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Thompson L, Florissi C, Yoon J, Singh A, Saraf A. Optimizing Care Across the Continuum for Older Adults with Lung Cancer: A Review. Cancers (Basel) 2024; 16:3800. [PMID: 39594755 PMCID: PMC11593030 DOI: 10.3390/cancers16223800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2024] [Revised: 11/01/2024] [Accepted: 11/04/2024] [Indexed: 11/28/2024] Open
Abstract
Older adults with lung cancer experience inferior clinical outcomes compared to their younger counterparts. This review provides the scaffolding to address these disparities by delineating (1) the distinct and varied care needs of older adults with lung malignancies, (2) evidence-based measures for identifying subgroups within this population meriting tailored approaches to care, (3) age-specific considerations for the selection of cancer-directed therapy, and (4) opportunities for future work to enhance clinical outcomes and care delivery.
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Affiliation(s)
- Leah Thompson
- Department of Radiation Oncology, Brigham and Women’s Hospital, Boston, MA 02115, USA
- Harvard Medical School, Boston, MA 02115, USA; (C.F.)
| | | | - Jaewon Yoon
- Harvard Medical School, Boston, MA 02115, USA; (C.F.)
| | - Anupama Singh
- Department of Surgery, University of Massachusetts Chan Medical School, Worcester, MA 01655, USA;
| | - Anurag Saraf
- Department of Radiation Oncology, Brigham and Women’s Hospital, Boston, MA 02115, USA
- Harvard Medical School, Boston, MA 02115, USA; (C.F.)
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Yuan W, Jiang Y, Sun M, Zhao Q, Qiao G, Zheng Y. Factors influencing social avoidance and distress after radical lung cancer resection: a mediation analysis. Am J Transl Res 2024; 16:4770-4778. [PMID: 39398552 PMCID: PMC11470348 DOI: 10.62347/attp3522] [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: 06/13/2024] [Accepted: 08/12/2024] [Indexed: 10/15/2024]
Abstract
OBJECTIVE To investigate factors influencing social avoidance and distress (SAD) in patients following radical resection of lung cancer (RRLC) and analyze the mediating effects among these factors. METHODS Clinical data from 320 patients who underwent RRLC between January 2022 and December 2023 at the General Hospital of Western Theater Command PLA were analyzed. Data were collected using the General Information Questionnaire, Social Avoidance and Distress Scale (SADS), Hospital Anxiety and Depression Scale (HADS), Perceived Social Support Scales (PSSS), General Self-Efficacy Scale (GSES), and Consumer Experiences of Stigma Questionnaire (CESQ). Spearman correlation analysis explored the relationships between SAD, anxiety and depression, social support, self-efficacy, and stigma. Multiple linear regression identified factors influencing SAD. The PROCESS tool was used to test the mediating effects of these factors. RESULTS The mean SADS score was 16.73±4.69. SAD was positively correlated with anxiety, depression, and stigma (r=0.662, P<0.001; r=0.687, P<0.001) and negatively correlated with self-efficacy and social support (r=-0.682, P<0.001; r=-0.705, P<0.001). Multiple linear regression indicated that anxiety, depression, social support, self-efficacy, and stigma were significant influencers of SAD (β=0.132, P<0.001; β=-0.078, P<0.001; β=-0.178, P<0.001; β=0.115, P=0.002). Mediation analysis revealed that anxiety and depression directly affected SAD and indirectly influenced SAD through social support, stigma, and self-efficacy, both independently and via chain mediation (P<0.05). CONCLUSIONS Patients post-RRLC generally exhibit moderate SAD levels. Anxiety and depression directly influence SAD and also indirectly through the mediating effects of social support, stigma, and self-efficacy. Therefore, reducing depression and stigma while enhancing social support and self-efficacy is crucial for alleviating SAD in these patients.
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Affiliation(s)
- Wanshi Yuan
- Department of Chest Surgery, The General Hospital of Western Theater Command PLA Chengdu 610083, Sichuan, China
| | - Yunqin Jiang
- Department of Chest Surgery, The General Hospital of Western Theater Command PLA Chengdu 610083, Sichuan, China
| | - Mengyao Sun
- Department of Chest Surgery, The General Hospital of Western Theater Command PLA Chengdu 610083, Sichuan, China
| | - Qin Zhao
- Department of Chest Surgery, The General Hospital of Western Theater Command PLA Chengdu 610083, Sichuan, China
| | - Guobing Qiao
- Department of Chest Surgery, The General Hospital of Western Theater Command PLA Chengdu 610083, Sichuan, China
| | - Yifeng Zheng
- Department of Chest Surgery, The General Hospital of Western Theater Command PLA Chengdu 610083, Sichuan, China
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Moss JL, Bernacchi V, Kitt-Lewis E. Active social engagement and health among older adults: assessing differences by cancer survivorship status. Health Qual Life Outcomes 2024; 22:67. [PMID: 39164759 PMCID: PMC11337903 DOI: 10.1186/s12955-024-02281-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 08/07/2024] [Indexed: 08/22/2024] Open
Abstract
INTRODUCTION The number of older adults who are cancer survivors is rapidly growing. Evidence is needed to inform interventions to support successful aging among older adults (including older adult cancer survivors). Active engagement with life, that is, spending time with family and/or close friends, may be related to health outcomes, but this concept remains understudied. METHODS We used survey data to assess active engagement among older adults (ages 50 + years) from seven mid-Atlantic US states (n = 2,914), and geocoded their residence to collect collected measures of community availability of social interaction. Outcomes were physical and mental health-related quality of life (HRQoL), assessed with the SF-12. We used multivariable, multilevel linear regression to evaluate relationships between social interactions (i.e., "active engagement with life," or visiting with family and/or friends at least once per week and having at least three close friends, and community-level availability, measured with census tract-level park land and walkability and with county-level availability of social associations) and HRQoL. Finally, we explored differences in these relationships by recent cancer survivorship. RESULTS Overall, 1,518 (52.3%) participants were actively engaged. Active engagement was associated with higher physical HRQoL (estimate = 0.94, standard error [SE] = 0.46, p = .04) and mental HRQoL (estimate = 2.10, SE = 0.46, p < .001). The relationship between active engagement and physical HRQoL was stronger for recent cancer survivors (estimate = 4.95, SE = 1.84, p < .01) than for the general population (estimate = 1.10, SE = 0.43, p = .01). Community-level availability of social interaction was not associated with HRQoL. CONCLUSION Our analysis demonstrated promising associations between active engagement with life and HRQoL among older adults, with large benefits for older cancer survivors. Additional research is needed on how active engagement is associated with better HRQoL, which can inform future policies and programs to optimize the aging process in the US.
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Affiliation(s)
- Jennifer L Moss
- Department of Family and Community Medicine, Department of Public Health Sciences, Penn State College of Medicine, The Pennsylvania State University, 90 Hope Drive, #2120E, MC A172, P.O. Box 855, Hershey, PA, 17033, USA.
| | - Veronica Bernacchi
- College of Nursing, Michigan State University, East Lansing, MI, 48824, USA
| | - Erin Kitt-Lewis
- Penn State Ross and Carol Nese College of Nursing, University Park, PA, 16803, USA
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Zhang R, Yang Z, Shen X, Xia L, Cheng Y. Preoperative Physical Dysfunction Characteristics and Influence Factors Among Elderly Patients with Early Lung Cancer: A Latent Class Analysis. J Multidiscip Healthc 2024; 17:1743-1754. [PMID: 38680878 PMCID: PMC11055519 DOI: 10.2147/jmdh.s455669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 04/09/2024] [Indexed: 05/01/2024] Open
Abstract
Objective To identify latent classes of preoperative physical dysfunction in elderly patients with early lung cancer. To analyze the differences in demographic characteristics between different classes. Methods We invited elderly patients with early lung cancer who were scheduled for surgery at Shanghai Elderly Characteristic Hospital to participate in the study using a convenience sampling method. We took latent class analysis to divide elderly patients with early lung cancer into latent classes based on preoperative physical dysfunction features. Furthermore, we used single-factor analysis and multinomial logistic regression to investigate the influence variables of each latent class. Results The characteristics of preoperative physical dysfunction in elderly patients with early lung cancer can be divided into "Anxiety/depression emotion-poor sleep group" "Frailty of physical function group" "Pulmonary hypofunction-low activity tolerance group". The distribution of age, chronic disease history, COPD history, smoking history and perceived social support level of elderly patients with early lung cancer in different potential categories were not the same, and the differences were statistically significant (P<0.05). The elderly lung cancer patients with chronic disease history and age ≥75 years were more likely to be classified as "frailty of physical function group". The elderly lung cancer patients with COPD and smoking history were more likely to be classified into "pulmonary hypofunction-low activity tolerance group". Elderly lung cancer patients with moderate or low degree of perceived social support were more prone to be grouped into "anxiety/depression emotion-poor sleep group". Conclusion The variety of preoperative physical dysfunction seen in elderly patients with early lung cancer can be categorized into three latent classes. Medical professionals should create strategies for intervention for multiple patient populations with the goal of further enhancing their general state of life.
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Affiliation(s)
- Rui Zhang
- Department of Nursing, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, People’s Republic of China
- School of Nursing, Fudan University, Shanghai, 200030, People’s Republic of China
| | - Zhengyao Yang
- Department of Chest Surgery, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, People’s Republic of China
| | - Xiaoyong Shen
- Department of Chest Surgery, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, People’s Republic of China
| | - Lu Xia
- Day Surgery Unit, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, People’s Republic of China
| | - Yun Cheng
- School of Medicine, The Chinese University of Hong Kong, Shenzhen, 518172, People’s Republic of China
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Ruff SM, Stevens L, Bressler L, Khatri R, Sarna A, Ejaz AM, Dillhoff M, Pawlik TM, Rose K, Cloyd JM. Evaluating the caregiver experience during neoadjuvant therapy for pancreatic ductal adenocarcinoma. J Surg Oncol 2024; 129:775-784. [PMID: 38063046 DOI: 10.1002/jso.27558] [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: 07/09/2023] [Revised: 11/10/2023] [Accepted: 11/25/2023] [Indexed: 02/17/2024]
Abstract
INTRODUCTION Neoadjuvant therapy (NT) is increasingly recommended for patients with localized pancreatic ductal adenocarcinoma (PDAC). Recent research has highlighted the significant treatment burden that patients experience during NT, but caregiver well-being during NT is poorly understood. METHODS A cross-sectional mixed-methods analysis of primary caregivers of patients with localized PDAC receiving NT was undertaken. All patients completed the Caregiver Quality of Life Index-Cancer (CQOLC) survey, while semi-structured interviews were conducted among a convenience sample of participants. RESULTS Among 28 caregivers, the mean age was 60.1 years, and most were patient spouses/significant others (71.4%). Patients had resectable (18%), borderline resectable (46%), or locally advanced (36%) PDAC with a mean treatment duration of 2.9 months at the time of their caregiver's enrollment. Most caregivers felt that they received adequate emotional/psychosocial support (80%) and understood the rationale for NT (93%). A majority (60%) reported that caregiving responsibilities impacted their daily lives and required a decrease in their work hours, leading to financial challenges (47%). While overall QOL was moderate (mean 83 ± 21.1, range 0-140), "emotional burden" (47.3 ± 20.9), and "positive adaption" (57.3 ± 13.9) were the lowest ranked CQOLC subsection scores. DISCUSSION Caregivers of patients with PDAC undergoing NT experience significant emotional symptoms and impact on their daily lives. Assessing caregiver needs and providing resources during NT should be a priority.
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Affiliation(s)
- Samantha M Ruff
- Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Lena Stevens
- Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Luke Bressler
- Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Rakhsha Khatri
- Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Angela Sarna
- Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Aslam M Ejaz
- Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Mary Dillhoff
- Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Timothy M Pawlik
- Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Karen Rose
- College of Nursing, The Ohio State University, Columbus, Ohio, USA
| | - Jordan M Cloyd
- Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio, USA
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Sridhar A, Sekhon VK, Nguyen C, Abushalha K, Tahanan A, Rahbar MH, Jafri SH. Major Stressful Life Events and the Risk of Pancreatic, Head and Neck Cancers: A Case-Control Study. Cancers (Basel) 2024; 16:451. [PMID: 38275892 PMCID: PMC10814511 DOI: 10.3390/cancers16020451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/08/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Major stressful life events have been shown to be associated with an increased risk of lung cancer, breast cancer and the development of various chronic illnesses. The stress response generated by our body results in a variety of physiological and metabolic changes which can affect the immune system and have been shown to be associated with tumor progression. In this study, we aim to determine if major stressful life events are associated with the incidence of head and neck or pancreatic cancer (HNPC). METHODS This is a matched case-control study. Cases (CAs) were HNPC patients diagnosed within the previous 12 months. Controls (COs) were patients without a prior history of malignancy. Basic demographic data information on major stressful life events was collected using the modified Holmes-Rahe stress scale. A total sample of 280 was needed (79 cases, 201 controls) to achieve at least 80% power to detect odds ratios (ORs) of 2.00 or higher at the 5% level of significance. RESULTS From 1 January 2018 to 31 August 2021, 280 patients were enrolled (CA = 79, CO = 201) in this study. In a multivariable logistic regression analysis after controlling for potential confounding variables (including sex, age, race, education, marital status, smoking history), there was no difference between the lifetime prevalence of major stressful event in cases and controls. However, patients with HNPC were significantly more likely to report a major stressful life event within the preceding 5 years when compared to COs (p = 0.01, OR = 2.32, 95% CI, 1.18-4.54). CONCLUSIONS Patients with head, neck and pancreatic cancers are significantly associated with having a major stressful life event within 5 years of their diagnosis. This study highlights the potential need to recognize stressful life events as risk factors for developing malignancies.
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Affiliation(s)
- Arthi Sridhar
- Division of Hematology/Oncology, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Vishaldeep Kaur Sekhon
- Division of Geriatric Medicine and Gerontology, School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Chandler Nguyen
- McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA;
| | - Kamelah Abushalha
- MetroWest Medical Center/Tufts University School of Medicine, Framingham, MA 01702, USA
| | - Amirali Tahanan
- Center for Clinical and Translational Sciences, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA; (A.T.); (M.H.R.)
| | - Mohammad Hossein Rahbar
- Center for Clinical and Translational Sciences, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA; (A.T.); (M.H.R.)
| | - Syed Hasan Jafri
- Division of Hematology/Oncology, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
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Baudot A, Barth N, Colas C, Garros M, Garcin A, Oriol M, Collange F, Bongue B, Roche F, Chauvin F, Bourmaud A, Hupin D. The Acti-Pair program helps men with prostate cancer increase physical activity with peer support: a mixed method pilot study. Front Public Health 2024; 11:1321230. [PMID: 38259748 PMCID: PMC10800526 DOI: 10.3389/fpubh.2023.1321230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 12/11/2023] [Indexed: 01/24/2024] Open
Abstract
Background Although the health benefits of physical activity (PA) are recognized, prostate cancer patients do not follow PA recommendations. Barriers to PA, whether physical, environmental or organizational, are known. Furthermore, even when these barriers are overcome, this achievement is not systematically accompanied by lifestyle change. Many strategies have shown to be effective in increasing patient adherence to PA. This study aims to assess the feasibility and the viability of the Acti-Pair program which combines three strategies: peer support, a personalized and realistic PA project, and support from health and adapted physical activity professionals in a local context. Methods and analysis We conducted a pilot study utilizing a mixed qualitative and quantitative methodology, employing feasibility and viability assessments. Quantitative assessments included recruitment, retention adherence rates, process and potential effectiveness (PA and motivation) indicators; while qualitative methods were used to evaluate the program's practicality, suitability and usefulness. Indicators of potential effectiveness were assessed before and after the intervention using a Wilcoxon test for matched data. Qualitative data were collected through semistructured interviews conducted by two researchers with various program stakeholders. The study lasted for 3 years. Results Twenty-four patients were recruited over a 25-month period. Forty-two percent of patients completed the program 3 months after the beginning. We recruited 14 peers and trained nine peers over a 10-month period. The program was coordinated extensively by adapted PA professionals, while health professionals were involved in recruiting patients and peers. Self-reporting of moderate to vigorous PA was increased after the Acti-Pair program initiation [42.86 (30.76) at baseline to 53.29 (50.73)]. Intrinsic motivation significantly increased after participation in the Acti-Pair program [1.76 (1.32) before the intervention vs. 2.91 (1.13) after the intervention]. The key player to support the Acti-Pair program in the field has been the PA support system. The main challenge has been the difficulty of health professionals in promoting PA. Discussion This pilot study has shown that the Acti-Pair program is feasible and viable. It will allow us to extend the peer support intervention to other contexts and assess the effectiveness of this intervention and its generalization.
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Affiliation(s)
- Amandine Baudot
- National Institute of Health and Medical (INSERM) CIC1408 Centre d'Investigation Clinique Saint-Etienne, Saint-Etienne, France
- Unité de recherche Clinique, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
- National Institute of Health and Medical Research (INSERM) U1059 SAnté INgéniérie BIOlogie, Saint-Etienne, France
- Presage Institute - Université Jean Monnet, Saint-Etienne, France
| | - Nathalie Barth
- National Institute of Health and Medical Research (INSERM) U1059 SAnté INgéniérie BIOlogie, Saint-Etienne, France
- Presage Institute - Université Jean Monnet, Saint-Etienne, France
- Chaire santé des aînés - Université Jean Monnet, Saint-Etienne, France
- Gérontopôle Auvergne Rhône-alpes, Saint-Etienne, France
| | - Claire Colas
- National Institute of Health and Medical Research (INSERM) U1059 SAnté INgéniérie BIOlogie, Saint-Etienne, France
- Department of Clinical and Exercise Physiology, University Hospital Center of Saint-Etienne, Saint-Etienne, France
| | - Maël Garros
- Sport-Health House, Departmental Olympic and Sports Committee of the Loire (42), Saint-Etienne, France
| | - Arnauld Garcin
- Unité de recherche Clinique, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
| | - Mathieu Oriol
- Centre Technique d'Appui et de Formation (CETAF), Saint-Etienne, France
| | - Fanny Collange
- National Institute of Health and Medical (INSERM) CIC1408 Centre d'Investigation Clinique Saint-Etienne, Saint-Etienne, France
- Presage Institute - Université Jean Monnet, Saint-Etienne, France
| | - Bienvenu Bongue
- National Institute of Health and Medical Research (INSERM) U1059 SAnté INgéniérie BIOlogie, Saint-Etienne, France
- Presage Institute - Université Jean Monnet, Saint-Etienne, France
- Chaire santé des aînés - Université Jean Monnet, Saint-Etienne, France
| | - Frederic Roche
- National Institute of Health and Medical Research (INSERM) U1059 SAnté INgéniérie BIOlogie, Saint-Etienne, France
- Presage Institute - Université Jean Monnet, Saint-Etienne, France
- Chaire santé des aînés - Université Jean Monnet, Saint-Etienne, France
- Department of Clinical and Exercise Physiology, University Hospital Center of Saint-Etienne, Saint-Etienne, France
| | - Franck Chauvin
- National Institute of Health and Medical (INSERM) CIC1408 Centre d'Investigation Clinique Saint-Etienne, Saint-Etienne, France
- Presage Institute - Université Jean Monnet, Saint-Etienne, France
| | - Aurelie Bourmaud
- National Institute of Health and Medical Research (INSERM) U1137 Infection, Antimicrobiens, Modélisation, Evolution, Paris, France
- National Institute of Health and Medical Research (INSERM) CIC1426 Centre d'Investigation Clinique Robert Debré, Paris, France
| | - David Hupin
- National Institute of Health and Medical Research (INSERM) U1059 SAnté INgéniérie BIOlogie, Saint-Etienne, France
- Presage Institute - Université Jean Monnet, Saint-Etienne, France
- Chaire santé des aînés - Université Jean Monnet, Saint-Etienne, France
- Department of Clinical and Exercise Physiology, University Hospital Center of Saint-Etienne, Saint-Etienne, France
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Yang Y, Chen X, Pan X, Tang X, Fan J, Li Y. The unmet needs of patients in the early rehabilitation stage after lung cancer surgery: a qualitative study based on Maslow's hierarchy of needs theory. Support Care Cancer 2023; 31:677. [PMID: 37934256 DOI: 10.1007/s00520-023-08129-z] [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: 05/04/2023] [Accepted: 10/19/2023] [Indexed: 11/08/2023]
Abstract
PURPOSE This study aimed to explore the unmet needs of lung cancer patients in early rehabilitation, based on Maslow's hierarchy of needs theory. METHODS Information on the experiences of 20 patients was collected through semi-structured interviews. The interviews were conducted in the surgical nursing clinic within 1 week of discharge from hospital. The data were analysed using a combination of deductive (theory-driven) and inductive (data-driven) methods, using Maslow's Hierarchy of Needs as a framework for identifying and organising themes. RESULTS Patients had a mean age of 50.92 years (SD 11.88); n = 11 (55%) were female. Major themes aligned with the dimensions of Maslow's hierarchy of needs model. Five major themes with 12 corresponding sub-themes emerged: (1) physiological needs, including "self-care and independence in life", "return to pre-operative status as soon as possible", "increase exercise under specialist guidance" and "reduce cough and pain and improve sleep quality"; (2) safety and security needs, such as "symptom management", "regulation of the emotions of worry and fear" and "access accurate treatment information"; (3) love and belonging needs, including "accompany family members" and "chat with friends";(4)Esteem needs: "live with dignity";(5) Self-actualization, such as "accept and submit to the reality of cancer" and "live meaningfully". CONCLUSIONS The findings of this study indicated that there were many unmet needs for patients during the early recovery period after lung cancer surgery. An overview of the different areas of need identified in this study may guide future research and development of interventions to improve patients' quality of life during the home rehabilitation phase.
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Affiliation(s)
- Yingzi Yang
- School of Medicine, Tongji University, 1239 Siping Road, Shanghai, 200092, People's Republic of China
- Department of Nursing, Huadong Sanatorium, No. 67, Dajishan, Wuxi City, Jiangsu Province, 214100, People's Republic of China
| | - Xinxin Chen
- School of Medicine, Tongji University, 1239 Siping Road, Shanghai, 200092, People's Republic of China
- Department of Nursing, Shanghai Pulmonary Hospital, Tongji University, No.507, Zhengmin Road, Shanghai, 200433, People's Republic of China
| | - Xiaoting Pan
- School of Medicine, Tongji University, 1239 Siping Road, Shanghai, 200092, People's Republic of China
| | - Xuefeng Tang
- Department of Nursing, Huadong Sanatorium, No. 67, Dajishan, Wuxi City, Jiangsu Province, 214100, People's Republic of China
| | - Jiaxin Fan
- School of Medicine, Tongji University, 1239 Siping Road, Shanghai, 200092, People's Republic of China
| | - Yumei Li
- Department of Nursing, Shanghai Pulmonary Hospital, Tongji University, No.507, Zhengmin Road, Shanghai, 200433, People's Republic of China.
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Clausing D, Fowler ME, Harmon C, Tucker A, Outlaw D, Akce M, El-Rayes B, Giri S, Williams GR. Association of emotional support with quality of life, mental health, and survival in older adults with gastrointestinal malignancies-Results from the CARE registry. Cancer Med 2023; 12:19102-19111. [PMID: 37644881 PMCID: PMC10557900 DOI: 10.1002/cam4.6477] [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: 07/02/2023] [Revised: 08/10/2023] [Accepted: 08/14/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Emotional support (ES) is the most frequently reported support need among older adults with cancer. Yet, the association of ES with cancer outcomes is largely unknown. This study examined the association of ES with health-related quality of life (HRQoL), mental health, and survival among older adults with gastrointestinal (GI) malignancies. METHODS We included newly diagnosed older adults (≥60 years) with GI cancer undergoing self-reported geriatric assessment at their first clinic visit. ES was measured using an adaptation of the Medical Outcomes Study (dichotomized adequate ES vs. inadequate ES). Outcomes included physical and mental HRQoL, anxiety, depression, and survival. Multivariable linear regression evaluated the association between ES and HRQoL scores. Multivariable logistic regression evaluated the association of ES with anxiety and depression. All models were adjusted for age at geriatric assessments, race, sex, and cancer type/stage. RESULTS 795 participants were included. Median patient age was 68 years (IQR: 64-74), 58% were male, and most cancers were either colorectal (37.9%) or pancreatic (30.8%). Most (77.6%) had adequate ES. Patients with inadequate ES were more likely to be Black (31.5 vs. 20.8%, p = 0.005), disabled (24.1 vs. 10.4%, p < 0.001), widowed/divorced (54.2 vs. 24.8%, p < 0.001) and had lower physical and mental HRQoL t-scores (Physical β: -3.35, 95% CI: -5.25, -1.46; Mental β: -2.46, 95% CI: -4.11, -0.81) and higher odds of depression (aOR: 2.22, CI: 1.34-3.69). This study found no difference between those with adequate ES versus inadequate ES in the proportion of deaths within 1 year of diagnosis (24.3% vs. 24.2%, p = 0.966), or within 2 years of diagnosis (32.4% vs. 33.2%, p = 0.126). CONCLUSIONS Older adults with inadequate ES have worse physical and mental HRQoL and higher odds of depression compared to those with adequate ES.
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Affiliation(s)
- Daniel Clausing
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Mackenzie E Fowler
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Christian Harmon
- Institute for Cancer Outcomes & Survivorship, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Abigail Tucker
- Institute for Cancer Outcomes & Survivorship, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Darryl Outlaw
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Mehmet Akce
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Bassel El-Rayes
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Smith Giri
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Institute for Cancer Outcomes & Survivorship, University of Alabama at Birmingham, Birmingham, Alabama, USA
- O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Grant R Williams
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Institute for Cancer Outcomes & Survivorship, University of Alabama at Birmingham, Birmingham, Alabama, USA
- O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama, USA
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10
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Birmingham WC, Jorgensen A, Hancock S, Wadsworth LL, Hung M. Social Support: The Effect on Nocturnal Blood Pressure Dipping. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4579. [PMID: 36901589 PMCID: PMC10001803 DOI: 10.3390/ijerph20054579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/01/2023] [Accepted: 03/02/2023] [Indexed: 05/13/2023]
Abstract
Social support has long been associated with cardiovascular disease risk assessed with blood pressure (BP). BP exhibits a circadian rhythm in which BP should dip between 10 and 15% overnight. Blunted nocturnal dipping (non-dipping) is a predictor of cardiovascular morbidity and mortality independent of clinical BP and is a better predictor of cardiovascular disease risk than either daytime or nighttime BP. However, it is often examined in hypertensive individuals and less often in normotensive individuals. Those under age 50 are at increased risk for having lower social support. This study examined social support and nocturnal dipping in normotensive individuals under age 50 using ambulatory blood pressure monitoring (ABP). ABP was collected in 179 participants throughout a 24-h period. Participants completed the Interpersonal Support Evaluation List, which assesses perceived levels of social support in one's network. Participants with low levels of social support demonstrated blunted dipping. This effect was moderated by sex, with women showing greater benefit from their social support. These findings demonstrate the impact social support can have on cardiovascular health, exhibited through blunted dipping, and are particularly important as the study was conducted in normotensive individuals who are less likely to have high levels of social support.
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Affiliation(s)
| | - Anna Jorgensen
- Psychology Department, Brigham Young University, Provo, UT 84602, USA
| | - Sinclaire Hancock
- Psychology Department, Brigham Young University, Provo, UT 84602, USA
| | - Lori L. Wadsworth
- Romney Institute of Public Management, Brigham Young University, Provo, UT 84602, USA
| | - Man Hung
- Department of Orthopedic Surgery Operations, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA
- College of Dental Medicine, Roseman University of Health Sciences, 10894 S River Front Pkwy, South Jordan, UT 84095, USA
- George E. Wahlen Department of Veteran Affairs Medical Center, 500 Foothill Drive, Salt Lake City, UT 84148, USA
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11
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Gomes F, Taylor S, Scanlon L, Coombermoore J, Eastwood C, Stanworth M, Williamson A, Barnes C, Yorke J. The experience of patients with lung cancer during the COVID-19 pandemic and its importance for post-pandemic outpatient cancer care planning: A cross sectional study exploring the roles of age and frailty. J Geriatr Oncol 2023; 14:101449. [PMID: 36870223 PMCID: PMC9933321 DOI: 10.1016/j.jgo.2023.101449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/12/2022] [Accepted: 02/08/2023] [Indexed: 02/18/2023]
Abstract
INTRODUCTION The COVID-19 pandemic impacted the care and experiences of people with cancer, but it presented an opportunity to improve the delivery of outpatient care post-pandemic. MATERIALS AND METHODS We performed an observational cross-sectional study with people with lung cancer throughout the COVID-19 pandemic. A survey investigated patients' experiences and preferences regarding the delivery of cancer care to plan for post-pandemic care, as well as the pandemic's impact on their functional status (physical and psycho-social), exploring the role of age and frailty. RESULTS Amongst 282 eligible participants, 88%, 86%, and 59% of patients reported feeling appropriately supported during the pandemic by their cancer centre, friends/family, and primary care services, respectively. Remote oncology consultations were delivered to 90% of patients during the pandemic, of which 3% did not meet patients' expectations. Regarding post-pandemic outpatient care preferences, face-to-face appointments were preferred by 93% for the first appointment, by 64% when discussing imaging results, and by 60% for reviews during anti-cancer treatments. Older patients aged 70 years and above were more likely to favour face-to-face appointments (p = 0.007), regardless of their frailty status. Patient preferences changed over time, with the more recent participants preferring remote appointments during anti-cancer treatments (p = 0.0278). Regarding the pandemic's impact, abnormal levels of anxiety and depression were found in 16% and 17% of patients, respectively. Younger patients experienced higher abnormal levels of anxiety and depression (p = 0.036, p = 0.021). Amongst the older sub-group, those with frailty had higher levels of anxiety and depression (p < 0.001). Amongst all participants, 54% reported a considerable negative impact from the pandemic on different aspects of their daily life, particularly emotional and psychological health and sleep patterns, which were more marked in younger patients and the older sub-group with frailty. Older patients without frailty reported the least impact on their functional status. DISCUSSION There is a need for more personalised outpatient consultation options during cancer care. Whilst there is a preference for face-to-face consultations for older patients, following the pandemic there is a growing acceptance of remote consultations particularly during anti-cancer treatment. Older patients with lung cancer without frailty were less affected by the pandemic than those with frailty and younger patients, requiring less support from healthcare services.
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Affiliation(s)
- Fabio Gomes
- Medical Oncology Department, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK; Christie Patient Centred Research, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK; Clinical Outcomes Unit, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK.
| | - Sally Taylor
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK; School of Nursing and Midwifery, The University of Manchester, Oxford Road, Manchester M13 9PL, UK
| | - Lauren Scanlon
- Clinical Outcomes Unit, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK
| | - Jake Coombermoore
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK
| | - Charlotte Eastwood
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK
| | - Melissa Stanworth
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK
| | - Andrew Williamson
- Medical Oncology Department, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK
| | - Claire Barnes
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK
| | - Janelle Yorke
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK; School of Nursing and Midwifery, The University of Manchester, Oxford Road, Manchester M13 9PL, UK
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12
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Liu S, Jia Y, Chai J, Ge H, Huang R, Li A, Cheng H. A Predictive Model for the Early Death of Breast Cancer With Synchronous Liver Metastases: A Population-Based Study. Cancer Control 2023; 30:10732748231202851. [PMID: 37724916 PMCID: PMC10510350 DOI: 10.1177/10732748231202851] [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: 04/15/2023] [Revised: 07/29/2023] [Accepted: 08/21/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Breast cancer liver metastasis (BCLM) is a severe condition often resulting in early death. The identification of prognostic factors and the construction of accurate predictive models can guide clinical decision-making. METHODS A large sample of data from the Surveillance, Epidemiology, and End Results (SEER) database was analyzed, including 3711 patients diagnosed with de novo BCLM between 2010 and 2015. Predictive models were developed using histograms, and stepwise regression addressed variable collinearity. Internal validation was performed, and results were compared to similar studies. RESULTS In this study of 3711 BCLM patients, 2571 didn't have early death. Out of the 1164 who died early, 1086 had cancer-specific early death. Prognostic factors for early death, including age, race, tumor size, and lymph node involvement, were identified. A nomogram based on these factors was constructed, accurately predicting early all-cause and cancer-specific death. CONCLUSIONS Valuable insights into the prognosis of BCLM patients were provided, and important prognostic factors for early death were identified. The developed nomogram can assist clinicians in identifying high-risk patients for early death and inform treatment decisions.
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Affiliation(s)
- Shaochun Liu
- Department of Oncology, The Second Hospital of Anhui Medical University, Hefei, China
| | - Yingxue Jia
- Department of Oncology, The Second Hospital of Anhui Medical University, Hefei, China
| | - Jiaying Chai
- Department of Oncology, The Second Hospital of Anhui Medical University, Hefei, China
| | - Han Ge
- Department of Oncology, The Second Hospital of Anhui Medical University, Hefei, China
| | - Runze Huang
- Department of Oncology, The Second Hospital of Anhui Medical University, Hefei, China
| | - Anlong Li
- Department of Oncology, The Second Hospital of Anhui Medical University, Hefei, China
| | - Huaidong Cheng
- Department of Oncology, The Second Hospital of Anhui Medical University, Hefei, China
- Shenzhen Clinical Medical School of Southern Medical University
- Department of Oncology, Shenzhen Hospital of Southern Medical University, Shenzhen, China
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