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Kahraman-Erkus O, Ar-Karci Y, Gençöz T. "My body is a cage": A qualitative investigation into the self-discrepancy experiences of young women with metastatic cancer. Chronic Illn 2024; 20:117-134. [PMID: 37036432 PMCID: PMC10865759 DOI: 10.1177/17423953231168014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 03/20/2023] [Indexed: 04/11/2023]
Abstract
OBJECTIVES The current study investigated self-discrepancy experiences of young women with metastatic cancer. METHODS Semistructured interviews were conducted. Data were analyzed through interpretative phenomenological analysis. FINDINGS Eight female patients with metastatic cancer aged between 27 and 38 years formed the sample. Three superordinate themes emerged: (1) compulsory changes in self-concept with ambivalent evaluations; (2) new ideals not on the agenda of a healthy young woman; and (3) so-called 'minimalist' expectations from others. DISCUSSION Findings indicated that diagnosis and treatment of metastatic cancer impose unique developmental challenges for young adult women. Advanced cancer disrupted the tasks and responsibilities of young adulthood, resulting in frustration, grief, isolation, and overcompensation. These findings suggest that a developmental perspective is crucial when working with self-discrepancy experiences of young women with metastatic cancer.
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Affiliation(s)
| | | | - Tülin Gençöz
- Department of Psychology, Middle East Technical University, Ankara, Turkey
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Kim J, Gang M. Identifying the Risk Factors of Suicidal Ideation in Patients With Hematologic Malignancies Using a Multidimensional Approach. West J Nurs Res 2024; 46:81-89. [PMID: 38078450 DOI: 10.1177/01939459231216870] [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] [Indexed: 01/07/2024]
Abstract
BACKGROUND Patients with hematologic malignancies have a 3.5-fold higher rate of suicide completion than the noncancer population, and the Hodgkin lymphoma has the highest suicide rate among all cancers. Although the risk factors for suicidal ideation among the cancer population are well-known, the specific risk factors contributing to the high suicide rate among patients with hematologic malignancies are elusive. OBJECTIVE This study aimed to identify the risk factors for suicidal ideation among patients with hematologic malignancies using a multidimensional approach. METHODS This was a cross-sectional, observational study. A total of 163 patients were recruited from the oncology department of a university hospital. We collected data on psychological and physical symptoms, social support, and suicidal ideation using the Memorial Symptom Assessment Scale-Short Form, the Multidimensional Scale of Perceived Social Support, and the Suicidal Ideation Scale. Multiple regression analysis was performed using SPSS (version 26.0) to analyze the clinical data. RESULTS Among the 163 participants, 96 (58.9%) were male, 57 (35%) were diagnosed with acute leukemia, and 97 (59.5%) received chemotherapy. The mean age was 55.26 ± 15.75. Physical symptoms, psychological symptoms, and willingness to use mental health services accounted for 39.5% of suicidal ideation cases. CONCLUSIONS Assessment of psychological conditions at the beginning of diagnosis, provision of appropriate interventions throughout treatment, and follow-up care to relieve psychological symptoms should be initiated in patients with hematologic malignancies to prevent suicide.
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Affiliation(s)
- Junglyun Kim
- College of Nursing, Chungnam National University, Daejeon, South Korea
- College of Nursing, University of Florida, Gainesville, FL, USA
| | - Moonhee Gang
- College of Nursing, Chungnam National University, Daejeon, South Korea
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Sheridan R, McCaughan D, Hewison A, Roman E, Smith A, Patmore R, Howell D. Experiences and preferences for psychosocial support: a qualitative study exploring the views of patients with chronic haematological cancers. BMJ Open 2023; 13:e070467. [PMID: 37597866 PMCID: PMC10441118 DOI: 10.1136/bmjopen-2022-070467] [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: 11/24/2022] [Accepted: 08/02/2023] [Indexed: 08/21/2023] Open
Abstract
OBJECTIVES Patients with chronic haematological cancers are often treated on a relapsing-remitting pathway, which may extend for many years. Such diagnoses are associated with uncertainties that often cause anxiety and distress, meaning patients (and families) are susceptible to potentially prolonged emotional difficulties, across the cancer journey. Experiences and preferences regarding psychosocial needs and support over time are relatively unexplored, which this study aimed to address. SETTING AND DESIGN Set within the UK's Haematological Malignancy Research Network (an ongoing population-based cohort that generates evidence to underpin improved clinical practice) a qualitative, exploratory study was conducted, using semistructured interviews. Reflexive thematic analysis was used to assess the interview data via an exploratory, inductive approach, underpinned by the research questions. PARTICIPANTS Thirty-five patients were included with chronic lymphocytic leukaemia, follicular lymphoma, marginal zone lymphoma or myeloma; 10 of whom were interviewed alongside a relative. RESULTS Five themes were identified from the data: (1) accessing support, (2) individual coping behaviour affecting support preferences, (3) divergent and fluctuating thoughts on patient support forums, (4) the role, influence and needs of family and friends and (5) other sources of support and outstanding needs. Findings suggest that patients' individual attitudes towards support varied over time. This also influenced whether support was perceived to be available, and if it was then used. CONCLUSION This study highlighted the variation in preferences towards psychosocial support among patients with chronic haematological cancers. As patients can live for many years with significant emotional difficulties, they may benefit from frequent monitoring of their psychosocial well-being, as well as signposting to holistic support, if this is needed.
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Affiliation(s)
| | | | - Ann Hewison
- Department of Health Sciences, University of York, York, UK
| | - Eve Roman
- Department of Health Sciences, University of York, York, UK
| | | | - Russell Patmore
- Queens Centre for Oncology and Haematology, Castle Hill Hospital, Cottingham, UK
| | - Debra Howell
- Department of Health Sciences, University of York, York, UK
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Turan GB, Dural G. Does Spiritual Well-Being Affect Death Anxiety and Psychological Resilience in Cancer Patients? OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221129948. [PMID: 36154332 DOI: 10.1177/00302228221129948] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
This study was conducted to research the effects of spiritual well-being on death anxiety and psychological resilience in cancer patients. This cross-sectional, descriptive and correlational study was carried out with 260 cancer patients who were admitted to oncology and haematology outpatient clinic of a university hospital in east of Turkey between October 2021 and April 2022. The data were collected by using "Personal Information Form", "Spiritual Well-being Scale (FACIT-sp), Death Anxiety Scale (DAS) and The Brief Resilience Scale (BRS). It was found that mean DAS total score of cancer patients was 12.51 ± 3.39, while their mean FACIT-sp total score was 26.10 ± 6.93 and their mean BRS total score was 16.1 ± 7.05. It was found that FACIT-sp total score affected DAS and BRS total score positively, while DAS total score affected BRS total score negatively (p < .001). It was found that cancer patients had moderate level of spiritual well-being and psychological resilience and high level of death anxiety. It was also found that death anxiety and psychological resilience of cancer patients increased as their spiritual well-being levels increased. Psychological resilience was found to decrease as death anxiety increased.
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Affiliation(s)
- Gülcan B Turan
- Faculty of Health Sciences, Department of Nursing, Fırat University, Elazığ, Turkey
| | - Gül Dural
- Faculty of Health Sciences, Department of Nursing, Fırat University, Elazığ, Turkey
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Ekels A, van de Poll-Franse LV, Posthuma EFM, Kieffer J, Issa DE, Koster A, Nijziel MR, Pruijt JHFM, Stevens WBC, Tick LW, Oerlemans S. Persistent symptoms of fatigue, neuropathy and role-functioning impairment among indolent non-Hodgkin lymphoma survivors: A longitudinal PROFILES registry study. Br J Haematol 2022; 197:590-601. [PMID: 35365860 DOI: 10.1111/bjh.18139] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/22/2022] [Accepted: 02/25/2022] [Indexed: 11/27/2022]
Abstract
Little is known about the long-term health-related quality of life (HRQoL) and persistence of symptoms among patients with indolent non-Hodgkin lymphoma (iNHL). This large population-based longitudinal study therefore investigated the long-term HRQoL and persistence of symptoms and identified associated sociodemographic, clinical and psychological factors. Patients diagnosed between 1999 and 2014 and four or more months after diagnosis were invited to participate in a longitudinal survey. Sociodemographic and clinical data were obtained from the Netherlands Cancer Registry. The EORTC QLQ-C30 and CLL-16 were completed by 669 patients (74% response rate). Patients completed on average four questionnaires. Primary treatment was active surveillance (52%), systemic therapy (31%) or radiotherapy (13%). Respectively, 36% reported persistent fatigue, 33% persistent neuropathy and 25% persistent role-functioning impairment. This was 2-3 times higher than in the age- and sex-matched normative population. Up to 10 years after diagnosis, scores remained relatively stable without clinically relevant changes. Comorbidities, psychological distress, shorter time since diagnosis, systemic therapy, younger age, education level and having no partner were associated with worse outcomes (all ps < 0.05). Up to a third of patients with iNHL experience long-term persistent symptoms which do not improve over time. Early recognition of symptoms will help in providing tailored supportive care for those in need.
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Affiliation(s)
- Afke Ekels
- Department of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands.,Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Lonneke V van de Poll-Franse
- Department of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands.,Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands.,Department of Medical and Clinical Psychology, Center of Research on Psychological and Somatic Disorders (CoRPS), Tilburg University, Tilburg, The Netherlands
| | | | - Jacobien Kieffer
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Djamila E Issa
- Department of Internal Medicine, Jeroen Bosch Hospital, s-Hertogenbosch, The Netherlands
| | - Adrianus Koster
- Department of Internal Medicine, VieCuri Medical Centre, Venlo and Venray, The Netherlands
| | - Marten R Nijziel
- Department of Hemato-Oncology, Catharina Cancer Institute, Catharina Hospital, Eindhoven, The Netherlands
| | - Johannes H F M Pruijt
- Department of Internal Medicine, Jeroen Bosch Hospital, s-Hertogenbosch, The Netherlands
| | - Wendy B C Stevens
- Department of Haematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Lidwine W Tick
- Department of Internal Medicine, Máxima Medical Centre, Eindhoven, The Netherlands
| | - Simone Oerlemans
- Department of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands
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Gowin K, Langlais BT, Kosiorek HE, Dueck A, Millstine D, Huberty J, Eckert R, Mesa RA. The SIMM study: Survey of integrative medicine in myeloproliferative neoplasms. Cancer Med 2020; 9:9445-9453. [PMID: 33140580 PMCID: PMC7774715 DOI: 10.1002/cam4.3566] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 08/25/2020] [Accepted: 09/30/2020] [Indexed: 12/22/2022] Open
Abstract
Myeloproliferative neoplasms (MPNs) are characterized by significant symptom burden. Integrative medicine (IM) offers unique symptom management strategies. This study describes IM interventions utilized by MPN patients and the association with symptom burden, quality of life, depression, and fatigue adjusted for lifestyle confounders. MPN patients were surveyed online for IM utilization, MPN symptom burden (MPN‐Symptom Assessment Form Total Symptom Score), depression (Patient Health Questionnaire), fatigue (Brief Fatigue Inventory), and a single question on overall quality of life. Measures were compared by IM participation and adjusted for alcohol and tobacco use, BMI, diet, and MPN type using multiple linear and logistic regression. A total of 858 participants were included in the analysis. Aerobic activity (p =< 0.001) and strength training (p = 0.01) were associated with lower mean symptom burden while massage (p =< 0.001) and support groups (p =< 0.001) were associated with higher levels of symptom burden. Higher quality of life was reported in massage (p = 0.04) and support groups (p = 0.002) while lower quality of life was noted in aerobic activity (p =< 0.001) and strength training (p = 0.001). A lower depression screening score was noted in those participating in aerobic activity (p = 0.006), yoga (p = 0.03), and strength training (p = 0.02). Lower fatigue was noted in those participating in aerobic activity (p =< 0.001) and strength training (p = 0.03) while higher fatigue was noted in those participating in massage (p =< 0.001) and breathing techniques (p = 0.02). Data available on request from the authors. This international survey of MPN patients on IM usage, has shown that patients who participated in a form of IM had a pattern of decreased levels of symptom burden, fatigue, depression, and higher QoL, as adjusted for health lifestyle practices overall.
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Affiliation(s)
- Krisstina Gowin
- Department of Hematology, University of Arizona, Tucson, AZ, USA
| | - Blake T Langlais
- Department of Biostatistics, Mayo Clinic, Phoenix, Phoenix, AZ, USA
| | - Heidi E Kosiorek
- Department of Biostatistics, Mayo Clinic, Phoenix, Phoenix, AZ, USA
| | - Amylou Dueck
- Department of Biostatistics, Mayo Clinic, Phoenix, Phoenix, AZ, USA
| | - Denise Millstine
- Integrative Medicine Program, Department of Medicine, Mayo Clinic, Phoenix, AZ, USA
| | - Jennifer Huberty
- School of Nutrition and Health Promotion, Arizona State University, Phoenix, AZ, USA
| | - Ryan Eckert
- Mays Cancer Center, University of Texas, San Antonio, TX, USA
| | - Ruben A Mesa
- Mays Cancer Center, University of Texas, San Antonio, TX, USA
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Raphael D, Frey R, Gott M. Distress in post-treatment hematological cancer survivors: Prevalence and predictors. J Psychosoc Oncol 2019; 38:328-342. [PMID: 31642396 DOI: 10.1080/07347332.2019.1679320] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objectives: To calculate the prevalence of psychosocial distress, and identify factors that predict distress, in early post-treatment hematological cancer survivors.Design: Cross-sectional survey containing self-report measures.Sample/Methods: Post-treatment hematological cancer survivors in remission (>18 years) (n = 409) completed questionnaires. Distress was measured with the distress thermometer (DT). Logistic regression was used to identify predictors of distress.Findings: Overall 21.9% (n = 93) of respondents reported significant distress (DT ≥4). Significant distress was twice as high in those born overseas (OR = 2.09, p = .03), 3.5 times higher in those with lower social support (OR = 3.51, p = <.001) and five times higher in those with increased fear of recurrence (OR = 0.17, p = <.001).Implications for Psychosocial Providers: Early identification of distress may decrease psychosocial issues in the post-treatment period, especially as psychosocial services have been shown to improve wellbeing for those who are distressed.
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Affiliation(s)
- Deborah Raphael
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Rosemary Frey
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Merryn Gott
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
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Hathiramani S, Pettengell R, Moir H, Younis A. Relaxation and exercise in lymphoma survivors (REIL study): a randomised clinical trial protocol. BMC Sports Sci Med Rehabil 2019; 11:17. [PMID: 31428434 PMCID: PMC6697965 DOI: 10.1186/s13102-019-0127-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 07/18/2019] [Indexed: 01/10/2023]
Abstract
BACKGROUND Lymphoma survivors commonly report ongoing complaints including fatigue, pain, depression and decreased quality of life (QoL) following treatment. Although evidence suggests that both relaxation and exercise can significantly improve such symptoms, there is no consensus on which intervention is more effective. This paper presents the REIL (Relaxation and Exercise In Lymphoma) Study protocol. The REIL study aims to compare the effect of two home-based interventions - relaxation and exercise - on QoL in lymphoma survivors. METHODS Eligible participants (n = 36) will be randomised to a relaxation or exercise programme to perform at least three times per week. The primary outcome measure is QoL, assessed by the European Organisation for Research and Treatment of Cancer QoL Questionnaire Core 30 (EORTC QLQ-C30). Secondary outcome measures include body composition, cardiovascular status, pulmonary function, grip strength, functional exercise capacity (six minute walk test), well-being assessed by the FACT-Lym questionnaire, and psychological status assessed by the Hospital Anxiety and Depression Scale. Total duration of the study will be twelve weeks and outcome measures will be assessed at baseline, six weeks and at the end of the study. DISCUSSION It is anticipated that results from this preliminary study will begin to highlight effective pathways to improve QoL following chemotherapy for this population. This will better inform healthcare professionals to optimise QoL of lymphoma patients, and enable a smooth transition from being a cancer patient to survivor. TRIAL REGISTRATION The REIL study has been registered on a publicly accessible database, ClinicalTrials.gov, Registration Number: NCT02272751, October 2014.
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Affiliation(s)
- Suchita Hathiramani
- Kingston University and St. George’s University of London, London, UK
- Faculty of Health, Social Care & Education, Cranmer Terrace, London, SW17 0RE UK
| | | | - Hannah Moir
- Kingston University, Kingston Upon Thames, London, UK
| | - Ahmed Younis
- Kingston University and St. George’s University of London, London, UK
- Faculty of Health, Social Care & Education, Cranmer Terrace, London, SW17 0RE UK
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Hathiramani S, Pettengell R, Moir H, Younis A. Lymphoma survivors' experience of participation in a home-based intervention post-chemotherapy. Qual Life Res 2019; 28:2951-2955. [PMID: 31273623 PMCID: PMC6803568 DOI: 10.1007/s11136-019-02244-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2019] [Indexed: 12/14/2022]
Abstract
Purpose Further research on patient experience and involvement is recommended in order to develop evidence-based and meaningful care pathways for lymphoma survivors. This study aims to explore the experience of a sample of lymphoma survivors participating in a home-based intervention following chemotherapy. Methods Eligible participants who completed a 12-week home-based intervention were invited to complete the End of Study Questionnaire designed to explore perceptions, preferences and barriers to participation. Content analysis was used to generate codes, describe frequencies and identify themes. Results Participating in a home-based intervention post-treatment was a positive experience overall, and aided recovery in this sample of lymphoma survivors (n = 35). Participants felt the programme provided structure, motivation and liked contact with the researcher. Participants highlighted their need for advice on healthy lifestyle, diet in particular. Conclusions Lymphoma survivors in this study reported participation in a home-based intervention following treatment beneficial and aided recovery. Implications for cancer survivors A large proportion of lymphoma survivors would benefit from a rehabilitation intervention post-chemotherapy. Intervention programmes should include follow-ups to monitor progress and provide support and motivation. Health professionals should recommend healthy lifestyle guidelines to survivors on completion of treatment or refer patients to appropriate services for rehabilitation and advice.
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Affiliation(s)
- Suchita Hathiramani
- Faculty of Health, Social Care & Education, Kingston and St. George's University of London, Cranmer Terrace, London, UK.
| | - R Pettengell
- Haematology and Medical Oncology, St. George's Hospital, St. George's Healthcare NHS Trust, Tooting, London, UK
| | - H Moir
- Faculty of Science, Engineering and Computing, Kingston University London, Kingston upon Thames, Surrey, UK
| | - A Younis
- Faculty of Health, Social Care & Education, Kingston and St. George's University of London, Cranmer Terrace, London, UK
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