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Rashidi A, Thapa S, Kahawaththa Palliya Guruge WS, Kaur S. Patient experiences: a qualitative systematic review of chemotherapy adherence. BMC Cancer 2024; 24:658. [PMID: 38816684 PMCID: PMC11138062 DOI: 10.1186/s12885-024-12353-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 05/07/2024] [Indexed: 06/01/2024] Open
Abstract
Adherence to chemotherapy treatment is recognized as a crucial health concern, especially in managing cancer patients. Chemotherapy presents challenges for patients, as it can lead to potential side effects that may adversely affect their mobility and overall function. Patients may sometimes neglect to communicate these side effects to health professionals, which can impact treatment management and leave their unresolved needs unaddressed. However, there is limited understanding of how patients' experiences contribute to improving adherence to chemotherapy treatment and the provision of appropriate support. Therefore, gaining insights into patients' experiences is crucial for enhancing the accompaniment and support provided during chemotherapy.This review synthesizes qualitative literature on chemotherapy adherence within the context of patients' experiences. Data were collected from Medline, Web of Science, CINAHL, PsychINFO, Embase, Scopus, and the Cochrane Library, systematically searched from 2006 to 2023. Keywords and MeSH terms were utilized to identify relevant research published in English. Thirteen articles were included in this review. Five key themes were synthesized from the findings, including positive outlook, receiving support, side effects, concerns about efficacy, and unmet information needs. The review underscores the importance for healthcare providers, particularly nurses, to focus on providing comprehensive information about chemotherapy treatment to patients. Adopting recommended strategies may assist patients in clinical practice settings in enhancing adherence to chemotherapy treatment and improving health outcomes for individuals living with cancer.
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Affiliation(s)
- Amineh Rashidi
- School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, Perth, WA, 6027, Australia.
| | - Susma Thapa
- School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, Perth, WA, 6027, Australia
| | | | - Shubhpreet Kaur
- School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, Perth, WA, 6027, Australia
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Shannon AH, Sarna A, Bressler L, Monsour C, Palettas M, Huang E, D'Souza DM, Kneuertz PJ, Ejaz A, Pawlik TM, Santry H, Cloyd JM. Quality of Life and Real-time Patient Experience During Neoadjuvant Therapy: A Prospective Cohort Study. Ann Surg 2024; 279:850-856. [PMID: 37641957 DOI: 10.1097/sla.0000000000006090] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
OBJECTIVE To use a customized smartphone application to prospectively measure QOL and the real-time patient experience during neoadjuvant therapy (NT). BACKGROUND NT is increasingly used for patients with localized gastrointestinal (GI) cancers. There is little data assessing patient experience and quality of life (QOL) during NT for GI cancers. METHODS Patients with GI cancers receiving NT were instructed on using a customized smartphone application through which the Functional Assessment of Cancer Therapy-General (FACT-G) questionnaire, a validated measure of health-related QOL, was administered at baseline, every 30 days, and at the completion of NT. Participants also tracked their moods and symptoms and used free-text journaling functionalities in the application. Mean overall and subsection health-related QOL scores were calculated during NT. RESULTS Among 104 enrolled patients, the mean age was 60.5 ± 11.5 years and 55% were males. Common cancer diagnoses were colorectal (40%), pancreatic (37%), and esophageal (15%). Mean overall FACT-G scores did not change during NT ( P = 0.987). While functional well-being scores were consistently the lowest and social well-being scores the highest, FACT subscores similarly did not change during NT (all P > 0.01). The most common symptoms reported during NT were fatigue, insomnia, and anxiety (39.3%, 34.5%, and 28.3% of patient entries, respectively). Qualitative analysis of free-text journaling entries identified anxiety, fear, and frustration as the most common themes, but also the importance of social support systems and confidence in health care providers. CONCLUSIONS While patient symptom burden remains high, results of this prospective cohort study suggest QOL is maintained during NT for localized GI cancers.
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Affiliation(s)
- Alexander H Shannon
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH
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Grant SJ, Kay S, Lacey J, Kumar S, Kerin-Ayres K, Stehn J, Gonzalez M, Templeton S, Heller G, Cockburn J, Wahlroos S, Malalasekera A, Mak C, Graham S. Feasibility study of a multimodal prehabilitation programme in women receiving neoadjuvant therapy for breast cancer in a major cancer hospital: a protocol. BMJ Open 2024; 14:e080239. [PMID: 38508617 PMCID: PMC10961545 DOI: 10.1136/bmjopen-2023-080239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 02/27/2024] [Indexed: 03/22/2024] Open
Abstract
INTRODUCTION Neoadjuvant therapy has become a standard treatment for patients with stage II/III HER2 positive and triple negative breast cancer, and in well-selected patients with locally advanced and borderline resectable high risk, luminal B breast cancer. Side effects of neoadjuvant therapy, such as fatigue, cardiotoxicity, neurotoxicity, anxiety, insomnia, vasomotor symptoms, gastrointestinal disturbance as well as a raft of immune-related adverse events, may impact treatment tolerance, long-term outcomes, and quality of life. Providing early supportive care prior to surgery (typically termed 'prehabilitation') may mitigate these side effects and improve quality of life.During our codesign of the intervention, consumers and healthcare professionals expressed desire for a programme that 'packaged' care, was easy to access, and was embedded in their care pathway. We hypothesise that a multimodal supportive care programme including exercise and complementary therapies, underpinned by behavioural change theory will improve self-efficacy, quality of life, readiness for surgery and any additional treatment for women with breast cancer. We seek to explore cardiometabolic, residual cancer burden and surgical outcomes, along with chemotherapy completion (relative dose intensity). This article describes the protocol for a feasibility study of a multimodal prehabilitation programme. METHODS AND ANALYSIS This is a prospective, mixed-method, feasibility study of a multi-modal programme in a hospital setting for 20-30 women with breast cancer receiving neoadjuvant therapy. Primary outcomes are recruitment rate, retention rate, adherence and acceptability. Secondary outcomes include patient reported outcome measures (PROMs), surgical outcomes, length of stay, satisfaction with surgery, chemotherapy completion rates, changes in metabolic markers and adverse events. Interviews and focus groups to understand the experience with prehabilitation and different factors that may affect feasibility of the intervention . The output of this study will be a codesigned, evidence-informed intervention assessed for feasibility and acceptability by women with breast cancer and the healthcare professionals that care for them. ETHICS AND DISSEMINATION The study received ethics approval from the St Vincents Hospital HREC (HREC/2021/ETH12198). Trial results will be communicated to participants, healthcare professionals, and the public via publication and conferences. TRIAL REGISTRATION NUMBER ACTRN12622000584730.
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Affiliation(s)
- Suzanne J Grant
- Supportive Care and Integrative Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
- NICM Health Research Institute, Western Sydney University, Westmead, New South Wales, Australia
| | - Shelley Kay
- Supportive Care and Integrative Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Judith Lacey
- Supportive Care and Integrative Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
- NICM Health Research Institute, Western Sydney University, Westmead, New South Wales, Australia
| | - Sanjeev Kumar
- Medical Oncology Department, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Kim Kerin-Ayres
- Supportive Care and Integrative Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Justine Stehn
- Supportive Care and Integrative Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Maria Gonzalez
- Supportive Care and Integrative Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
- NICM Health Research Institute, Western Sydney University, Westmead, New South Wales, Australia
| | - Sandra Templeton
- Supportive Care and Integrative Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Gillian Heller
- NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Jane Cockburn
- Patient Advocate, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Sara Wahlroos
- Medical Oncology Department, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Ashanya Malalasekera
- Supportive Care and Integrative Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
- School of Medicine, University of Sydney SDN, Sydney, New South Wales, Australia
| | - Cindy Mak
- Surgical Oncology Department, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Susannah Graham
- Surgical Oncology Department, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
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Omari M, Amaadour L, El Asri A, Benbrahim Z, Mellas N, El Rhazi K, Ragala MEA, El Hilaly J, Halim K, Zarrouq B. Psychological distress and coping strategies in breast cancer patients under neoadjuvant therapy: A systematic review. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241276232. [PMID: 39287572 PMCID: PMC11409301 DOI: 10.1177/17455057241276232] [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: 09/19/2024]
Abstract
BACKGROUND During neoadjuvant therapy (NAT), patients with locally advanced breast cancer (LABC) experience psychological distress (PD) and adopt appropriate coping strategies. OBJECTIVE This systematic review aimed to examine the prevalence and changes in PD and coping strategies in patients with LABC during NAT and to evaluate effective interventions to reduce their PD. DESIGN Quantitative (cross-sectional, longitudinal, and interventional) and qualitative studies reporting PD and coping strategies related to NAT during LABC were included. DATA SOURCES AND METHODS PubMed, Cochrane Library, Scopus, ScienceDirect, Wiley Online Library, and Web of Science databases were consulted to gather relevant literature from the first publications until July 25, 2023. Selection was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS A total of 41 articles were included, of which four were qualitative. The main results showed that the prevalence of depression before NAT ranged from 0% to 46% and that of anxiety from 5.5% to 54%. After NAT, the prevalence of depression ranged from 40% to 78.5% and anxiety accounted for 27%. Additionally, PD decreased during NAT. The main determinants of PD were perceived social support, living in joint families, being affected by COVID-19 infection, delays in diagnosis, and starting neoadjuvant treatment. For coping strategies, after NAT, "resigned coping" decreased, whereas "social support" increased, and active coping strategies were correlated with better PD. Some interventions found a reduction in PD, such as a mobile health application, fasting-mimicking diet, relaxation training, and guided imaging. CONCLUSION These findings highlight the importance of considering PD and coping strategies in patients with LABC from diagnosis to the end of NAT. The results suggest that effective psychological interventions should be implemented.
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Affiliation(s)
- Majid Omari
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine, Pharmacy and Dental Medicine, Sidi Mohamed Ben Abdallah University, Fez, Morocco
- Laboratory of Natural Substances, Pharmacology, Environment, Modeling, Health & Quality of Life, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdallah University, Fez, Morocco
- Nursing Training and Research Department, Hassan II University Hospital, Fez, Morocco
| | - Lamiae Amaadour
- Faculty of Medicine, Pharmacy and Dental Medicine, Sidi Mohamed Ben Abdallah University, Fez, Morocco
- Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
| | - Achraf El Asri
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine, Pharmacy and Dental Medicine, Sidi Mohamed Ben Abdallah University, Fez, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Regional Health Directorate Fez-Meknes, El Ghassani Hospital, Fez, Morocco
| | - Zineb Benbrahim
- Faculty of Medicine, Pharmacy and Dental Medicine, Sidi Mohamed Ben Abdallah University, Fez, Morocco
- Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
| | - Nawfel Mellas
- Faculty of Medicine, Pharmacy and Dental Medicine, Sidi Mohamed Ben Abdallah University, Fez, Morocco
- Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
| | - Karima El Rhazi
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine, Pharmacy and Dental Medicine, Sidi Mohamed Ben Abdallah University, Fez, Morocco
| | - Mohammed El Amine Ragala
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine, Pharmacy and Dental Medicine, Sidi Mohamed Ben Abdallah University, Fez, Morocco
- Department of Biology and Geology, Teacher's Training College (Ecole Normale Supérieure), Sidi Mohamed Ben Abdallah University, Fez, Morocco
| | - Jaouad El Hilaly
- Laboratory of Pedagogical and Didactic Engineering of Sciences and Mathematics, Regional Center of Education and Training (CRME F), Fez, Morocco
- R.N.E Laboratory, Multidisciplinary Faculty of Taza, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Karima Halim
- Laboratory of Natural Substances, Pharmacology, Environment, Modeling, Health & Quality of Life, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdallah University, Fez, Morocco
- Department of Human and Social Sciences-Education Sciences, Teachers Training College (Ecole Normale Superieure), Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Btissame Zarrouq
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine, Pharmacy and Dental Medicine, Sidi Mohamed Ben Abdallah University, Fez, Morocco
- Department of Biology and Geology, Teacher's Training College (Ecole Normale Supérieure), Sidi Mohamed Ben Abdallah University, Fez, Morocco
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Westendorp J, Geerse OP, van der Lee ML, Schoones JW, van Vliet MHM, Wit T, Evers AWM, van Vliet LM. Harmful communication behaviors in cancer care: A systematic review of patients and family caregivers perspectives. Psychooncology 2023; 32:1827-1838. [PMID: 37957777 DOI: 10.1002/pon.6247] [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: 08/04/2023] [Revised: 10/13/2023] [Accepted: 10/30/2023] [Indexed: 11/15/2023]
Abstract
OBJECTIVE Issues regarding clinician communication remain an important source of complaints within healthcare. This systematic review aims to determine cancer patients' and their family caregivers' views on which clinicians' communication behaviors can harm (i.e. eliciting negative feelings/consequences for patients/family caregivers). METHODS We searched for all types of peer-reviewed studies that determined adult (≥18 years) cancer patients' and/or family caregivers' perspectives on which clinicians' communication behaviors can harm in several databases (PubMed, Embase, Web of Science, Cochrane Library, Emcare, PsycINFO and Academic Search Premier), supplemented by expert-consultation. Studies were screened using the Artificial intelligence screening tool of ASReview and data was analyzed using Thematic Analysis. To assess the quality of the studies the Qualsyst critical appraisal tool was used. RESULTS A total of 47 studies were included. Four main themes of harmful communication behaviors were identified: (1) Lack of tailored information provision (e.g. giving too little or too much/specific information) (2) Lack of tailored decision making (ranging from; patient exclusion, to the patients' responsibility, and/or haste) (3) Lack of feeling seen and heard (seen as a disease, not as a human being; not listened to concerns and emotions) (4) Lack of feeling held and remembered (forgotten agreements; lack of care continuity). CONCLUSIONS Our results reveal an overview of patients' and family caregivers' perspectives on which clinicians' communication behaviors can harm. Harm could be prevented when information and decision involvement are tailored and patients' and family caregivers' needs to feel seen, heard, held and remembered are met.
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Affiliation(s)
- Janine Westendorp
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - Olaf P Geerse
- Department of Medical Oncology, Amsterdam UMC, Amsterdam, The Netherlands
- Department of Pulmonary Diseases, Amsterdam UMC, Amsterdam, The Netherlands
| | - Marije L van der Lee
- Scientific Research Department, Helen Dowling Institute, Centre for Psycho-Oncology, Bilthoven, The Netherlands
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Jan W Schoones
- Directorate of Research Policy, Leiden University Medical Center, Leiden, The Netherlands
| | - Milon H M van Vliet
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Tamara Wit
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - Andrea W M Evers
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands
- Medical Delta, Leiden University, TU Delft and Erasmus University, Leiden, The Netherlands
| | - Liesbeth M van Vliet
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands
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Ofri A, Elstner K, Mann GB, Kumar S, Warrier S. Neoadjuvant chemotherapy in non-metastatic breast cancer: The surgeon's perspective. Surgeon 2023; 21:356-360. [PMID: 37088639 DOI: 10.1016/j.surge.2023.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/30/2023] [Accepted: 04/03/2023] [Indexed: 04/25/2023]
Abstract
Breast cancer is the most common non-skin cancer in Australia, affecting 1 in 7 women by the age of 85 years. Current management of early breast cancer is becoming increasingly variable and complex. The typical range of treatments include some combination of surgery, chemotherapy and targeted therapy, immunotherapy, radiotherapy, and endocrine therapy. Neoadjuvant chemotherapy (NACT) in carefully selected patients can facilitate increased rates of breast conservation therapy, and when successful, offers improved cosmesis due to less extensive resection of tissue. A neoadjuvant approach also provides biological insight into a patient's tumour, prognostication based on a patient's response to therapy, as well as enabling their treating oncologist to personalise adjuvant strategies based on the presence or absence of residual cancer at surgery. Neoadjuvant chemotherapy has become an integral element in the provision of breast conserving surgery to selected early-stage breast cancer patients. Appreciating the indications and understanding the likely outcomes from NACT in select situations, can result in significant improvements in patient tailored care.
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Affiliation(s)
- A Ofri
- Department of Surgery, Mater Hospital, North Sydney NSW 2060, Australia; St Vincent's Clinical School, University of New South Wales, Sydney NSW 2052, Australia; Royal Prince Alfred Hospital Institute of Academic Surgery, Camperdown NSW 2050, Australia.
| | - K Elstner
- Department of Breast Services, Monash Health, Bentleigh East VIC 3165, Australia
| | - G B Mann
- Department of Surgery, The University of Melbourne, Parkville, VIC 3052, Australia
| | - S Kumar
- Department of Medical Oncology, Chris O'Brien Lifehouse, Camperdown NSW 2050, Australia; Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead NSW 2145, Australia; Westmead Breast Cancer Institute, Westmead Hospital, Westmead, NSW 2145, Australia
| | - S Warrier
- Royal Prince Alfred Hospital Institute of Academic Surgery, Camperdown NSW 2050, Australia; Department of Surgery, Chris O'Brien Lifehouse, 119-143 Missenden Rd, Camperdown NSW 2050, Australia
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Chao YH, Wang SY, Sheu SJ. Decision-making process for breast-conserving therapy from the perspective of women with breast cancer: A grounded theory study. Eur J Oncol Nurs 2023; 66:102375. [PMID: 37499401 DOI: 10.1016/j.ejon.2023.102375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 11/11/2022] [Accepted: 06/14/2023] [Indexed: 07/29/2023]
Abstract
PURPOSE To explore the decision-making and coping processes of women with newly diagnosed breast cancer receiving breast-conserving therapy. METHODS The grounded theory methodology approach was employed in this study. Purposive and theoretical sampling methods were used to enroll 27 women with stage I-III breast cancer. Individual interviews were conducted using a semi-structured interview guide, and data were analyzed using open, axial, and selective coding. RESULTS The core category is "limitations of boundaries," which includes three categories: feminine body boundary, emotional boundary, and knowledge boundary. Clusters, conflicts, and changeability were among the unique contextual conditions. The decision-making process became more challenging because of the differences between the levels of knowledge of physicians and patients receiving treatment information. Women's actions and interactions included information seeking, controlling, negotiating, and accepting nondecision-making support. The consequences of decisions included redecision and reoperation, and most women did not regret receiving breast-conserving therapy. CONCLUSION Even after choosing breast-conserving therapy, some women may experience changes in treatment procedures. Medical professionals should identify women's challenges and limitations during their decision-making process, explain the benefits and drawbacks of different surgical modalities, address concerns about the outcome of breast-conserving surgery, and provide intellectual and emotional support for decision-making.
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Affiliation(s)
- Yu-Huan Chao
- Department of Nursing, College of Nursing, HungKuang University Taiwan, No. 1018, Sec. 6, Taiwan Boulevard, Shalu District, Taichung City, 433304, Taiwan, ROC.
| | - Shou-Yu Wang
- Discipline of Nursing, School of Health, University of New England, Australia; University of New England, Elm Avenue, Armidale, NSW, 2351, Australia.
| | - Shuh-Jen Sheu
- Institute of Community Health Care, College of Nursing, National Yang Ming Chiao Tung University Taiwan, No.155, Sec.2, Linong Street, Taipei, 112, Taiwan, ROC.
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Fan R, Wang L, Bu X, Wang W, Zhu J. Unmet supportive care needs of breast cancer survivors: a systematic scoping review. BMC Cancer 2023; 23:587. [PMID: 37365504 PMCID: PMC10294377 DOI: 10.1186/s12885-023-11087-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 06/19/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Breast cancer is the most common type of cancer in women worldwide. Though improved treatments and prolonged overall survival, breast cancer survivors (BCSs) persistently suffer from various unmet supportive care needs (USCNs) throughout the disease. This scoping review aims to synthesize current literature regarding USCNs among BCSs. METHODS This study followed a scoping review framework. Articles were retrieved from Cochrane Library, PubMed, Embase, Web of Science, and Medline from inception through June 2023, as well as reference lists of relevant literature. Peer-reviewed journal articles were included if USCNs among BCSs were reported. Inclusion/exclusion criteria were adopted to screen articles' titles and abstracts as well as to entirely assess any potentially pertinent records by two independent researchers. Methodological quality was independently appraised following Joanna Briggs Institute (JBI) critical appraisal tools. Content analytic approach and meta-analysis were performed for qualitative and quantitative studies respectively. Results were reported according to the PRISMA extension for scoping reviews. RESULTS A total of 10,574 records were retrieved and 77 studies were included finally. The overall risk of bias was low to moderate. The self-made questionnaire was the most used instrument, followed by The Short-form Supportive Care Needs Survey questionnaire (SCNS-SF34). A total of 16 domains of USCNs were finally identified. Social support (74%), daily activity (54%), sexual/intimacy (52%), fear of cancer recurrence/ spreading (50%), and information support (45%) were the top unmet supportive care needs. Information needs and psychological/emotional needs appeared most frequently. The USCNs was found to be significantly associated with demographic factors, disease factors, and psychological factors. CONCLUSION BCSs are experiencing a large number of USCNs in fearing of cancer recurrence, daily activity, sexual/intimacy, psychology and information, with proportions ranging from 45% to 74%. Substantial heterogeneity in study populations and assessment tools was observed. There is a need for further research to identify a standard evaluation tool targeted to USCNs on BCSs. Effective interventions based on guidelines should be formulated and conducted to decrease USCNs among BCSs in the future.
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Affiliation(s)
- Rongrong Fan
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, No.37, Guoxue Lane, Wuhou District, Chengdu, Sichuan China
| | - Lili Wang
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, No.37, Guoxue Lane, Wuhou District, Chengdu, Sichuan China
| | - Xiaofan Bu
- The School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Wenxiu Wang
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, No.37, Guoxue Lane, Wuhou District, Chengdu, Sichuan China
| | - Jing Zhu
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, No.37, Guoxue Lane, Wuhou District, Chengdu, Sichuan China
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Rodriguez-Ortega A, Ferro T, Pérez X, Pla Farnós MJ, Gil-Gil M, López Ojeda A, Borrás JM. Self-assessment of a breast care nursing model within a Breast Unit: learning process and keys to improving breast care. J Clin Nurs 2023; 32:2722-2732. [PMID: 36760012 DOI: 10.1111/jocn.16639] [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: 04/29/2022] [Accepted: 05/03/2022] [Indexed: 02/11/2023]
Abstract
AIM AND OBJECTIVES To assess the adherence of a nursing care model in a multidisciplinary breast cancer unit in a tertiary hospital to the recommended competencies and quality indicators. BACKGROUND Aligning the competencies of the breast care nurse with international recommendations for this role helps better fulfil patient needs, increases satisfaction and ensures continuity of care. DESIGN Cohort study. METHODS Breast care nursing was assessed in all patients treated at the Functional Breast Unit from 1 July 2016 to 30 June 2017. Patients were followed for 1 year. Sociodemographic, clinical and pathological data, treatments performed and nursing interventions were collected. The strobe checklist has been used to report this study. RESULTS We analysed nursing interventions carried out in 382 patients attended over 1 year in a multidisciplinary breast cancer unit. All patients with early disease had contact with the nurse at different times during their primary treatment. Only 58% of patients with advanced disease had contact with the nurse during their first year of illness. Moreover, first contact with the nurse was delayed by more than a week from diagnosis, the interval recommended by international guidelines. CONCLUSION The nursing care model meets the core competencies defined for the breast care nurse in patients with early breast cancer, but the first visit should be organised earlier, and follow-up should extend beyond completion of primary treatment. RELEVANCE TO CLINICAL PRACTICE This study evaluated the breast care nurse model in one breast cancer unit according to international guidelines. Nursing care adhered to most guideline requirements in patients with early breast cancer, but not in those with advanced disease. New models of care need to be developed for women with advanced breast cancer in order to achieve true patient-centred care. PATIENT OR PUBLIC CONTRIBUTION No contribution from the patient or the public because the data collected was entered into the clinical history by the health professionals of the Breast Unit as part of their usual clinical practice.
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Affiliation(s)
- Ana Rodriguez-Ortega
- Catalan Institute of Oncology-Bellvitge University Hospital, Barcelona, Spain.,Departament d'Infermeria Fonamental i Medicoquirúrgica, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
| | - Tàrsila Ferro
- Departament d'Infermeria Fonamental i Medicoquirúrgica, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
| | | | - Maria Jesus Pla Farnós
- Breast Unit Catalan Institute of Oncology-Bellvitge University Hospital, Barcelona, Spain
| | - Miguel Gil-Gil
- Functional Units of Oncology, Catalan Institute of Oncology-Bellvitge University Hospital, Barcelona, Spain
| | | | - Josep María Borrás
- University of Barcelona and Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
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Fjell M, Langius-Eklöf A, Nilsson M, Sundberg K. Patients’ Experiences of Care With or Without the Support of an Interactive App During Neoadjuvant Chemotherapy for Breast Cancer: Interview Study. JMIR Nurs 2022; 5:e39983. [PMID: 35969443 PMCID: PMC9412756 DOI: 10.2196/39983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/07/2022] [Accepted: 07/10/2022] [Indexed: 11/13/2022] Open
Abstract
Background
Neoadjuvant chemotherapy (NACT) is often recommended for patients with breast cancer with more aggressive tumor characteristics. As with all chemotherapies, they can cause substantially disturbing symptoms. Most patients receive their treatment as outpatients, which means that they must take responsibility for self-care and management of symptoms at home for a long period. Patients with breast cancer undergoing chemotherapy may not receive sufficient support for management of treatment-related symptoms. For patients undergoing NACT, it has been concluded that information and supportive needs are not always met. In our previous study, the use of mobile health to support patients with breast cancer undergoing NACT reduced symptoms during treatment with the support of an interactive app. Therefore, it is important to investigate how patients experience their care and explore any specific contribution that the app may have brought in care.
Objective
This study aims to explore patients’ experiences of care with or without the support of an interactive app during NACT for breast cancer.
Methods
This qualitative study was part of a larger randomized controlled trial and included 40 individual face-to-face interviews conducted with patients in both intervention and control groups after the end of NACT. The interviews were audio recorded, and the data were analyzed inductively using thematic analysis.
Results
No major differences in experience of care were observed between the groups. A total of 4 overarching themes emerged. In the first theme, The health care context, patients described care as assessible, although sometimes there was a lack of time and continuity with nurses. In the second theme, Being a recipient of care, it emerged that the patients experienced a warm and positive atmosphere at the clinics. In the third theme, Taking an active role as a patient, patients described being active in searching for information and various ways of participation in their own care. In the fourth theme, The value of the app, patients who had used the app experienced it as a complementary source of information, creating a sense of security. Using the app provided patients with the support of being contacted by a nurse if needed, enabled self-care, and facilitated the planning of daily activities.
Conclusions
Overall, patients’ experiences of care were similar and mostly positive. However, for patients using the app, it provided additional support for information and self-care and enhanced participation in their own care. The easy access to a nurse gave patients a sense of security. The findings suggest integrating an interactive app as a complement to standard care to support patients with breast cancer during treatment.
International Registered Report Identifier (IRRID)
RR2-DOI: 10.1186/s12885-017-3450-y
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Affiliation(s)
- Maria Fjell
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Ann Langius-Eklöf
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Marie Nilsson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Kay Sundberg
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
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11
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Stevens L, Brown ZJ, Zeh R, Monsour C, Wells-Di Gregorio S, Santry H, Ejaz AM, Pawlik TM, Cloyd JM. Characterizing the patient experience during neoadjuvant therapy for pancreatic ductal adenocarcinoma: A qualitative study. World J Gastrointest Oncol 2022; 14:1175-1186. [PMID: 35949220 PMCID: PMC9244990 DOI: 10.4251/wjgo.v14.i6.1175] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 04/01/2022] [Accepted: 05/17/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Neoadjuvant therapy (NT) has increasingly been utilized for patients with localized pancreatic ductal adenocarcinoma (PDAC). It is the recommended approach for borderline resectable (BR) and locally advanced (LA) cancers and an increasingly utilized option for potentially resectable (PR) disease. Despite its increased use, little research has focused on patient-centered metrics among patients undergoing NT, including patient experiences, preferences, and recommendations. A better understanding of all aspects of the patient experience during NT may identify opportunities to design interventions aimed at improving quality of life; it may also facilitate the completion of NT and receipt of surgery, ultimately optimizing long-term outcomes. AIM To understand the experience of patients initiating and receiving NT to identify opportunities to improve neoadjuvant cancer care delivery. METHODS Semi-structured interviews of patients with localized PDAC during NT were conducted to explore their experience initiating and receiving NT. Interviews took place between August 2020 and October 2021. Due to the descriptive nature of the research, questions were open ended. Interviews were conducted over the phone, audio recorded and then transcribed. All interviews were coded by two independent researchers using NVivo 12, iteratively identifying themes until thematic saturation was achieved. An integrative approach to qualitative analysis was used, utilizing both inductive and deductive methods. RESULTS A total of 12 patients with localized PDAC were interviewed. Patients with BR (n = 7), PR (n = 2), and LA (n = 3) cancers participated in the study. All patients indicated that choosing NT was the doctor's recommendation, while most reported not being familiar with the concept of NT (n = 11) and that NT was presented as the only option (n = 8). Five themes describing the patient experience emerged: physical symptoms, emotional symptoms, coping mechanisms, access to care, and life factors. The most commonly cited recommendation for improving the experience of NT was improved education before and during NT (n = 7). Patients highlighted the need for more information on the rationale behind choosing NT prior to surgery, the anticipated surgery and its likelihood of surgery occurring after NT, as well as general information prior to starting NT treatment. The need for seeing different members of the healthcare team, including ancillary services was also frequently cited as a recommendation for improving the experience of NT (n = 5). CONCLUSION This study provides a framework to allow for a better understanding of the PDAC patient experience during NT and highlights opportunities to improve quality and quantity of life outcomes.
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Affiliation(s)
- Lena Stevens
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States
| | - Zachary J Brown
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States
| | - Ryan Zeh
- Department of General Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, United States
| | - Christina Monsour
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States
| | - Sharla Wells-Di Gregorio
- Department of Psychiatry, Center for Palliative Care, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States
| | - Heena Santry
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States
| | - Aslam M Ejaz
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States
| | - Timothy Michael Pawlik
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States
| | - Jordan M Cloyd
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States
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12
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Davoodi SH, Yousefinejad V, Ghaderi B, Akbari ME, Darvishi S, Mehrabi Y, Darvishi N. Oral Propolis, Nutritional Status and Quality of Life with Chemotherapy for Breast Cancer: A Randomized, Double-Blind Clinical Trial. Nutr Cancer 2021; 74:2029-2037. [PMID: 34622721 DOI: 10.1080/01635581.2021.1988118] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Chemotherapy-induced side effects include an impaired nutritional status and reduced quality of life in patients. The contribution of propolis, as a co-adjuvant nutritional supplement in cancer treatment, is suggested due to its functional characteristics and biological activities such as antitumoral activity, DNA protection, free radicals scavenging, and immune stimulation; however, clinical trials to support these effects in cancer patients are necessary. This is a randomized, double-blind, placebo-controlled clinical trial to assess the effect of propolis vs. placebo on the nutritional status and quality of life in patients diagnosed with breast cancer who are receiving chemotherapy (No. IRCT2016062828679N1). A total of 60 patients from the Oncology Clinic at Tohid Hospital, Sanandaj, Iran were randomized to receive propolis (250 mg/two times per day for three months) or a placebo. After three months of intervention, energy intake of patients who received propolis increased significantly compared to placebo group (p = 0.000). The quality of life also showed significant improvements in patients receiving propolis, particularly with regards to emotional functioning (p = 0.03), global QoL functioning (p = 0.04), and financial difficulties (p = 0.01) compared to the control group. Propolis is suggested an adequate and safe therapeutic option to improve the nutritional status and quality of life in patients diagnosed with breast cancer receiving chemotherapy. However, more trials are needed in order to draw robust conclusions with regard to its efficacy in chemotherapy-induced side effects.
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Affiliation(s)
- Seyed Hossein Davoodi
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Nutrition Department, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Vahid Yousefinejad
- Liver and Digestive Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Bayazid Ghaderi
- Liver and Digestive Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | | | - Shoaleh Darvishi
- Food Sciences and Technology Department, Sanandaj Branch, Islamic Azad University, Sanandaj, Iran
| | - Yadollah Mehrabi
- Epidemiology Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nazila Darvishi
- Nutrition Department, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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13
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Evans Webb M, Murray E, Younger ZW, Goodfellow H, Ross J. The Supportive Care Needs of Cancer Patients: a Systematic Review. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:899-908. [PMID: 33492650 PMCID: PMC8523012 DOI: 10.1007/s13187-020-01941-9] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/06/2020] [Indexed: 06/12/2023]
Abstract
Cancer, and the complex nature of treatment, has a profound impact on lives of patients and their families. Subsequently, cancer patients have a wide range of needs. This study aims to identify and synthesise cancer patients' views about areas where they need support throughout their care. A systematic search of the literature from PsycInfo, Embase and Medline databases was conducted, and a narrative. Synthesis of results was carried out using the Corbin & Strauss "3 lines of work" framework. For each line of work, a group of key common needs were identified. For illness-work, the key needs idenitified were; understanding their illness and treatment options, knowing what to expect, communication with healthcare professionals, and staying well. In regards to everyday work, patients wanted to maintain a sense of normalcy and look after their loved ones. For biographical work, patients commonly struggled with the emotion impact of illness and a lack of control over their lives. Spiritual, sexual and financial problems were less universal. For some types of support, demographic factors influenced the level of need reported. While all patients are unique, there are a clear set of issues that are common to a majority of cancer journeys. To improve care, these needs should be prioritised by healthcare practitioners.
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Affiliation(s)
- Madeleine Evans Webb
- UCL Research Department of Epidemiology & Public Health, 1-19 Torrington Place, London, WC1E 6BT UK
| | - Elizabeth Murray
- Department of Primary Care and Population Health, Upper 3rd Floor, Royal Free Hospital, Rowland Hill Street, London, NW3 2PF UK
| | - Zane William Younger
- Department of Primary Care and Population Health, Upper 3rd Floor, Royal Free Hospital, Rowland Hill Street, London, NW3 2PF UK
| | - Henry Goodfellow
- Department of Primary Care and Population Health, Upper 3rd Floor, Royal Free Hospital, Rowland Hill Street, London, NW3 2PF UK
| | - Jamie Ross
- Department of Primary Care and Population Health, Upper 3rd Floor, Royal Free Hospital, Rowland Hill Street, London, NW3 2PF UK
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14
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Korde LA, Somerfield MR, Carey LA, Crews JR, Denduluri N, Hwang ES, Khan SA, Loibl S, Morris EA, Perez A, Regan MM, Spears PA, Sudheendra PK, Symmans WF, Yung RL, Harvey BE, Hershman DL. Neoadjuvant Chemotherapy, Endocrine Therapy, and Targeted Therapy for Breast Cancer: ASCO Guideline. J Clin Oncol 2021; 39:1485-1505. [PMID: 33507815 PMCID: PMC8274745 DOI: 10.1200/jco.20.03399] [Citation(s) in RCA: 435] [Impact Index Per Article: 145.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 12/04/2020] [Indexed: 12/24/2022] Open
Abstract
PURPOSE To develop guideline recommendations concerning optimal neoadjuvant therapy for breast cancer. METHODS ASCO convened an Expert Panel to conduct a systematic review of the literature on neoadjuvant therapy for breast cancer and provide recommended care options. RESULTS A total of 41 articles met eligibility criteria and form the evidentiary basis for the guideline recommendations. RECOMMENDATIONS Patients undergoing neoadjuvant therapy should be managed by a multidisciplinary care team. Appropriate candidates for neoadjuvant therapy include patients with inflammatory breast cancer and those in whom residual disease may prompt a change in therapy. Neoadjuvant therapy can also be used to reduce the extent of local therapy or reduce delays in initiating therapy. Although tumor histology, grade, stage, and estrogen, progesterone, and human epidermal growth factor receptor 2 (HER2) expression should routinely be used to guide clinical decisions, there is insufficient evidence to support the use of other markers or genomic profiles. Patients with triple-negative breast cancer (TNBC) who have clinically node-positive and/or at least T1c disease should be offered an anthracycline- and taxane-containing regimen; those with cT1a or cT1bN0 TNBC should not routinely be offered neoadjuvant therapy. Carboplatin may be offered to patients with TNBC to increase pathologic complete response. There is currently insufficient evidence to support adding immune checkpoint inhibitors to standard chemotherapy. In patients with hormone receptor (HR)-positive (HR-positive), HER2-negative tumors, neoadjuvant chemotherapy can be used when a treatment decision can be made without surgical information. Among postmenopausal patients with HR-positive, HER2-negative disease, hormone therapy can be used to downstage disease. Patients with node-positive or high-risk node-negative, HER2-positive disease should be offered neoadjuvant therapy in combination with anti-HER2-positive therapy. Patients with T1aN0 and T1bN0, HER2-positive disease should not be routinely offered neoadjuvant therapy.Additional information is available at www.asco.org/breast-cancer-guidelines.
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Affiliation(s)
- Larissa A Korde
- Clinical Investigations Branch, CTEP, DCTD, National Cancer Institute, Bethesda, MD
| | | | - Lisa A Carey
- University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | | | | | | | | | | | | | - Alejandra Perez
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Plantation, FL
| | | | - Patricia A Spears
- University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | | | | | | | | | - Dawn L Hershman
- Herbert Irving Comprehensive Cancer Center at Columbia University, New York, NY
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15
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Di Leone A, Terribile D, Magno S, Sanchez AM, Scardina L, Mason EJ, D’Archi S, Maggiore C, Rossi C, Di Micco A, Carnevale S, Paris I, Marazzi F, Masiello V, Orlandi A, Palazzo A, Fabi A, Masetti R, Franceschini G. Neoadjuvant Chemotherapy in Breast Cancer: An Advanced Personalized Multidisciplinary Prehabilitation Model (APMP-M) to Optimize Outcomes. J Pers Med 2021; 11:324. [PMID: 33919061 PMCID: PMC8143137 DOI: 10.3390/jpm11050324] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/09/2021] [Accepted: 04/12/2021] [Indexed: 01/01/2023] Open
Abstract
Neoadjuvant chemotherapy is increasingly being employed in the management of breast cancer patients. Efforts and resources have been devoted over the years to the search for an optimal strategy that can improve outcomes in the neoadjuvant setting. Today, a multidisciplinary approach with the application of evidence-based medicine is considered the gold standard for the improvement of oncological results and patient satisfaction. However, several clinical complications and psychological issues due to various factors can arise during neoadjuvant therapy and undermine outcomes. To ensure that health care needs are adequately addressed, clinicians must consider that women with breast cancer have a high risk of developing "unmet needs" during treatment, and often require a clinical intervention or additional care resources to limit possible complications and psychological issues that can occur during neoadjuvant treatment. This work describes a multidisciplinary model developed at "Fondazione Policlinico Universitario Agostino Gemelli" (FPG) in Rome in an effort to optimize treatment, ease the application of evidence-based medicine, and improve patient quality of life in the neoadjuvant setting. In developing our model, our main goal was to adequately meet patient needs while preventing high levels of distress.
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Affiliation(s)
- Alba Di Leone
- Multidisciplinary Breast Centre, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (D.T.); (S.M.); (A.M.S.); (L.S.); (E.J.M.); (S.D.); (R.M.); (G.F.)
| | - Daniela Terribile
- Multidisciplinary Breast Centre, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (D.T.); (S.M.); (A.M.S.); (L.S.); (E.J.M.); (S.D.); (R.M.); (G.F.)
| | - Stefano Magno
- Multidisciplinary Breast Centre, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (D.T.); (S.M.); (A.M.S.); (L.S.); (E.J.M.); (S.D.); (R.M.); (G.F.)
| | - Alejandro Martin Sanchez
- Multidisciplinary Breast Centre, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (D.T.); (S.M.); (A.M.S.); (L.S.); (E.J.M.); (S.D.); (R.M.); (G.F.)
| | - Lorenzo Scardina
- Multidisciplinary Breast Centre, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (D.T.); (S.M.); (A.M.S.); (L.S.); (E.J.M.); (S.D.); (R.M.); (G.F.)
| | - Elena Jane Mason
- Multidisciplinary Breast Centre, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (D.T.); (S.M.); (A.M.S.); (L.S.); (E.J.M.); (S.D.); (R.M.); (G.F.)
| | - Sabatino D’Archi
- Multidisciplinary Breast Centre, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (D.T.); (S.M.); (A.M.S.); (L.S.); (E.J.M.); (S.D.); (R.M.); (G.F.)
| | - Claudia Maggiore
- Centre of Integrative Oncology—Multidisciplinary Breast Centre—Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli I RCCS, 00168 Rome, Italy; (C.M.); (C.R.); (A.D.M.)
| | - Cristina Rossi
- Centre of Integrative Oncology—Multidisciplinary Breast Centre—Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli I RCCS, 00168 Rome, Italy; (C.M.); (C.R.); (A.D.M.)
| | - Annalisa Di Micco
- Centre of Integrative Oncology—Multidisciplinary Breast Centre—Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli I RCCS, 00168 Rome, Italy; (C.M.); (C.R.); (A.D.M.)
| | - Stefania Carnevale
- UOS Psicologia Clinica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy;
| | - Ida Paris
- Department of Woman and Child Health and Public Health, Woman Health Area, Fondazione Policlinico Universitario A. Gemelli I RCCS, 00168 Rome, Italy;
| | - Fabio Marazzi
- UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli I RCCS, 00168 Rome, Italy; (F.M.); (V.M.)
| | - Valeria Masiello
- UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli I RCCS, 00168 Rome, Italy; (F.M.); (V.M.)
| | - Armando Orlandi
- Comprehensive Cancer Center, Multidisciplinary Breast Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli, 8, 00168 Rome, Italy; (A.O.); (A.P.)
| | - Antonella Palazzo
- Comprehensive Cancer Center, Multidisciplinary Breast Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli, 8, 00168 Rome, Italy; (A.O.); (A.P.)
| | - Alessandra Fabi
- Medicina di Precisione in Senologia, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy;
| | - Riccardo Masetti
- Multidisciplinary Breast Centre, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (D.T.); (S.M.); (A.M.S.); (L.S.); (E.J.M.); (S.D.); (R.M.); (G.F.)
| | - Gianluca Franceschini
- Multidisciplinary Breast Centre, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (D.T.); (S.M.); (A.M.S.); (L.S.); (E.J.M.); (S.D.); (R.M.); (G.F.)
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16
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Enhancing Self-Esteem and Body Image of Breast Cancer Women through Interventions: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041640. [PMID: 33572137 PMCID: PMC7914971 DOI: 10.3390/ijerph18041640] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/02/2021] [Accepted: 02/05/2021] [Indexed: 12/12/2022]
Abstract
Breast Cancer (BC) is the most common neoplasm in women worldwide, considered a global public health problem. Among BC women, some of the most common psychological symptoms in the adaptation to the disease are reduction in self-esteem and distorted body image (BI). Although there are numerous studies with the goal of promoting different psychological variables, BI and self-esteem are often separately observed despite their relationship and their importance in the process of the illness. Moreover, there have been no reviews that have synthesized the findings related to interventions aimed at enhancing both self-esteem and BI in BC women. Therefore, the objective of this review was to identify and examine the implemented interventions aimed at boosting both variables in this population. For this purpose, a systematic review was implemented following the PRISMA statement. A thorough search was performed on the following databases: Web of Science, PubMed, PsychInfo, PsychArticles, and Scopus. Among 287 records, only eight articles met the eligibility criteria. Interventions were grouped into three types according to their characteristics: Group therapies, Physical activity therapies, and Cosmetic and beauty treatments. The levels of effectiveness of the different interventions varied between them, and within each, in their impact on self-esteem and BI. More interventions focused on developing BI and self-esteem in this population are needed due to their ability to predict psychological functioning and quality of life of women with breast cancer.
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17
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Experience of women with breast cancer undergoing chemotherapy: a systematic review of qualitative research. Qual Life Res 2021; 30:1249-1265. [DOI: 10.1007/s11136-020-02754-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2020] [Indexed: 01/26/2023]
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18
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Magalhães B, Fernandes C, Lima L, Martinez-Galiano JM, Santos C. Cancer patients’ experiences on self-management of chemotherapy treatment-related symptoms: A systematic review and thematic synthesis. Eur J Oncol Nurs 2020; 49:101837. [DOI: 10.1016/j.ejon.2020.101837] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 09/10/2020] [Accepted: 09/16/2020] [Indexed: 01/12/2023]
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19
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Mitchell KAR, Brassil KJ, Rodriguez SA, Tsai E, Fujimoto K, Krause KJ, Shay LA, Springer AE. Operationalizing patient-centered cancer care: A systematic review and synthesis of the qualitative literature on cancer patients' needs, values, and preferences. Psychooncology 2020; 29:1723-1733. [PMID: 32715542 PMCID: PMC7901502 DOI: 10.1002/pon.5500] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 07/06/2020] [Accepted: 07/22/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Efficiently addressing patient priorities and concerns remains a challenge in oncology. Systematic operationalization of patient-centered care (PCC) can support improved assessment and practice of PCC in this unique care setting. This review aimed to synthesize the qualitative empirical literature exploring the National Academy of Medicine (NAM)'s PCC constructs of values, needs, and preferences among patients' during their cancer treatment experiences. METHODS A systematic review of qualitative studies published between 2002 and 2018 addressing adult patient values, needs, and preferences during cancer treatment was conducted. Medline, EMBASE, PsycINFO, and SCOPUS databases were searched on September 10, 2018. Methodological rigor was assessed using a modified version of the Evaluation Tool for Qualitative Studies. Included study findings were analyzed using line-by-line coding; and the emergent themes were compared to the National Academy of Medicine (NAM)'s PCC dimensions. RESULTS Twenty-nine primary studies were included in the synthesis. Descriptive themes for values (autonomy, being involved, family, hope, normality, and sincerity), needs (care coordination, information, privacy, support of physical well-being, emotional support (family/friends, peer, provider), and self-support), and preferences (care coordination, decision-making, information delivery, source of social support, and treatment) were identified. "Cancer care context" emerged as an important domain in which these constructs are operationalized. This thematic framework outlines PCC attributes that oncology care stakeholders can evaluate to improve patient experiences. CONCLUSIONS These findings build on previous PCC research and may contribute to the systematic assessment of patient priorities and the improvement of oncology care quality from the patient perspective.
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Affiliation(s)
- Kerri-Anne R. Mitchell
- Department of Health Behavior and Policy, Virginia
Commonwealth University School of Medicine, Richmond, Virginia
| | | | - Serena A. Rodriguez
- Department of Population and Data Sciences, University of
Texas Southwestern Medical Center, Dallas, Texas
| | - Edward Tsai
- Division of Public Health Sciences, Department of Surgery,
Washington University School of Medicine, St. Louis, Missouri
| | - Kayo Fujimoto
- Department of Health Promotion & Behavioral Sciences,
The University of Texas Health Science Center at Houston (UTHealth) School of Public
Health, Houston, Texas
| | - Kate J. Krause
- Research Medical Library, The University of Texas MD
Anderson Cancer Center, Houston, Texas
| | - L. Aubree Shay
- Department of Health Promotion & Behavioral Sciences,
UTHealth School of Public Health, San Antonio, Texas
| | - Andrew E. Springer
- Michael & Susan Dell Center for Healthy Living,
Department of Health Promotion & Behavioral Sciences, UTHealth School of Public
Health, Austin, Texas
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20
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Patient experience and quality of life during neoadjuvant therapy for pancreatic cancer: a systematic review and study protocol. Support Care Cancer 2020; 29:3009-3016. [PMID: 33030596 DOI: 10.1007/s00520-020-05813-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 10/02/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE Neoadjuvant therapy (NT) is increasingly being offered to patients with pancreatic ductal adenocarcinoma (PDAC) prior to surgical resection. However, the experience and quality of life (QOL) of patients undergoing NT are poorly understood. METHODS A systematic review of the Cinahl, Embase, Medline, Pubmed, Scopus, and Web of Science databases was conducted to evaluate the available literature pertaining to the experience and QOL of patient's undergoing NT for PDAC. RESULTS Among 6041 articles screened, only six met criteria for full-text review including three prospective clinical trials of NT with QOL secondary endpoints. Overall, global QOL during or following NT did not significantly change from baseline. Pain scores seemed to improve during NT while the impact of NT on physical functioning varied across studies. No studies were identified evaluating other aspects of the patient experience. CONCLUSION Although NT appears to have a minor impact on the QOL of patients with PDAC, this systematic review identified significant evidence gaps in the literature. A protocol of a prospective observational cohort study utilizing a digital smartphone app that aims to evaluate the patient experience and longitudinal QOL of patients with PDAC undergoing NT is presented.
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Hissa J, Connolly A, Timulak L, Hession N. Emotion-focused perspective on breast cancer patients’ experiences of comorbid anxiety and depression: a qualitative case analysis of three clients’ in-session presentations. PERSON-CENTERED & EXPERIENTIAL PSYCHOTHERAPIES 2020. [DOI: 10.1080/14779757.2020.1717988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Joana Hissa
- School of Psychology, Trinity College, Dublin, Ireland
| | - Allison Connolly
- School of Psychology, Trinity College, Dublin, Ireland
- St. Luke’s Radiation Oncology Network, Dublin, Ireland
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Fjell M, Langius-Eklöf A, Nilsson M, Wengström Y, Sundberg K. Reduced symptom burden with the support of an interactive app during neoadjuvant chemotherapy for breast cancer - A randomized controlled trial. Breast 2020; 51:85-93. [PMID: 32247251 PMCID: PMC7375618 DOI: 10.1016/j.breast.2020.03.004] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 02/12/2020] [Accepted: 03/19/2020] [Indexed: 02/07/2023] Open
Abstract
Objectives Neoadjuvant chemotherapy causes distressing symptoms, which have to be managed by patients at home. Assessing and acting upon relevant patient-reported symptoms regularly with the support of mHealth such as apps, has shown to decrease symptom burden and improve health-related quality of life (HRQoL). There is a lack of apps for patients with breast cancer which are tested in rigorous trials and only a few include interactive components for immediate clinical management. The aim of this study was to evaluate whether the use of the interactive app Interaktor improves patients’ levels of symptom burden and HRQoL during neoadjuvant chemotherapy for breast cancer. Materials and methods This randomized controlled trial included patients in an intervention group (n = 74) and a control group (n = 75), recruited at two university hospitals in Stockholm, Sweden. The intervention group used Interaktor for symptom reporting, self-care advice and support from health-care professionals during treatment, and the control group received standard care alone. Self-reported symptoms and HRQoL were assessed at two time points to determine differences between the groups. Results The intervention group rated statistically significant less symptom prevalence in nausea, vomiting, feeling sad, appetite loss and constipation. Overall symptom distress and physical symptom distress were rated statistically significant lower in the intervention group. Further, emotional functioning was rated statistically significant higher in the intervention group. Conclusions By using the Interaktor app in clinical practice, patients get individual support when managing treatment-related symptoms during neoadjuvant chemotherapy for breast cancer, leading to decreased symptom burden and improved emotional functioning. Using the app Interaktor reduced symptom burden in patients with breast cancer. The use of Interaktor enhanced emotional functioning during treatment. Interaktor provided individual support during neoadjuvant chemotherapy. Use of Interaktor allowed breast cancer patients for daily reflection over symptoms.
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Affiliation(s)
- Maria Fjell
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Nursing, Stockholm, Sweden.
| | - Ann Langius-Eklöf
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Nursing, Stockholm, Sweden
| | - Marie Nilsson
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Nursing, Stockholm, Sweden; Karolinska University Hospital, Function Area Social Work in Health Care, Stockholm, Sweden; Stockholm County Council, Academic Primary Health Care Center, Stockholm, Sweden
| | - Yvonne Wengström
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Nursing, Stockholm, Sweden; Karolinska University Hospital, Cancer Theme, Stockholm, Sweden
| | - Kay Sundberg
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Nursing, Stockholm, Sweden
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Mitchell KAR, Brassil KJ, Fujimoto K, Fellman BM, Shay LA, Springer AE. Exploratory Factor Analysis of a Patient-Centered Cancer Care Measure to Support Improved Assessment of Patients' Experiences. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2020; 23:351-361. [PMID: 32197731 PMCID: PMC7086403 DOI: 10.1016/j.jval.2019.10.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 08/26/2019] [Accepted: 10/20/2019] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To increase the understanding of patient-centered care (PCC) and address the need for cross-cutting quality cancer care measures that are relevant to both patients and providers. METHODS An exploratory factor analysis (EFA) was performed on a short version of the Patients and the Cancer Care Experience Survey, a patient-reported measure of perceived importance of social, emotional, physical, and informational aspects of care, administered to adult patients (n = 104) at a National Cancer Institute-designated comprehensive cancer center. Relationships between PCC dimensions and patient characteristics were also assessed. Principal axis factoring was applied and bivariate analyses were performed using Wilcoxon rank-sum tests. RESULTS Most of our sample was over 60 years old (63.4%), female (57.4%), and white (74.2%), with either breast (41.2%) or prostate cancer (27.5%). A 5-factor model was identified: (1) quality of life (α = .91), (2) provider social support (α = .83), (3) psychosocial needs (α = .91), (4) nonprovider social support (α = .79), and (5) health information and decision-making support (α = .88). No statistically significant associations were found between these factors and patients' characteristics. CONCLUSIONS A preliminary factor structure for a cancer PCC measure was identified. Our findings reinforce the interrelated nature of PCC dimensions. The lessons learned from this study may be used to develop a single PCC measure that identifies patient priorities across the cancer care continuum. Data collected from such a measure can be used to support patient engagement in treatment planning and decision-making.
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Affiliation(s)
- Kerri-Anne R Mitchell
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, VA, USA.
| | | | - Kayo Fujimoto
- Department of Health Promotion & Behavioral Sciences, University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA; Department of Biostatistics and Data Science, University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA
| | - Bryan M Fellman
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Laura Aubree Shay
- Department of Health Promotion & Behavioral Sciences, University of Texas Health Science Center at Houston School of Public Health, San Antonio, TX, USA
| | - Andrew E Springer
- Department of Health Promotion and Behavioral Sciences, Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston School of Public Health, Austin, TX, USA
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Custódio IDD, Franco FDP, Marinho EDC, Pereira TSS, Lima MTM, Molina MDCB, Shivappa N, Hebert JR, Paiva CE, Maia YCDP. Prospective Analysis of Food Consumption and Nutritional Status and the Impact on the Dietary Inflammatory Index in Women with Breast Cancer during Chemotherapy. Nutrients 2019; 11:E2610. [PMID: 31683752 PMCID: PMC6893533 DOI: 10.3390/nu11112610] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 09/20/2019] [Accepted: 09/30/2019] [Indexed: 12/12/2022] Open
Abstract
Considering the implications of adverse effects of chemotherapy (CT) and the potential impact of diet on patients' recovery, this study aimed to prospectively evaluate the association between the consumption of food groups, patients' Dietary Inflammatory Index (DII®) scores, and their nutritional status. Anthropometric and dietary assessments of 55 women with breast cancer (BC) were performed at three time points. T0 is the time point after the first CT cycle, T1 is the time point after the intermediate CT cycle, and T2 is the time point after the last CT cycle. We identified a significant increase in weight, body mass index, and waist circumference during CT. Consumption of poultry and eggs was higher in T1 when compared to T2, while consumption of total fruit and total vegetables was higher at T0 compared to T1 and T2. The diet became more pro-inflammatory over the course of treatment (X2(2) = 61.127), and was related to higher abdominal adiposity. Total fruit (T0: R2 = 0.208, T1: R2 = 0.095, T2: R2 = 0.120) and total vegetable consumption (T0: R2 = 0.284, T1: R2 = 0.365, T2: R2 = 0.580) predicted DII® change at the three-time points. Meanwhile, consumption of total grains was significantly associated only with T1 (R2 = 0.084) and T2 (R2 = 0.118), and consumption of simple sugars was significantly associated only with T0 (R2 = 0.137) and T1 (R2 = 0.126). Changes in food consumption led to an increase in the inflammatory profile of the diet, suggesting the necessity to improve the guidelines during and after CT. These results reinforce the need to promote healthier eating practices in concert with maintaining a healthy nutritional status in women with BC treated with CT.
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Affiliation(s)
- Isis Danyelle Dias Custódio
- Graduate Program in Health Sciences, Federal University of Uberlandia, Uberlandia, 38405-320 Minas Gerais, Brazil.
| | - Fernanda de Paula Franco
- Nutrition Course, Medical Faculty, Federal University of Uberlandia, Uberlandia, 38405-320 Minas Gerais, Brazil.
| | - Eduarda da Costa Marinho
- Graduate Program in Health Sciences, Federal University of Uberlandia, Uberlandia, 38405-320 Minas Gerais, Brazil.
| | | | - Mariana Tavares Miranda Lima
- Graduate Program in Health Sciences, Federal University of Uberlandia, Uberlandia, 38405-320 Minas Gerais, Brazil.
| | - Maria Del Carmen Bisi Molina
- Graduate Program in Nutrition and Health, Federal University of Espirito Santo, Vitoria, 29047-105 Espirito Santo, Brazil.
- Nutrition Course, Federal University of Espirito Santo, Vitoria, 29047-105 Espirito Santo, Brazil.
| | - Nitin Shivappa
- South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA.
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC 29208, USA.
- Connecting Health Innovations LLC, Columbia, SC 29201, USA.
| | - James R Hebert
- South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA.
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC 29208, USA.
- Connecting Health Innovations LLC, Columbia, SC 29201, USA.
| | - Carlos Eduardo Paiva
- Department of Clinical Oncology, Graduate Program in Oncology, Barretos, 14784-400 Sao Paulo, Brazil.
- Palliative Care and Quality of Life Research Group (GPQual), Pio XII Foundation-Barretos Cancer Hospital, Barretos, 14784-400 Sao Paulo, Brazil.
| | - Yara Cristina de Paiva Maia
- Graduate Program in Health Sciences, Federal University of Uberlandia, Uberlandia, 38405-320 Minas Gerais, Brazil.
- Nutrition Course, Medical Faculty, Federal University of Uberlandia, Uberlandia, 38405-320 Minas Gerais, Brazil.
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Wakiuchi J, Marcon SS, Oliveira DCD, Sales CA. Rebuilding subjectivity from the experience of cancer and its treatment. Rev Bras Enferm 2019; 72:125-133. [DOI: 10.1590/0034-7167-2018-0332] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 07/28/2018] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objective: To analyze the social representations of chemotherapy and the experiences built by people with cancer. Method: Descriptive study with a qualitative approach. Data collection occurred between August and December 2016, through interviews with 29 cancer patients undergoing chemotherapy at an institution in the northern part of Paraná State, and the Thematic-Categorical Content Analysis. Results: Four categories have emerged denoting attitudes, feelings and experiences associated with chemotherapy and the need for reconstruction of daily life, permeated by the distancing of social life and work. At the same time, we note the close ties with friends and family, as well as adaptive strategies, new meanings of experiences lived and life priority setting. Final considerations: Cancer represents an interruption of plans and dreams, modifying everyday tasks and generating new experiences. This process facilitates giving a new meaning to the past and the reconstruction of subjectivity.
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Nathoo D, Willis S, Tran WT. Distress Among Locally Advanced Breast Cancer Patients from Diagnosis to Follow-Up: A Critical Review of Literature. J Med Imaging Radiat Sci 2018; 49:325-336. [PMID: 32074060 DOI: 10.1016/j.jmir.2018.04.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 04/18/2018] [Accepted: 04/24/2018] [Indexed: 01/17/2023]
Abstract
OBJECTIVE This critical review used a systematic approach to explore the prevalence of distress among locally advanced breast cancer (LABC) patients along their treatment journey. This review explored the domains of distress (psychosocial, physical and/or practical) that are significant to this patient population and determined indications for psychosocial support throughout the patients' treatment. METHODS Electronic databases including CINAHL, EmBase, Medline PsycInfo, and gray literature were searched from the year 2000 to 2016, to produce relevant literature. A critical review was conducted on 73 articles meeting the inclusion and exclusion criteria. A narrative synopsis was used to summarize the findings under key themes. RESULTS The results indicate that 16/73 studies assessed for distress in all three domains of distress throughout the treatment course. A meta-analysis was not possible due to the methodological heterogeneity of the articles, the variation of assessment tools used, timing in which the assessments were done, and the different treatment modalities. Distress was prevalent from the time of diagnosis, through treatment, and into survivorship. Sexuality, body image, age, financial difficulty, family/social support, and informational needs were common themes that emerged among the LABC population in these studies. CONCLUSIONS Comprehensive assessments incorporating all three domains of distress with the appropriate tools will assist health care professionals throughout the complicated treatment trajectory of LABC patients in taking a more proactive approach in assisting patients' concerns and preventing undue or increase in psychological distress during or after active treatment. This will encourage effective patient-centered communication and supportive care referrals for a better patient experience.
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Affiliation(s)
- Dilshad Nathoo
- Department of Radiation Therapy, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario.
| | | | - William T Tran
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario
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Nies YH, Ali AM, Abdullah N, Islahudin F, Shah NM. A qualitative study among breast cancer patients on chemotherapy: experiences and side-effects. Patient Prefer Adherence 2018; 12:1955-1964. [PMID: 30319245 PMCID: PMC6167974 DOI: 10.2147/ppa.s168638] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The objective of this study was to explore the experiences and side-effects of breast cancer patients on chemotherapy in Malaysia. PARTICIPANTS AND METHODS Purposive sampling of 36 breast cancer patients who have completed chemotherapy and agreed to participate in semi-structured in-depth interviews. A constant comparative method and thematic analysis were used to analyze the interviews. RESULTS Data were categorized into six main themes: know nothing of chemotherapy; fear of chemotherapy; patients' beliefs in alternative treatments; symptom management; staying healthy after chemotherapy; and concerns of patients after chemotherapy. CONCLUSION Despite complaints about the bad experiences of their chemotherapy-induced side-effects, these patients still managed to complete the entire course of chemotherapy. Moreover, there is a need for a clinical pharmacy service in the oncology clinic setting in Malaysia in order to provide relevant information to help patients understand the chemotherapy received.
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Affiliation(s)
- Yong Hui Nies
- Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia,
| | - Adliah Mhd Ali
- Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia,
| | - Norlia Abdullah
- Department of Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Farida Islahudin
- Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia,
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Marinho EDC, Custódio IDD, Ferreira IB, Crispim CA, Paiva CE, Maia YCDP. Impact of chemotherapy on perceptions related to food intake in women with breast cancer: A prospective study. PLoS One 2017; 12:e0187573. [PMID: 29190717 PMCID: PMC5708740 DOI: 10.1371/journal.pone.0187573] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Accepted: 10/23/2017] [Indexed: 12/17/2022] Open
Abstract
Breast cancer (BC) treatment includes mostly chemotherapy (CT), which can cause side effects like nausea, taste changes, early satiety, slow gastric emptying and xerostomia. In this way, the individual’s relationship with food may change during the treatment. The aim of this study was to evaluate the impact of chemotherapy on perceptions related to food intake of women with BC. Fifty-five women with BC were followed, and data were collected at three periods during first-line CT: beginning (T0), intermediate (T1) and end (T2). A visual analogue scale (VAS) (0 to 10 cm) for hunger, appetite for various food categories and meal enjoyment was investigated. The frequency and intensity of side effects were evaluated using a 4 cm scale. The results showed a higher prevalence of taste changes in T1 (p = 0.044) and more nausea in T1 and T2 (p = 0.018). Furthermore, the intensity of nausea was higher in T2 (p = 0.01) than in the other periods. We observed moderate hunger in T0, T1 and T2 (p = 0.113), but the overall appetite increased between T0 and T2 (p = 0.003). Meal enjoyment was reduced from T0 to T1and returned back to the initial value in T2 (p = 0.021). The appetite for salty (p = 0.004) and spicy (p = 0.03) foods was increased in T1. There was an increase of body weight (p = 0.008), body mass index (BMI) (p = 0.009) and waist circumference (WC) (p = 0.03) during CT. CT changes food hedonism, increasing the overall appetite and the appetite for salty and spicy foods. Moreover, we observed the negative impact of CT on meal enjoyment and an increase in side effects and anthropometric parameters.
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Affiliation(s)
- Eduarda da Costa Marinho
- Graduate Program in Health Sciences, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | | | - Isabela Borges Ferreira
- Nutrition Course, Medical Faculty, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | - Cibele Aparecida Crispim
- Graduate Program in Health Sciences, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
- Nutrition Course, Medical Faculty, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | - Carlos Eduardo Paiva
- Department of Clinical Oncology, Graduate Program in Oncology, Palliative Care and Quality of Life Research Group (GPQual), Pio XII Foundation-Barretos Cancer Hospital, Barretos, Sao Paulo, Brazil
| | - Yara Cristina de Paiva Maia
- Graduate Program in Health Sciences, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
- Nutrition Course, Medical Faculty, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
- * E-mail:
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Wulandari SK, Hermayanti Y, Yamin A, Efendi F. Family Process with Breast Cancer Patient in Indonesia. JURNAL NERS 2017. [DOI: 10.20473/jn.v12i2.5970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction: Breast cancer occupies the first position in Asia’s women cancer cases in recent years. Signs and symptoms experienced by the patient affect the stress condition of the patient as well as the family as a caregiver. The condition changes to deal with problems during patient assistance as a major problem in an outpatient setting. The demands of adaptation to through the needs during the period of assistance by the family is more complex. The study aimed to determine the experience of stress and adaptation of breast cancer patient’s family.Methods: The qualitative method used with in-depth interviews on seven respondents who were the family caregiver of breast cancer patients. Setting carried out at the shelter house in Bandung. The analysis process used thematic analysis based on Braun & Clarke.Results: The results found five main themes are: 1) Stressor on breast cancer patients, 2) Crisis fulfillment of companion needs, 3) Crisis accompaniment, 4) Coping mechanisms of caregiver, and 5) Ability in adaptation.Conclusion: Family experience in assisting breast cancer patients who undergo outpatient also impact families tension who traversed with a subjective effort optimally to adapt in accompanying patients and the needs of other resource support system. Suggestions for future step are early recognition of stress by health workers especially nurses to be able to provide targeted interventions to develop positive adaptation to clients. The development through research is needed in applying family center care both the outpatient and inpatient care in an integrated manner.
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Abstract
BACKGROUND The diagnosis and treatment of breast cancer may negatively affect the quality of life (QOL) of women. OBJECTIVES The aim of this study is to assess QOL in women with breast cancer who were treated with or without chemotherapy and to identify factors associated with improved or worsening QOL in these women. METHODS This cross-sectional study enrolled 112 women who were treated with chemotherapy (CTX group, with 85 [75.9%] women) or without chemotherapy (non-CTX group, with 27 [24.1%] women) for breast cancer. The Short-Form Health Survey (SF-36) assessed QOL and the Hospital Anxiety and Depression scale assessed anxiety and depression. RESULTS The overall mean SF-36 score was below 50 in all domains. Relative to CTX women, non-CTX women were significantly older (P = .001) and more likely to engage in physical exercise (P = .002). The non-CTX group had higher scores in the Physical Functioning (P = .001) and Role-Physical (P = .0009) domains of the SF-36 relative to the CTX group, and the fluoruracil + epirubicin + cyclophosphamide group had significantly lower scores in the SF-36 domains Physical Functioning (P = .009) and Role-Physical (P = .02). CONCLUSION Chemotherapy treatment for breast cancer worsens QOL in the Physical Functioning and the Role-Physical domains of the SF-36 relative to women treated without chemotherapy. IMPLICATIONS FOR PRACTICE Nurses should assess Physical Functioning and the Role-Physical before treatment, as a woman who was not physically active before breast cancer is not likely to become physically active after treatment. Establishing support groups and providing educational sessions about the disease and its management, supportive care can improve the QOL of this population.
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Wilhelmsson A, Roos M, Hagberg L, Wengström Y, Blomberg K. Motivation to uphold physical activity in women with breast cancer during adjuvant chemotherapy treatment. Eur J Oncol Nurs 2017; 29:17-22. [PMID: 28720261 DOI: 10.1016/j.ejon.2017.03.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 03/28/2017] [Accepted: 03/29/2017] [Indexed: 12/22/2022]
Abstract
PURPOSE Physical activity (PA) is important for recovery after a breast cancer diagnosis; however, women's motivation to engage in PA can be impacted by disease and/or treatment, and can therefore be a challenge. This study explored factors associated with PA levels during chemotherapy among women with breast cancer. METHOD The study had a cross-sectional descriptive and comparative design using a study-specific questionnaire. One hundred women with breast cancer receiving adjuvant chemotherapy were included. Data were analysed by Pearson's correlation coefficient and linear regression. The open question was subjected to manifest content analysis. RESULTS Identified factors associated with engaging in PA during chemotherapy treatment were: being physically active before diagnosis, and the information given by the oncology nurse before the treatment start. The physically active women experienced higher psychological wellbeing, less fatigue, and faster recovery after treatment. They also experienced an overall feeling of fitness. CONCLUSION It seems that PA is associated with less fatigue, better recovery between chemotherapy treatments, and a better mental condition leading to wellbeing. Information given by the oncology nurse may be an important factor for being physically active. Women with breast cancer need to get specific advice about and support in engaging in PA to feel better during chemotherapy treatment. Further research is required to develop guidelines for advice about and support regarding PA during chemotherapy treatment.
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Affiliation(s)
- Anna Wilhelmsson
- Department of Oncology, Örebro University Hospital, Örebro, Sweden
| | - Maria Roos
- Department of Oncology, Örebro University Hospital, Örebro, Sweden
| | - Lars Hagberg
- University Health Care Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Yvonne Wengström
- Neurobiology Care Science and Society, Nursing, Karolinska Institute, & Department of Oncology, Karolinska University Hospital, Stockholm, Sweden
| | - Karin Blomberg
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden.
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Carolan C, Smith A, Davies G, Forbat L. Seeking, accepting and declining help for emotional distress in cancer: A systematic review and thematic synthesis of qualitative evidence. Eur J Cancer Care (Engl) 2017; 27:e12720. [DOI: 10.1111/ecc.12720] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2017] [Indexed: 11/27/2022]
Affiliation(s)
- C.M. Carolan
- Faculty of Health Sciences and Sport; University of Stirling (Western Isles Campus); Stornoway UK
- NHS Western Isles; Stornoway UK
| | - A. Smith
- Faculty of Health Sciences and Sport; University of Stirling (Western Isles Campus); Stornoway UK
| | - G.R. Davies
- PGT Tertiary & Higher Education; Faculty of Arts, Humanities and Business; Lews Castle College UHI; Stornoway UK
| | - L. Forbat
- Palliative Care; Australian Catholic University and Calvary Health Care; Australian Catholic University; Canberra ACT Australia
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Zhang JE, Wong FKY, Zheng MC. The preoperative reaction and decision-making process regarding colostomy surgery among Chinese rectal cancer patients. Eur J Oncol Nurs 2017; 28:107-113. [DOI: 10.1016/j.ejon.2017.03.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 03/26/2017] [Accepted: 03/29/2017] [Indexed: 10/19/2022]
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Szalai M, Szirmai A, Füge K, Makai A, Erdélyi G, Prémusz V, Bódis J. Special aspects of social support: Qualitative analysis of oncologic rehabilitation through a belly dancing peer support group. Eur J Cancer Care (Engl) 2017; 26. [PMID: 28194904 DOI: 10.1111/ecc.12656] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2016] [Indexed: 11/29/2022]
Abstract
Tumour-related peer support groups (PSGs) show long-term development in quality of life and coping, and decrease distress in cancer care. To clarify channels of social support in oncologic rehabilitation by combined exercise and psychosocial therapy, individual semi-structured interviews were conducted after 1 year additional belly dance rehabilitation in a closed PSG among 51 patients with malignant tumour diagnosis in Budapest, Hungary. Interview data were transcribed and analysed using qualitative content analysis (ATLAS.ti 6 Win). Results suggest that group experience provides emotional-, practical- and informational support. We could point out specific social effects of "role model" function and extend the coping model. The group dispose all the features of effective suggestion and may be effectively applied as additional therapy for patients with malignancies. The extended coping model and the introduction of "role model" function could be useful for PSGs' efficacy assessment.
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Affiliation(s)
- M Szalai
- Department of Head and Neck Surgery, National Institute of Oncology, Budapest, Hungary.,Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
| | - A Szirmai
- Doctoral School of Psychology, Faculty of Humanities, Eötvös Loránd University, Budapest, Hungary
| | - K Füge
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
| | - A Makai
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
| | - G Erdélyi
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
| | - V Prémusz
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
| | - J Bódis
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Pécs, Hungary.,Department of Obstetrics and Gynaecology, Medical School, University of Pécs, Pécs, Hungary
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35
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Chen Q, Ding H, Zhou J, Zhao X, Zhang J, Yang C, Li K, Qiao M, Hu H, Ding P, Zhao X. Novel glycyrrhetinic acid conjugated pH-sensitive liposomes for the delivery of doxorubicin and its antitumor activities. RSC Adv 2016. [DOI: 10.1039/c6ra01580h] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
A novel pH-sensitive conjugate glycyrrhetinic acid–polyethylene glycol–Schiff bond–cholesterol (GPSC) has been synthesized successfully and used to construct doxorubicin-loaded liposomes with both pH-sensitive features and active targeting ability.
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Affiliation(s)
- Qing Chen
- School of Pharmacy
- Shenyang Pharmaceutical University
- Shenyang
- P.R. China
| | - Huaiwei Ding
- School of Pharmaceutical Engineering
- Shenyang Pharmaceutical University
- P.R. China
| | - Jinxing Zhou
- School of Pharmacy
- Shenyang Pharmaceutical University
- Shenyang
- P.R. China
| | - Xiufeng Zhao
- Hongqi Hospital of Mudanjiang Medical University
- Mudanjiang
- P.R. China
| | - Jiulong Zhang
- School of Pharmacy
- Shenyang Pharmaceutical University
- Shenyang
- P.R. China
| | - Chunrong Yang
- College Pharmacy of Jiamusi University
- Jiamusi
- P.R. China
| | - Kexin Li
- School of Pharmacy
- Shenyang Pharmaceutical University
- Shenyang
- P.R. China
| | - Mingxi Qiao
- School of Pharmacy
- Shenyang Pharmaceutical University
- Shenyang
- P.R. China
| | - Haiyang Hu
- School of Pharmacy
- Shenyang Pharmaceutical University
- Shenyang
- P.R. China
| | - Pingtian Ding
- School of Pharmacy
- Shenyang Pharmaceutical University
- Shenyang
- P.R. China
| | - Xiuli Zhao
- School of Pharmacy
- Shenyang Pharmaceutical University
- Shenyang
- P.R. China
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