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Update on Prevalence of Pain in Patients with Cancer 2022: A Systematic Literature Review and Meta-Analysis. Cancers (Basel) 2023; 15:cancers15030591. [PMID: 36765547 PMCID: PMC9913127 DOI: 10.3390/cancers15030591] [Citation(s) in RCA: 69] [Impact Index Per Article: 69.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/13/2023] [Accepted: 01/14/2023] [Indexed: 01/20/2023] Open
Abstract
Experiencing pain and insufficient relief can be devastating and negatively affect a patient's quality of life. Developments in oncology such as new treatments and adjusted pain management guidelines may have influenced the prevalence of cancer pain and severity in patients. This review aims to provide an overview of the prevalence and severity of pain in cancer patients in the 2014-2021 literature period. A systematic literature search was performed using the databases PubMed, Embase, CINAHL, and Cochrane. Titles and abstracts were screened, and full texts were evaluated and assessed on methodological quality. A meta-analysis was performed on the pooled prevalence and severity rates. A meta-regression analysis was used to explore differences between treatment groups. We identified 10,637 studies, of which 444 studies were included. The overall prevalence of pain was 44.5%. Moderate to severe pain was experienced by 30.6% of the patients, a lower proportion compared to previous research. Pain experienced by cancer survivors was significantly lower compared to most treatment groups. Our results imply that both the prevalence of pain and pain severity declined in the past decade. Increased attention to the assessment and management of pain might have fostered the decline in the prevalence and severity of pain.
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Zou W, Zhang Y, Gong L, Zhang M, Wu X, Xie J, Zhang M. Factors associated with psychosocial adjustment in working-age colorectal cancer survivors: A cross-sectional study. Asia Pac J Oncol Nurs 2022; 9:100057. [PMID: 35647223 PMCID: PMC9130516 DOI: 10.1016/j.apjon.2022.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 03/25/2022] [Indexed: 12/05/2022] Open
Abstract
Objective This study aimed to describe the level of psychosocial adjustment and identify factors associated with psychosocial adjustment in working-age colorectal cancer survivors. Methods This cross-sectional study involved 212 colorectal cancer survivors visiting a cancer clinic at a specialized oncology hospital in China. Socio-demographic characteristics, disease-related characteristics, status of returning to work, Work Ability Index scores, M. D. Anderson Symptom Inventory for Gastrointestinal Cancer scores, and self-reported Psychological Adjustment to Illness Scale scores were collected from all participants. Data analyses included descriptive statistics, independent t-test, one-way analysis of variance, correlation analysis, and multiple linear regression analysis, which were performed using the Statistical Package for the Social Sciences version 25.0 (IBM Corporation, Armonk, NY, USA). Results Participants reported a medium level of psychosocial maladjustment (35.73 ± 19.68), with 19.3% of participants experiencing severe maladjustment, 29.7% experiencing moderate maladjustment, and 50.9% experiencing mild maladjustment, respectively. Age, gender, marital status, having a child, education level, having a stoma, comorbidities, return to work, work ability, and symptom distress were entered into a multiple linear regression analysis. The strongest factor influencing the level of psychosocial adjustment was work ability (β = −0.393, P < 0.001), followed by symptom distress (β = 0.380, P < 0.001) and an education level of college or above (β = 0.150, P = 0.027). These variables accounted for 46.1% of the variance in psychosocial adjustment. Conclusions Colorectal cancer survivors with low work ability, high symptom distress, and an education level of college or above are at a high risk for psychosocial maladjustment. Nursing interventions for psychosocial adjustment should attach increased importance to the work status and symptom distress of colorectal cancer survivors.
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Legg M, Meertens RM, van Roekel E, Breukink SO, Janssen ML, Keulen ETP, Steindorf K, Weijenberg MP, Bours M. The Association between Sleep Quality and Fatigue in Colorectal Cancer Survivors up until Two Years after Treatment: A Cross-Sectional and Longitudinal Analysis. Cancers (Basel) 2022; 14:cancers14061527. [PMID: 35326678 PMCID: PMC8945971 DOI: 10.3390/cancers14061527] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/02/2022] [Accepted: 03/11/2022] [Indexed: 02/01/2023] Open
Abstract
Simple Summary Fatigue is a distressing complaint with high detriment to quality of life that persists in one third of colorectal cancer survivors after cancer treatment. Surprisingly, the contribution of poor sleep quality to fatigue in colorectal cancer survivors is underinvestigated. We aimed to investigate the association between sleep quality and fatigue in colorectal cancer survivors up until two years post-treatment. Results showed worse sleep quality in colorectal cancer patients was associated with higher levels of fatigue during the first two years post-treatment. The results of this study suggest that more attention for sleep quality in colorectal cancer survivors and offering sleep health interventions may lead to less fatigue and better quality of life in this group. Abstract Fatigue is a distressing complaint with high detriment to quality of life that persists in one-third of colorectal cancer survivors after cancer treatment. Previous studies in mixed groups of cancer patients have suggested sleep quality is associated with fatigue. We aimed to investigate this association in colorectal cancer survivors up until two years post-treatment. Data on n = 388 stage I–III colorectal cancer patients were utilized from the EnCoRe study. Sleep quality and fatigue were measured at 6 weeks and 6, 12, and 24 months post-treatment. Sleep quality was measured using the Pittsburgh Sleep Quality Index (cross-sectional analysis only) and the single-item insomnia scale from the EORTC QLQ-C30. Fatigue was measured by the Checklist Individual Strength. Linear and mixed-model regression analyses analysed associations between sleep quality and fatigue cross-sectionally and longitudinally. Longitudinal analysis revealed worsening sleep quality over time was significantly associated with increased levels of fatigue over time (β per 0.5 SD increase in the EORTC-insomnia score = 2.56, 95% Cl: 1.91, 3.22). Significant cross-sectional associations were observed between worse sleep quality and higher levels of fatigue at all time points. Worse sleep quality in colorectal cancer patients was associated with higher levels of fatigue during the first two years post-treatment.
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Affiliation(s)
- Meera Legg
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, 6200 MD Maastricht, The Netherlands;
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, 6200 MD Maastricht, The Netherlands; (E.v.R.); (M.P.W.); (M.B.)
| | - Ree M. Meertens
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, 6200 MD Maastricht, The Netherlands;
- Correspondence:
| | - Eline van Roekel
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, 6200 MD Maastricht, The Netherlands; (E.v.R.); (M.P.W.); (M.B.)
| | - Stéphanie O. Breukink
- Department of Surgery, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center+, 6202 AZ Maastricht, The Netherlands;
| | - Maryska L. Janssen
- Department of Clinical Epidemiology, VieCuri Medical Centre, Tegelseweg 210, 5912 BL Venlo, The Netherlands;
| | - Eric T. P. Keulen
- Department of Internal Medicine and Gastroenterology, Zuyderland Medical Centre, Dr. H. van der Hoffplein 1, 6162 BG Sittard-Geleen, The Netherlands;
| | - Karen Steindorf
- Division of Physical Activity, Prevention and Cancer, National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany;
| | - Matty P. Weijenberg
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, 6200 MD Maastricht, The Netherlands; (E.v.R.); (M.P.W.); (M.B.)
| | - Martijn Bours
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, 6200 MD Maastricht, The Netherlands; (E.v.R.); (M.P.W.); (M.B.)
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Gonzalez-Mercado VJ, Lim J, Saligan LN, Perez N, Rodriguez C, Bernabe R, Ozorio S, Pedro E, Sepehri F, Aouizerat B. Gut Microbiota and Depressive Symptoms at the End of CRT for Rectal Cancer: A Cross-Sectional Pilot Study. DEPRESSION RESEARCH AND TREATMENT 2021; 2021:7967552. [PMID: 35003805 PMCID: PMC8731300 DOI: 10.1155/2021/7967552] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 11/24/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND The role of alterations in gut microbiota composition (termed dysbiosis) has been implicated in the pathobiology of depressive symptoms; however, evidence remains limited. This cross-sectional pilot study is aimed at exploring whether depressive symptom scores changed during neoadjuvant chemotherapy and radiation therapy to treat rectal cancer, and if gut microbial taxa abundances and predicted functional pathways correlate with depressive symptoms at the end of chemotherapy and radiation therapy. METHODS 40 newly diagnosed rectal cancer patients (ages 28-81; 23 males) were assessed for depressive symptoms using the Hamilton Rating Scale for Depression (HAM-D) and provided stool samples for 16S rRNA sequencing. Gut microbiome data were analyzed using QIIME2, and correlations and regression analyses were performed in R. RESULTS Participants had significantly higher depressive symptoms at the end as compared to before CRT. The relative abundances of Gemella, Bacillales Family XI, Actinomyces, Streptococcus, Lactococcus, Weissella, and Leuconostocaceae were positively correlated (Spearman's rho = 0.42 to 0.32), while Coprobacter, Intestinibacter, Intestimonas, Lachnospiraceae, Phascolarctobacterium, Ruminiclostridium, Ruminococcaceae (UCG-005 and uncultured), Tyzzerella, and Parasutterella (Spearman's rho = -0.43 to - 0.31) were negatively correlated with HAM-D scores. Of the 14 predicted MetaCyc pathways that correlated with depressive symptom scores at the end of CRT, 11 (79%) were associated with biosynthetic pathways. CONCLUSIONS Significant bacterial taxa and predicted functional pathways correlated with depressive symptoms at the end of chemotherapy and radiation therapy for rectal cancer which warrants further examination and replication of our findings.
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Affiliation(s)
| | - Jean Lim
- University of Miami, Miami, FL, USA
| | - Leorey N. Saligan
- Intramural Program, National Institute of Nursing Research/National Institute of Health, Bethesda, MD, USA
| | - Nicole Perez
- Rory Meyers College of Nursing, New York University, New York, NY, USA
| | | | - Raul Bernabe
- Department of General Studies, University of Puerto Rico, San Juan, Puerto Rico
| | - Samia Ozorio
- College of Nursing, University of South Florida, Tampa, FL, USA
| | - Elsa Pedro
- School of Pharmacy, Medical Science Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - Farrah Sepehri
- College of Nursing, University of South Florida, Tampa, FL, USA
| | - Brad Aouizerat
- Bluestone Center for Clinical Research, Department of Oral and Maxillofacial Surgery College of Dentistry, New York University, New York, NY, USA
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Giannopoulos P, Mertens YJ, Secomandi LE, Olsder L, van Leeuwen BL. Development, validation and evaluation of a patient information booklet for rectal cancer survivors with a stoma: A three-step approach. PATIENT EDUCATION AND COUNSELING 2021; 104:2275-2285. [PMID: 33685763 DOI: 10.1016/j.pec.2021.02.045] [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: 10/10/2020] [Revised: 02/06/2021] [Accepted: 02/23/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Quantitatively measure the degree of patient satisfaction and perceived acquired knowledge through the development of a patient information booklet for rectal cancer survivors with a stoma, according to a novel three-step approach. METHODS The study included a systematic literature review to identify relevant information for the booklet, which was validated by experts based on relevance, clarity and essentiality. It underwent testing on quality, readability, and layout and design and was quantitatively evaluated by rectal cancer survivors with a stoma. RESULTS In total, 145 articles were used for the development of the booklet. It scored 91% for relevance according to 17 experts, 70% for readability, 75.63% for quality and 23 out of 32 for design. The mean score of patient satisfaction was 8.03 out of 10. All 20 patients found the booklet 'useful' and 95% felt better informed. CONCLUSIONS The booklet scored high for patient satisfaction and increased perceived acquired information. It ensured satisfactory levels of quality, readability, and layout and design. PRACTICE IMPLICATIONS This study offers a novel three-step approach for development of informational tools for cancer survivors, assuring that a variety of newly created written patient materials would be of increased quality and relevance to any target population.
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Affiliation(s)
| | - Yannick J Mertens
- Department of Surgical Oncology, University of Groningen, Groningen, the Netherlands
| | - Laura E Secomandi
- Department of Surgical Oncology, University of Groningen, Groningen, the Netherlands
| | - Linde Olsder
- Department of Gastrointestinal Oncology, University of Groningen, Groningen, the Netherlands
| | - Barbara L van Leeuwen
- Department of Surgical Oncology, University of Groningen, Groningen, the Netherlands
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Abstract
Delirium is a manifestation of brain injury or acute and generalized dysfunction of the upper cerebral cortical processes. In this way, it is important to analyze delirium more broadly as a symptom to understand and intervene taking into account that it is manifesting the presence of brain lesions whose consequences are deleterious to the neurological performance of patients. This article is intended to present a comprehensive approach of delirium analyzed from a symptom perspective and from theoretical and conceptual structure, such as the Dynamic Symptoms Model, specific to the nursing practice. A literature review related to delirium and components of Dynamic Symptoms Model was carried out. We searched the MEDLINE, ScienceDirect, SciELO, and Scopus databases using the terms Delirium, Intensive Care Units, Nursing, and Risk Factor. The existing literature provides evidence of the antecedents, experience, interventions, interactions, and consequences of delirium, which are components of the Model. Thus, the analysis from the Dynamic Symptoms Model perspective bears relevance and contributes to the understanding and approach of delirium.
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González-Mercado VJ, Henderson WA, Sarkar A, Lim J, Saligan LN, Berk L, Dishaw L, McMillan S, Groer M, Sepehri F, Melkus GD. Changes in Gut Microbiome Associated With Co-Occurring Symptoms Development During Chemo-Radiation for Rectal Cancer: A Proof of Concept Study. Biol Res Nurs 2021; 23:31-41. [PMID: 32700552 PMCID: PMC7874367 DOI: 10.1177/1099800420942830] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
PURPOSE To examine a) whether there are significant differences in the severity of symptoms of fatigue, sleep disturbance, or depression between patients with rectal cancer who develop co-occurring symptoms and those with no symptoms before and at the end of chemotherapy and radiation therapy (CRT); b) differences in gut microbial diversity between those with co-occurring symptoms and those with no symptoms; and c) whether before-treatment diversity measurements and taxa abundances can predict co-occurrence of symptoms. METHODS Stool samples and symptom ratings were collected from 31 patients with rectal cancer prior to and at the end of (24-28 treatments) CRT. Descriptive statistics were computed and the Mann-Whitney U test was performed for symptoms. Gut microbiome data were analyzed using R's vegan package software. RESULTS Participants with co-occurring symptoms reported greater severity of fatigue at the end of CRT than those with no symptoms. Bacteroides and Blautia2 abundances differed between participants with co-occurring symptoms and those with no symptoms. Our random forest classification (unsupervised learning algorithm) predicted participants who developed co-occurring symptoms with 74% accuracy, using specific phylum, family, and genera abundances as predictors. CONCLUSION Our preliminary results point to an association between the gut microbiota and co-occurring symptoms in rectal cancer patients and serves as a first step in potential identification of a microbiota-based classifier.
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Affiliation(s)
- Velda J González-Mercado
- NYU Rory Meyers College of Nursing, New York, NY, USA
- College of Nursing, 7831University of South Florida, Tampa, FL, USA
| | | | - Anujit Sarkar
- College of Nursing and College of Public Health, 7831University of South Florida, Tampa, FL, USA
| | - Jean Lim
- 96722Rosenstiel School of Marine and Atmosphereic Science, University of Miami, FL, USA
| | - Leorey N Saligan
- Symptom Science Center, Symptom Biology Unit, Division of Intramural Research, NINR, NIH, DHHS, Bethesda, MD, USA
| | - Lawrence Berk
- College of Medicine Radiology, 7831University of South Florida, Tampa, FL, USA
| | - Larry Dishaw
- Department of Pediatrics, Molecular Genetics Children's Research Institute, 7831University of South Florida, St. Petersburg, FL, USA
| | - Susan McMillan
- College of Nursing, 7831University of South Florida, Tampa, FL, USA
| | - Maureen Groer
- College of Nursing, 7831University of South Florida, Tampa, FL, USA
| | - Farrah Sepehri
- College of Nursing, 7831University of South Florida, Tampa, FL, USA
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Han CJ, Yang GS, Syrjala K. Symptom Experiences in Colorectal Cancer Survivors After Cancer Treatments: A Systematic Review and Meta-analysis. Cancer Nurs 2020; 43:E132-E158. [PMID: 32000174 PMCID: PMC7182500 DOI: 10.1097/ncc.0000000000000785] [Citation(s) in RCA: 75] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND With improved survivorship rates for colorectal cancer (CRC), more CRC survivors are living with long-term disease and treatment side effects. Little research exists on CRC symptoms or symptom management guidelines to support these individuals after cancer treatments. OBJECTIVES The aims of this study were to systematically review symptom experiences, risk factors, and the impact of symptoms and to examine the pooled frequency and severity of symptoms via meta-analyses in CRC survivors after cancer treatments. METHODS Relevant studies were systematically searched in 7 databases from 2009 to 2019. Meta-analysis was conducted for pooled estimates of symptom frequency and severity. RESULTS Thirty-five studies met the inclusion criteria. Six studies assessed multiple CRC symptoms, whereas 29 focused on a single symptom, including peripheral neuropathy, psychological distress, fatigue, body image distress, cognitive impairment, and insomnia. The pooled mean frequency was highest for body image distress (78.5%). On a scale of 0 to 100, the pooled mean severity was highest for fatigue (50.1). Gastrointestinal and psychological symptoms, peripheral neuropathy, and insomnia were also major problems in CRC survivors. Multiple factors contributed to adverse symptoms, such as younger age, female gender, and lack of family/social support. Symptoms negatively impacted quality of life, social and sexual functioning, financial status, and caregivers' physical and mental conditions. CONCLUSIONS Colorectal cancer survivors experienced multiple adverse symptoms related to distinct risk factors. These symptoms negatively impacted patients and caregivers' well-being. IMPLICATIONS FOR PRACTICE Healthcare providers can use study findings to better assess and monitor patient symptoms after cancer treatments. More research is needed on CRC-specific symptoms and their effective management.
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Affiliation(s)
- Claire J Han
- Author Affiliations: Department of Public Health, University of Washington, Seattle (Drs Han and Syrjala); College of Nursing, University of Florida, Gainesville (Dr Yang); and Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, Washington (Drs Han and Syrjala)
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González-Mercado VJ, Pérez-Santiago J, Lyon D, Dilán-Pantojas I, Henderson W, McMillan S, Groer M, Kane B, Marrero S, Pedro E, Saligan LN. The Role of Gut Microbiome Perturbation in Fatigue Induced by Repeated Stress from Chemoradiotherapy: A Proof of Concept Study. Adv Med 2020; 2020:6375876. [PMID: 32090133 PMCID: PMC7029262 DOI: 10.1155/2020/6375876] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 09/20/2019] [Accepted: 10/10/2019] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES The objectives of this proof of concept study were to (a) examine the temporal changes in fatigue and diversity of the gut microbiome over the course of chemoradiotherapy (CRT) in adults with rectal cancers; (b) investigate whether there are differences in diversity of the gut microbiome between fatigued and nonfatigued participants at the middle and at the end of CRT; and (c) investigate whether there are differences in the relative abundance of fecal microbiota at the phylum and genus levels between fatigued and nonfatigued participants at the middle and at the end of CRT. METHODS Stool samples and symptom ratings were collected prior to the inception of CRT, at the middle (after 12-16 treatments) and at the end (after 24-28 treatments) of the CRT. Descriptive statistics and Mann-Whitney U test were computed for fatigue. Gut microbiome data were analyzed using the QIIME2 software. RESULTS Participants (N = 29) ranged in age from 37 to 80 years. The median fatigue score significantly changed at the end of CRT (median = 23.0) compared with the median score before the initiation of CRT for the total sample (median = 17.0; p ≤ 0.05). At the middle of CRT, the alpha diversity (abundance of Operational Taxonomic Units) was lower for fatigued participants (149.30 ± 53.1) than for nonfatigued participants (189.15 ± 44.18, t(23) = 2.08, p ≤ 0.05). At the middle of CRT, the alpha diversity (abundance of Operational Taxonomic Units) was lower for fatigued participants (149.30 ± 53.1) than for nonfatigued participants (189.15 ± 44.18, Proteobacteria, Firmicutes, and Bacteroidetes were the dominant phyla for fatigued participants, and Escherichia, Bacteroides, Faecalibacterium, and Oscillospira were the most abundant genera for fatigued participants. CONCLUSION CRT-associated perturbation of the gut microbiome composition may contribute to fatigue.
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Affiliation(s)
| | - Josué Pérez-Santiago
- Puerto Rico Omics Center, Comprehensive Cancer Center, University of Puerto Rico, San Juan, PR, USA
| | - Debra Lyon
- College of Nursing, University of Florida, Gainesville, FL, USA
| | - Israel Dilán-Pantojas
- Puerto Rico Omics Center, Comprehensive Cancer Center, University of Puerto Rico, San Juan, PR, USA
| | - Wendy Henderson
- Intramural Program, National Institute of Nursing Research/National Institute of Health, Bethesda, MD, USA
| | - Susan McMillan
- College of Nursing, University of South Florida, Tampa, FL, USA
| | - Maureen Groer
- College of Nursing, University of South Florida, Tampa, FL, USA
| | - Brad Kane
- College of Nursing, University of South Florida, Tampa, FL, USA
| | - Sara Marrero
- College of Arts and Sciences, University of South Florida, Tampa, FL, USA
| | - Elsa Pedro
- School of Pharmacy, Medical Science Campus, University of Puerto Rico, San Juan, PR, USA
| | - Leorey N. Saligan
- Intramural Program, National Institute of Nursing Research/National Institute of Health, Bethesda, MD, USA
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Wulff-Burchfield E, Dietrich MS, Ridner S, Murphy BA. Late systemic symptoms in head and neck cancer survivors. Support Care Cancer 2019; 27:2893-2902. [PMID: 30554277 PMCID: PMC6597600 DOI: 10.1007/s00520-018-4577-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 11/27/2018] [Indexed: 12/30/2022]
Abstract
PURPOSE Neuroinflammation and central sensitization from cancer and its therapy may result in chronic systemic symptoms (CSS) such as fatigue, sleep disturbance, chronic widespread pain, mood disorders, neuropsychiatric symptoms, and temperature dysregulation. We undertook a cross-sectional study of CSS in head and neck cancer (HNC) survivors to determine their frequency, severity, and impact. METHODS HNC patients without evidence of recurrence who were at least 12 months post-treatment completed a one-time battery of self-report measures including the Vanderbilt Head and Neck Symptom survey plus the General Symptom Subscale, the Body Image Quality of Life Inventory, Neurotoxicity Rating Scale, the Profile of Mood States, and a five-item quality of life measure. RESULTS One hundred five patients completed the surveys. Forty-eight point four percent of patients experienced one or more moderate-to-severe systemic symptom. The frequency of individual symptoms was between 20% and 56% with almost half of patients rating symptoms as moderate-to-severe in intensity. Low and high systemic symptom burden populations were identified. Previously undescribed chronic neuropsychiatric symptoms were also found to be frequent and severe. The vigor score on the POMS was low. Body image was not adversely impacted. At least 40% of HNC survivors have diminished quality of life, and up to 15% have a poor quality of life. CONCLUSIONS CSS are common among HNC survivors and are frequently moderate to severe in intensity. Of note, previously underrecognized neuropsychiatric symptoms were endorsed by a significant cohort of patients warranting further study. Quality of life was diminished in a significant cohort.
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Affiliation(s)
- Elizabeth Wulff-Burchfield
- Department of Medicine, Divisions of Medical Oncology and Palliative Medicine, University of Kansas Medical Center, 2330 Shawnee Mission Pkwy, MS 5003, Westwood, KS, 66205, USA.
| | - Mary S Dietrich
- Center for Quantitative Sciences, Vanderbilt University School of Medicine, 2220 Pierce Ave, 571 Preston Research Building, Nashville, TN, 37232, USA
- School of Nursing, Vanderbilt University Medical Center, 461 21st Ave South, Nashville, TN, 37240, USA
| | - Sheila Ridner
- School of Nursing, Vanderbilt University Medical Center, 461 21st Ave South, Nashville, TN, 37240, USA
| | - Barbara A Murphy
- Department of Medicine, Division of Hematology/Oncology, Vanderbilt University Medical Center, 2220 Pierce Avenue, 777 Preston Research Building, Nashville, TN, 37232, USA
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Carrillo-González GM. Los grupos de síntomas en personas con cáncer: una revisión integrativa. AQUICHAN 2017. [DOI: 10.5294/aqui.2017.17.3.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objetivo: explorar el estado actual de desarrollo investigativo del área temática de grupos de síntomas en adultos con cáncer. Método: revisión integrativa de producción científica generada entre 2001 y 2016. Se incluyeron 61 artículos por su aporte en la comprensión del área temática. Resultados: el estudio de los grupos de síntomas en personas con cáncer se consolida como un área temática novedosa, pertinente y necesaria para la investigación y práctica de enfermería en oncología, con tendencias y retos que incluyen: (1) El desarrollo de marcos conceptuales que aporten a la fundamentación, atributos y efectos (2) La determinación de métodos y formas de crearlos y clasificarlos (3) La generación de estudios con poblaciones específicas por tipos de cáncer y tratamiento y la consolidación de intervenciones de enfermería. Conclusiones: los pacientes con cáncer experimentan múltiples síntomas de forma simultánea durante las distintas fases de la enfermedad. Es incipiente el estudio de este fenómeno, los retos para la enfermería se centran en la generación de respuestas que alivien la carga de los grupos de síntomas y mejoren la calidad de vida de estos pacientes. Es necesario validar escalas de carga del síntoma y explorar los grupos de síntomas incluyendo variables clínicas ligadas a los tratamientos oncológicos.
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Reb A, Ruel N, Fakih M, Lai L, Salgia R, Ferrell B, Sampath S, Kim JY, Raz DJ, Sun V. Empowering survivors after colorectal and lung cancer treatment: Pilot study of a Self-Management Survivorship Care Planning intervention. Eur J Oncol Nurs 2017; 29:125-134. [PMID: 28720259 DOI: 10.1016/j.ejon.2017.06.003] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 06/02/2017] [Accepted: 06/07/2017] [Indexed: 12/16/2022]
Abstract
PURPOSE This study evaluates the feasibility and acceptability of a Self-Management Survivorship Care Planning (SM-SCP) intervention in colorectal and lung cancer survivors. METHODS This is a single-group, pre- and post-mixed methods study of an advance practice nurse-driven survivorship care intervention that integrates a survivorship care plan with self-management skills coaching. Colorectal and lung cancer survivors with stage I-III disease were enrolled at 3-6 months after completing treatments, and the intervention was administered in one in-person or telephone session. Survivor outcome measures included depression, anxiety, self-efficacy, QOL, and satisfaction. Paired t-tests were used for exploratory evaluations of pre-to post-intervention score changes. Content analysis was conducted to analyze the qualitative data to describe survivors' experience with the intervention. RESULTS Thirty participants (15 colorectal, 15 lung) enrolled and completed the study (73% retention). It took an average of 40 min to complete the TS/CP and 34.2 min to deliver the intervention. Exploratory analysis revealed significant differences from baseline to post-intervention in depression, anxiety, self-efficacy, physical functioning, role limitations-physical, pain, general health, health transition, physical health summary, and total QOL. Three qualitative themes emerged: 1) Feeling empowered about having a plan; 2) Struggling with psychosocial concerns; and 3) Suggestions for intervention content and delivery. CONCLUSIONS The SM-SCP intervention was feasible and acceptable for colorectal and lung cancer survivors after treatment completion. Survivorship care interventions have potential to fulfill the unmet needs of colorectal and lung cancer survivors. Their effectiveness might be greater by integrating conceptually-based models of care, such as self-management skills building.
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Affiliation(s)
- Anne Reb
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Nora Ruel
- Biostatistics Core, Department of Information Sciences, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Marwan Fakih
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Lily Lai
- Division of Surgical Oncology, Department of Surgery, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Ravi Salgia
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Betty Ferrell
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Sagus Sampath
- Department of Radiation Oncology, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Jae Y Kim
- Division of Thoracic Surgery, Department of Surgery, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Dan J Raz
- Division of Thoracic Surgery, Department of Surgery, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Virginia Sun
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, CA, United States.
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