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Kim JY, Love M, Woo Y, Campos B, Yu A, Chang J, Erhunmwunsee L, Krouse RS, Melstrom L, Sun V. Pilot study of a telehealth intervention for personalized self-management for eating symptoms after gastroesophageal cancer surgery. J Surg Oncol 2024; 129:728-733. [PMID: 38164022 DOI: 10.1002/jso.27568] [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: 09/27/2023] [Revised: 11/14/2023] [Accepted: 12/10/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND AND OBJECTIVES Following gastric and esophageal cancer surgery, patients often experience significant, prolonged eating-related symptoms. One promising approach to help patients improve their eating-related quality of life (QOL) is through self-management coaching to aid in diet modification. We performed a randomized pilot study of a nutritionist-led telehealth intervention for the self-management of eating after gastroesophageal cancer surgery. METHODS Patients who were within 30 days of resuming oral intake after undergoing surgery for gastric and/or esophageal cancer were consented and then randomized to the intervention or usual care. The intervention was performed by a nutritionist trained in self-management coaching and delivered in four telehealth sessions over 4 months. The following outcomes were measured at baseline and at 6 months after baseline: QOL (EORTC QLQC30), weight, body mass index, and sarcopenia. RESULTS Fifty-three patients were enrolled. 22/27 usual care and 21/26 intervention patients completed the study for a retention rate of 81%. Differences between the intervention and control groups were not statistically significant, but the intervention group had indications of greater improvements in overall QOL as measured by EORTC QLQC30 Summary Score (8.7 vs. 2.3, p = 0.17) as well as greater improvements in 4/5 functional domains (p > 0.3). The intervention group also had slightly more weight gain (6 kg vs. 3 kg, p = 0.3) and less sarcopenia (3/16 vs. 9/18, p = 0.07). CONCLUSIONS This pilot study demonstrated the feasibility and acceptability of a telehealth intervention for self-management of eating symptoms after gastroesophageal cancer surgery. There were trends toward improved overall QOL in the intervention group. A larger study is needed to validate the results.
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Affiliation(s)
- Jae Y Kim
- Department of Surgery, City of Hope Cancer Center, Duarte, California, USA
| | - Madeleine Love
- Southern Illinois University School of Medicine, Springfield, Illinois, USA
| | - Yanghee Woo
- Department of Surgery, City of Hope Cancer Center, Duarte, California, USA
| | - Beatriz Campos
- Department of Clinical Nutrition, City of Hope, Duarte, California, USA
| | - Adern Yu
- Department of Clinical Nutrition, City of Hope, Duarte, California, USA
| | - Justin Chang
- Touro University College of Osteopathic Medicine, Vallejo, California, USA
| | | | - Robert S Krouse
- Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Laleh Melstrom
- Department of Surgery, City of Hope Cancer Center, Duarte, California, USA
| | - Virginia Sun
- Department of Surgery, City of Hope Cancer Center, Duarte, California, USA
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope, Duarte, California, USA
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Schandl A, Färnqvist K, Mälberg K, Nielsen S, Lagergren P. Self-care advice for patients after surgery for oesophageal cancer - a mixed-methods systematic review. J Cancer Surviv 2024:10.1007/s11764-024-01551-0. [PMID: 38361104 DOI: 10.1007/s11764-024-01551-0] [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: 10/19/2023] [Accepted: 02/05/2024] [Indexed: 02/17/2024]
Abstract
PURPOSE The aim of the literature review was to identify and synthesise research on self-care advice for oesophageal cancer survivors. METHODS A mixed-methods systematic review and synthesis of existing literature on the topic. Five databases were searched for studies providing information on self-care advice for survivorship after oesophageal cancer surgery, in English, with no time filter. The Critical Appraisal Skills Program was used to assess the risk of bias. Data were presented by textual descriptions and grouping of data. RESULTS Among the 13 studies included in the review, five pieces of self-care advice were identified; reconstructing eating habits, bed-head elevation, health-promoting advice, monitoring symptoms and body functions, and involving family and friends. The self-care advice was experienced to be hard work, but worth the effort. They also provided reassurance and an increased understanding of bodily changes and social consequences of the disease and treatment. CONCLUSIONS There are is little evidence-based self-care advice for oesophageal cancer survivors. However, the existing self-care advice was appreciated and contributed to an increased understanding of the situation. Comprehensible and easy-to-follow recommendations should be provided to all oesophageal cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS Evidence-based self-care advice helpful for the individual oesophageal cancer survivor may be imperative to cope with the consequences of oesophagectomy after hospital discharge.
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Affiliation(s)
- Anna Schandl
- Surgical Care Science, Department of Molecular Medicine and Surgery, Karolinska Institutet, Retzius Väg 13A, 4th Floor, 17177, Stockholm, Sweden.
- Department of Anaesthesia and Intensive Care, Södersjukhuset, 11883, Stockholm, Sweden.
- Department of Clinical Science and Education, Karolinska Institutet Södersjukhuset, 11883, Stockholm, Sweden.
| | - Kenneth Färnqvist
- Surgical Care Science, Department of Molecular Medicine and Surgery, Karolinska Institutet, Retzius Väg 13A, 4th Floor, 17177, Stockholm, Sweden
| | - Kalle Mälberg
- Surgical Care Science, Department of Molecular Medicine and Surgery, Karolinska Institutet, Retzius Väg 13A, 4th Floor, 17177, Stockholm, Sweden
| | - Sandra Nielsen
- Surgical Care Science, Department of Molecular Medicine and Surgery, Karolinska Institutet, Retzius Väg 13A, 4th Floor, 17177, Stockholm, Sweden
| | - Pernilla Lagergren
- Surgical Care Science, Department of Molecular Medicine and Surgery, Karolinska Institutet, Retzius Väg 13A, 4th Floor, 17177, Stockholm, Sweden
- Department of Surgery and Cancer, Imperial College London, London, UK
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Li ZY, Ren JY, Zhong JD, Zhang JE. Understanding the supportive care needs among discharged patients with esophageal cancer after esophagectomy: A qualitative study. Eur J Oncol Nurs 2023; 64:102337. [PMID: 37290163 DOI: 10.1016/j.ejon.2023.102337] [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: 02/01/2023] [Revised: 04/26/2023] [Accepted: 04/29/2023] [Indexed: 06/10/2023]
Abstract
PURPOSE Patients with esophageal cancer experience physical and psychosocial difficulties after surgery. Understanding their unmet supportive care needs could help medical staff in providing high quality of care. This study aimed to gain insights into the supportive care needs of discharged patients with esophageal cancer after esophagectomy. METHOD A descriptive qualitative study design was used. A purposive sample of 20 patients was studied using semi-structured interviews. The thematic analysis approach was used to analyze the data. RESULTS Four themes and 14 sub-themes emerged from the analysis: (1) symptom management needs (dysphagia, reflux, fatigue, and other symptoms), (2) dietary and nutritional needs (unclear nutrition information, eating habit change, and dining out restriction), (3) psychosocial adjustment needs (stigma, dependency, fear of recurrence, and desire for normalcy), and (4) social support needs (medical staff support, family support, and peer support). CONCLUSION Chinese patients with esophageal cancer have various unmet supportive care needs after esophagectomy. Medical professionals should recognize patients' unmet supportive care needs in time, provide professional access and practical guidance, relieve their bad mood, and fully utilize online communicating channels, such as a consulting platform or a WeChat group, for further support.
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Affiliation(s)
- Zi Yun Li
- School of Nursing, Sun Yat-sen University, Zhongshan 2 Rd 74#, Guangzhou, Guangdong, PR China
| | - Jin Ying Ren
- School of Nursing, Sun Yat-sen University, Zhongshan 2 Rd 74#, Guangzhou, Guangdong, PR China
| | - Jiu Di Zhong
- Department of Thoracic Oncology, Cancer Center, Sun Yat-Sen University, Dongfeng 1 Rd 651#, Guangzhou, Guangdong, PR China
| | - Jun E Zhang
- School of Nursing, Sun Yat-sen University, Zhongshan 2 Rd 74#, Guangzhou, Guangdong, PR China.
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Wen Y, Ma J, Jiang X, Gao G, Xie H, Lu P. Influencing factors of holistic nursing intervention under a social medical model on the psychology and quality of life of patients with advanced gastric cancer. Am J Transl Res 2021; 13:3369-3379. [PMID: 34017512 PMCID: PMC8129223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 12/11/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE This research was designed to probe into the influencing factors of holistic nursing intervention under a social medical model on psychology and quality of life in advanced gastric cancer (GC) patients. METHODS Altogether 194 patients with advanced GC treated in our hospital from May 2017 to July 2018 were divided into two groups according to different nursing intervention methods. Where from, 86 were given routine nursing intervention and 108 were given holistic nursing intervention under a social medical model. The psychology, pain relief, sleep quality and self-nursing ability of patients were compared before and after intervention. The quality of life before and after intervention and the nursing satisfaction score after nursing were recorded. The factors affecting their quality of life were assessed by Logistic regression analysis. RESULTS The SAS, SDS, NRS and PSQI scores in the intervention group (IG) were obviously lower than those in the control group (CG) after nursing. The ESCA and EORTC QLQ-C30 scores after nursing in the IG were markedly higher than those in the CG. The total nursing satisfaction of patients in the IG after nursing was obviously higher than that in the CG. Logistic regression analysis revealed that age, lymph node metastasis, TNM stage, unimproved negative emotion, lack of self-nursing ability and routine nursing intervention all increased the risk of reduced quality of life. CONCLUSION The decline in the quality of life of patients with advanced GC results from a comprehensive action of various risk factors, and holistic nursing under a social medical model can improve the psychology of patients, improve their self-nursing ability and quality of life.
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Affiliation(s)
- Yao Wen
- Minzu University of China (College of Ethnology and Sociology)Beijing 100089, China
- Huaiyin Institute of Technology (College of Humanities)Huai’an 223001, Jiangsu, China
| | - Jun Ma
- Department of Oncology, Huai’an Hospital of Chinese Medicine, Affiliated to Huai’an Hospital of Nanjing University of Chinese MedicineHuai’an 223001, Jiangsu Province, China
| | - Xuan Jiang
- Department of Oncology, Huai’an Second People’s Hospital, Affiliated to Xuzhou Medical UniversityHuai’an 223001, Jiangsu Province, China
| | - Guangyi Gao
- Department of Oncology, Huai’an Second People’s Hospital, Affiliated to Xuzhou Medical UniversityHuai’an 223001, Jiangsu Province, China
| | - Huaibing Xie
- Department of Oncology, Huai’an Second People’s Hospital, Affiliated to Xuzhou Medical UniversityHuai’an 223001, Jiangsu Province, China
| | - Peng Lu
- Department of Pharmacy, Huai’an Maternity and Child Healthcare Hospital Affiliated to Yangzhou University Medical AcademyHuai’an 223001, Jiangsu Province, China
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He YL, Zhang B. Clinical significance of expression of CBX2 in gastric cancer. Shijie Huaren Xiaohua Zazhi 2019; 27:872-877. [DOI: 10.11569/wcjd.v27.i14.872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The incidence of gastric cancer (GC) is high in recent years and it is very urgent to explore new targets for the diagnosis and treatment of GC.
AIM To investigate the expression and clinical significance of chromobox homolog 2 (CBX2) in GC cells and tissues.
METHODS The expression levels of CBX2 mRNA and protein in GC cells, normal gastric mucosal epithelial cells, GC tissues, and their adjacent normal tissues were detected by real-time fluorescent quantitative PCR and Western blot, respectively. The expression of CBX2 in 66 cases of GC and matched paracancerous tissues was detected by immunohistochemistry. The relationship between the expression of CBX2 and the clinicopathological features and prognosis of GC patients was analyzed.
RESULTS The expression of CBX2 mRNA in GC cells was higher than that in normal gastric mucosal epithelial cells (P < 0.05). The expression of CBX2 mRNA and protein in GC tissues was higher than that in adjacent tissues (P < 0.05). The positive expression rate of CBX2 in GC tissues was 40.9% (27/66), and it was 12.1% (8/66) in normal tissues adjacent to cancer. CBX2 was positively expressed in GC tissues. The expression rate was higher than that of adjacent tissues (P < 0.05). The expression of CBX2 protein was correlated with tumor metastasis (P < 0.05).
CONCLUSION CBX2 is overexpressed in GC cells and tissues, and it has a certain degree of connection with the prognosis and outcome of patients with GC.
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Affiliation(s)
- Yi-Lan He
- Department of Oncology, Third People's Hospital of Yuhang District, Hangzhou 311115, Zhejiang Province, China
| | - Bo Zhang
- Department of Oncology, Integrated Traditional Chinese and Western Medicine, Zhejiang Cancer Hospital, Hangzhou 310022, Zhejiang Province, China
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