. HCPs enable involvement of AYACs, and this needs to be actively promoted. AYACs preference for their level of involvement requires continual assessment. The three themes are interlinked and exist within the wider scope of the triadic encounter and cancer experience. CONCLUSION Supporters, most often parents were a key feature across the data and were seemingly paradoxical in nature. Triadic communication, the presence of a third person, is a central tenet of communication with AYACs and we propose a conceptual model to represent the nuances, components, and facets of this complex communication.
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Affiliation(s)
- Deborah J Critoph
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Maria Cable
- Institute of Clinical Sciences, College of Medical and Dental School, University of Birmingham, Birmingham, UK
| | - Jessica Farmer
- Haematology & Oncology Department, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - Helen M Hatcher
- Department of Oncology, Addenbrooke's Hospital, Cambridge University Hospital NHS Trust, Cambridge, UK
| | - Isla Kuhn
- Isla Kuhn, Head of Medical Library Services, University of Cambridge Medical Library, Cambridge, UK
| | - Rachel M Taylor
- Centre for Nurse, Midwife and Allied Health Profession Led Research (CNMAR), University College London Hospitals NHS Foundation Trust, London, UK
| | - Luke A M Smith
- Department of Oncology, Addenbrooke's Hospital, Cambridge University Hospital NHS Trust, Cambridge, UK
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Forsner M, Cyrén M, Gerdin A, Rullander A. It hurts to get forced: Children's narratives about restraint during medical procedures. PAEDIATRIC & NEONATAL PAIN 2023; 5:110-118. [PMID: 38149218 PMCID: PMC10749400 DOI: 10.1002/pne2.12093] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 11/08/2022] [Accepted: 01/09/2023] [Indexed: 12/28/2023]
Abstract
According to the UN Convention on the Rights of the Child (UNCRC), children have the right to be involved in decisions about medical procedures affecting them. However, research has shown that healthcare professionals sometimes find this difficult to achieve and those procedures then are performed against the will of the child. The aim was to illuminate restraint from the perspective of children's and young people's experiences of feeling forced during medical procedures. Following the phenomenological hermeneutic method, a secondary qualitative analysis of narrative data from four datasets collected between 2001 and 2020 was performed. Twelve children and young people aged 6-19 years (three male, nine female) from central and northern Sweden narrated their experiences of restraint related to medical procedures in nine narrative interviews and three short written narratives. The analysis revealed that it hurts to get forced, this being illustrated in six themes: bodily misery, emotional rebellion, feeling disregarded, physically limited, desiring escape, and leaving deep traces. From the perspective of children and young people, restraint was interpreted with inspiration from the philosopher Michel Foucault, as being overpowered - not voluntary submission but offering resistance - and according to the theory of caring and uncaring, a relationship in which the healthcare professional is perceived as indifferent to the patient as a person. In conclusion restraint hurts and means powerlessness to the child, leaving deep traces that remain for a long time. The findings call the healthcare profession to take action to support children's self-determination, participation, and integrity in healthcare. How children experience restraint in healthcare merits further investigation from the children's own perspective.
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Nogéus M, Nilsson S, Björk M. Pediatric Nurses' Person-Centered Approach to Nausea Management in Children With Cancer. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2023; 40:91-99. [PMID: 36718504 DOI: 10.1177/27527530221140056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Background: Nausea is a problematic side effect of childhood cancer treatment. However, it is not clear what interventions and assessments pediatric oncology nurses make when caring for a child with nausea. A person-centered approach can illuminate nausea management in pediatric care. The aim was to investigate how pediatric nurses retrieve the patient's narrative, establish partnership, and document nausea in hospitalized children with cancer. Methods: Individual interviews with nurses were conducted and analyzed using deductive content analysis with the framework of person-centered care. Results: The pediatric nurses described retrieving the patient's narrative regarding their nausea by listening to and observing the child. The pediatric nurses tried to establish a partnership with the child by allowing previous knowledge and the child's own preferences guide the interventions that focus on decreasing the child's nausea. The pediatric nurses also documented the effect of the given interventions and described the child's nausea using subjective words. When planning for the child's care it was rare for the nurses to have a documented care plan, but they did review documentation of previously administered interventions to plan for future care. Discussion: The results highlight the pediatric nurses' willingness to listen to the child, but also emphasize the need to further include the child and the parents in the partnership and documentation of nausea management. Collaboration with the child and the parents contributes to higher quality care and a partnership with trust.
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Affiliation(s)
| | - Stefan Nilsson
- 174416Institute of Health and Care Sciences, University of Gothenburg Centre for Person-Centred Care, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Maria Björk
- CHILD Research Group, Department of Nursing, School of Health and Welfare, 4161Jönköping University, Jönköping, Sweden
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Barratt M, Bail K, Paterson C. Children living with long-term conditions and their experiences of partnership in nursing care: An integrative systematic review. J Clin Nurs 2022. [PMID: 35768938 DOI: 10.1111/jocn.16429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 05/01/2022] [Accepted: 06/09/2022] [Indexed: 12/26/2022]
Abstract
AIMS AND OBJECTIVE To describe the experiences of nursing care and partnership nursing as expressed by children living with long-term conditions. BACKGROUND Children with long-term conditions have higher rates of hospitalisations and adverse events in hospital, yet little is known about their experiences of nursing care. How children perceive partnership in care with their families and nurses is of interest in the achievement of safe and effective care DESIGN: An integrative review following Joanna Briggs Institute protocols for systematic reviews. METHOD An integrative review was chosen following Joanna Briggs Institute protocols for systematic reviews. A total of 5150 articles were screened, with 251 full-text publications reviewed. A total of 21 studies were included, three mixed-method studies and 18 qualitative studies. This review has been reported as per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS Four integrated findings were identified: "Children are aware of their surroundings and needs," "Children value positive communication," "Children want to be recognised as an individual in the triadic relationship, and this can be done through nurses using tailored play;" and "Children seek a shared decision-making process." DISCUSSION Children wanted to be seen as an individual in Children and Young People's nursing as well as a child who craves security, fun and comfort, both from their families and nursing staff. Children described observing partnership between nursing staff and parents but felt uninvolved, with some children craving more knowledge and power to better understand their long-term condition. RELEVANCE TO CLINICAL PRACTICE Further research is required on how Children and Young People's nursing staff can better support children and empower them to be active members in the shared decision-making process if the child wishes to be involved.
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Affiliation(s)
- Macey Barratt
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - Kasia Bail
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, Australian Capital Territory, Australia.,Canberra Health Services & ACT Health, SYNERGY Nursing & Midwifery Research Centre, ACT Health Directorate Level 3, Canberra Hospital, Canberra, Australia
| | - Catherine Paterson
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, Australian Capital Territory, Australia.,Canberra Health Services & ACT Health, SYNERGY Nursing & Midwifery Research Centre, ACT Health Directorate Level 3, Canberra Hospital, Canberra, Australia.,Prehabilitation, Activity, Cancer Exercises and Survivorship (PACES) Research Group, University of Canberra, Bruce, Australian Capital Territory, Australia.,Robert Gordon University, Aberdeen, UK
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Olesen AMR, Boisen KA, Missel M. How Adolescents and Young Adults with Cancer Experience an Age-Appropriate Intervention When Undergoing Treatment in Adult Surgery Clinics: A Qualitative Study. J Adolesc Young Adult Oncol 2022; 12:177-184. [PMID: 35759421 DOI: 10.1089/jayao.2022.0012] [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: 11/12/2022] Open
Abstract
Purpose: Despite growing international attention, few interventions specifically target adolescents and young adults (AYAs) with cancer even though appropriate interventions may improve care delivery during cancer treatment. The study's purpose was to explore how AYAs with cancer experience an age-appropriate intervention when undergoing treatment in adult surgery clinics. Methods: Twenty AYAs with cancer, aged 18-29 years, from five surgery clinics at Copenhagen University Hospital Rigshospitalet participated in an intervention consisting of three main components: care provided by trained youth coordinator nurses (YCNs) to the greatest extent possible; a 1-hour one-on-one conversation with a YCN during hospitalization; and a postdischarge phone call. Semistructured interviews were used to collect data, which were analyzed in a stepwise process based on inductive content analysis. Results: Three themes were identified: a beacon in the dark; from patient to person; and the caring check-up. Participants felt safe and experienced a sense of presence and a caring environment in a significant and trusting relationship with YCNs, which encouraged them to share thoughts, feelings, and needs they previously had kept silent about. The one-on-one conversations helped them begin reflecting and in emotional processing and the postdischarge phone call was perceived as a caring check-up. Conclusions: The study shows how an age-appropriate intervention was experienced overall as meaningful for the participants hospitalized in adult surgery clinics, but more research is required to further examine the significance and effect of interventions that target AYAs with cancer.
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Affiliation(s)
- Anne Marie Roholm Olesen
- Department of Cardiothoracic Surgery, The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Kirsten A Boisen
- Department of Paediatrics and Adolescent Medicine, Centre of Adolescent Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Malene Missel
- Department of Cardiothoracic Surgery, The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
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Sisk BA, Harvey K, Friedrich AB, Antes AL, Yaeger LH, Mack JW, DuBois J. Multilevel barriers and facilitators of communication in pediatric oncology: A systematic review. Pediatr Blood Cancer 2022; 69:e29405. [PMID: 34662485 PMCID: PMC8875310 DOI: 10.1002/pbc.29405] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 01/03/2023]
Abstract
Multiple factors can facilitate or impede the fulfillment of communication functions in pediatric cancer. In this systematic review, we evaluated 109 studies from the preceding 20 years that presented qualitative or quantitative evidence of barriers or facilitators to communication in pediatric cancer. Using a multilevel framework developed in our prior study, we then analyzed and categorized the levels of barriers and facilitators identified in included studies. The vast majority of studies focused on individual-level barriers, rather than team, organization/system, collaborating hospital, community, or policy-level barriers. Future studies should explore the full range of factors that affect communication.
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Affiliation(s)
- Bryan A. Sisk
- Department of Pediatrics, Division of Hematology/Oncology, Washington University School of Medicine, St. Louis, Missouri.,Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Kieandra Harvey
- Brown School of Social Work, Washington University School of Medicine, St. Louis, Missouri
| | - Annie B. Friedrich
- Albert Gnaegi Center for Health Care Ethics, Saint Louis University, St. Louis, Missouri
| | - Alison L. Antes
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Lauren H Yaeger
- Bernard Becker Medical Library, Washington University School of Medicine, St. Louis, Missouri
| | - Jennifer W. Mack
- Pediatric Oncology and Division of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts; and Division of Pediatric Hematology/Oncology, Boston Children’s Hospital, Boston, Massachusetts
| | - James DuBois
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
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Lehmann V, Laan ETM, den Oudsten BL. Sexual health-related care needs among young adult cancer patients and survivors: a systematic literature review. J Cancer Surviv 2021; 16:913-924. [PMID: 34669141 PMCID: PMC9300501 DOI: 10.1007/s11764-021-01084-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 07/02/2021] [Indexed: 01/05/2023]
Abstract
Purpose Young adult cancer patients and survivors have age-specific care needs, but care needs related to sexual health are poorly understood. A systematic literature review was conducted to examine sexual health-related care needs among patients/survivors diagnosed with cancer during young adulthood (age: 18–39 years). The prevalence and types needs were assessed along with associated patient factors. Methods Four major databases were screened to identify relevant studies, which were also assessed for risk of bias; all following PRISMA guidelines. Results Identified studies (N = 35) often assessed sexual health-related care needs by whether participants experienced a generic need for support from providers. The prevalence of such needs ranged between 8 and 61.7% and was higher in female survivors and those with more health impairments. The type of diagnosis could also play a role in these varying prevalence rates, but was not systematically tested in included studies. Types of sexual health-related care needs were clustered into practical/emotional support needs (e.g., coping with physical side effects), information needs (e.g., more details), and communication needs (e.g., providers should initiate conversations, validate concerns, be empathetic/open). Needs should be addressed in-person and/or online. Conclusions The extent of needs related to sexual health varies among young adult patients and survivors, but types of needs center around improving provision of support and information by providers. Implications for Cancer Survivors Sexual health should routinely be addressed alongside other potential effects of cancer treatment to allow for constructive conversations between patients and providers. Referrals to (online) resources or specialists should be tailored to individual preferences. Supplementary Information The online version contains supplementary material available at 10.1007/s11764-021-01084-w.
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Affiliation(s)
- Vicky Lehmann
- Department of Medical Psychology, Amsterdam University Medical Center, Cancer Center Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands.
| | - Ellen T M Laan
- Department of Sexology and Psychosomatic Gynecology, Amsterdam University Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands
| | - Brenda L den Oudsten
- Department of Medical and Clinical Psychology, Center of Research On Psychological and Somatic Disorders, Tilburg University, Tilburg, Netherlands
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Experiences of living with cancer of adolescents and young adults and their families: A narrative review and synthesis. ENFERMERÍA CLÍNICA (ENGLISH EDITION) 2021; 31:234-246. [PMID: 34243911 DOI: 10.1016/j.enfcle.2020.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 12/07/2020] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Adolescence is a critical life stage marked by significant physical, psychological, and social change. Cancer diagnosis during adolescence profoundly affects this experience for adolescents and young adults (AYA) and their families with an impact that continues throughout life. It is important to understand these experiences to ensure delivery of appropriate and high-quality supportive care. This narrative review critically appraised and synthesised qualitative literature that explored the experiences of AYAs and their families living with cancer. METHOD Narrative review and synthesis of qualitative research of AYAs' and their families' experiences of cancer. MEDLINE, CINAHL and PsycINFO were searched between February 2000 and September 2019 using search terms including "adolescent", "young people", "young adult", "cancer", "family", and "qualitative". Literature was appraised and synthesised using Popay et al.'s1 framework. RESULTS 3016 articles were retrieved (Medline n=1298, CINAHL n=1632, PsycINFO n=86). Of these, 151 duplicates were removed. 2865 papers were screened with 121 abstracts considered for eligibility for inclusion. Eighteen papers met the inclusion criteria. Three inter-related themes were identified: being diagnosed with cancer; uncertainty - holding on to life and gaps in care delivery. DISCUSSION AND RECOMMENDATIONS Few studies discuss the impact of cancer on the families of AYA living with cancer. Future research should explore this experience. By doing so the relational impact of cancer will be better understood as the basis of supportive family-centred care. PROSPERO Registration: CRD42017084148.
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Beyond Resilience: A Concept Analysis of Human Flourishing in Adolescents and Young Adults With Cancer. ANS Adv Nurs Sci 2021; 43:172-189. [PMID: 31922987 DOI: 10.1097/ans.0000000000000292] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
This article explores the concept of human flourishing in the context of adolescents and young adults with cancer, using Rodgers' Evolutionary Concept Analysis method. We describe flourishing in adolescents and young adults with cancer experience as a continuous and dynamic process of growth and maturity among intrapersonal, interpersonal, and person-environmental dimensions. Flourishing adolescents and young adults with cancer achieve internal integration, evoke positive changes in their environments, and ultimately create a harmonious and balanced existence with the outside world. Human flourishing can be a new health care goal that nurses can apply to this population.
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Olesen AMR, Missel M, Boisen KA. The Needs and Care Experiences of Adolescents and Young Adults Treated for Cancer in Adult Surgery Clinics: A Qualitative Study. J Adolesc Young Adult Oncol 2021; 11:48-55. [PMID: 33844956 DOI: 10.1089/jayao.2021.0010] [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] [Indexed: 11/12/2022] Open
Abstract
Purpose: Adolescents and young adults (AYAs) with cancer hospitalized in adult surgery clinics are an overlooked group of patients. They are a minority hospitalized among elderly surgical patients, and the surroundings and care are designed with older patients in mind. A growing body of research focuses on AYAs' experiences of cancer care. However, studies exploring care experiences in terms of in-patient surgery treatment are still needed. Hence, the purpose of the study was to explore the needs and care experiences of AYAs, 15-29 years of age, treated for cancer in adult surgery clinics. Methods: This qualitative study was based on semistructured interviews with 15 AYAs with cancer from seven surgery clinics at Rigshospitalet, Copenhagen University Hospital, Denmark. Data were analyzed and interpreted using inductive content analysis. The Danish Data Protection Agency approved the study (project no.: 05617). Results: Three themes were identified: (1) being the black sheep - experiences of being young in an adult environment, (2) the significant nurse - experiences of the essential relationship between AYAs and the nurses, and (3) the wounded body - experiences of how the physically changed body affects the mind. Conclusions: Our findings showed that the psychosocial needs of AYAs with cancer hospitalized in adult surgery clinics were not being adequately met. Initiatives are needed to improve the psychological and social well-being of this vulnerable patient group, while hospitalized for treatment in surgery clinics.
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Affiliation(s)
- Anne Marie Roholm Olesen
- Department of Cardiothoracic Surgery, The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Malene Missel
- Department of Cardiothoracic Surgery, The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Kirsten A Boisen
- Department of Pediatrics and Adolescent Medicine, Center of Adolescent Medicine, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
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Woodford J, Månberg J, Cajander Å, Enebrink P, Harila-Saari A, Hagström J, Karlsson M, Placid Solimena H, von Essen L. Help-seeking behaviour and attitudes towards internet-administered psychological support among adolescent and young adults previously treated for cancer during childhood: protocol for a survey and embedded qualitative interview study in Sweden. BMJ Open 2021; 11:e041350. [PMID: 34155002 PMCID: PMC8039225 DOI: 10.1136/bmjopen-2020-041350] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION A subgroup of adolescent and young adult childhood cancer survivors (AYACCS) are at increased risk of psychological distress. Despite this, AYACCS experience difficulties accessing psychological support. E-mental health (e-MH) may offer a solution to reduce this treatment gap. However, research examining e-MH for AYACCS has experienced difficulties with recruitment, retention and adherence. Such difficulties may relate to: (1) help-seeking behaviour and/or (2) e-MH acceptability. The overall study aims are to: (1) examine potential associations between health service use factors, informed by Andersen's behavioural model of health services use, and help-seeking behaviour; (2) examine attitudes towards e-MH interventions; and (3) explore perceived need for mental health support; past experience of receiving mental health support; preferences for support; and barriers and facilitators to help-seeking. METHODS AND ANALYSIS An online and paper-based cross-sectional self-report survey (98 items) and embedded qualitative interview study across Sweden, with a target sample size of n=365. Participants are aged 16-39 years, diagnosed with cancer when 0-18 years and have completed successful cancer treatment. The survey examines sociodemographic and clinical characteristics, actual help-seeking behaviour, attitudes towards e-MH, stigma of mental illness, mental health literacy, social support and current symptoms of depression, anxiety, and stress. Survey respondents with past and/or current experience of mental health difficulties are invited into the qualitative interview study to explore: (1) perceived need for mental health support; (2) past experience of receiving mental health support; (3) preferences for support; and (4) barriers and facilitators to help-seeking. Potential associations between health service use factors and help-seeking behaviour are examined using univariable and multivariable logistic regressions. Qualitative interviews are analysed using content analysis. ETHICS AND DISSEMINATION Ethical approval has been obtained from the Swedish Ethical Review Authority (Dnr: 2020-06271). Results will be disseminated in scientific publications and academic conference presentations. TRIAL REGISTRATION NUMBER ISRCTN70570236.
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Affiliation(s)
- Joanne Woodford
- Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Jenny Månberg
- Child and Adolescent Psychiatry, Region Vasternorrland, Sundsvall, Sweden
| | - Åsa Cajander
- Department of Information Technology, Uppsala University, Uppsala, Sweden
| | - Pia Enebrink
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Arja Harila-Saari
- Pediatric Oncology, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Josefin Hagström
- Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Mathilda Karlsson
- Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Hanna Placid Solimena
- International Maternal and Child Health Care, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Louise von Essen
- Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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15
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McInally W, Gray-Brunton C, Chouliara Z, Kyle RG. Experiences of living with cancer of adolescents and young adults and their families: A narrative review and synthesis. ENFERMERIA CLINICA 2021; 31:S1130-8621(21)00034-6. [PMID: 33810981 DOI: 10.1016/j.enfcli.2020.12.044] [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: 11/10/2020] [Accepted: 12/07/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Adolescence is a critical life stage marked by significant physical, psychological, and social change. Cancer diagnosis during adolescence profoundly affects this experience for adolescents and young adults (AYA) and their families with an impact that continues throughout life. It is important to understand these experiences to ensure delivery of appropriate and high-quality supportive care. This narrative review critically appraised and synthesised qualitative literature that explored the experiences of AYAs and their families living with cancer. METHOD Narrative review and synthesis of qualitative research of AYAs' and their families' experiences of cancer. MEDLINE, CINAHL and PsycINFO were searched between February 2000 and September 2019 using search terms including "adolescent", "young people", "young adult", "cancer", "family", and "qualitative". Literature was appraised and synthesised using Popay et al.'s1 framework. RESULTS 3016 articles were retrieved (Medline n=1298, CINAHL n=1632, PsycINFO n=86). Of these, 151 duplicates were removed. 2865 papers were screened with 121 abstracts considered for eligibility for inclusion. Eighteen papers met the inclusion criteria. Three inter-related themes were identified: being diagnosed with cancer; uncertainty - holding on to life and gaps in care delivery. DISCUSSION AND RECOMMENDATIONS Few studies discuss the impact of cancer on the families of AYA living with cancer. Future research should explore this experience. By doing so the relational impact of cancer will be better understood as the basis of supportive family-centred care. PROSPERO Registration: CRD42017084148.
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Affiliation(s)
- Wendy McInally
- Faculty of Wellbeing, Education and Language Studies, Open University, Edinburgh, UK.
| | | | - Zoe Chouliara
- Faculty of Social & Health Sciences, Division of Mental Health & Counselling, Abertay University, Dundee, UK
| | - Richard G Kyle
- Research & Evaluation Division, Public Health Wales, Cardiff, UK
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16
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How Do Young Women with Cancer Experience Oncofertility Counselling during Cancer Treatment? A Qualitative, Single Centre Study at a Danish Tertiary Hospital. Cancers (Basel) 2021; 13:cancers13061355. [PMID: 33802795 PMCID: PMC8002475 DOI: 10.3390/cancers13061355] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/12/2021] [Accepted: 03/16/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Adolescents and young adults (AYAs) with cancer are at risk of therapy-induced infertility. The importance of initial and specialized fertility counselling to this patient group is undisputed. Despite international guidelines, oncofertility counselling is still inadequate. The purpose of this study was to examine how female AYA cancer patients and survivors experienced initial and specialized oncofertility counselling, and to present their specific suggestions on how to improve the oncofertility counselling. METHODS Twelve individual semi-structured interviews were performed with AYAs aged 20-35 with cancer or who were survivors. Participants were recruited via a youth support centre and social organization for AYAs with cancer. Data was analysed using thematic analysis. RESULTS Three main themes were found: Support is needed for navigating the fertility information jungle; The doctor's approach determines the content of the patient consultation; Inadequate and worrying information causes mistrust and frustration. CONCLUSION Results indicate a continuing problem regarding insufficient oncofertility counselling to AYAs with cancer. To ensure adequate and uniform information, especially in the initial oncofertility counselling, national guidelines for oncology specialists are suggested including multidisciplinary effort and collaboration between oncology and fertility specialists in mind. In addition, participants suggest focus on communication skills.
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17
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David CL, Lowrey L. A qualitative investigation assessing whether implementing a Teenage Young Adult information evening, within a radiotherapy department, would improve the information support and treatment pathway for 18-24-year-old cancer patients. Radiography (Lond) 2021; 27:847-853. [PMID: 33589304 DOI: 10.1016/j.radi.2021.01.005] [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: 09/01/2020] [Revised: 01/11/2021] [Accepted: 01/17/2021] [Indexed: 10/22/2022]
Abstract
INTRODUCTION This study evaluated the current information services provided to 10 Teenage Young Adult (TYA) oncology patients within a single radiotherapy department through retrospective patient views. Additionally, the participants provided valuable perspectives on the aptness and merit of implementing a dedicated information evening within the radiotherapy department. METHODS Focus group sessions and open-ended questionnaires were used as the primary data collection tools for this study, producing rich and informative data. The transcriptions from the focus groups, along with the questionnaire responses were then analysed using coding techniques, resulting in 6 distinct themes. RESULTS The participants felt they received adequate information about their radiotherapy treatment and its side effects. However, participants did report some gaps within the service provision that need to be addressed to improve treatment pathways in future. Furthermore, the information was always supplied in paper format which was often undesirable to the cohort with a more interactive format preferred. The participants disclosed very strong feelings of being different to "usual cancer patients" and displayed a desire for more opportunities to meet other TYA patients to be provided within their pathway. CONCLUSION AND IMPLICATIONS FOR PRACTICE The findings of this study suggest that the implementation of a dedicated TYA open evening would improve the information support and treatment pathway for 18-24-year-old cancer patients. The evening could offer a wanted opportunity where TYA patients could meet each other and additionally, treatment information and age appropriate support information could be provided in a different and more suitable format than current paper-based literature.
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Affiliation(s)
- C L David
- Radiotherapy Department, Basement P-2, University College Hospital, 235 Euston Road, London, NW1 2BU, UK.
| | - L Lowrey
- Kingston and St George's Joint Faculty, Health, Social Care and Education, Bay 18/desk 21 6th, Floor Hunter Wing, Cranmer Terrace, London, SW17 0RE, UK
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18
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Davies JP, McGill BC, Sansom-Daly UM, Wakefield CE, Kelly DM. "This Is the First Time I've Talked About This": Considerations When Conducting Qualitative Research Interviews with Adolescents and Young Adults with Cancer. J Adolesc Young Adult Oncol 2021; 10:540-548. [PMID: 33393866 DOI: 10.1089/jayao.2020.0122] [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] [Indexed: 01/19/2023] Open
Abstract
Qualitative research is a useful and important way to describe and analyze the experiences of adolescents and young adults (AYAs) with cancer. However, undertaking qualitative research with AYAs living with, or beyond, a cancer diagnosis requires careful planning and a well-informed approach for participants with a high level of vulnerability and who are at a crucial stage developmentally. This article reflects on the challenges of including AYAs with cancer between the ages of 16 and 25 years in qualitative research. By drawing on each author's own experiences of engaging in qualitative research interviews with AYAs with cancer, the article provides suggestions regarding how best to manage challenges and yield valuable data describing their experiences. Insights that are shared between qualitative researchers in this field may assist in preparing for the challenges posed by conducting qualitative research with this group and may help researchers to manage this activity successfully.
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Affiliation(s)
- Jane P Davies
- School of Healthcare Sciences, Cardiff University, Cardiff, United Kingdom
| | - Brittany C McGill
- School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Sydney, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Ursula M Sansom-Daly
- School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Sydney, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Claire E Wakefield
- School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Sydney, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Daniel M Kelly
- School of Healthcare Sciences, Cardiff University, Cardiff, United Kingdom
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19
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Stenmarker M, Enskär K, Björk M, Pinkava M, Rolander B, Golsäter M. Childhood Cancer Survivors: Self-Reported Quality of Life during and after the Cancer Trajectory. Asia Pac J Oncol Nurs 2020; 7:336-345. [PMID: 33062828 PMCID: PMC7529025 DOI: 10.4103/apjon.apjon_22_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 04/21/2020] [Indexed: 11/04/2022] Open
Abstract
Objective This cross-sectional study aimed to present how the unique cancer experience in childhood influences young adults' quality of life (QOL). Methods Qualitative and quantitative methods were used to code and analyze a study-specific questionnaire (133 items). These data are presented in accordance with a conceptual QOL/health-related QOL model. Results The participants included 34 women and 28 men (n = 62) diagnosed with solid tumors/lymphoma in the period 1983-2003, who had been treated at the same childhood cancer center in Sweden. The current mean age was 28.7 years (range: 18-45, standard deviation [SD]: 6.3, median value: 28.5), the mean age at diagnosis was 12.9 years (range: 8-17, SD: 2.3, median value: 13), and the mean time elapsed since treatment was 15.7 years (range: 4-28, SD: 2.4, median value: 15). The response rate was 65%. Higher levels of psychological maturity were reported by women versus men (P = 0.01) and by survivors diagnosed with cancer during adolescence versus school age (P = 0.04). Male participants reported lower levels of physical limitations (P = 0.03) and emotional distress when being of treatment and in contact with health care services (P = 0.04). The strongest factor influencing QOL during therapy was parental support (97%), while the strongest factors after therapy were to live a life similar to peers (82%) and to be satisfied with one's life situation (81%). During treatment, limitations influencing QOL were related to lack of school support (2%), and after treatment, to deteriorated relationships with siblings (5%). Conclusions Life-threatening diseases at young ages have long-term psychosocial effects with ambiguous results at multiple levels. To capture these experiences, we recommend clinical studies that are based on conceptual clarifying frameworks and adopt a quantitative and qualitative research approach.
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Affiliation(s)
- Margaretha Stenmarker
- Department of Pediatrics, Institution for Clinical Sciences, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Karin Enskär
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Maria Björk
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Mirka Pinkava
- Department of Pediatrics, Södra Älvsborg Hospital, Borås, Sweden
| | - Bo Rolander
- Department of Behavioral Science and Social Work, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Marie Golsäter
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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20
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De Clercq E, Rost M, Gumy-Pause F, Diesch T, Espeli V, Elger BS. Moving Beyond the Friend-Foe Myth: A Scoping Review of the Use of Social Media in Adolescent and Young Adult Oncology. J Adolesc Young Adult Oncol 2020; 9:561-571. [DOI: 10.1089/jayao.2019.0168] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Eva De Clercq
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| | - Michael Rost
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| | - Fabienne Gumy-Pause
- Département de l'Enfant et de l'Adolescent, Onco-hématologie pédiatrique, Hôpitaux Universitaires de Genève, Geneve, Switzerland
| | - Tamara Diesch
- Onkologie/Hämatologie, Universitäts-Kinderspital Basel, Basel, Switzerland
| | - Vittoria Espeli
- Oncologia medica, Istituto Oncologico della Svizzera Italiana, Bellinzona, Switzerland
| | - Bernice S. Elger
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
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21
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Smith LA, Critoph DJ, Hatcher HM. How Can Health Care Professionals Communicate Effectively with Adolescent and Young Adults Who Have Completed Cancer Treatment? A Systematic Review. J Adolesc Young Adult Oncol 2020; 9:328-340. [DOI: 10.1089/jayao.2019.0133] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Affiliation(s)
- Luke A.M. Smith
- School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Deborah J. Critoph
- Clinical Communications Skills Department, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Helen M. Hatcher
- School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
- Department of Oncology and Addenbrookes Hospital, Cambridge University Hospitals NHS Trust Foundation, Cambridge, United Kingdom
- TYA Cancer Service, Addenbrookes Hospital, Cambridge University Hospitals NHS Trust Foundation, Cambridge, United Kingdom
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22
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Lin B, Gutman T, Hanson CS, Ju A, Manera K, Butow P, Cohn RJ, Dalla‐Pozza L, Greenzang KA, Mack J, Wakefield CE, Craig JC, Tong A. Communication during childhood cancer: Systematic review of patient perspectives. Cancer 2019; 126:701-716. [DOI: 10.1002/cncr.32637] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 10/10/2019] [Accepted: 10/17/2019] [Indexed: 01/01/2023]
Affiliation(s)
- Beryl Lin
- School of Public Health University of Sydney Sydney New South Wales Australia
- School of Women's and Children's Health University of New South Wales Sydney New South Wales Australia
| | - Talia Gutman
- School of Public Health University of Sydney Sydney New South Wales Australia
- Centre for Kidney Research The Children's Hospital at Westmead Westmead New South Wales Australia
| | - Camilla S. Hanson
- School of Public Health University of Sydney Sydney New South Wales Australia
- Centre for Kidney Research The Children's Hospital at Westmead Westmead New South Wales Australia
| | - Angela Ju
- School of Public Health University of Sydney Sydney New South Wales Australia
- Centre for Kidney Research The Children's Hospital at Westmead Westmead New South Wales Australia
| | - Karine Manera
- School of Public Health University of Sydney Sydney New South Wales Australia
- Centre for Kidney Research The Children's Hospital at Westmead Westmead New South Wales Australia
| | - Phyllis Butow
- Psycho‐oncology Co‐operative Research Group School of Psychology University of Sydney Sydney New South Wales Australia
| | - Richard J. Cohn
- School of Women's and Children's Health University of New South Wales Sydney New South Wales Australia
- Kids Cancer Centre Sydney Children's Hospital Randwick New South Wales Australia
| | - Luciano Dalla‐Pozza
- Cancer Centre for Children The Children's Hospital at Westmead Sydney New South Wales Australia
| | - Katie A. Greenzang
- Dana‐Farber/Boston Children's Cancer and Blood Disorders Center Dana‐Farber Cancer Institute Boston Massachusetts
| | - Jennifer Mack
- Dana‐Farber/Boston Children's Cancer and Blood Disorders Center Dana‐Farber Cancer Institute Boston Massachusetts
| | - Claire E. Wakefield
- School of Women's and Children's Health University of New South Wales Sydney New South Wales Australia
- Kids Cancer Centre Sydney Children's Hospital Randwick New South Wales Australia
| | - Jonathan C. Craig
- School of Public Health University of Sydney Sydney New South Wales Australia
- Centre for Kidney Research The Children's Hospital at Westmead Westmead New South Wales Australia
| | - Allison Tong
- School of Public Health University of Sydney Sydney New South Wales Australia
- Centre for Kidney Research The Children's Hospital at Westmead Westmead New South Wales Australia
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23
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Drew D, Kable A, van der Riet P. The adolescent’s experience of cancer: An integrative literature review. Collegian 2019. [DOI: 10.1016/j.colegn.2019.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Shoghi M, Shahbazi B, Seyedfatemi N. The Effect of the Family-Centered Empowerment Model (FCEM) on the Care Burden of the Parents of Children Diagnosed with Cancer. Asian Pac J Cancer Prev 2019; 20:1757-1764. [PMID: 31244297 PMCID: PMC7021596 DOI: 10.31557/apjcp.2019.20.6.1757] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Indexed: 01/23/2023] Open
Abstract
Background: Families face multiple problems after their children are diagnosed with cancer. This study aims to
determine the effect of the Family-Centered Empowerment Model (FCEM) on the care burden of the parents of children,
diagnosed with cancer. Methods: This quasi-experimental study was conducted with 78 parents, having children with
cancer. The FCEM was implemented in the intervention group in four stages, namely perceived a threat, self-efficacy,
educational participation, and evaluation during four sessions of 20-40 minutes. The control group only received the
usual care. The burden of care of the control and intervention groups were measured one month after filling out the
initial questionnaire, and one month after the end of the intervention, respectively. Results: The two groups were
similar in terms of demographic variables and level of burden of care. However, a statistically significant difference
was observed between the two groups, in terms of the level of burden (p<0.001). Conclusion: The results of this study
showed that the empowerment of parents of children with cancer has an impact on reducing their care burden, and
using this empowerment model is recommended to the treatment team, especially nurses.
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Affiliation(s)
- Mahnaz Shoghi
- Center for Nursing Care Research, Faculty of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.
| | - Bahareh Shahbazi
- Center for Nursing Care Research, Faculty of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.
| | - Naimeh Seyedfatemi
- Member of Center for Nursing Care Research, Iran University of Medical Sciences, Tehran, Iran
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25
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Reed-Berendt R, Shafran R, Langdon D, Christie D, Hough R, Coughtrey A. Experiences of Low Mood in Young People With Cancer: A Qualitative Study. J Pediatr Oncol Nurs 2019; 36:424-435. [DOI: 10.1177/1043454219844232] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Young people with cancer are at increased risk of psychological difficulty; yet there is little research on their experiences of low mood or depressive symptoms to help inform treatment interventions. This qualitative study explored experiences and opinions of low mood or depression in young people with cancer, how their mood related to developmental challenges, strategies used to cope, and how services could improve support. Nineteen young people diagnosed and treated for cancer completed semistructured interviews. Transcripts were thematically analyzed using the framework approach, and analysis produced eight themes, organized into three domains: “A Harder Time of Life,” “Interpersonal Impact of Cancer,” and “Learning to Understand and Describe Low Mood,” Participants interviewed experienced low mood during cancer and predominantly felt “low mood” was a helpful term to describe their emotions. There were similarities and variations in their reported mood compared with clinical depression. The developmental challenges of being a young person with cancer negatively affected their mood. Participants used a variety of different coping strategies to manage these challenges. Young people were clear that they would like others to help them understand negative emotions experienced through cancer are normal to feel and support for low mood to be accessible and available.
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Affiliation(s)
| | - Roz Shafran
- UCL Great Ormond Street Institute of Child Health, London, UK
| | | | | | | | - Anna Coughtrey
- UCL Great Ormond Street Institute of Child Health, London, UK
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26
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Taylor RM, Fern LA, Barber J, Alvarez-Galvez J, Feltbower R, Morris S, Hooker L, McCabe MG, Gibson F, Raine R, Stark DP, Whelan JS. Description of the BRIGHTLIGHT cohort: the evaluation of teenage and young adult cancer services in England. BMJ Open 2019; 9:e027797. [PMID: 31005941 PMCID: PMC6500338 DOI: 10.1136/bmjopen-2018-027797] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE International recognition of the unique needs of young people with cancer is growing. Many countries have developed specialist age-appropriate cancer services believing them to be of value. In England, 13 specialist principal treatment centres (PTCs) deliver cancer care to young people. Despite this expansion of specialist care, systematic investigation of associated outcomes and costs has, to date, been lacking. The aim of this paper is to describe recruitment and baseline characteristics of the BRIGHTLIGHT cohort and the development of the bespoke measures of levels of care and disease severity, which will inform the evaluation of cancer services in England. DESIGN Prospective, longitudinal, observational study. SETTING Ninety-seven National Health Service hospitals in England. PARTICIPANTS A total of 1114 participants were recruited and diagnosed between July 2012 and December 2014: 55% (n=618) were men, mean age was 20.1 years (SD=3.3), most (86%) were white and most common diagnoses were lymphoma (31%), germ cell tumour (19%) and leukaemia (13%). RESULTS At diagnosis, median quality of life score was significantly lower than a published control threshold (69.7 points); 40% had borderline to severe anxiety, and 21% had borderline to severe depression. There was minimal variation in other patient-reported outcomes according to age, diagnosis or severity of illness. Survival was lower in the cohort than for young people diagnosed during the same period who were not recruited (cumulative survival probability 4 years after diagnosis: 88% vs 92%). CONCLUSIONS Data collection was completed in March 2018. Longitudinal comparisons will determine outcomes and costs associated with access/exposure to PTCs. Findings will inform international intervention and policy initiatives to improve outcomes for young people with cancer.
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Affiliation(s)
- Rachel M Taylor
- Cancer Clinical Trials, University College Hospitals NHS Foundation Trust, London, UK
| | - Lorna A Fern
- Department of Oncology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Julie Barber
- Department of Statistical Science, University College London, London, UK
| | - Javier Alvarez-Galvez
- Department of Biomedicine, Biotechnology and Public Health, University of Cadiz, Cádiz, Spain
| | | | - Stephen Morris
- Department of Applied Health Research, University College London, London, UK
| | - Louise Hooker
- Wessex Teenage and Young Adult Cancer Service, University Hospital Southhamptom, Southampton, UK
| | - Martin G McCabe
- Division of Cancer Sciences, University of Manchester, Manchester, UK
| | - Faith Gibson
- ORCHID, Great Ormond Street Hospital For Children NHS Trust, London, UK
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Rosalind Raine
- Institute of Epidemiology & Health, University College London, London, UK
| | - Dan P Stark
- Leeds Insitute of Molecular Medicine, University of Leeds, Leeds, UK
| | - Jeremy S Whelan
- Department of Oncology, University College London Hospitals NHS Foundation Trust, London, UK
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27
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Newton HL, Friend AJ, Feltbower R, Hayden CJ, Picton HM, Glaser AW. Survival from cancer in young people: An overview of late effects focusing on reproductive health. Acta Obstet Gynecol Scand 2019; 98:573-582. [DOI: 10.1111/aogs.13584] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 02/06/2019] [Indexed: 12/18/2022]
Affiliation(s)
- Hannah L. Newton
- Reproduction and Early Development Group, Discovery and Translational Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine School of Medicine and Health, University of Leeds Leeds UK
- Leeds Institute of Health Research School of Medicine and Health University of Leeds Leeds UK
- Leeds Teaching Hospitals NHS Trust Leeds UK
| | - Amanda J. Friend
- Leeds Institute of Health Research School of Medicine and Health University of Leeds Leeds UK
- Leeds Teaching Hospitals NHS Trust Leeds UK
| | - Richard Feltbower
- Department of Clinical and Population Sciences, School of Medicine and Health University of Leeds Leeds UK
- Leeds Institute for Data Analytics University of Leeds Leeds UK
| | | | - Helen M. Picton
- Reproduction and Early Development Group, Discovery and Translational Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine School of Medicine and Health, University of Leeds Leeds UK
- Leeds Teaching Hospitals NHS Trust Leeds UK
| | - Adam W. Glaser
- Leeds Institute of Health Research School of Medicine and Health University of Leeds Leeds UK
- Leeds Teaching Hospitals NHS Trust Leeds UK
- Leeds Institute for Data Analytics University of Leeds Leeds UK
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Adolescent and young adult cancer survivors' perceptions of participating in a survey – Ethical and methodological considerations. Eur J Oncol Nurs 2019; 39:55-61. [DOI: 10.1016/j.ejon.2019.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 01/30/2019] [Accepted: 02/01/2019] [Indexed: 11/20/2022]
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Georgievski G, Shama W, Lucchetta S, Niepage M. Through our eyes: A photovoice intervention for adolescents on active cancer treatment. J Psychosoc Oncol 2018; 36:700-716. [PMID: 30372377 DOI: 10.1080/07347332.2018.1469564] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
RESEARCH APPROACH Photovoice, a participatory action research methodology, is a novel and promising intervention for adolescents with cancer. Photovoice was used as an intervention for eliciting and addressing the psychosocial needs of adolescents on active cancer treatment. PARTICIPANTS Six adolescents, aged thirteen to seventeen years old, who were on active treatment or had completed treatment in the three months prior to recruitment participated in a seven-week photovoice group that took place from March to May 2017. Methodological Approach: Each of the seven sessions was recorded and later transcribed. A content analysis was used to identify themes that were analyzed using an integrated framework developed earlier. The framework broadly categorized the themes into six domains: (i) physical changes, (ii) psychosocial impacts, (iii) short-term social impacts, (iv) long-term social impacts, (v) impacts on holistic well-being, and (vi) informational needs. INTERPRETATION Photovoice is an effective intervention for eliciting and addressing the psychosocial needs of adolescents on active cancer treatment.
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Affiliation(s)
- Georgi Georgievski
- a Department of Social Work , The Hospital for Sick Children , Toronto , Ontario , Canada.,b Factor-Inwentash Faculty of Social Work , University of Toronto , Toronto , Ontario , Canada
| | - Wendy Shama
- a Department of Social Work , The Hospital for Sick Children , Toronto , Ontario , Canada.,b Factor-Inwentash Faculty of Social Work , University of Toronto , Toronto , Ontario , Canada
| | - Sonia Lucchetta
- a Department of Social Work , The Hospital for Sick Children , Toronto , Ontario , Canada.,b Factor-Inwentash Faculty of Social Work , University of Toronto , Toronto , Ontario , Canada
| | - Mark Niepage
- a Department of Social Work , The Hospital for Sick Children , Toronto , Ontario , Canada.,c Mood and Anxiety Services, Centre for Addiction and Mental Health , Toronto , Ontario , Canada
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Davies J, Kelly D, Hannigan B. ‘Life then’, ‘life interrupted’, ‘life reclaimed’: The fluctuation of agency in teenagers and young adults with cancer. Eur J Oncol Nurs 2018; 36:48-55. [DOI: 10.1016/j.ejon.2018.05.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 02/09/2018] [Accepted: 05/11/2018] [Indexed: 11/29/2022]
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Christen S, Weishaupt E, Vetsch J, Rueegg CS, Mader L, Dehler S, Michel G. Perceived information provision and information needs in adolescent and young adult cancer survivors. Eur J Cancer Care (Engl) 2018; 28:e12892. [DOI: 10.1111/ecc.12892] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 04/03/2018] [Accepted: 06/15/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Salome Christen
- Department of Health Sciences and Health Policy; University of Lucerne; Lucerne Switzerland
| | - Esther Weishaupt
- Department of Health Sciences and Health Policy; University of Lucerne; Lucerne Switzerland
| | - Janine Vetsch
- Department of Health Sciences and Health Policy; University of Lucerne; Lucerne Switzerland
- Discipline of Paediatrics; School of Women's and Children's Health; UNSW Medicine; University of New South Wales; Sydney New South Wales Australia
- Kids Cancer Centre; Sydney Children's Hospital; Sydney New South Wales Australia
| | - Corina S. Rueegg
- Department of Health Sciences and Health Policy; University of Lucerne; Lucerne Switzerland
- Oslo Centre for Biostatistics and Epidemiology; Oslo University Hospital, and Institute of Basic Medical Sciences; University of Oslo; Oslo Norway
| | - Luzius Mader
- Department of Health Sciences and Health Policy; University of Lucerne; Lucerne Switzerland
| | - Silvia Dehler
- Departement Gesundheit und Soziales; Abteilung Gesundheit; Aarau Switzerland
- Cancer Registry Zurich and Zug; Institute of Surgical Pathology; University Hospital Zurich; Zurich Switzerland
- Epidemiology, Biostatistics and Prevention Institute; University Zurich; Zurich Switzerland
| | - Gisela Michel
- Department of Health Sciences and Health Policy; University of Lucerne; Lucerne Switzerland
- Institute of Social and Preventive Medicine; University of Bern; Bern Switzerland
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Factors influencing the documentation of fertility-related discussions for adolescents and young adults with cancer. Eur J Oncol Nurs 2018; 34:42-48. [DOI: 10.1016/j.ejon.2018.02.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 02/11/2018] [Accepted: 02/26/2018] [Indexed: 11/24/2022]
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Olsson M, Steineck G, Enskär K, Wilderäng U, Jarfelt M. Sexual function in adolescent and young adult cancer survivors—a population-based study. J Cancer Surviv 2018; 12:450-459. [DOI: 10.1007/s11764-018-0684-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 02/21/2018] [Indexed: 10/17/2022]
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Marshall S, Grinyer A, Limmer M. The Experience of Adolescents and Young Adults Treated for Cancer in an Adult Setting: A Review of the Literature. J Adolesc Young Adult Oncol 2018; 7:283-291. [PMID: 29437492 DOI: 10.1089/jayao.2017.0123] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The purpose of this review is to explore the literature on the experience of adolescents and young adults (AYAs) having cancer treatment in an adult setting, rather than on a specialist adolescent cancer unit. The integrative review method was used to explore the current literature. Primary research on the topic was located systematically and then synthesized into a thematic narrative. The experience of AYAs undergoing treatment in an adult setting was generally negative. This can be attributed to three themes: feeling isolated in the adult setting; the lack of empathy from staff working in the adult setting; and the inappropriateness of the adult environment for this age group. As many AYAs with cancer will continue to have treatment in adult settings, staff working in this environment should be aware of the negative experience of this cohort and the impact this can have on a vulnerable group of patients. Staff could consider simple ways of improving the AYA experience, such as connecting AYA patients with their peers to reduce isolation; adapting their approach to take account of the unique emotional needs of this age group; and considering ways of making the environment more welcoming and age-appropriate.
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Affiliation(s)
- Steve Marshall
- 1 Palliative Care Team, King's College Hospital NHS Foundation Trust, Cicely Saunders Institute , London, United Kingdom
| | - Anne Grinyer
- 2 Faculty of Health and Medicine, Furness College, Lancaster University , Lancaster, United Kingdom
| | - Mark Limmer
- 2 Faculty of Health and Medicine, Furness College, Lancaster University , Lancaster, United Kingdom
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Marshall S, Grinyer A, Limmer M. The 'lost tribe' reconsidered: Teenagers and young adults treated for cancer in adult settings in the UK. Eur J Oncol Nurs 2018; 33:85-90. [PMID: 29551183 DOI: 10.1016/j.ejon.2018.02.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 01/25/2018] [Accepted: 02/02/2018] [Indexed: 11/15/2022]
Abstract
PURPOSE Although the UK has pioneered the development of specialist adolescent cancer units, the majority of teenagers and young adults (TYAs) continue to be treated at their local hospital or at a cancer centre alongside adults of all ages. This study aimed to elicit young people's views on this experience of having cancer treatment in an adult setting. METHODS Seventeen participants who had been treated for cancer in an adult hospital between the ages of 15 and 24 were recruited via cancer charities and social media. Telephone interviews were conducted with the participants and the resulting data were analysed using thematic analysis. RESULTS Already feeling out of sync as a TYA with cancer, participants felt out of place in the adult setting. Four factors contributed to this negative experience: a lack of affinity with older patients; the challenging issues in the adult setting; the absence of empathy towards TYAs by staff; and the unsuitability of the environment for adolescents. CONCLUSION Staff working with TYAs with cancer in the adult setting should be aware of the potentially detrimental impact of this environment on this cohort of patients, and consider ways of adapting and modifying their approach.
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Affiliation(s)
- Steve Marshall
- Palliative Care Team, King's College Hospital NHS Foundation Trust, Cicely Saunders Institute, Bessemer Road, London, SE5 9PJ, United Kingdom.
| | - Anne Grinyer
- Faculty of Health and Medicine, Furness College, Lancaster University, Lancaster, LA1 4YG, United Kingdom.
| | - Mark Limmer
- Faculty of Health and Medicine, Furness College, Lancaster University, Lancaster, LA1 4YG, United Kingdom.
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Niepage M, Georgievski G, Shama W, Lucchetta S. Exploring Adolescents' Cancer Journey Through Photovoice: A Narrative Synthesis. J Adolesc Young Adult Oncol 2018; 7:15-21. [DOI: 10.1089/jayao.2017.0073] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Mark Niepage
- Department of Social Work, The Hospital for Sick Children, Toronto, Canada
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Georgi Georgievski
- Department of Social Work, The Hospital for Sick Children, Toronto, Canada
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Wendy Shama
- Department of Social Work, The Hospital for Sick Children, Toronto, Canada
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Sonia Lucchetta
- Department of Social Work, The Hospital for Sick Children, Toronto, Canada
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
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Olsson M, Enskär K, Steineck G, Wilderäng U, Jarfelt M. Self-Perceived Physical Attractiveness in Relation to Scars Among Adolescent and Young Adult Cancer Survivors: A Population-Based Study. J Adolesc Young Adult Oncol 2018; 7:358-366. [PMID: 29373051 DOI: 10.1089/jayao.2017.0089] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE Cancer treatment may result in various effects that last long after treatment has been concluded. The purpose of this study was to explore to what extent scars affect adolescents and young adults postcancer treatment. METHODS In this population-based study, a study-specific questionnaire was developed by a method used in several previous investigations carried out by our research group, Clinical Cancer Epidemiology. Question development involved expert validation by professionals from oncology units, midwives, epidemiologists, and statisticians. The questionnaire was developed in collaboration with adolescent and young adult cancer survivors. The topics covered in the questionnaire were as follows: psychosocial health, body image and sexuality, fertility, education, work, and leisure. The web-based questionnaire was sent to teenage and young adult cancer survivors and matched controls in Sweden. RESULTS In this study, the relative risk of feeling less attractive due to scars was higher both for female cancer survivors RR 1.48, CI 1.05-2.08 and male cancer survivors RR 1.90, CI 1.15-3.13 compared to controls. The feeling of attractiveness was negatively related to the size of scars in both cancer and control groups. In a logistic regression analysis, significant associations were found between age, education, exercise, depression, and the feeling of low attractiveness due to scars. CONCLUSIONS The results of this study provide a basis for care interventions for teenage and young adult cancer patients during and after cancer treatment. Further research is needed on care interventions to reduce, if possible, the impact of scars.
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Affiliation(s)
- Maria Olsson
- 1 Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg , Goteborg, Sweden
| | - Karin Enskär
- 2 Department of Nursing Science, School of Health Sciences, Jönköping University , Jonkoping, Sweden
| | - Gunnar Steineck
- 3 Division of Clinical Cancer Epidemiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg , Goteborg, Sweden
| | - Ulrica Wilderäng
- 3 Division of Clinical Cancer Epidemiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg , Goteborg, Sweden
| | - Marianne Jarfelt
- 4 Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg , Goteborg, Sweden
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Logan S, Perz J, Ussher J, Peate M, Anazodo A. A systematic review of patient oncofertility support needs in reproductive cancer patients aged 14 to 45 years of age. Psychooncology 2017; 27:401-409. [DOI: 10.1002/pon.4502] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 06/28/2017] [Accepted: 07/17/2017] [Indexed: 12/22/2022]
Affiliation(s)
- S. Logan
- School of Women and Children's Health; Faculty of Medicine, UNSW; Sydney New South Wales Australia
| | - J. Perz
- Centre for Health Research, School of Medicine; Western Sydney University; Sydney New South Wales Australia
| | - J.M. Ussher
- Centre for Health Research, School of Medicine; Western Sydney University; Sydney New South Wales Australia
| | - M. Peate
- Psychosocial Health and Wellbeing (emPoWeR) Unit, Department of Obstetrics and Gynaecology, Royal Women's Hospital; University of Melbourne; Melbourne Victoria Australia
| | - A. Anazodo
- School of Women and Children's Health; Faculty of Medicine, UNSW; Sydney New South Wales Australia
- Sydney Children's Hospital; Sydney New South Wales Australia
- Prince of Wales Hospital; Sydney New South Wales Australia
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Tremblay D, Roberge D, Touati N, Maunsell E, Berbiche D. Effects of interdisciplinary teamwork on patient-reported experience of cancer care. BMC Health Serv Res 2017; 17:218. [PMID: 28320372 PMCID: PMC5360056 DOI: 10.1186/s12913-017-2166-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 03/16/2017] [Indexed: 11/30/2022] Open
Abstract
Background Interdisciplinary teamwork (ITW) is deemed necessary for quality cancer care practices. Nevertheless, variation in ITW intensity among cancer teams is understudied, and quantitative evidence of the effect of different ITW intensities among cancer teams on patients’ perceived experience of care is limited. This study aims to compare patient-reported experience measures (PREMs) of cancer outpatients followed by teams characterized by high vs. low ITW intensity. Methods The study is designed as an ex post facto quasi-experimental study. Participants (n = 1379) were recruited in nine outpatient oncology clinics characterized by different ITW intensities. ITW intensities were evaluated using the characteristics of structure (team composition and size) and process (interactions among team members), as per West’s seminal work on team effectiveness. ITW intensity was dichotomized (high vs. low ITW intensity). PREMs were classified and measured using validated scales corresponding to six dimensions: Prompt access to care, Person-centred response, Quality of patient-professional communication, Quality of the care environment, Continuity of care, and Results of care. Dichotomous variables were created for each dimension (positive vs. less positive experience). Multiple logistic regression analyses were performed to assess the association between ITW intensities and the six PREMs dimensions, while controlling for patient and organizational characteristics. PROC GENMOD was used to fit logistic models for categorical variables. Results Outpatients treated by teams characterized by high ITW intensity reported almost four times more positive perceptions of Prompt access to care compared to patients treated by low ITW intensity teams (OR = 3.99; CI = 1.89–8.41). High ITW intensity also positively affected patients’ perceptions of Quality of patient-professional communication (OR = 2.37; CI = 1.25–4.51), Person-centred response (OR = 2.11; CI = 1.05–4.24], and Continuity of care (OR = 2.18; CI = 1.07–4.45). No significant association was found between ITW intensity and perceived Results of care (OR = 1.31; CI = 0.68–2.52) or Quality of the care environment (OR = 0.66; CI = 0.31–1.39). Conclusions This study provides empirical evidence, from the patient’s perspective, that ITW intensity affects some critical aspects of patient-reported quality of care. Future research will allow explaining how and why ITW structure and processes may contribute to positive cancer care experiences. Electronic supplementary material The online version of this article (doi:10.1186/s12913-017-2166-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Dominique Tremblay
- Nursing School, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Quebec, Canada. .,Charles-Le Moyne Hospital Research Center, Greenfield Park, Quebec, Canada.
| | - Danièle Roberge
- Charles-Le Moyne Hospital Research Center, Greenfield Park, Quebec, Canada.,Department of Community Health Sciences, Faculty of Medicine and Health Sciences, Université de Sherbrooke (Longueuil Campus), Longueuil, Quebec, Canada
| | - Nassera Touati
- École nationale d'administration publique, Montreal, Quebec, Canada
| | - Elizabeth Maunsell
- Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, Québec City, Quebec, Canada
| | - Djamal Berbiche
- Charles-Le Moyne Hospital Research Center, Greenfield Park, Quebec, Canada
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Sawyer SM, McNeil R, McCarthy M, Orme L, Thompson K, Drew S, Dunt D. Unmet need for healthcare services in adolescents and young adults with cancer and their parent carers. Support Care Cancer 2017; 25:2229-2239. [DOI: 10.1007/s00520-017-3630-y] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 02/06/2017] [Indexed: 02/01/2023]
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41
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Sexual Consequences of Cancer and Its Treatment in Adolescents and Young Adults. CANCER IN ADOLESCENTS AND YOUNG ADULTS 2017. [DOI: 10.1007/978-3-319-33679-4_24] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Badarau DO, De Clercq E, Wangmo T, Dragomir M, Miron I, Kühne T, Elger BS. Cancer care in Romania: challenges and pitfalls of children's and adolescents' multifaceted involvement. JOURNAL OF MEDICAL ETHICS 2016; 42:757-761. [PMID: 27697792 DOI: 10.1136/medethics-2016-103418] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 08/09/2016] [Accepted: 09/06/2016] [Indexed: 06/06/2023]
Abstract
Communication about diagnosis and medical treatment for children suffering from life-threatening illnesses is complex. It is a primary step in involving underage patients and families in care and lays the foundation for obtaining parental permission and patient assent for treatment. In practice child participation in care is often difficult to obtain due to patients' different and sometimes fluctuating preferences, but also parents' protective strategies. Physicians may be susceptible to parental wishes to limit information and feel uncomfortable discussing issues related to uncertainty of cure with patients. A qualitative study in Romanian paediatric oncology units was conducted to explore children's involvement from the perspectives of parents and oncologists. Interviews with participants discussed 18 patient cases. Data were transcribed and thematic analysis was used to interpret and mine patients' involvement during treatment. Different facets of patient participation were identified: restricting, widening and enhancing involvement. A fourth category, unintentional involvement, occurred for all patients due to children's observations during long-term hospitalisations and access to Internet. Uncertainty overarched parental attitudes regarding the extent to which children should be included. Physicians usually complied with parental wishes to limit involvement, but together with parents involved patients at least in a practical way. Adults' protective attitude may backfire, as adolescents' online searches often expose patients to worse-case scenarios. Further research should acknowledge the hazards of restricted diagnosis disclosure and develop clinician tools to support families in communicating with patients. This should be paralleled by physician efforts to elicit patients' needs regarding participation.
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Affiliation(s)
- Domnita O Badarau
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| | - Eva De Clercq
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| | - Tenzin Wangmo
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| | - Monica Dragomir
- Department of Pediatric Oncology, Prof. Dr. Al. Trestioreanu Oncology Institute, Bucharest, Romania
| | - Ingrid Miron
- Department of Pediatric Oncology, St. Mary Emergency Hospital, Iasi, Romania
| | - Thomas Kühne
- Department of Pediatric Oncology and Haematology, University Children's Hospital, Basel, Switzerland
| | - Bernice S Elger
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
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Pålsson A, Malmström M, Follin C. Childhood leukaemia survivors' experiences of long-term follow-ups in an endocrine clinic - A focus-group study. Eur J Oncol Nurs 2016; 26:19-26. [PMID: 28069148 DOI: 10.1016/j.ejon.2016.10.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 09/30/2016] [Accepted: 10/31/2016] [Indexed: 10/20/2022]
Abstract
The survival rate after childhood cancer has improved markedly and today more than 80% of patients will survive. Many childhood cancer survivors suffer from late complications due to radiotherapy and chemotherapy. Survivors of Acute Lymphoblastic Leukaemia (ALL), treated with cranial radiotherapy, are at a particularly high risk of having endocrine complications. PURPOSE To illuminate childhood ALL survivors' experiences of a long-term follow-up in an endocrine clinic. METHOD Data collection carried out using semi-structured focus-group interviews. Fifteen ALL survivors were included in the study, divided into 4 groups. Data was analysed with conventional qualitative content analysis. RESULTS The survivors' experiences were captured in the theme: "The need for understanding and support in order to manage daily life". An understanding of their situation, as well as support for managing daily life was fundamental. Lack of understanding and support from the community was connected with a fear for the future. The follow-up at the endocrine clinic was shown to be crucial for increasing the survivors' understanding of late complications. The past feeling of being out of control was replaced with an increased self-confidence. CONCLUSION Many leukaemia survivors experienced their daily lives as a struggle and as a complicated issue to cope with. The theme "understanding and support to manage daily life" mirrors how the survivors are in need of knowledge and support in order to handle and understand their complex situation after surviving leukaemia. Offering understanding and support with a holistic approach, may be a way in which to strengthen the survivors' health.
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Affiliation(s)
- Anna Pålsson
- Department of Endocrinology, Skåne University Hospital, Institution of Clinical Sciences, Lund, Sweden
| | - Marlene Malmström
- Department of Surgery, Skåne University Hospital, Institution of Clinical Sciences, Lund, Sweden
| | - Cecilia Follin
- Department of Endocrinology, Skåne University Hospital, Institution of Clinical Sciences, Lund, Sweden.
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Weller D. Living with cancer: challenges across the lifespan. Eur J Cancer Care (Engl) 2016; 25:345-7. [DOI: 10.1111/ecc.12506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2016] [Indexed: 11/30/2022]
Affiliation(s)
- D. Weller
- Centre for Population Health Sciences; University of Edinburgh; Edinburgh UK
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Jervaeus A, Nilsson J, Eriksson LE, Lampic C, Widmark C, Wettergren L. Exploring childhood cancer survivors' views about sex and sexual experiences -findings from online focus group discussions. Eur J Oncol Nurs 2015; 20:165-72. [PMID: 26251362 DOI: 10.1016/j.ejon.2015.07.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 07/03/2015] [Accepted: 07/16/2015] [Indexed: 11/19/2022]
Abstract
PURPOSE To explore childhood cancer survivors' views about sex and sexual experiences and, as an additional aim, their possible needs for care and support from health care professionals regarding sexual life. METHODS Written online focus group discussions were performed with survivors of childhood cancer, identified through the Swedish Childhood Cancer Registry; 133 (36%; aged 16-25) participated. Written text was analysed using qualitative content analysis. RESULTS The analysis resulted in one main category: Could my cancer experience have an impact on my sexual life? with four generic categories: Sex considered to be good, Feeling insecure and falling behind, Relating sex to a stable relationship and Concerns related to the physical body. In general, participants had not reflected on the possibility that their cancer experience could impact on sexual life. Sex was often considered to be something natural, important and taken for granted. However, thoughts and worries were expressed including being shy, feeling insecure and falling behind peers. Physical concerns included vaginal dryness and difficulties related to erection and reaching orgasm. Many participants stated that sexual issues had not been discussed with health care professionals, however, the need for such support differed. CONCLUSIONS Many of the childhood cancer survivors' did not relate their sexual experiences to previous cancer treatment. However, problems were expressed, both of emotional and physical nature. Many participants stated that they had not received any information or support regarding sexual issues from health care professionals, why it is recommended to be regularly addressed in follow-up care.
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Affiliation(s)
- Anna Jervaeus
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Huddinge, Sweden.
| | - Jenny Nilsson
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Huddinge, Sweden
| | - Lars E Eriksson
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Huddinge, Sweden; Department of Learning, Informatics, Management and Ethics, Medical Management Center (LIME, MMC), Karolinska Institutet, Stockholm, Sweden; Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden; School of Health Sciences, City University London, United Kingdom
| | - Claudia Lampic
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Huddinge, Sweden; School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - Catarina Widmark
- Department of Learning, Informatics, Management and Ethics, Medical Management Center (LIME, MMC), Karolinska Institutet, Stockholm, Sweden; Department of Quality and Patient Safety, Karolinska University Hospital, Stockholm, Sweden
| | - Lena Wettergren
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Huddinge, Sweden
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