1
|
Ben-Arye E, Balneaves LG, Yaguda S, Shulman B, Gressel O, Tapiro Y, Sharabi IS, Samuels N. Nurse-guided patient self-treatment in integrative oncology: a randomized controlled trial. Support Care Cancer 2023; 31:233. [PMID: 36964801 PMCID: PMC10039353 DOI: 10.1007/s00520-023-07689-4] [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: 07/08/2022] [Accepted: 03/13/2023] [Indexed: 03/26/2023]
Abstract
OBJECTIVE Nurses are increasingly becoming involved in integrative oncology (IO) programs. This study examined the additive effect of nurse-provided guidance for self-administered IO therapies on cancer-related fatigue and quality of life (QoL). METHODS The study was randomized and controlled, enrolling patients undergoing active oncology treatment with IO interventions for fatigue and other QoL-related outcomes. IO practitioner guidance on self-treatment with manual, relaxation, and/or traditional herbal therapies was provided to patients in both the intervention and control arms. However, patients in the intervention arms also received additional guidance on self-treatment by IO-trained palliative care nurses. All participants were assessed for fatigue and QoL at baseline and at 24-h follow-up, using the Edmonton Symptom Assessment Scale (ESAS) and the Measure Yourself Concerns and Wellbeing (MYCAW) questionnaire tools. RESULTS Of 353 patients recruited, 187 were randomized to the intervention and 166 to the control group. Both groups had similar demographic and oncology-related characteristics. Patients in the intervention arm reported significantly greater improvement in ESAS scores for fatigue (p = 0.026) and appetite (p = 0.003) when compared to controls. CONCLUSION The addition of nurse-provided guidance on self-administration of IO treatments to that provided by IO practitioners further reduced short-term scores for fatigue and improved appetite. The relationship between palliative and IO-supportive cancer care requires further study.
Collapse
Affiliation(s)
- Eran Ben-Arye
- Integrative Oncology Program, The Oncology Service; Lin, Carmel, and Zebulun Medical Centers, Clalit Health Services, 35 Rothschild St, Haifa, Israel.
- Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
| | - Lynda G Balneaves
- College of Nursing, Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Susan Yaguda
- Department of Supportive Oncology, Levine Cancer Institute, Charlotte, NC, USA
| | - Bella Shulman
- Integrative Oncology Program, The Oncology Service; Lin, Carmel, and Zebulun Medical Centers, Clalit Health Services, 35 Rothschild St, Haifa, Israel
| | - Orit Gressel
- Integrative Oncology Program, The Oncology Service; Lin, Carmel, and Zebulun Medical Centers, Clalit Health Services, 35 Rothschild St, Haifa, Israel
| | - Yehudit Tapiro
- Integrative Oncology Program, The Oncology Service; Lin, Carmel, and Zebulun Medical Centers, Clalit Health Services, 35 Rothschild St, Haifa, Israel
| | - Ilanit Shalom Sharabi
- Integrative Oncology Program, The Oncology Service; Lin, Carmel, and Zebulun Medical Centers, Clalit Health Services, 35 Rothschild St, Haifa, Israel
| | - Noah Samuels
- Department of Supportive Oncology, Levine Cancer Institute, Charlotte, NC, USA
- Center for Integrative Complementary Medicine, Faculty of Medicine, Shaare Zedek Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| |
Collapse
|
2
|
Mastroianni B, Lochmann M, Girodet M, Blay JY, Christophe V, Chvetzoff G. L’oncologie intégrative : état des lieux et place d’une consultation dédiée dans un centre de lutte contre le cancer. Bull Cancer 2022; 109:1308-1314. [DOI: 10.1016/j.bulcan.2022.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 09/06/2022] [Accepted: 09/19/2022] [Indexed: 11/07/2022]
|
3
|
Stie M, Delmar C, Nørgaard B, Jensen LH. Efficacy of open dialogue about complementary and alternative medicine compared with standard care in improving quality of life in patients undergoing conventional oncology treatment (CAMONCO 2): protocol for a randomised controlled trial. BMJ Open 2022; 12:e059960. [PMID: 35470199 PMCID: PMC9039403 DOI: 10.1136/bmjopen-2021-059960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Complementary and alternative medicine (CAM) has been shown to reduce symptoms and adverse effects and improve quality of life of patients undergoing conventional oncology treatment, but CAM might also cause symptoms and adverse effects such as headache and fatigue. Thus, patients need guidance towards safe and healthy use of CAM. According to published results, open dialogue about CAM (OD-CAM) between health professionals and patients as an integral part of anticancer treatment may improve patients' quality of life and well-being. Since the literature on the issue is sparse, the aim of this study is to assess the efficacy of OD-CAM integrated early in conventional oncology treatment versus standard care (SC) in patients undergoing standard anticancer treatment. METHODS AND ANALYSIS The study is a randomised controlled trial, being conducted at an oncology outpatient clinic in Denmark. 207 patients undergoing curative or palliative oncology treatment for breast, gynaecological, prostate, pulmonary, colorectal, anal or pancreatic cancer will be randomly assigned to SC with or without OD-CAM. A nurse specialist will facilitate the OD-CAM in one or two sessions. The primary endpoint is patient reported quality of life in relation to psychological well-being 8 weeks after enrollment. Secondary endpoints are patient reported level of depression and anxiety, top concerns, and decision regret 8, 12 and 24 weeks after enrolment, and overall survival. ETHICS AND DISSEMINATION According to the Committee on Health Research Ethics for Southern Denmark, ethics approval of this study is not required (S-20202000-5, 20/1019). The Region of Southern Denmark (Journal no. 20/11100) approved the storing and handling of data. Participants' informed consent will be obtained before inclusion and randomisation. The results of the study, whether positive, negative or inconclusive, will be disseminated through open-access, peer-reviewed publications, stake-holder-reporting and presentations at relevant conferences. TRIAL REGISTRATION NUMBER NCT04299451.
Collapse
Affiliation(s)
- Mette Stie
- Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- Oncology, Lillebaelt Hospital - University Hospital of Southern Denmark, Vejle, Denmark
| | - Charlotte Delmar
- Department of Public Health, Research Unit for Nursing and Healht Care, Aarhus Universitet, Aarhus, Denmark
| | - Birgitte Nørgaard
- Department Public Health, University of Southern Denmark, Odense, Denmark
| | - Lars Henrik Jensen
- Oncology, Lillebaelt Hospital - University Hospital of Southern Denmark, Vejle, Denmark
| |
Collapse
|
4
|
The Use of Complementary and Alternative Medicine in Thai Gynecologic Oncology Patients: Influencing Factors. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:1322390. [PMID: 34804172 PMCID: PMC8598354 DOI: 10.1155/2021/1322390] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 10/26/2021] [Indexed: 01/22/2023]
Abstract
Background To determine the factors influencing the use of complementary and alternative medicine (CAM) in gynecologic cancer patients and the prevalence and pattern of CAM use. Methods This was a cross-sectional study of 370 gynecologic cancer patients conducted at the outpatient clinic, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. After obtaining informed consent, participants were asked to complete a standardized questionnaire including sociodemographic and clinical characteristics, detail of CAM use, attitude of CAM use, and quality of life using EORTC-QLQ-C30. Results The prevalence of CAM use was 25.13%. The most common type was herbal medicine (55.90%). The participants who resided or had a birthplace in rural areas presented with a higher proportion of CAM use than those in urban areas (P=0.470 and P=0.004, respectively). Participants who received multiple modalities of cancer treatment reported a significantly higher proportion of CAM use (P=0.024). Most CAM users agreed that the CAM could be used in combination with standard treatment, and some rather disagreed that CAM could interrupt the treatment effect of the conventional treatment. CAM users had significantly higher role functioning in quality-of-life scores. Conclusion Factors influencing CAM use in gynecologic cancer patients were rural area birthplace or residency, receiving multiple modalities of cancer treatment, having positive attitude toward CAM use. CAM users had better performance in role functioning in the quality-of-life score. Therefore, gynecologic oncologists should pay attention to these factors in order to communicate with gynecologic cancer patients about CAM use.
Collapse
|
5
|
Arring NM, Millstine D, Barton DL, Lyons KS, Girardo M, Hutson A, Nail LM. Trends in integrative medicine and health consults: differences between cancer survivors and patients without cancer. Support Care Cancer 2020; 29:3103-3112. [PMID: 33057818 DOI: 10.1007/s00520-020-05815-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 10/06/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVES The objectives were to compare patients with and without cancer who sought an integrative health (IH) consult and reasons for seeking a consult. DESIGN Descriptive cross-sectional study that employed a secondary analysis of an integrative health database supplemented by a retrospective medical record review. SETTING/LOCATION Integrative Medicine and Health program in a Southwestern United States academic medical center. SUBJECTS Eight hundred thirty-nine adults over the age of 18 seeking IH consultation. RESULTS The number of complementary therapies reported prior to consult were not significantly different between groups. The most reported complementary therapies used by cancer survivors were multivitamins, exercise, and turmeric. Patients without cancer reported significantly higher pain levels than cancer survivors. Cancer survivors reported significantly higher energy, sleep levels, overall health, spiritual wellbeing, and significantly better relationships compared to patients without cancer. Cancer survivors reported fatigue and cancer as the top reasons for IH consult. CONCLUSION Participants without cancer reported higher levels of pain and lower levels of energy, sleep, overall health, spiritual wellbeing, and relationships compared to cancer survivors. However, cancer survivors still reported levels of unmanaged symptoms. Complementary therapy use prior to IMH consult was similar between groups; however, IMH providers recommended more treatments for patients without cancer. Our results highlight that more evidence is needed to guide IMH recommendations, especially for cancer survivors who may still be in treatment. Additionally, our results support evidence-based recommendations that all cancer survivors should be assessed for complementary therapy use and provided counseling by qualified providers on their advantages and limitations.
Collapse
Affiliation(s)
- Noël M Arring
- School of Nursing, University of Michigan, 400 North Ingalls St, RM 4320, Ann Arbor, MI, 48108, USA. .,Department of Nursing, Mayo Clinic, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA.
| | - Denise Millstine
- Division of General Internal Medicine, Division of Women's Health Internal Medicine, Mayo Clinic, 13737 North 92nd Street, Scottsdale, AZ, 85260, USA
| | - Debra L Barton
- School of Nursing, University of Michigan, 400 North Ingalls St, RM 4320, Ann Arbor, MI, 48108, USA
| | - Karen S Lyons
- William F. Connell School of Nursing, Boston College, Maloney Hall, 140 Commonwealth Ave, Chestnut Hill, MA, 02467, USA
| | - Marlene Girardo
- Research Biostatistics Division, Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ, 85259, USA
| | - Amy Hutson
- Department of Nursing, Mayo Clinic, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA
| | - Lillian M Nail
- Oregon Health & Science University, School of Nursing, 3455 SW US Veterans Hospital Rd, OR, 97239, Portland, USA
| |
Collapse
|
6
|
The Perspective of Cancer Patients on the Use of Complementary Medicine. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2019. [DOI: 10.5812/ijcm.89916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
7
|
Ben-Arye E, Samuels N, Lavie O. Integrative Medicine for Female Patients with Gynecologic Cancer. J Altern Complement Med 2018; 24:881-889. [DOI: 10.1089/acm.2018.0163] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Eran Ben-Arye
- Integrative Oncology Program, The Oncology Service, Lin and Carmel Medical Centers, Clalit Health Services, Haifa, Israel
- Complementary and Traditional Medicine Unit, Department of Family Medicine, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
- Clalit Health Services, Haifa, Israel
| | - Noah Samuels
- Tal Center for Integrative Medicine, Institute of Oncology, Sheba Medical Center, Tel Hashomer, Israel
| | - Ofer Lavie
- Department of Obstetrics and Gynecology, Gynecologic Oncology Service, Carmel Medical Center, Haifa, Israel
| |
Collapse
|
8
|
Cortis LJ, Ward PR, McKinnon RA, Koczwara B. Integrated care in cancer: What is it, how is it used and where are the gaps? A textual narrative literature synthesis. Eur J Cancer Care (Engl) 2017; 26. [PMID: 28426142 DOI: 10.1111/ecc.12689] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2017] [Indexed: 11/30/2022]
Abstract
Integrated care is an underpinning concept of contemporary health care policy proffered as a strategy to overcome the fragmentations in care encountered by people with complex care needs (Shaw et al. [2011] What is Integrated Care? An Overview of Integrated Care in the NHS). Cancer patients have potential to benefit from such policy, often having needs that extend beyond cancer. This paper seeks to understand how the concept of integrated care is used in the cancer literature. A search of leading databases was conducted for original research relating to integrated care or an integration intervention aiming to improve outcomes of cancer patients, and analysed using textual narrative synthesis. 38 papers were included, each with a focus on improving cancer-specific aspects of care enhancing the capabilities of the cancer multidisciplinary team. Of the eight studies involving integration between the cancer service and other care providers, all focused on utilising the external provider to deliver aspects of cancer care or placed them in a passive role, as survey participant, a recipient of cancer-related clinical information or as the comparator "usual care" arm. Within the cancer literature, integration is predominantly used to describe initiatives to improve cancer-related aspects of care. Less attention is given to integration initiatives that enhance coordination across levels of the healthcare system or service providers.
Collapse
Affiliation(s)
- L J Cortis
- Flinders Centre for Innovation in Cancer, Flinders University, Adelaide, SA, Australia
| | - P R Ward
- Discipline of Public Health, School of Health Sciences, Flinders University, Adelaide, SA, Australia
| | - R A McKinnon
- Flinders Centre for Innovation in Cancer, Flinders University, Adelaide, SA, Australia
| | - B Koczwara
- Flinders Centre for Innovation in Cancer, Flinders University, Adelaide, SA, Australia
| |
Collapse
|
9
|
Akpunar D, Bebis H, Yavan T. Use of Complementary and Alternative Medicine in Patients with Gynecologic Cancer: a Systematic Review. Asian Pac J Cancer Prev 2016; 16:7847-52. [PMID: 26625809 DOI: 10.7314/apjcp.2015.16.17.7847] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
PURPOSE Research carried out with gynecologic cancer patients using CAM was reviewed to provide a source for discussing which CAM method is used for which purpose, patients' perceptions on the effects/side effects occurred during/after using CAM and their sources of information regarding CAM. MATERIALS AND METHODS This literature review was carried out for the period between January 2000 and March 2015 using Scopus, Dynamed, Med-Line, Science Direct, Ulakbim, Research Starters, Ebscohost, Cinahl Complete, Academic Onefile, Directory of Open Access Journals, BMJ Online Journals (2007-2009), Ovid, Oxford Journal, Proquest Hospital Collection, Springer-Kluwer Link, Taylor and Francis, Up To Date, Web Of Science (Citation Index), Wiley Cochrane-Evidence Base, Wiley Online Library, and Pub-Med search databases with "complementary and alternative medicine, gynecologic cancer" as keywords. After searching through these results, a total of 12 full length papers in English were included. RESULTS CAM use in gynecologic cancer patients was discussed in 8 studies and CAM use in breast and gynecologic cancer patients in 4. It was determined that the frequency of CAM use varies between 40.3% and 94.7%. As the CAM method, herbal medicines, vitamins/minerals were used most frequently in 8 of the studies. When the reasons why gynecologic cancer patients use CAM are examined, it is determined that they generally use to strengthen the immune system, reduce the side effects of cancer treatment and for physical and psychological relaxation. In this review, most of the gynecologic cancer patients perceived use of CAM as beneficial. CONCLUSIONS In order that the patients obtain adequate reliable information about CAM and avoid practices which may harm the efficiency of medical treatment, it is recommended that "Healthcare Professionals" develop a common language.
Collapse
Affiliation(s)
- Dercan Akpunar
- Public Health Nursing Department, Gulhane Military Medical Academy, Health Sciences Institution, Ankara, Turkey E-mail :
| | | | | |
Collapse
|