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Atherton MA, Park S, Horan NL, Nicholson S, Dolan JC, Schmidt BL, Scheff NN. Sympathetic modulation of tumor necrosis factor alpha-induced nociception in the presence of oral squamous cell carcinoma. Pain 2023; 164:27-42. [PMID: 35714327 PMCID: PMC9582047 DOI: 10.1097/j.pain.0000000000002655] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 04/08/2022] [Indexed: 01/09/2023]
Abstract
ABSTRACT Head and neck squamous cell carcinoma (HNSCC) causes more severe pain and psychological stress than other types of cancer. Despite clinical evidence linking pain, stress, and cancer progression, the underlying relationship between pain and sympathetic neurotransmission in oral cancer is unknown. We found that human HNSCC tumors and mouse tumor tissue are innervated by peripheral sympathetic and sensory nerves. Moreover, β-adrenergic 1 and 2 receptors (β-ARs) are overexpressed in human oral cancer cell lines, and norepinephrine treatment increased β-AR2 protein expression as well as cancer cell proliferation in vitro. We have recently demonstrated that inhibition of tumor necrosis factor alpha (TNFα) signaling reduces oral cancer-induced nociceptive behavior. Norepinephrine-treated cancer cell lines secrete more TNFα which, when applied to tongue-innervating trigeminal neurons, evoked a larger Ca 2+ transient; TNF-TNFR inhibitor blocked the increase in the evoked Ca 2+ transient. Using an orthotopic xenograft oral cancer model, we found that mice demonstrated significantly less orofacial cancer-induced nociceptive behavior during systemic β-adrenergic inhibitory treatment with propranolol. Furthermore, chemical sympathectomy using guanethidine led to a significant reduction in tumor size and nociceptive behavior. We infer from these results that sympathetic signaling modulates oral cancer pain through TNFα secretion and tumorigenesis. Further investigation of the role of neurocancer communication in cancer progression and pain is warranted.
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Affiliation(s)
- Megan A Atherton
- Department of Neurobiology, University of Pittsburgh, Pittsburgh, PA, United States
- Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Stella Park
- Bluestone Center for Clinical Research, DDS Program, College of Dentistry, New York University, New York, NY, United States
| | - Nicole L Horan
- Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Samuel Nicholson
- Bluestone Center for Clinical Research, DDS Program, College of Dentistry, New York University, New York, NY, United States
| | - John C Dolan
- Bluestone Center for Clinical Research, DDS Program, College of Dentistry, New York University, New York, NY, United States
| | - Brian L Schmidt
- Bluestone Center for Clinical Research, DDS Program, College of Dentistry, New York University, New York, NY, United States
| | - Nicole N Scheff
- Department of Neurobiology, University of Pittsburgh, Pittsburgh, PA, United States
- Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
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Jayaseelan P, Deodhar J, Ashok A, Jiwnani S, Kuriakose J, Poojary S. Palliative care needs assessment in patients with metastatic and locally advanced oesophageal cancer. PROGRESS IN PALLIATIVE CARE 2022. [DOI: 10.1080/09699260.2022.2158287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Prarthna Jayaseelan
- Department of Palliative Medicine, Tata Memorial Hospital, Mumbai, India
- Homi Bhabha National Institute, India
| | - Jayita Deodhar
- Department of Palliative Medicine, Tata Memorial Hospital, Mumbai, India
- Homi Bhabha National Institute, India
| | - Apurva Ashok
- Homi Bhabha National Institute, India
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, India
| | - Sabita Jiwnani
- Homi Bhabha National Institute, India
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, India
| | - Jyothsna Kuriakose
- Department of Palliative Medicine, Tata Memorial Hospital, Mumbai, India
- Homi Bhabha National Institute, India
| | - Shamali Poojary
- Department of Palliative Medicine, Tata Memorial Hospital, Mumbai, India
- Homi Bhabha National Institute, India
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3
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McDowell L, Rischin D, Gough K, Henson C. Health-Related Quality of Life, Psychosocial Distress and Unmet Needs in Older Patients With Head and Neck Cancer. Front Oncol 2022; 12:834068. [PMID: 35242716 PMCID: PMC8885992 DOI: 10.3389/fonc.2022.834068] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 01/24/2022] [Indexed: 01/22/2023] Open
Abstract
Head and neck squamous cell carcinoma (HNSCC) is the most common cancer involving the mucosal surfaces of the head and neck and is associated with a number of etiological factors, including cigarette smoking, alcohol and betel nut consumption and exposure to high-risk human papillomavirus. The risk of HNSCC increases with age, peaking in the seventh and eighth decade, but this varies by anatomical and histological subtype. While several advancements have been made in the treatment of head and neck cancer (HNC) in recent decades, undertaking curative treatment still subjects the majority of HNSCC patients to substantial treatment-related toxicity requiring patients to tolerate a gamut of physical, psychological, and emotional demands on their reserves. In conjunction with other patient-related factors, clinicians involved in treating patients with HNSCC may incorporate advancing chronological age into their decision-making process when determining treatment recommendations. While advancing chronological age may be associated with increased concerns regarding physical treatment tolerability, clinicians may also be concerned about heightened vulnerability in various health and wellbeing outcomes. The available literature, however, does not provide evidence of this vulnerability in patients with advancing age, and, in many instances, older patients self-report greater resilience compared to their younger counterparts. While this data is reassuring it is limited by selection bias and heterogeneity in trial and study design and the absence of a consistent definition of the elderly patient with HNSCC. This narrative review article also includes a review of the measures used to assess HRQL, psychosocial outcomes and unmet needs in elderly or older patients with HNSCC.
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Affiliation(s)
- Lachlan McDowell
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia
| | - Danny Rischin
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia.,Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Karla Gough
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,Department of Nursing, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Carlton, VIC, Australia
| | - Christina Henson
- Department of Radiation Oncology, Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK, United States
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4
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Factors impacting posttraumatic growth in head-and-neck cancer patients with oncologic emergencies. Support Care Cancer 2022; 30:4515-4525. [PMID: 35112211 DOI: 10.1007/s00520-021-06772-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 12/18/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE To identify factors associated with posttraumatic growth (PTG) of head-and-neck cancer squamous cancer (HNC) patients with oncologic emergencies (OE) within the first six months post-treatment. METHODS We conducted a cross-sectional study of HNC patients in Taiwan from May 2019 to April 2021 using patient-reported outcomes. Patients were assessed for symptom distress, anxiety, fear of recurrence (FCR), and PTG. Multiple regression analysis was conducted to identify factors associated with PTG. The independent-samples t-test was used to compare PTG and its five specific domains in patients with low FCR, high FCR, low anxiety, and high anxiety. RESULTS Of the 114 patients surveyed, 46.5% reported little-to-no PTG, and 53.5% had moderate-to-high PTG. Greater PTG was associated with greater FCR, longer time since OE, less anxiety, having a cancer recurrence, and greater educational attainment. These factors explained 38.6% of the variance in PTG. CONCLUSION A notable proportion of HNC patients with OE-reported PTG but almost half-reported little-to-no PTG. PTG occurred most in the domain of appreciation of life. The study results also suggest that training patients in coping skills and inviting them to group growth experiences can help them increase PTG and cope with cancer-related psychological threats related to OE.
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Lewis S, Pandey S, Salins N, Deodhar J, Patil V, Gupta T, Laskar SG, Budrukkar A, Murthy V, Joshi A, Prabhash K, Nair S, Chaturvedi P, Noronha V, Agarwal JP. Distress Screening in Head and Neck Cancer Patients Planned for Cancer-Directed Radiotherapy. Laryngoscope 2021; 131:2023-2029. [PMID: 33720420 DOI: 10.1002/lary.29491] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 02/01/2021] [Accepted: 02/17/2021] [Indexed: 11/05/2022]
Abstract
OBJECTIVE/HYPOTHESIS To estimate the prevalence of baseline clinically significant distress (distress score ≥ 4) in head and neck cancer patients planned and treated with radical intent radiotherapy using the National Comprehensive Cancer Network Distress Thermometer (DT) and assess factors predictive of distress. STUDY DESIGN Cross-sectional study. METHODS This was a cross-sectional study evaluating distress in 600 head and neck cancer patients undergoing radiation therapy. The DT was used to screen patients for distress at baseline before radiotherapy. RESULTS The median distress score of the entire cohort was 4 interquartile range (IQR) (IQR: 3-5), and 340 patients (56.7%) had clinically significant distress. On univariate analysis, the causal factors predictive of distress were low socioeconomic status (P = .04), presence of proliferative growth at presentation (P = .008), site of the tumor (oral cavity, P = .02), comorbidity (P = .04), and presence of Ryle's tube or tracheostomy tube at baseline (P = .01). Low socioeconomic status was significant (P = .04) on multivariate analysis for high levels of distress. CONCLUSIONS Among head and neck cancer patients, 56% of patients had clinically significant baseline distress, and patients with low socioeconomic status had high distress. There is a need for interventions to mitigate distress. LEVEL OF EVIDENCE 4 Laryngoscope, 131:2023-2029, 2021.
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Affiliation(s)
- Shirley Lewis
- Department of Radiotherapy and Oncology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Saket Pandey
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Naveen Salins
- Department of Palliative Medicine and supportive care, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Jayita Deodhar
- Department of Palliative Medicine, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Vijay Patil
- Department of Medical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Tejpal Gupta
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Sarbani Ghosh Laskar
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Ashwini Budrukkar
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Vedang Murthy
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Amit Joshi
- Department of Medical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Kumar Prabhash
- Department of Medical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Sudhir Nair
- Department of Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Pankaj Chaturvedi
- Department of Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Vanita Noronha
- Department of Medical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Jai Prakash Agarwal
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
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6
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de Souza MG, Gomes ESB, Costa LB, Andrade ADS, de Jesus SF, de Paula DPS, Rocha RGD, Santos SHS, de Paula AMB, Farias LC, Guimaraes ALS. Might anxiety disorders promote head and neck cancer development? IBRO Rep 2020; 9:9-13. [PMID: 33336100 PMCID: PMC7733128 DOI: 10.1016/j.ibror.2020.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 06/10/2020] [Indexed: 01/03/2023] Open
Abstract
Cancer patients present a higher risk of experiencing anxiety disorders (AD). However, it is not clear if AD might be associated with cancer development. Thus, our study aimed to evaluate if AD might be related to head and neck squamous cell carcinoma (HNSCC) development. The combination of an applied animal basic study and a retrospective diagnostic case and control study in patients was performed. As a result, we obtained that stress reduced the locomotor activity of the animals in the group stress and stress + 4NqO (p < 0.0001). The stress showed no influence on the progression of neoplasia in mice. In the same way, the case group did not present differences in anxiety scores in comparison to control. Moreover, no association between HNSCC staging and anxiety scores was observed. In conclusion, our in vivo findings in humans and animals have shown that there is no relationship between AD and oral squamous cell carcinoma.
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Affiliation(s)
| | | | - Lorena Barbosa Costa
- Department of Dentistry, Universidade Estadual de Montes Claros, Montes Claros, Minas Gerais, Brazil
| | - Amanda Dias Silva Andrade
- Department of Dentistry, Universidade Estadual de Montes Claros, Montes Claros, Minas Gerais, Brazil
| | - Sabrina Ferreira de Jesus
- Department of Dentistry, Universidade Estadual de Montes Claros, Montes Claros, Minas Gerais, Brazil
| | | | | | - Sérgio Henrique Sousa Santos
- Institute of Agricultural Sciences, Food Engineering College, Universidade Federal de Minas Gerais (UFMG), Montes Claros, Minas Gerais, Brazil
| | | | - Lucyana Conceição Farias
- Department of Dentistry, Universidade Estadual de Montes Claros, Montes Claros, Minas Gerais, Brazil
| | - André Luiz Sena Guimaraes
- Department of Dentistry, Universidade Estadual de Montes Claros, Montes Claros, Minas Gerais, Brazil
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Chang YL, Lin CY, Kang CJ, Liao CT, Chung CF, Yen TC, Peng HL, Chen SC. Association between multidisciplinary team care and the completion of treatment for oral squamous cell carcinoma: A cohort population-based study. Eur J Cancer Care (Engl) 2020; 30:e13367. [PMID: 33174667 DOI: 10.1111/ecc.13367] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 08/17/2020] [Accepted: 10/14/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVES This study investigates the relationship between multidisciplinary team care (MDTC) and patient completion of their treatment regimen for oral squamous cell carcinoma (OSCC). METHODS We conducted a retrospective cohort study in patients diagnosed with OSCC in Taiwan from 1 January 2016 to 30 June 2018 using a linked cancer registry database. RESULTS Of the 969 OSCC MDTC patients in the study cohort, 6.3% reported incomplete treatment, with 1.3% interrupting ongoing treatment and 5.0% terminating definitive treatment. Patients who had advanced-stage disease, experienced primary cancer recurrence or a secondary cancer, or were treated with surgery combined with chemotherapy, radiotherapy or chemoradiotherapy were more likely to terminate treatment before completion. The major reasons for interruption of ongoing treatment included 'patient or their family considered the patient to be in poor physical condition' and 'difficulty enduring physical discomfort caused by treatment'. The major reason for termination of definitive treatment was 'patient or their families or friends experienced negative treatment effects and worried about the side-effects of treatment'. CONCLUSION Advanced-stage cancer, recurrence or secondary cancer, and surgery combined with chemotherapy, radiotherapy or chemoradiotherapy negatively affected treatment completion. MDTC allows for shared decision-making to determine the optimal treatment.
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Affiliation(s)
- Ya-Lan Chang
- Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chien-Yu Lin
- Department of Radiation Oncology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chung-Jan Kang
- Department of Otorhinolaryngology, Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chun-Ta Liao
- Department of Otorhinolaryngology, Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ching-Fang Chung
- Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Tzu-Chen Yen
- Nuclear Medicine and Molecular Imaging Center, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
| | - Hsi-Ling Peng
- Department of Nursing, Oriental Institute of Technology, Taipei, Taiwan
| | - Shu-Ching Chen
- Department of Radiation Oncology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,School of Nursing and Geriatric and Long-Term Care Research Center, College of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan.,School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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8
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Wu VS, Smith AB, Girgis A. The unmet supportive care needs of Chinese patients and caregivers affected by cancer: A systematic review. Eur J Cancer Care (Engl) 2020; 31:e13269. [PMID: 32495473 DOI: 10.1111/ecc.13269] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 12/04/2019] [Accepted: 04/16/2020] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Cancer patients and caregivers have myriad unmet needs which can have detrimental consequences on their psychosocial wellbeing. This systematic review aims to identify the unmet supportive care needs of immigrant and native Chinese cancer patients and caregivers. METHODS We systematically searched various electronic databases (e.g. Scopus, CINAHL, PsycInfo, etc.) from the earliest date available until January 2018. Additional studies were identified through reference lists and citation tracking. Eligibility criteria included: (a) qualitative, quantitative and/or mixed methods studies published in English; (b) immigrant and native Chinese cancer patients and/or caregivers (age ≥18 years); (c) unmet needs and/or their correlates. Studies were assessed for their risk of bias, and a narrative synthesis of findings was performed. RESULTS Forty-seven papers from 45 studies met eligibility criteria. The most prevalent area of unmet needs was health system and information. Patients most commonly desired one member of the hospital to talk to about all aspects of their care. Caregivers preferred information about the patient's prognosis and likely outcome. Anxiety was most commonly associated with higher levels of health system and information needs. CONCLUSION Chinese patients and caregivers experience a range of unmet health system and information needs, which differ depending on their stage along the cancer trajectory.
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Affiliation(s)
- Verena Shuwen Wu
- Psycho-Oncology Research Group, Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, The University of New South Wales, Liverpool, NSW, Australia
| | - Allan Ben Smith
- Psycho-Oncology Research Group, Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, The University of New South Wales, Liverpool, NSW, Australia
| | - Afaf Girgis
- Psycho-Oncology Research Group, Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, The University of New South Wales, Liverpool, NSW, Australia
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9
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Shunmugasundaram C, Rutherford C, Butow PN, Sundaresan P, Dhillon HM. Content comparison of unmet needs self-report measures used in patients with head and neck cancer: A systematic review. Psychooncology 2019; 28:2295-2306. [PMID: 31654540 DOI: 10.1002/pon.5257] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 09/18/2019] [Accepted: 09/24/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Morbidity from head and neck cancers (HNCs) and their treatment are significant, given their proximity to anatomical sites impacting facial appearance and function. Assessing the needs of HNC patients throughout their cancer journey is critical to informing quality care and improving quality of life. We aimed to identify available unmet needs measures in the HNC setting and appraise their content and psychometric properties. METHODS We conducted a systematic search of five electronic databases (July 2007-July 2019) to identify studies of unmet needs in patients with HNC. In addition, three web-based patient-reported outcome measures (PROMs) databases were searched for unmet needs measures. Citations were screened for eligibility and identified measures reviewed for content coverage and psychometric properties. From identified measures and literature, a conceptual framework with 12 clinically relevant aspects of unmet needs was developed and used to assess the conceptual coverage of available unmet needs measures. RESULTS Literature search identified 273 records of which 28 studies assessing unmet needs in HNC cancer met eligibility criteria. Seven unmet needs measures were identified from retrieved studies and seven additional measures from PROM databases. Thus, 14 measures in total were reviewed. Content mapping revealed that three measures demonstrated excellent content validity (greater than 80% conceptual coverage): Patient Concerns Inventory (PCI), Needs Assessment for Advanced Cancer Patients (NA-ACP), and James Supportive Care Screening (JSCS). CONCLUSION We recommend PCI be used to measure unmet needs in the HNC setting considering the importance of content validity over quantitative psychometric properties.
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Affiliation(s)
- Chindhu Shunmugasundaram
- Centre for Medical Psychology and Evidence-based Decision-making, School of Psychology, Faculty of Science, University of Sydney, Camperdown, New South Wales, Australia.,Psycho-Oncology Cooperative Research Group, University of Sydney, Camperdown, New South Wales, Australia
| | - Claudia Rutherford
- Quality of Life Office, School of Psychology, Faculty of Science, University of Sydney, Camperdown, New South Wales, Australia.,Sydney Nursing School, Cancer Nursing Research Unit (CNRU), University of Sydney, Camperdown, New South Wales, Australia
| | - Phyllis N Butow
- Centre for Medical Psychology and Evidence-based Decision-making, School of Psychology, Faculty of Science, University of Sydney, Camperdown, New South Wales, Australia.,Psycho-Oncology Cooperative Research Group, University of Sydney, Camperdown, New South Wales, Australia
| | - Puma Sundaresan
- Radiation Oncology Network, Western Sydney Local Health District, North Parramatta, New South Wales, Australia.,Sydney Medical School, University of Sydney, Camperdown, New South Wales, Australia
| | - Haryana M Dhillon
- Centre for Medical Psychology and Evidence-based Decision-making, School of Psychology, Faculty of Science, University of Sydney, Camperdown, New South Wales, Australia.,Psycho-Oncology Cooperative Research Group, University of Sydney, Camperdown, New South Wales, Australia
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10
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Williamson TJ, Jorge-Miller A, McCannel TA, Beran TM, Stanton AL. Sociodemographic, Medical, and Psychosocial Factors Associated With Supportive Care Needs in Adults Diagnosed With Uveal Melanoma. JAMA Ophthalmol 2019; 136:356-363. [PMID: 29470565 DOI: 10.1001/jamaophthalmol.2018.0019] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Importance Understanding supportive care needs in patients with cancer is important for developing approaches that enhance quality of life and promote satisfaction with care. Objective To characterize the nature and frequency of sociodemographic, medical, and psychosocial factors associated with unmet needs in patients with uveal melanoma 1 week and 3 months after diagnosis. Design, Setting, and Participants This 3-month, prospective, longitudinal survey study was conducted at a university-based ophthalmology practice from June 1, 2007, to July 1, 2011. Data were analyzed in April 2017. Consecutive patients (n = 429) scheduled for diagnostic evaluation for an intraocular abnormality were assessed for eligibility. Participants were ineligible (n = 25) if they were younger than 18 years, had previous advanced cancer, or evidenced cognitive impairment. Of the patients who provided informed consent (n = 306), those subsequently diagnosed with uveal melanoma by an ophthalmologist (n = 107) were included in the analysis. Main Outcomes and Measures Unmet needs (ie, desire for help in psychological, physical, health information, communication, or social domains) were assessed using the Cancer Needs Questionnaire. Multivariable regression analyses determined factors associated with unmet need severity across 3 months. Results One hundred seven patients (58 [54%] men; mean [SD] age, 59.0 [12.8] years) completed the baseline assessment. At 1 week after diagnosis, nearly all patients (85 of 86 [99%]) expressed at least 1 unmet need, as did 68 of 79 (86%) 3 months later. The most frequently endorsed needs were in the health information and psychological domains. Patients' unmet needs declined significantly over 3 months (mean [SD] change, -10.0 [14.4]; 95% CI, -6.4 to -13.6; t = -5.6). Sociodemographic and medical characteristics were unrelated to unmet need severity. However, higher prediagnosis instrumental social support (b = -0.2; 95% CI, -0.3 to -0.1; z = -2.8) and lower neuroticism (b = 0.3; 95% CI, 0.1-0.5; z = 2.9) predicted lower unmet need severity 1 week after diagnosis. Having a smaller social network predicted lower unmet need severity 3 months after diagnosis (b < 0.1; 95% CI, <0.1 to <0.1; z = 2.4) as well as a decline in needs from diagnosis to 3 months later (b < 0.1; 95% CI, <0.1 to <0.1; z = 2.3). Conclusions and Relevance Within 1 week after diagnosis and 3 months later, most patients with uveal melanoma cited important health information and psychological needs. These findings suggest that prior to or at diagnosis, the severity of such needs and psychosocial factors that may be associated can be identified for proactive supportive intervention.
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Affiliation(s)
| | - Alexandra Jorge-Miller
- Department of Psychology, University of California, Los Angeles.,Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Tara A McCannel
- Department of Ophthalmology, Stein and Doheny Eye Institutes, University of California, Los Angeles.,Jonsson Comprehensive Cancer Center, University of California, Los Angeles
| | - Tammy M Beran
- Department of Psychology, University of California, Los Angeles
| | - Annette L Stanton
- Department of Psychology, University of California, Los Angeles.,Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles.,Jonsson Comprehensive Cancer Center, University of California, Los Angeles.,Cousins Center of Psychoneuroimmunology, Semel Institute, University of California, Los Angeles
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11
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Huang CC, Kuo HP, Lin YE, Chen SC. Effects of a Web-based Health Education Program on Quality of Life and Symptom Distress of Initially Diagnosed Advanced Non-Small Cell Lung Cancer Patients: A Randomized Controlled Trial. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2019; 34:41-49. [PMID: 28780685 DOI: 10.1007/s13187-017-1263-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Advanced non-small cell lung cancer (NSCLC) patients treated with chemotherapy experience functional decline and decreased quality of life. The purpose of this study was to evaluate the effects of a web-based health education program on global quality of life, quality of life-related functional dimensions, and symptom distress of initially diagnosed advanced non-small cell lung cancer patients. This study used a randomized, pre- and post-repeated measures design. A total of 55 participants were randomly assigned to an experimental group (n = 27) and a control group (n = 28). The experimental group participated in a web-based health education program, and the control group received usual care. Patients were assessed at 4 time points: baseline assessment (T0), and then 1, 2, and 3 months (T1, T2, and T3) after participating in the web-based health education program or receiving usual care. Patients in the experimental group had significantly greater global quality of life and emotional function, and significantly less top ten significant symptom distresses compared to those in the control group. There were no differences between the groups and within groups with respect to physical function, role function, cognitive function, and social function. The web-based health education can improve global quality of life, emotional function, and top ten significant symptom distresses in patients receiving chemotherapy during the first 3 months after initial diagnosis of advanced NSCLC. Web-based health education can improve quality of life and lessen distress of initially diagnosed NSCLC patients treated with chemotherapy.
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Affiliation(s)
- Chi-Chin Huang
- Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Han-Pin Kuo
- Department of Chest Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yueh-E Lin
- Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Nursing, College of Nursing, Chang Gung University of Science and Technology, 261, Wen-Hua 1st Road, Kweishan, Taoyuan, 333, Taiwan
| | - Shu-Ching Chen
- Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
- Department of Nursing, College of Nursing, Chang Gung University of Science and Technology, 261, Wen-Hua 1st Road, Kweishan, Taoyuan, 333, Taiwan.
- Department of Radiation Oncology, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Proton and Radiation Therapy Center, Taoyuan, Taiwan.
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12
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Jansen F, Eerenstein SEJ, Lissenberg‐Witte BI, Uden‐Kraan CF, Leemans CR, Verdonck‐de Leeuw IM. Unmet supportive care needs in patients treated with total laryngectomy and its associated factors. Head Neck 2018; 40:2633-2641. [DOI: 10.1002/hed.25358] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 02/16/2018] [Accepted: 05/16/2018] [Indexed: 11/11/2022] Open
Affiliation(s)
- Femke Jansen
- Department of Otolaryngology ‐ Head and Neck Surgery, Cancer Center Amsterdam (CCA)VU University Medical Center Amsterdam The Netherlands
| | - Simone Elisabeth Jacoba Eerenstein
- Department of Otolaryngology ‐ Head and Neck Surgery, Cancer Center Amsterdam (CCA)VU University Medical Center Amsterdam The Netherlands
| | | | - Cornelia Foekje Uden‐Kraan
- Department of Clinical Psychology, Faculty Behavioural and Movement Sciences, Amsterdam Public Health Research InstituteVrije Universiteit Amsterdam Amsterdam The Netherlands
| | - Charles René Leemans
- Department of Otolaryngology ‐ Head and Neck Surgery, Cancer Center Amsterdam (CCA)VU University Medical Center Amsterdam The Netherlands
| | - Irma Maria Verdonck‐de Leeuw
- Department of Otolaryngology ‐ Head and Neck Surgery, Cancer Center Amsterdam (CCA)VU University Medical Center Amsterdam The Netherlands
- Department of Clinical Psychology, Faculty Behavioural and Movement Sciences, Amsterdam Public Health Research InstituteVrije Universiteit Amsterdam Amsterdam The Netherlands
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13
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Osazuwa-Peters N, Simpson MC, Zhao L, Boakye EA, Olomukoro SI, Deshields T, Loux TM, Varvares MA, Schootman M. Suicide risk among cancer survivors: Head and neck versus other cancers. Cancer 2018; 124:4072-4079. [PMID: 30335190 DOI: 10.1002/cncr.31675] [Citation(s) in RCA: 130] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 06/21/2018] [Accepted: 06/25/2016] [Indexed: 01/18/2023]
Abstract
BACKGROUND Cancer survivors face psychosocial issues that increase their risk of suicide. This study examined the risk of suicide across cancer sites, with a focus on survivors of head and neck cancer (HNC). METHODS The Surveillance, Epidemiology, and End Results 18-registry database (from 2000 to 2014) was queried for the top 20 cancer sites in the database, including HNC. The outcome of interest was suicide as a cause of death. The mortality rate from suicide was estimated for HNC sites and was compared with rates for 19 other cancer sites that were included in the study. Poisson regression was used to estimate adjusted rate ratios (aRRs) and 95% confidence intervals (CIs) for 1) HNC versus non-HNC sites (the other 19 cancer sites combined), and 2) HNC versus each individual cancer site. Models were stratified by sex, controlling for race, marital status, age, year, and stage at diagnosis. RESULTS There were 404 suicides among 151,167 HNC survivors from 2000 to 2014, yielding a suicide rate of 63.4 suicides per 100,000 person-years. In this timeframe, there were 4493 suicides observed among 4219,097 cancer survivors in the study sample, yielding an incidence rate of 23.6 suicides per 100,000 person-years. Compared with survivors of other cancers, survivors of HNC were almost 2 times more likely to die from suicide (aRR, 1.97; 95% CI, 1.77-2.19). There was a 27% increase in the risk of suicide among HNC survivors during the period from 2010 to 2014 (aRR, 1.27; 95% CI, 1.16-1.38) compared with the period from 2000 to 2004. CONCLUSIONS Although survival rates in cancer have improved because of improved treatments, the risk of death by suicide remains a problem for cancer survivors, particularly those with HNC.
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Affiliation(s)
- Nosayaba Osazuwa-Peters
- Department of Otolaryngology-Head and Neck Surgery, St. Louis University School of Medicine St. Louis, Missouri.,St. Louis University Cancer Center, St. Louis, Missouri.,Department or Epidemiology and Biostatistics, St. Louis University College for Public Health and Social Justice, St. Louis, Missouri
| | - Matthew C Simpson
- Department of Otolaryngology-Head and Neck Surgery, St. Louis University School of Medicine St. Louis, Missouri
| | - Longwen Zhao
- Department or Epidemiology and Biostatistics, St. Louis University College for Public Health and Social Justice, St. Louis, Missouri
| | - Eric Adjei Boakye
- St. Louis University Center for Outcomes Research (SLUCOR), St. Louis, Missouri
| | - Stephanie I Olomukoro
- Department of Internal Medicine, St. Louis University School of Medicine, St. Louis, Missouri
| | - Teresa Deshields
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Travis M Loux
- Department or Epidemiology and Biostatistics, St. Louis University College for Public Health and Social Justice, St. Louis, Missouri
| | - Mark A Varvares
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts
| | - Mario Schootman
- Department or Epidemiology and Biostatistics, St. Louis University College for Public Health and Social Justice, St. Louis, Missouri
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14
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Solomon I, Voiculescu VM, Caruntu C, Lupu M, Popa A, Ilie MA, Albulescu R, Caruntu A, Tanase C, Constantin C, Neagu M, Boda D. Neuroendocrine Factors and Head and Neck Squamous Cell Carcinoma: An Affair to Remember. DISEASE MARKERS 2018; 2018:9787831. [PMID: 29854027 PMCID: PMC5966665 DOI: 10.1155/2018/9787831] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 03/21/2018] [Accepted: 04/15/2018] [Indexed: 02/07/2023]
Abstract
Head and neck squamous cell carcinoma (HNSCC) is one of the most aggressive malignancies. Therefore, the major goal of cancer treatment is inhibition of tumor cell growth and of metastasis development. In order to choose the best management option for HNSCC patients, we need to identify reliable prognostic factors and to develop new molecular techniques in order to obtain a better understanding of therapy resistance. By acting as neurohormones, neurotransmitters, or neuromodulators, the neuroendocrine factors are able to signal the maintenance of physiological homeostasis or progression to malignant disease. Certain neuropeptides possess strong antitumor properties acting as tumor suppressors and immunomodulators, providing additional benefits for future potential therapeutic strategies. In light of the current understanding, cancer starts as a localized disease that can be effectively treated if discovered on proper time. Unfortunately, more than often cancer cells migrate to the surrounding tissues generating distant metastases, thus making the prognosis and survival in this stage much worse. As cellular migration is mandatory for tumor invasion and metastasis development, searching for alternate controllers of these processes, such as the neuroendocrine factors, it is an active tremendous task.
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Affiliation(s)
- Iulia Solomon
- 1Department of Dermatology and Allergology, Elias Emergency University Hospital, Bucharest, Romania
| | - Vlad Mihai Voiculescu
- 1Department of Dermatology and Allergology, Elias Emergency University Hospital, Bucharest, Romania
- 2Department of Dermatology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Constantin Caruntu
- 3Department of Physiology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- 4Department of Dermatology, “Prof. N. C. Paulescu” National Institute of Diabetes, Nutrition and Metabolic Diseases, Bucharest, Romania
| | - Mihai Lupu
- 5Department of Dermatology, MEDAS Titan Medical Center, Bucharest, Romania
| | - Alexandra Popa
- 1Department of Dermatology and Allergology, Elias Emergency University Hospital, Bucharest, Romania
| | - Mihaela Adriana Ilie
- 6Dermatology Research Laboratory, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- 7Department of Biochemistry, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Radu Albulescu
- 8Chemical and Pharmaceutical National Institute, Bucharest, Romania
| | - Ana Caruntu
- 9Department of Oral and Maxillofacial Surgery, Carol Davila Central Military Emergency Hospital, Bucharest, Romania
- 10Faculty of Medicine, Titu Maiorescu University, Bucharest, Romania
| | - Cristiana Tanase
- 10Faculty of Medicine, Titu Maiorescu University, Bucharest, Romania
- 11Victor Babes National Institute of Pathology, Bucharest, Romania
| | - Carolina Constantin
- 11Victor Babes National Institute of Pathology, Bucharest, Romania
- 12Colentina Clinical Hospital, Bucharest, Romania
| | - Monica Neagu
- 11Victor Babes National Institute of Pathology, Bucharest, Romania
- 12Colentina Clinical Hospital, Bucharest, Romania
- 13Faculty of Biology, University of Bucharest, Bucharest, Romania
| | - Daniel Boda
- 6Dermatology Research Laboratory, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
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15
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Ghazali N, Roe B, Lowe D, Tandon S, Jones T, Shaw R, Risk J, Rogers SN. Using the patients concerns inventory for distress screening in post-treatment head and neck cancer survivors. J Craniomaxillofac Surg 2017; 45:1743-1748. [PMID: 28844398 DOI: 10.1016/j.jcms.2017.07.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Revised: 07/16/2017] [Accepted: 07/18/2017] [Indexed: 10/19/2022] Open
Abstract
PURPOSE Cancer patients can experience significant distress during their cancer trajectory, which impacts upon clinical outcomes and quality of life. Screening for distress using holistic assessments can help identify and address unmet concerns/needs. The purpose of this study was to evaluate the relationship between concerns and distress, and the impact of distress on clinic outcomes in post-treatment head and neck cancer patients. METHODS 170 patients attending routine follow-up clinics were prospectively recruited. All patients completed the Patient Concerns Inventory (PCI) and the Distress thermometer (DT) at preconsultation. RESULTS The rate of significant distress (i.e. DT cut-off score ≥4) was 36% (62/170). Significantly distressed patients selected more items overall than patients without distress (mean, median (QR) of 5.40, 5 (2-8) vs 2.61, 2 (0-4), p < 0.001). Significant distress was most strongly associated with Physical and Functional well-being (p < 0.001) and Psychological and Emotional well-being domains (p = 0.001). On balance, very little difference was noted between cut-off points of either ≥4 or ≥5 PCI items of concern selected. Both cut-off points demonstrated an acceptable level of sensitivity, specificity and predictive values for significant distress. Consultations were longer with increasing numbers of concerns. CONCLUSIONS Just over one-third of patients are significantly distressed. They were more likely to express a higher number of concerns. A cutoff score ≥4 or ≥5 PCI items selected can identify those at risk of significant distress. Concerns causing significant distress were related to emotional/psychological issues and physical function.
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Affiliation(s)
- Naseem Ghazali
- Department of Molecular & Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, UK; Regional Maxillofacial Unit, Aintree University Hospitals NHS Trust, Liverpool, UK.
| | - Brenda Roe
- Evidence-Based Practice Research Centre, Faculty of Health & Social Care, Edge Hill University, Ormskirk, UK
| | - Derek Lowe
- Regional Maxillofacial Unit, Aintree University Hospitals NHS Trust, Liverpool, UK; Evidence-Based Practice Research Centre, Faculty of Health & Social Care, Edge Hill University, Ormskirk, UK
| | - Sank Tandon
- ENT Unit, Aintree University Hospitals NHS Trust, Liverpool, UK
| | - Terry Jones
- Department of Molecular & Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, UK; ENT Unit, Aintree University Hospitals NHS Trust, Liverpool, UK
| | - Richard Shaw
- Department of Molecular & Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, UK; Regional Maxillofacial Unit, Aintree University Hospitals NHS Trust, Liverpool, UK
| | - Janet Risk
- Department of Molecular & Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Simon N Rogers
- Regional Maxillofacial Unit, Aintree University Hospitals NHS Trust, Liverpool, UK; Evidence-Based Practice Research Centre, Faculty of Health & Social Care, Edge Hill University, Ormskirk, UK
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16
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Ghazali N, Roe B, Lowe D, Tandon S, Jones T, Brown J, Shaw R, Risk J, Rogers SN. Screening for distress using the distress thermometer and the University of Washington Quality of Life in post-treatment head and neck cancer survivors. Eur Arch Otorhinolaryngol 2017; 274:2253-2260. [PMID: 28168421 DOI: 10.1007/s00405-017-4474-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 01/18/2017] [Indexed: 03/04/2023]
Abstract
The primary aim was to determine the efficacy of the Distress Thermometer (DT) in screening for anxiety and mood problems against the University of Washington Quality of Life, version 4 (UWQOL). Secondary aims were to evaluate the association between demographic, clinical and health-related QOL variables with significant distress. Two hundred and sixty one disease-free HNC ambulatory patients attending routine follow-up clinics were prospectively recruited. Both DT and UWQOL were completed pre-consultation. Receiver operating characteristic (ROC) curve analyses of DT score for anxiety dysfunction yielded an area under the curve (AUC) of 0.877, with a sensitivity of 84% (43/51) and specificity of 76% (159/210) for a DT cut-off of ≥4; with a corresponding AUC of 0.825 for mood with sensitivity 78% (28/36) and specificity 71% (159/225). Treatment with radiotherapy and a longer consultation time were associated with significant distress (DT ≥4). Significant distress was also reported in two third of those reporting less than "Good" overall QOL. Distress levels were particularly associated with poor Social-Emotional function, more so than the association seen with poor physical function. DT is a reasonable screening tool for distress in the HNC population. The DT cut-off score ≥4 was effective in identifying those with significant distress. Significant distress is associated in survivors with poor health-related quality of life, those who received radiotherapy and patients who have longer consultation times in clinic.
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Affiliation(s)
- Naseem Ghazali
- Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, UK. .,Regional Maxillofacial Unit, Aintree University Hospitals NHS Trust, Lower Lane, Liverpool, L9 7AL, UK.
| | - Brenda Roe
- Faculty of Health and Social Care, Evidence-Based Practice Research Centre, Edge Hill University, Ormskirk, UK
| | - Derek Lowe
- Regional Maxillofacial Unit, Aintree University Hospitals NHS Trust, Lower Lane, Liverpool, L9 7AL, UK.,Faculty of Health and Social Care, Evidence-Based Practice Research Centre, Edge Hill University, Ormskirk, UK
| | - Sank Tandon
- ENT Unit, Aintree University Hospitals NHS Trust, Liverpool, UK
| | - Terry Jones
- Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, UK.,ENT Unit, Aintree University Hospitals NHS Trust, Liverpool, UK
| | - James Brown
- Regional Maxillofacial Unit, Aintree University Hospitals NHS Trust, Lower Lane, Liverpool, L9 7AL, UK
| | - Richard Shaw
- Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, UK.,Regional Maxillofacial Unit, Aintree University Hospitals NHS Trust, Lower Lane, Liverpool, L9 7AL, UK
| | - Janet Risk
- Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Simon N Rogers
- Regional Maxillofacial Unit, Aintree University Hospitals NHS Trust, Lower Lane, Liverpool, L9 7AL, UK.,Faculty of Health and Social Care, Evidence-Based Practice Research Centre, Edge Hill University, Ormskirk, UK
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17
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Lin MF, Lee AY, Chou CC, Liu TY, Tang CC. Factors predicting emotional cue-responding behaviors of nurses in Taiwan: An observational study. Psychooncology 2016; 26:1548-1554. [PMID: 27891700 DOI: 10.1002/pon.4330] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 11/22/2016] [Accepted: 11/23/2016] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Responding to emotional cues is an essential element of therapeutic communication. The purpose of this study is to examine nurses' competence of responding to emotional cues (CRE) and related factors while interacting with standardized patients with cancer. METHODS This is an exploratory and predictive correlational study. A convenience sample of registered nurses who have passed the probationary period in southern Taiwan was recruited to participate in 15-minute videotaped interviews with standardized patients. The Medical Interview Aural Rating Scale was used to describe standardized patients' emotional cues and to measure nurses' CRE. The State-Trait Anxiety Inventory was used to evaluate nurses' anxiety level before the conversation. We used descriptive statistics to describe the data and stepwise regression to examine the predictors of nurses' CRE. RESULTS A total of 110 nurses participated in the study. Regardless of the emotional cue level, participants predominately responded to cues with inappropriate distancing strategies. Prior formal communication training, practice unit, length of nursing practice, and educational level together explain 36.3% variances of the nurses' CRE. CONCLUSIONS This study is the first to explore factors related to Taiwanese nurses' CRE. Compared to nurses in other countries, Taiwanese nurses tended to respond to patients' emotional cues with more inappropriate strategies. We also identified significant predictors of CRE that show the importance of communication training. Future research and education programs are needed to enhance nurses' CRE and to advocate for emotion-focused communication.
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Affiliation(s)
- Mei-Feng Lin
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - An-Yu Lee
- Department of Nursing, Chung Hwa University of Medical Technology, Tainan, Taiwan
| | - Cheng-Chen Chou
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Tien-Yu Liu
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chia-Chun Tang
- School of Nursing, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
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18
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Parker V, Bennett L, Bellamy D, Britton B, Lambert S. Study Protocol: Evaluation of a DVD intervention designed to meet the informaton needs of patients with head and neck cancer and their partner, carer and families. BMC Health Serv Res 2016; 16:670. [PMID: 27876035 PMCID: PMC5118897 DOI: 10.1186/s12913-016-1875-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 10/26/2016] [Indexed: 11/23/2022] Open
Abstract
Background Patients who undergo surgery for cancer of the head and neck and their families face complex and difficult challenges and are at risk of anxiety and depression and inability to cope with symptom and treatment burden. Information available to support them is not flexible enough to adjust to individual need. Design/Methods A randomised clinical trial pre and post intervention design, comparing the use of a tailored DVD intervention, provided preoperatively and used throughout the post- operative period, with usual treatment. One hundred fifty-six individuals or partner couples will be randomly recruited into either the intervention or control group. A survey will be administered at three time points, preoperatively, post operatively and 3 months post-surgery. Anxiety and empowerment are the primary outcome measures. Qualitative data about use of the resource will be gathered by phone interview. Discussion This is the first study to rigorously evaluate the impact of a DVD intervention for this group of patients and their family members. The study will help to understand the impact of information usage on patient and family well- being and test a means by which to evaluate information and education resources for this and other cancer patient groups. Trial registration ACTRN12614001104640. Date registered: 17/10/2014.
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Affiliation(s)
- Vicki Parker
- Hunter New England Local Health District, New Lambton Heights, Australia. .,School of Health, University of New England, Armidale, NSW, 2351, Australia.
| | - Leearna Bennett
- Hunter New England Local Health District, New Lambton Heights, Australia
| | - Douglas Bellamy
- Hunter New England Local Health District, New Lambton Heights, Australia.,University of Newcastle, Callaghan, Australia
| | - Benjamin Britton
- Hunter New England Local Health District, New Lambton Heights, Australia.,University of Newcastle, Callaghan, Australia.,Psycho-oncology, Calvary Mater Hospital, Waratah, Australia
| | - Sylvia Lambert
- Ingram School of Nursing, McGill University, Montreal, Canada
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19
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Balfe M, Maguire R, Hanly P, Butow P, O'Sullivan E, Timmons A, Gooberman-Hill R, Sharp L. Distress in long-term head and neck cancer carers: a qualitative study of carers' perspectives. J Clin Nurs 2016; 25:2317-27. [DOI: 10.1111/jocn.13242] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Myles Balfe
- National Cancer Registry of Ireland; Cork Airport Business Park; Cork Ireland
| | | | - Paul Hanly
- National College of Ireland; Dublin Ireland
| | - Phyllis Butow
- Centre for Medical Psychology; University of Sydney; Sydney NSW Australia
| | | | - Aileen Timmons
- National Cancer Registry of Ireland; Cork Airport Business Park; Cork Ireland
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20
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Lee MS, Nelson AM, Thompson LM, Donovan KA. Supportive care needs of oral cancer survivors: Prevalence and correlates. Oral Oncol 2016; 53:85-90. [DOI: 10.1016/j.oraloncology.2015.11.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 11/06/2015] [Accepted: 11/10/2015] [Indexed: 11/26/2022]
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21
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Abstract
BACKGROUND The prevalence of head and neck cancers is lower (3.5% of total cancers in Australia) than for a number of other cancers. Treatment for head and neck cancer is often drastic and debilitating and patient outcomes are poorer. OBJECTIVE This qualitative study explored the experiences of cancer patients who underwent surgery for head and neck cancer. METHODS In-depth face-to-face interviews were conducted with 12 patients 7 to 26 months after surgery. Interviews were thematically analyzed to produce a rich description of patients' experiences from diagnosis through surgery and beyond. RESULTS Critical aspects of patients' experiences are described through the following themes: only having half the story, shocks and aftershocks, living with the aftermath, and being supported. Participants identified difficulties arising from receiving insufficient, confusing, and often untimely information. The persistent and traumatic nature of what patients endure challenges their physical, mental, and emotional coping capacity and, in some cases, their motivation to live. CONCLUSIONS There is a need to address gaps in support and education of patients and carers. Of particular concern is the problem related to information provision and comprehension. Critical examination of current practices, together with efforts toward coordinated care tailored to individual needs, is required, along with outreach services for patients in rural areas. IMPLICATIONS FOR PRACTICE The development and evaluation of targeted resources in a variety of forms such as DVD, Internet, and pamphlets are needed. Robust assessment strategies are required to inform supportive interventions matched to stages and significant events in patients' journeys.
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22
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Longacre ML, Galloway TJ, Parvanta CF, Fang CY. Medical Communication-related Informational Need and Resource Preferences Among Family Caregivers for Head and Neck Cancer Patients. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2015; 30:786-791. [PMID: 25893922 PMCID: PMC5220670 DOI: 10.1007/s13187-015-0814-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Despite advances in treatment, head and neck cancer (HNC) patients often experience considerable functional impairment during and following treatment. As a result, family caregivers are essential in a patient's recovery; however, few caregivers are well-prepared to handle the extensive caregiving needs of this patient population. To date, little is known about HNC caregivers' informational needs in this role. Thus, we surveyed a sample of HNC caregivers about their informational needs including those related to interacting in the medical context as a caregiver and meeting patient needs. We also asked these caregivers their preferences for obtaining caregiving information. We conducted a cross-sectional study of 59 family caregivers for HNC patients who had completed radiation therapy at a comprehensive cancer center. The majority of caregivers (74.6%) reported having high informational need at diagnosis related to interacting as a caregiver. Although the need for such information decreased over time, over half still had a high need for information at treatment end. Importantly, caregivers who desired information about reducing patient pain and distress also reported having greater informational needs on issues related to interacting in the medical context. Further, the caregivers most often preferred to receive information from health-care professionals as a first source. However, preferring an informal (e.g., Internet) resource at first was significantly associated with needing information on how to talk to a doctor or nurse. The development of evidence-based resources and tools for HNC caregivers as well as clinicians may help caregivers more effectively manage patient symptoms and warrants further attention. Further, Internet resources may represent an effective resource for providing caregivers with strategies toward enhancing communication with healthcare professionals.
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Affiliation(s)
| | - Thomas J Galloway
- Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA, 19111, USA
| | - Claudia F Parvanta
- University of the Sciences, 600 South 43rd Street, Philadelphia, PA, 19104-4495, USA
| | - Carolyn Y Fang
- Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA, 19111, USA
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23
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Xie H, Li C, He Y, Griffin R, Ye Q, Li L. Chronic stress promotes oral cancer growth and angiogenesis with increased circulating catecholamine and glucocorticoid levels in a mouse model. Oral Oncol 2015; 51:991-997. [DOI: 10.1016/j.oraloncology.2015.08.007] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 06/10/2015] [Accepted: 08/12/2015] [Indexed: 01/02/2023]
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24
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Ghazali N, Roe B, Lowe D, Rogers S. Patients concerns inventory highlights perceived needs and concerns in head and neck cancer survivors and its impact on health-related quality of life. Br J Oral Maxillofac Surg 2015; 53:371-9. [DOI: 10.1016/j.bjoms.2015.01.022] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 01/28/2015] [Indexed: 11/28/2022]
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25
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Perceived unmet needs and health-related quality of life of Chinese cancer survivors at 1 year after treatment. Cancer Nurs 2014; 36:E23-32. [PMID: 22964864 DOI: 10.1097/ncc.0b013e318263f28e] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Although advanced cancer treatments prolong survivors' lives, a significant proportion experienced poorer health-related quality of life (HRQoL) than general populations. Identifying their needs is essential to develop a health service delivery model to improve patient outcomes. OBJECTIVE The objective of this study was to examine the perceived unmet needs and HRQoL of Chinese cancer survivors who completed treatment less than 1 year ago. METHODS Three hundred seventy-six participants completed a self-report survey: the 34-item Supportive Care Needs Survey, the supplementary module of access to healthcare and ancillary support services, and the Functional Assessment of Cancer Therapy: General. Descriptive statistics were used to examine the prevalence of unmet needs. Multivariable logistic regressions were conducted to identify participants' characteristics that were associated with unmet needs. Multiple linear regression was used to delineate which domains of unmet needs were significantly associated with HRQoL with adjustment for potential confounding factors. RESULTS Healthcare information was the most common unmet needs among the survivors. Age, stage of cancer, and remission were significantly associated with 1 or more unmet need domains. Participants with unmet needs in physical, psychological, and patient care domains, on average, have poorer HRQoL. CONCLUSIONS Chinese cancer survivors have various unmet needs that might have adverse effects on their HRQoL. Younger age, more advanced stages of cancer, and remission were factors contributing to further unmet needs. IMPLICATIONS FOR PRACTICE The results provided useful information on the special needs of survivors that may affect their HRQoL, enabling clinicians to plan better how to allocate existing limited resources to those who most require them.
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26
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Chen SC, Lai YH, Liao CT, Huang BS, Lin CY, Fan KH, Chang JTC. Unmet supportive care needs and characteristics of family caregivers of patients with oral cancer after surgery. Psychooncology 2014; 23:569-77. [DOI: 10.1002/pon.3458] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Revised: 10/30/2013] [Accepted: 11/01/2013] [Indexed: 11/06/2022]
Affiliation(s)
- Shu-Ching Chen
- Department of Nursing; Chang Gung University of Science and Technology; Taoyuan Taiwan
- Head and Neck Oncology Group; Chang Gung Medical Foundation, Chang Gung Memorial Hospital at LinKou; Taoyuan Taiwan
| | - Yeur-Hur Lai
- School of Nursing, College of Medicine; National Taiwan University; Taipei Taiwan
| | - Chun-Ta Liao
- Department of Otorhinolaryngology, Head and Neck Surgery; Chang Gung Medical Foundation, Chang Gung Memorial Hospital at LinKou; Taoyuan Taiwan
- College of Medicine; Chang Gung University; Taoyuan Taiwan
- Head and Neck Oncology Group; Chang Gung Medical Foundation, Chang Gung Memorial Hospital at LinKou; Taoyuan Taiwan
| | - Bing-Shen Huang
- College of Medicine; Chang Gung University; Taoyuan Taiwan
- Department of Radiation Oncology; Chang Gung Medical Foundation, Chang Gung Memorial Hospital at LinKou; Taoyuan Taiwan
- Head and Neck Oncology Group; Chang Gung Medical Foundation, Chang Gung Memorial Hospital at LinKou; Taoyuan Taiwan
| | - Chien-Yu Lin
- College of Medicine; Chang Gung University; Taoyuan Taiwan
- Department of Radiation Oncology; Chang Gung Medical Foundation, Chang Gung Memorial Hospital at LinKou; Taoyuan Taiwan
- Head and Neck Oncology Group; Chang Gung Medical Foundation, Chang Gung Memorial Hospital at LinKou; Taoyuan Taiwan
| | - Kang-Hsing Fan
- College of Medicine; Chang Gung University; Taoyuan Taiwan
- Department of Radiation Oncology; Chang Gung Medical Foundation, Chang Gung Memorial Hospital at LinKou; Taoyuan Taiwan
- Head and Neck Oncology Group; Chang Gung Medical Foundation, Chang Gung Memorial Hospital at LinKou; Taoyuan Taiwan
| | - Joseph Tung-Chien Chang
- College of Medicine; Chang Gung University; Taoyuan Taiwan
- Department of Radiation Oncology; Chang Gung Medical Foundation, Chang Gung Memorial Hospital at LinKou; Taoyuan Taiwan
- Head and Neck Oncology Group; Chang Gung Medical Foundation, Chang Gung Memorial Hospital at LinKou; Taoyuan Taiwan
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Shun SC, Yeh KH, Liang JT, Huang J, Chen SC, Lin BR, Lee PH, Lai YH. Unmet Supportive Care Needs of Patients With Colorectal Cancer: Significant Differences by Type D Personality. Oncol Nurs Forum 2013; 41:E3-11. [DOI: 10.1188/14.onf.e3-e11] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Head and neck cancer patients want us to support them psychologically in the posttreatment period: Survey results. Palliat Support Care 2013; 12:481-93. [PMID: 24153040 DOI: 10.1017/s1478951513000771] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES No study systematically has investigated the supportive care needs of general head and neck cancer patients using validated measures. These needs include physical and daily living needs, health system and information needs, patient care and support needs, psychological needs, and sexuality needs. Identifying the unmet needs of head and neck cancer patients is a necessary first step to improving the care we provide to patients seen in our head and neck oncology clinics. It is recommended as the first step in intervention development in the Pan-Canadian Clinical Practice Guideline of the Canadian Partnership Against Cancer (see Howell, 2009). This study aimed to identify: (1) met and unmet supportive care needs of head and neck cancer patients, and (2) variability in needs according to demographics, disease variables, level of distress, and quality-of-life domains. METHODS Participants were recruited from the otolaryngology-head and neck surgery clinics of two university teaching hospitals. Self-administered questionnaires included sociodemographic and medical questions, as well as validated measures such as the Supportive Care Needs Survey-Short Form (SCNS-SF34), the Hospital Anxiety and Depression Scale (HADS), and the Functional Assessment of Cancer Therapy-General (FACT-G) and Head and Neck Module (FACT-H&N) (quality of life measures). RESULTS One hundred and twenty-seven patients participated in the survey. 68% of them experienced unmet needs, and 25% revealed a clinically significant distress level on the HADS. The highest unmet needs were psychological (7 of top 10 needs). A multiple linear regression indicated a higher level of overall unmet needs when patients were divorced, had a high level of anxiety (HADS subscale), were in poor physical condition, or had a diminished emotional quality of life (FACT-G subscales). SIGNIFICANCE OF RESULTS The results of this study highlight the overwhelming presence of unmet psychological needs in head and neck cancer patients and underline the importance of implementing interventions to address these areas perceived by patients as important. In line with hospital resource allocation and cost-effectiveness, one may also contemplate screening patients for high levels of anxiety, as well as target patients who are divorced and present low levels of physical well-being, as these patients may have more overall needs to be met.
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Jean-Pierre P, Fundakowski C, Perez E, Jean-Pierre SE, Jean-Pierre AR, Melillo AB, Libby R, Sargi Z. Latent structure and reliability analysis of the measure of body apperception: cross-validation for head and neck cancer patients. Support Care Cancer 2013; 21:591-8. [PMID: 22886430 PMCID: PMC4086048 DOI: 10.1007/s00520-012-1561-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2012] [Accepted: 07/31/2012] [Indexed: 12/12/2022]
Abstract
PURPOSE Cancer and its treatments are associated with psychological distress that can negatively impact self-perception, psychosocial functioning, and quality of life. Patients with head and neck cancers (HNC) are particularly susceptible to psychological distress. This study involved a cross-validation of the Measure of Body Apperception (MBA) for HNC patients. METHODS One hundred and twenty-two English-fluent HNC patients between 20 and 88 years of age completed the MBA on a Likert scale ranging from "1 = disagree" to "4 = agree." We assessed the latent structure and internal consistency reliability of the MBA using Principal Components Analysis (PCA) and Cronbach's coefficient alpha (α), respectively. We determined convergent and divergent validities of the MBA using correlations with the Hospital Anxiety and Depression Scale (HADS), observer disfigurement rating, and patients' clinical and demographic variables. RESULTS The PCA revealed a coherent set of items that explained 38 % of the variance. The Kaiser-Meyer-Olkin measure of sampling adequacy was 0.73 and the Bartlett's test of sphericity was statistically significant (χ (2) (28) = 253.64; p < 0.001), confirming the suitability of the data for dimension reduction analysis. The MBA had good internal consistency reliability (α = 0.77) and demonstrated adequate convergent and divergent validities based on statistically significant moderate correlations with the HADS (p < 0.01) and observer rating of disfigurement (p < 0.026) and nonstatistically significant correlations with patients' clinical and demographic variables: tumor location, age at diagnosis, and birth place (all p (s) > 0.05). CONCLUSIONS The MBA is a valid and reliable screening measure of body apperception for HNC patients.
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Affiliation(s)
- Pascal Jean-Pierre
- Department of Radiation Oncology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, 1475 NW 12th Avenue, Suite 1500 (D-31), Miami, FL 33136-1002, USA.
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Enhanced patient reported outcome measurement suitable for head and neck cancer follow-up clinics. HEAD & NECK ONCOLOGY 2012; 4:32. [PMID: 22695251 PMCID: PMC3448513 DOI: 10.1186/1758-3284-4-32] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/23/2012] [Accepted: 05/23/2012] [Indexed: 01/27/2023]
Abstract
Background The ‘Worse-Stable-Better’ (W-S-B) question was introduced to capture patient-perceived change in University of Washington Quality of Life (UW-QOL) domains. Methods 202 head and neck cancer patients in remission prospectively completed UW-QOL and Patients Concerns Inventory (PCI). For each UW-QOL domain, patients indicated whether over the last month things had worsened (W), remained stable (S) or were better (B). Results 202 patients at 448 attendances selected 1752 PCI items they wanted to discuss in consultation, and 58% (1024/1752) of these were not covered by the UW-QOL. UW-QOL algorithms highlighted another 440 significant problems that the patient did not want to discuss (i.e. the corresponding items on the PCI were not selected). After making allowance for UW-QOL algorithms to identify 'significant problems' and PCI selection of corresponding issues for discussion there remained clear residual and notable variation in W-S-B responses, in particular to identify patients with significant problems that were getting worse, and patients without significant problems that wanted to discuss issues that were getting worse. Changes in mean UW-QOL scores were notably lower for those getting worse on the W-S-B question, typically by 10 or more units a magnitude that suggests clinically important changes in score. Conclusions The W-S-B question adds little questionnaire burden and could help to better identify patients who might benefit from intervention. The results of this study suggest that the UW-QOL with the W-S-B modification should be used together with the PCI to allow optimal identification of issues for patient-clinician discussion during routine outpatient clinics.
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Puts MTE, Papoutsis A, Springall E, Tourangeau AE. A systematic review of unmet needs of newly diagnosed older cancer patients undergoing active cancer treatment. Support Care Cancer 2012; 20:1377-94. [PMID: 22476399 DOI: 10.1007/s00520-012-1450-7] [Citation(s) in RCA: 161] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2011] [Accepted: 03/19/2012] [Indexed: 10/28/2022]
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Bernabé DG, Tamae AC, Biasoli ÉR, Oliveira SHP. Stress hormones increase cell proliferation and regulates interleukin-6 secretion in human oral squamous cell carcinoma cells. Brain Behav Immun 2011; 25:574-83. [PMID: 21187140 DOI: 10.1016/j.bbi.2010.12.012] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2010] [Revised: 12/16/2010] [Accepted: 12/18/2010] [Indexed: 12/15/2022] Open
Abstract
Patients with oral cancer can have high psychological distress levels, but the effects of stress-related hormones on oral cancer cells and possible mechanisms underlying these relationships are unknown. In this study, we have investigated the effects of stress-related hormones on interleukin-6 (IL-6) secretion and proliferation of oral squamous cell carcinoma (OSCC) cells. The effects of norepinephrine (NE), and cortisol were studied in SCC9, SCC15, and SCC25 cells and effects of isoproterenol in SCC9 and SCC25 cells. Real-time PCR studies revealed constitutive β1- and β2-adrenergic receptors (β-ARs) expression in the SCC9, SCC15, and SCC25 cells. The results showed that NE and isoproterenol significantly enhanced IL-6 mRNA expression and protein production in supernatants of SCC9 and SCC25 cells. Physiological stress levels of NE and isoproterenol (10 μM) at 1 h elicited the most robust IL-6 increase. Regarding IL-6 secretion, 10 μM NE induced a 5-fold increase at 1 h, 3.7-fold increase at 6 h, and 3.2-fold at 24 h in SCC9 cells. These effects were blocked by the β-adrenergic antagonist propranolol, supporting a role for β-ARs in IL-6 secretion. The effects of cortisol varied according to the hormone concentration. Pharmacological concentrations of cortisol (1000 nM) inhibited IL-6 production by SCC9 and SCC25 cells. Cortisol dose that simulates stress conditions (10 nM) tended to increase IL-6 expression in SCC9 cells. Hormonal doses that simulate stress conditions (10 μM NE, at 6 h in SCC9 and SCC15 cells and 10 nM cortisol, at 48 h in SCC15 cells) stimulated increased cell proliferation. Treatment of SCC9 cells with IL-6 neutralizing ab (10 μg/mL) partially inhibited NE-induced proliferation. Finally, 20 OSCC biopsies were shown to express β1- and β2-ARs. These findings suggest that stress hormones can affect oral cancer cells behavior.
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Affiliation(s)
- Daniel G Bernabé
- Oral Oncology Center, School of Dentistry of Araçatuba, UNESP - Univ. Estadual Paulista, Araçatuba, São Paulo, Brazil.
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Liao YC, Liao WY, Shun SC, Yu CJ, Yang PC, Lai YH. Symptoms, psychological distress, and supportive care needs in lung cancer patients. Support Care Cancer 2010; 19:1743-51. [PMID: 20949362 DOI: 10.1007/s00520-010-1014-7] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2010] [Accepted: 09/20/2010] [Indexed: 10/19/2022]
Abstract
PURPOSE The purpose of this study was to examine the level of symptoms, psychological distress, and supportive care needs and factors related to five unmet need domains in lung cancer patients. METHODS A cross-sectional study of 152 lung cancer patients at a medical center in Taiwan assessed their symptoms, psychological distress, and unmet supportive needs in five major care domains. Logistic regression was applied to examine the related factors of unmet supportive care needs. RESULTS In general, patients had mild-to-moderate levels of symptoms and high prevalence of psychological distress. Regardless of their treatment status, they reported high levels of supportive care needs. The top three need domains were: (1) health system and information, (2) psychological, and (3) patient care and support. Levels of symptoms, anxiety, and depression were the most significant factors in unmet supportive care needs. CONCLUSION The effect of symptoms and psychological distress on unmet supportive care needs is substantial. Therefore, a systematic assessment of patients' distress and care needs is important for clinical lung cancer care. Further intervention consisting of symptom management, continuing counseling, and preparation for transition from active treatment to the follow-up stages are essential in improving quality of care.
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Affiliation(s)
- Yu-Chien Liao
- Department of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
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Prevalence and Correlates of Supportive Care Needs in Oral Cancer Patients With and Without Anxiety During the Diagnostic Period. Cancer Nurs 2010; 33:280-9. [DOI: 10.1097/ncc.0b013e3181d0b5ef] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Chen SC, Lai YH, Cheng SY, Liao CT, Chang JTC. Psychometric testing of the Chinese-version cancer needs questionnaire short form head and neck cancer-specific version in oral cavity cancer patients. Support Care Cancer 2010; 19:647-56. [DOI: 10.1007/s00520-010-0877-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2009] [Accepted: 04/08/2010] [Indexed: 10/19/2022]
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