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Hodkiewicz CG, White MJ, Ankeny JS, Jensen EH, Marmor S, Brauer DG. Evaluating the redundancy of patient-centered internet-based content for pancreas cancer and pancreaticoduodenectomy. HPB (Oxford) 2024; 26:851-853. [PMID: 38499454 DOI: 10.1016/j.hpb.2024.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 02/27/2024] [Accepted: 02/29/2024] [Indexed: 03/20/2024]
Affiliation(s)
- Chase G Hodkiewicz
- Division of Surgical Oncology, Department of Surgery, University of Minnesota, USA
| | - McKenzie J White
- Division of Surgical Oncology, Department of Surgery, University of Minnesota, USA
| | - Jake S Ankeny
- Division of Surgical Oncology, Department of Surgery, University of Minnesota, USA
| | - Eric H Jensen
- Division of Surgical Oncology, Department of Surgery, University of Minnesota, USA
| | - Schelomo Marmor
- Division of Surgical Oncology, Department of Surgery, University of Minnesota, USA
| | - David G Brauer
- Division of Surgical Oncology, Department of Surgery, University of Minnesota, USA.
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Nguyen G, Furness K, Croagh D, Haines T, Hanna L. Supplemental tube feeding: qualitative study of patient perspectives in advanced pancreatic cancer. BMJ Support Palliat Care 2024:spcare-2024-004836. [PMID: 38580394 DOI: 10.1136/spcare-2024-004836] [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: 02/18/2024] [Accepted: 03/12/2024] [Indexed: 04/07/2024]
Abstract
OBJECTIVES Malnutrition is associated with poor quality of life and survival outcomes for patients with cancer, but is challenging to prevent or treat in pancreatic cancer due to the multifactorial drivers of nutritional decline. A novel application of percutaneous endoscopic gastrostomy with a jejunal extension tube to deliver supplementary nutrition may improve outcomes, and will be tested in a randomised controlled trial. This study explored the perspectives of people living with pancreatic cancer regarding the acceptability of this proposed intensive nutrition intervention, to elucidate appropriateness and anticipated barriers, and facilitate informed design of the planned trial. METHODS Participants were patients with pancreatic cancer previously enrolled in a Pancreaticobiliary Cancer Biobank. Qualitative semi-structured interviews were conducted by telephone and transcribed verbatim for deductive thematic analysis. The Framework Model was used, with the Theoretical Framework of Acceptability as the analytical framework. RESULTS 10 participants were recruited. Four overarching themes were developed from interviews: (1) deterioration in physical and mental well-being are consequences of debilitating nutrition impact symptoms; (2) willingness to participate depends on an individual threshold for nutritional deterioration; (3) predicted perceived effectiveness outweighed anticipated burdens and (4) adequate dietetic support is needed for maintaining a percutaneous endoscopic gastrostomy with jejunal extension feeding tube at home with confidence. CONCLUSIONS Most participants believed that the intervention would benefit people with advanced pancreatic cancer to maintain their nutrition throughout chemotherapy. Regular and ad hoc support was considered essential, and the degree of individual nutritional deterioration was identified as an important indicator for trial participation.
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Affiliation(s)
- Grace Nguyen
- Melbourne Medical School, The University of Melbourne, Parkville, Victoria, Australia
| | - Kate Furness
- Department of Sport, Exercise and Nutrition Sciences, La Trobe University, Bundoora, Victoria, Australia
| | - Daniel Croagh
- Upper Gastrointestinal and Hepatobiliary Surgery, Monash Health, Clayton, Victoria, Australia
- Department of Surgery, Monash University, Clayton, Victoria, Australia
| | - Terry Haines
- School of Primary and Allied Health Care, Monash University, Frankston, Victoria, Australia
| | - Lauren Hanna
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Victoria, Australia
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Wang C, Wacharasin C, Hengudomsub P. Self-efficacy as mediators of the association between dyadic coping and quality of life among spousal caregiver of patients with cervical cancer. Asia Pac J Oncol Nurs 2024; 11:100354. [PMID: 38426044 PMCID: PMC10904169 DOI: 10.1016/j.apjon.2023.100354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 11/30/2023] [Indexed: 03/02/2024] Open
Abstract
Objective This study aims to explore the influence of dyadic coping (DC) on the quality of life (QoL) of spousal caregivers for patients with cervical cancer and to investigate the mediating role of self-efficacy in this relationship. Methods A convenience sample of 206 spouses of cervical cancer patients from five hospitals in Jiangsu Province, China, was included in the study. The participants completed three instruments: the 12-item Short-Form Health Survey, the General Self-Efficacy Scale, and the Dyadic Coping Inventory. Structural Equation Modeling (SEM) was used to analyze the mediating effect of self-efficacy in the DC and QoL relationship. Results The study found a positive correlation between self-efficacy and DC. Self-efficacy partially mediated the impact of DC on QoL, accounting for 16% of the total effect. Self-efficacy played a mediating role in facilitating the indirect positive effects of DC on QoL. Conclusions Spousal caregivers of cervical cancer patients frequently experience a relatively low QoL. The results suggest that interventions aimed at enhancing DC among spousal caregivers should incorporate strategies to improve self-efficacy, given its mediating role in the positive relationship between DC and QoL.
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Affiliation(s)
- Chuntao Wang
- Faculty of Nursing, Burapha University, Muang, Chonburi, Thailand
- Faculty of Nursing, Jiangsu Vocational College of Medicine, Jiangsu, China
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Zamani M, Alizadeh-Tabari S. Anxiety and depression prevalence in digestive cancers: a systematic review and meta-analysis. BMJ Support Palliat Care 2023; 13:e235-e243. [PMID: 34417285 DOI: 10.1136/bmjspcare-2021-003275] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 08/12/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Cancers of the digestive system can be associated with disturbing and disabling symptoms, which can contribute to a negative psychological pressure on patients. AIM To investigate the reported prevalence of symptoms of anxiety and depression in patients with major digestive cancers, including oesophageal, gastric, colorectal, pancreatic or hepatic cancers. METHODS We searched Embase, PubMed, Scopus and Web of Science for articles published from inception to December 2020. We included studies reporting the prevalence of anxiety or depression symptoms using validated questionnaires in adult patients (≥18 years). RESULTS In total, 51 eligible papers were finally included. Overall, the pooled prevalence of anxiety symptoms was 20.4% (95% CI 17% to 23.8%). The estimate in patients with gastrointestinal (GI) cancers was 19.1% and in patients with hepatic cancer was 29.1%. Among GI cancers, the highest pooled prevalence of anxiety symptoms related to oesophageal cancer (20.6%), while the lowest pooled prevalence pertained to gastric cancer (18.7%). Regarding depression symptoms, the overall pooled prevalence was 30.2% (95% CI 24.3% to 36.1%). The estimate in patients with GI cancers was 31% and in patients with hepatic cancer was 21.5%. Among GI cancers, the highest pooled prevalence of depression symptoms related to oesophageal cancer (45.2%), while the lowest pooled prevalence pertained to colorectal cancer (22.9%). CONCLUSION A considerable prevalence of anxiety and depression symptoms is observed in patients with digestive cancers. Screening and preventive measures with early management of these psychological problems by clinicians could possibly improve outcomes for these patients. PROSPERO REGISTRATION NUMBER CRD42020210079.
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Affiliation(s)
- Mohammad Zamani
- Digestive Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Student Research Committee, Babol University of Medical Science, Babol, Iran
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Tarasiuk A, Mirocha G, Fichna J. Current status of Complementary and Alternative Medicine Interventions in the Management of Pancreatic Cancer - An Overview. Curr Treat Options Oncol 2023; 24:1852-1869. [PMID: 38079061 PMCID: PMC10781793 DOI: 10.1007/s11864-023-01146-4] [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] [Accepted: 10/24/2023] [Indexed: 01/11/2024]
Abstract
OPINION STATEMENT Pancreatic cancer (PC) remains the deadliest cancer worldwide. Most patients are diagnosed at the advanced or metastatic stage, leading to a poor prognosis. Awareness of the limitations of current therapy and accompanying pain, depression, malnutrition, and side effects of chemoradiotherapy may lead patients and physicians towards complementary and alternative medicine (CAM). CAM refers to a diverse set of medical and healthcare practices, products, and systems that are not part of conventional Western medicine. Despite the low-quality evidence supporting the efficacy of these methods, they remain appealing due to patients' beliefs, fear of death, and the slow development of conventional therapy. Hence, the possibility of using natural products for pancreatic cancer is increasing. CAM options such as: medical cannabis, plants, fungi, herbal formulas, and injections, which originate primarily from traditional Chinese or Japanese medicine i.e. Curcuma longa, Panax ginseng, Poria cocos, Hochuekkito, Juzentaihoto, and Rikkunshito, Shi-quan-da-bu-tang/TJ-48, Huang-qin-tang, Shuangbai San, Wen Jing Zhi Tong Fang, Xiang-Sha-Liu-jun-zi-tang, Aidi injection, Brucea javanica oil emulsion/Yadanziyouru injection, Compound Kushen injection, Huachansu injection, Kangai injection and Kanglaite injections are becoming promising candidates for the management of pancreatic cancer. The abovementioned substances/medications are the most popular or potentially effective in PC treatment and consequently CAM-based adjuvant therapy through improving patients' quality of life, might be a useful addition in the treatment of pancreatic cancer patients.
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Affiliation(s)
- Aleksandra Tarasiuk
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Mazowiecka 5, 92-215, Lodz, Poland.
| | - Grzegorz Mirocha
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Mazowiecka 5, 92-215, Lodz, Poland
| | - Jakub Fichna
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Mazowiecka 5, 92-215, Lodz, Poland
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Lin D, Ying W, Zhang H, Xiu Y, Li E, Zheng R, Wu Y. Comprehensive Need as a Mediator Between Psychological Stress and Quality of Life Among Caregivers of Patients With Cancer. Cancer Nurs 2023:00002820-990000000-00191. [PMID: 37976150 DOI: 10.1097/ncc.0000000000001310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
BACKGROUND Caregivers of patients with cancer are susceptible to profound psychological distress and low quality of life owing to the substantial demands of caregiving. The comprehensive needs of caregivers are closely linked to their quality of life. However, little is known about the relationship between these factors. OBJECTIVE This study aimed to determine whether comprehensive needs mediate the relationships between psychological stress and quality of life in caregivers of patients with cancer. METHODS A cross-sectional design was used to recruit 382 participants through convenience sampling. Psychological stress, comprehensive needs, and quality of life were measured using a questionnaire. RESULTS Psychological stress was associated with higher comprehensive needs (r = 0.30, P < .01) and lower quality of life (r = -0.20, P < .01). Comprehensive needs were negatively associated with quality of life (r = -0.28, P < .01). Mediation analysis findings revealed that both the indirect effect of psychological stress on quality of life via comprehensive needs (β = -0.10; P < .001) and its direct effect on quality of life (β = -0.16; P < .01) were statistically significant, suggesting a partial mediatory effect of comprehensive needs between psychological stress and quality of life. CONCLUSIONS Our findings suggest that reducing psychological stress can improve quality of life by promoting satisfaction with comprehensive needs. IMPLICATIONS FOR PRACTICE Interventions that help reduce psychological stress and meet the comprehensive needs of caregivers of patients with cancer can improve their quality of life.
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Affiliation(s)
- Danna Lin
- Author Affiliations: School of Nursing, Shantou University Medical College (Mss Lin and Xiu); The First Affiliated Hospital of Shantou University Medical College (Drs Ying and Wu and Mss Zhang and Li); and Longhu Hospital, The First Affiliated Hospital of Shantou University Medical College (Ms Zheng), Shantou, Guangdong, China
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Shield T, Bayliss K, Hodkinson A, Panagioti M, Wearden A, Flynn J, Rowland C, Bee P, Farquhar M, Harris D, Grande G. What factors are associated with informal carers' psychological morbidity during end-of-life home care? A systematic review and thematic synthesis of observational quantitative studies. HEALTH AND SOCIAL CARE DELIVERY RESEARCH 2023:1-58. [PMID: 37991230 DOI: 10.3310/htjy8442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2023]
Abstract
Background Family carers are central in supporting patients nearing end of life. As a consequence, they often suffer detrimental impacts on their own mental health. Understanding what factors may affect carers' mental health is important in developing strategies to maintain their psychological well-being during caregiving. Aim To conduct a systematic review and thematic evidence synthesis of factors related to carers' mental health during end-of-life caregiving. Method Searches of MEDLINE, CINAHL, PsychINFO, Social Sciences Citation Index, EMBASE, Cochrane Central Register of Controlled Trials and Database of Abstracts of Reviews of Effects 1 January 2009-24 November 2019. We included observational quantitative studies focusing on adult informal/family carers for adult patients at end of life cared for at home considering any factor related to carer mental health (anxiety, depression, distress and quality of life) pre-bereavement. Newcastle-Ottawa Quality Assessment Scale was used. Thematic analysis with box score presentation, and meta-analysis were done where data permitted. Results Findings from 63 included studies underpinned seven emergent themes. Patient condition (31 studies): worse patient psychological symptoms and quality of life were generally associated with worse carer mental health. Patient depression was associated with higher depression in carers (standardised mean difference = 0.59, 95% confidence interval 0.32 to 0.87, I2 = 77%). Patients' other symptoms and functional impairment may relate to carer mental health, but findings were unclear. Impact of caring responsibilities (14 studies): impact on carers' lives, task difficulty and general burden had clear associations with worse carer mental health. Relationships (8 studies): family dynamics and the quality of the carer-patient relationship may be important for carer mental health and are worthy of further investigation. Finance (6 studies): insufficient resources may relate to carers' mental health and warrant further study. Carers' psychological processes (13 studies): self-efficacy and preparedness were related to better mental health. However, findings regarding coping strategies were mixed. Support (18 studies): informal support given by family and friends may relate to better carer mental health, but evidence on formal support is limited. Having unmet needs was related to worse mental health, while satisfaction with care was related to better mental health. Contextual factors (16 studies): older age was generally associated with better carer mental health and being female was associated with worse mental health. Limitations Studies were mainly cross-sectional (56) rather than longitudinal (7) which raises questions about the likely causal direction of relationships. One-third of studies had samples < 100, so many had limited statistical power to identify existing relationships. Conclusions and future work Future work must adopt a comprehensive approach to improving carers' mental health because factors relating to carer mental health cover a broad spectrum. The literature on this topic is diverse and difficult to summarise, and the field would benefit from a clearer direction of enquiry guided by explanatory models. Future research should (1) further investigate quality of relationships and finances; (2) better define factors under investigation; (3) establish, through quantitative causal analyses, why factors might relate to mental health; and (4) utilise longitudinal designs more to aid understanding of likely causal direction of associations. Study registration This study is registered as PROSPERO registration 2019 CRD42019130279 at https://www.crd.york.ac.uk/prospero/. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme HSDR 18/01/01 and is published in full in Health and Social Care Delivery Research. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
- Tracey Shield
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Manchester, UK
| | - Kerin Bayliss
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Manchester, UK
| | - Alexander Hodkinson
- NIHR Greater Manchester Patient Safety Translational Research Centre, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, University of Manchester, Manchester, UK
| | - Maria Panagioti
- NIHR Greater Manchester Patient Safety Translational Research Centre, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, University of Manchester, Manchester, UK
| | - Alison Wearden
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
| | - Jackie Flynn
- Public and Community Involvement and Engagement (PCIE) Panel, NIHR Applied Research Collaboration (ARC) Greater Manchester, Manchester, UK
| | - Christine Rowland
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
| | - Penny Bee
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Manchester, UK
| | - Morag Farquhar
- School of Health Sciences, University of East Anglia, Norwich, UK
| | - Danielle Harris
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Manchester, UK
- NIHR Applied Research Collaboration (ARC) Greater Manchester, Manchester, UK
| | - Gunn Grande
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Manchester, UK
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Huynh TNT, Hartel G, Janda M, Wyld D, Merrett N, Gooden H, Neale RE, Beesley VL. The Unmet Needs of Pancreatic Cancer Carers Are Associated with Anxiety and Depression in Patients and Carers. Cancers (Basel) 2023; 15:5307. [PMID: 38001567 PMCID: PMC10670364 DOI: 10.3390/cancers15225307] [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: 09/01/2023] [Revised: 10/20/2023] [Accepted: 10/31/2023] [Indexed: 11/26/2023] Open
Abstract
Pancreatic cancer has one of the lowest survival rates, and patients experience debilitating symptoms. Family carers provide essential daily care. This study determined the prevalence of and risk factors for unmet supportive care needs among carers for pancreatic cancer patients and examined which carer needs were associated with anxiety and depression in carers and patients. Eighty-four pancreatic cancer patients and their carers were recruited. The carers completed a needs survey (SCNS-P&C). Both carers and patients completed the Hospital Anxiety and Depression Scale. Log binomial regression was used to identify associations between carer needs and anxiety and depression among carers and patients. The top 10 moderate-to-high unmet needs reported by ≥28% of carers were related to healthcare (e.g., discussing concerns with doctors) and information need domains (e.g., information about a patient's physical needs), plus one other item related to hospital parking. Being male or caring for a patient within 4 months of their diagnosis were associated with greater unmet needs. Some unmet needs, including 'accessing information about treatments' and 'being involved in patient care', were associated with both carers and patients having anxiety and depression. Carers should be involved in health care consultations and provided with information and opportunities to discuss concerns.
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Affiliation(s)
- Thi N. T. Huynh
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, QLD 4006, Australia; (T.N.T.H.); (G.H.); (R.E.N.)
- Faculty of Medicine, The University of Queensland, Brisbane, QLD 4006, Australia; (M.J.); (D.W.)
| | - Gunter Hartel
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, QLD 4006, Australia; (T.N.T.H.); (G.H.); (R.E.N.)
- Faculty of Medicine, The University of Queensland, Brisbane, QLD 4006, Australia; (M.J.); (D.W.)
- School of Nursing, Queensland University of Technology, Brisbane, QLD 4059, Australia
| | - Monika Janda
- Faculty of Medicine, The University of Queensland, Brisbane, QLD 4006, Australia; (M.J.); (D.W.)
| | - David Wyld
- Faculty of Medicine, The University of Queensland, Brisbane, QLD 4006, Australia; (M.J.); (D.W.)
- School of Nursing, Queensland University of Technology, Brisbane, QLD 4059, Australia
- Cancer Care Services, Royal Brisbane and Women’s Hospital, Herston, QLD 4029, Australia
| | - Neil Merrett
- School of Medicine, Western Sydney University, Sydney, NSW 2560, Australia;
| | - Helen Gooden
- School of Nursing and Midwifery, University of Sydney, Sydney, NSW 2006, Australia;
| | - Rachel E. Neale
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, QLD 4006, Australia; (T.N.T.H.); (G.H.); (R.E.N.)
- Faculty of Medicine, The University of Queensland, Brisbane, QLD 4006, Australia; (M.J.); (D.W.)
| | - Vanessa L. Beesley
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, QLD 4006, Australia; (T.N.T.H.); (G.H.); (R.E.N.)
- Faculty of Medicine, The University of Queensland, Brisbane, QLD 4006, Australia; (M.J.); (D.W.)
- School of Nursing, Queensland University of Technology, Brisbane, QLD 4059, Australia
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Avancini A, Borsati A, Trestini I, Tregnago D, Belluomini L, Sposito M, Rota M, Insolda J, Schena F, Milella M, Pilotto S. Exploring the feasibility of a combined exercise program for patients with advanced lung or pancreatic cancer. Asia Pac J Oncol Nurs 2023; 10:100298. [PMID: 38197044 PMCID: PMC10772206 DOI: 10.1016/j.apjon.2023.100298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 08/18/2023] [Indexed: 01/11/2024] Open
Abstract
Objective This study aims to assess the safety, feasibility, and potential benefits of a combined aerobic and resistance exercise intervention for patients diagnosed with advanced pancreatic or lung cancer. Methods A prospective, single-arm study was conducted, enrolling patients with advanced lung or pancreatic cancer. Participants engaged in a 12-week exercise intervention comprising personalized bi-weekly aerobic and resistance training tailored to individual baseline conditions. The primary study outcomes focused on safety (absence of serious adverse events) and feasibility. Secondary outcomes included assessments of functional capacity using the "Six minutes walking test", strength measured through handgrip and leg press tests, anthropometric measures including body mass index and waist-hip ratio, quality of life (QoL), and changes in blood parameters. Results The study involved twelve patients (mean age 57.66 ± 7.40 years), with seven having pancreatic cancer and five having lung cancer. The recruitment rate was 50%, and assessment adherence was 100%, with an 84% adherence to the exercise program and no dropouts. No exercise-related adverse events were recorded, while three non-severe, non-exercise-related adverse events were observed: treatment-related dermatitis (Grade 2), axillary lymphadenopathy (Grade 2), and migraine (Grade 1). Significant enhancements in functional capacity, emotional well-being, and social functioning within the QoL domains were observed. Anthropometric measures, specifically waist-hip ratio and body mass index, remained stable. Conclusions The findings suggest that a tailored 12-week exercise intervention is both feasible and safe for patients with advanced lung or pancreatic cancer. This intervention appears to enhance functional capacity, specific aspects of QoL, and contribute to maintaining body weight.
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Affiliation(s)
- Alice Avancini
- Section of Innovation Biomedicine - Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, Italy
| | - Anita Borsati
- Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - Ilaria Trestini
- Dietetics Service, Medical Direction, University Hospital of Verona, Verona, Italy
| | - Daniela Tregnago
- Section of Innovation Biomedicine - Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, Italy
| | - Lorenzo Belluomini
- Section of Innovation Biomedicine - Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, Italy
| | - Marco Sposito
- Section of Innovation Biomedicine - Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, Italy
| | - Michele Rota
- Section of Innovation Biomedicine - Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, Italy
| | - Jessica Insolda
- Section of Innovation Biomedicine - Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, Italy
| | - Federico Schena
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Michele Milella
- Section of Innovation Biomedicine - Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, Italy
| | - Sara Pilotto
- Section of Innovation Biomedicine - Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, Italy
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Alfano MS, Garnier J, Palen A, Ewald J, Piana G, Poizat F, Mitry E, Delpero JR, Turrini O. Peak Risk of Recurrence Occurs during the First Two Years after a Pancreatectomy in Patients Receiving Neoadjuvant FOLFIRINOX. Cancers (Basel) 2023; 15:5151. [PMID: 37958326 PMCID: PMC10649429 DOI: 10.3390/cancers15215151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/07/2023] [Accepted: 10/19/2023] [Indexed: 11/15/2023] Open
Abstract
No codified/systematic surveillance program exists for borderline/locally advanced pancreatic ductal carcinoma treated with neoadjuvant FOLFIRINOX and a secondary resection. This study aimed to determine the trend of recurrence in patients who were managed using such a treatment strategy. From 2010, 101 patients received FOLFIRINOX and underwent a pancreatectomy, in a minimum follow-up of 5 years. Seventy-one patients (70%, R group) were diagnosed with recurrence after a median follow-up of 11 months postsurgery. In the multivariable analysis, patients in the R-group had a higher rate of weight loss (p = 0.018), higher carbohydrate antigen (CA 19-9) serum levels at diagnosis (p = 0.012), T3/T4 stage (p = 0.017), and positive lymph nodes (p < 0.01) compared to patients who did not experience recurrence. The risk of recurrence in patients with T1/T2 N0 R0 was the lowest (19%), and all recurrences occurred during the first two postoperative years. The peak risk of recurrence for the entire population was observed during the first two postoperative years. The probability of survival decreased until the second year and rebounded to 100% permanently, after the ninth postoperative year. Close monitoring is needed at reduced intervals during the first 2 years following a pancreatectomy and should be extended to later than 5 years for those with unfavorable pathological results.
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Affiliation(s)
- Marie-Sophie Alfano
- Department of Surgical Oncology, Institut Paoli-Calmettes, 13009 Marseille, France; (M.-S.A.)
| | - Jonathan Garnier
- Department of Surgical Oncology, Institut Paoli-Calmettes, 13009 Marseille, France; (M.-S.A.)
| | - Anaïs Palen
- Department of Surgical Oncology, Institut Paoli-Calmettes, 13009 Marseille, France; (M.-S.A.)
| | - Jacques Ewald
- Department of Surgical Oncology, Institut Paoli-Calmettes, 13009 Marseille, France; (M.-S.A.)
| | - Gilles Piana
- Department of Radiology, Institut Paoli-Calmettes, 13009 Marseille, France
| | - Flora Poizat
- Department of Pathology, Institut Paoli-Calmettes, 13009 Marseille, France
| | - Emmanuel Mitry
- Department of Oncology, Institut Paoli-Calmettes, 13009 Marseille, France
| | - Jean-Robert Delpero
- Department of Surgical Oncology, Institut Paoli-Calmettes, 13009 Marseille, France; (M.-S.A.)
- Faculté de Médecine, Aix-Marseille University, 13005 Marseille, France
| | - Olivier Turrini
- Department of Surgical Oncology, Institut Paoli-Calmettes, 13009 Marseille, France; (M.-S.A.)
- Faculté de Médecine, Aix-Marseille University, 13005 Marseille, France
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Ji Y, Chen H, Yang Y, Zhou Y, Li H, Jin H, Xie J, Shen B. Health-related quality of life and survival outcomes for patients with major depressive disorder and anxiety: A longitudinal study in pancreatic ductal adenocarcinoma. Cancer Med 2023; 12:20070-20080. [PMID: 37746894 PMCID: PMC10587956 DOI: 10.1002/cam4.6577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 09/03/2023] [Accepted: 09/12/2023] [Indexed: 09/26/2023] Open
Abstract
BACKGROUND Major depressive disorder (MDD) and anxiety were recognized in treating pancreatic ductal adenocarcinoma (PDAC). This longitudinal study identified risk factors for MDD and anxiety and established associations with patients' quality of life (QoL) and survival outcomes. MATERIALS AND METHODS We used PHQ-9 and GAD-7 questionnaires to diagnose MDD and anxiety in PDAC patients between October 2021 and March 2022 at a Chinese center. Characteristics and clinical data were analyzed for risk factors and EORTC QLQ-C30 questionnaire was administered for QoL before the first chemotherapy. Furthermore, chemotherapy compliance and 1-year survival were compared during follow-up. RESULTS MDD and anxiety occurred in 51.8% and 44.7% of 114 patients over the half-year period. Employment at work (odds ratio [OR]: 5.514, p = 0.001; OR: 3.420, p = 0.011) was an independent risk factor, while radical surgery (OR: 0.342, p = 0.034; OR: 0.238, p = 0.004) was a protective factor. Several aspects of decreased QoL were discovered after their onsets. Higher incidences of physical disorders (p = 0.004; p < 0.001), mental disorders (p = 0.001; p < 0.001), anti-therapy emotions (p = 0.002; 0.001), and chemotherapy suspensions (p = 0.001; p = 0.043) were observed. Furthermore, the 1-year mortalities for all patients and those receiving radical surgeries were correlated with MDD (p = 0.007; 0.036) and anxiety (p = 0.010; 0.031). CONCLUSIONS MDD and anxiety are common in PDAC patients and correlated with poor QoL and survivals. Therefore, appropriate mental management is required in future.
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Affiliation(s)
- Yuchen Ji
- Department of General Surgery, Pancreatic Disease Center, Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
- Institute of Translational Medicine, Shanghai Jiao Tong UniversityShanghaiChina
- Research Institute of Pancreatic DiseaseShanghai Jiao Tong University School of MedicineShanghaiChina
- State Key Laboratory of Oncogenes and Related GenesShanghaiChina
| | - Haoda Chen
- Department of General Surgery, Pancreatic Disease Center, Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
- Institute of Translational Medicine, Shanghai Jiao Tong UniversityShanghaiChina
- Research Institute of Pancreatic DiseaseShanghai Jiao Tong University School of MedicineShanghaiChina
- State Key Laboratory of Oncogenes and Related GenesShanghaiChina
| | - Yuxuan Yang
- Department of General Surgery, Pancreatic Disease Center, Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
- Institute of Translational Medicine, Shanghai Jiao Tong UniversityShanghaiChina
- Research Institute of Pancreatic DiseaseShanghai Jiao Tong University School of MedicineShanghaiChina
- State Key Laboratory of Oncogenes and Related GenesShanghaiChina
| | - Yiran Zhou
- Department of General Surgery, Pancreatic Disease Center, Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
- Institute of Translational Medicine, Shanghai Jiao Tong UniversityShanghaiChina
- Research Institute of Pancreatic DiseaseShanghai Jiao Tong University School of MedicineShanghaiChina
- State Key Laboratory of Oncogenes and Related GenesShanghaiChina
| | - Hongzhe Li
- Department of General Surgery, Pancreatic Disease Center, Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
- Institute of Translational Medicine, Shanghai Jiao Tong UniversityShanghaiChina
- Research Institute of Pancreatic DiseaseShanghai Jiao Tong University School of MedicineShanghaiChina
- State Key Laboratory of Oncogenes and Related GenesShanghaiChina
| | - Haiyan Jin
- Department of PsychiatryRuijin Hospital, Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Junjie Xie
- Department of General Surgery, Pancreatic Disease Center, Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
- Institute of Translational Medicine, Shanghai Jiao Tong UniversityShanghaiChina
- Research Institute of Pancreatic DiseaseShanghai Jiao Tong University School of MedicineShanghaiChina
- State Key Laboratory of Oncogenes and Related GenesShanghaiChina
| | - Baiyong Shen
- Department of General Surgery, Pancreatic Disease Center, Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
- Institute of Translational Medicine, Shanghai Jiao Tong UniversityShanghaiChina
- Research Institute of Pancreatic DiseaseShanghai Jiao Tong University School of MedicineShanghaiChina
- State Key Laboratory of Oncogenes and Related GenesShanghaiChina
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12
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Chen X, Wang Z, Zhou J, Lin C, Luo H, Zhao J, Loke AY, Li Q. The impact of self-perceived burden, caregiver burden, and dyadic coping on negative emotions in colorectal cancer patient-spousal caregiver dyads: a dyadic analysis. Front Psychol 2023; 14:1238924. [PMID: 37818420 PMCID: PMC10561240 DOI: 10.3389/fpsyg.2023.1238924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 09/04/2023] [Indexed: 10/12/2023] Open
Abstract
Objective To explore the correlation between dyadic coping, self-perceived burden, caregiver burden, and anxiety/depression in colorectal cancer patient-spousal caregiver dyads. Methods This study surveyed 200 colorectal cancer patient-spousal caregiver dyads from August 2022 to December 2022. It evaluated self-perceived burden (only for patients), caregiver burden (only for spousal caregivers), dyadic coping, anxiety, and depression. It analyzed data through Pearson's correlation and the actor-partner interdependence mediation model. Results Self-perceived burden and caregiver burden were significantly associated with the anxiety/depression of both individuals in colorectal cancer patient-spousal caregiver dyads; patients' dyadic coping was associated with self-perceived burden and caregiver burden; caregivers' dyadic coping was only associated with patients' dyadic coping and depression. There was an actor-partner mediating effect of self-perceived burden between dyadic coping and anxiety/depression, but there was only a partner-mediating effect of caregiver burden between dyadic coping and anxiety/depression. Conclusion This study confirmed the interrelationship between self-perceived burden, caregiver burden, dyadic coping, anxiety, and depression. Self-perceived burden and caregiver burden mediated the relationship between dyadic coping and anxiety/depression in colorectal cancer patient-spousal caregiver dyads. This suggests dynamic interventions for self-perceived burden and caregiver burden can be implemented to improve anxiety/depression in both partners based on maintaining healthy dyadic coping between colorectal cancer patient-spousal caregiver dyads.
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Affiliation(s)
- Xuan Chen
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Zhiming Wang
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Junrui Zhou
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Chunyan Lin
- Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Huamin Luo
- Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Jie Zhao
- Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Alice Yuen Loke
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China
| | - Qiuping Li
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
- Affiliated Hospital of Jiangnan University, Wuxi, China
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13
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Lowe T, DeLuca J, Abenavoli L, Boccuto L. Familial pancreatic cancer: a case study and review of the psychosocial effects of diagnoses on families. Hered Cancer Clin Pract 2023; 21:17. [PMID: 37684686 PMCID: PMC10492294 DOI: 10.1186/s13053-023-00261-5] [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: 05/09/2023] [Accepted: 08/30/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Familial pancreatic cancer touches families through a genetic susceptibility to developing this neoplasia. Genetic susceptibility is assessed via family history, genetic testing, or both. Individuals with two or more first-degree relatives or three or more relatives of any degree diagnosed with pancreatic cancer are considered at elevated risk. Following a diagnosis of familial pancreatic cancer, patients and families face uncertainty and anxiety about the future. Psychosocial effects of a pancreatic cancer diagnosis on families include fear, concerns about personal health, and how lifestyle may impact the risk of developing pancreatic cancer. CASE PRESENTATION A 66-year-old male was diagnosed with pancreatic ductal adenocarcinoma stage IIB, T3, N1, M0. A genetic referral was made due to a history of multiple cases of pancreatic cancer within the patient's family. Genetic testing revealed the patient had a pathogenic variant in the ATM gene that is associated with an increased risk for pancreatic cancer development. The patient's one adult child was offered testing due to the autosomal dominant pattern of inheritance for this variant. The adult child was found to have the same pathogenic variant. She expressed fear for her future and her child's future health and longevity. Discussing a case study allows us to capture the multi-faceted relationship between the disease, the affected individuals, and their families. Examining the psychosocial stresses and concerns when there is a pancreatic cancer diagnosis in the family is essential to provide holistic care to patients and families. CONCLUSIONS The psychosocial effects of FPC may be overwhelming for patients and families. Healthcare providers can offer education, support, and referrals to appropriate services to help families cope through stages of evaluation, diagnosis, and treatment of FPC.
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Affiliation(s)
- Tracy Lowe
- School of Nursing, Clemson University, Clemson, SC, 29634, USA.
- , Clemson, USA.
| | - Jane DeLuca
- School of Nursing, Clemson University, Clemson, SC, 29634, USA
| | - Ludovico Abenavoli
- Gastroenterology, Department of Health Sciences, University Magna Graecia, 88100, Catanzaro, Italy
| | - Luigi Boccuto
- School of Nursing, Clemson University, Clemson, SC, 29634, USA
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14
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Martin D, Alberti P, Wigmore SJ, Demartines N, Joliat GR. Pancreatic Cancer Surgery: What Matters to Patients? J Clin Med 2023; 12:4611. [PMID: 37510726 PMCID: PMC10380608 DOI: 10.3390/jcm12144611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 06/28/2023] [Accepted: 07/08/2023] [Indexed: 07/30/2023] Open
Abstract
Pancreatic cancer is a leading cause of cancer-related death, with a poor overall survival rate. Although certain risk factors have been identified, the origins of pancreatic cancer are still not fully understood. Surgical resection remains the primary curative treatment, but pancreatic surgery is still associated with high morbidity and mortality rates, and most patients will experience recurrence. The impact of pancreatic cancer on patients' quality of life is significant, with an important loss of healthy life in affected individuals. Traditional outcome parameters, such as length of hospital stay, do not fully capture what matters to patients during recovery. Patient-centered care is therefore central, and the patient's perspective should be considered in pre-operative discussions. Patient-reported outcome and experience measures (PROMs and PREMs) could play an important role in assessing patient perspectives, but standardized methodology for evaluating and reporting them is needed. This narrative review aims to provide a comprehensive overview of patient perspectives and different patient-reported measures in pancreatic cancer surgery. Understanding the patient perspective is crucial for delivering patient-centered care and improving outcomes for patients with pancreatic cancer.
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Affiliation(s)
- David Martin
- Department of Visceral Surgery, University Hospital CHUV, University of Lausanne (UNIL), 1005 Lausanne, Switzerland
- Department of Surgery, Hepatobiliary and Pancreatic Unit, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK
| | - Piero Alberti
- Department of Surgery, Hepatobiliary and Pancreatic Unit, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK
| | - Stephen J Wigmore
- Department of Surgery, Hepatobiliary and Pancreatic Unit, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK
| | - Nicolas Demartines
- Department of Visceral Surgery, University Hospital CHUV, University of Lausanne (UNIL), 1005 Lausanne, Switzerland
| | - Gaëtan-Romain Joliat
- Department of Visceral Surgery, University Hospital CHUV, University of Lausanne (UNIL), 1005 Lausanne, Switzerland
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15
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Elberg Dengsø K, Thomsen T, Christensen BM, Sørensen CL, Galanakis M, Dalton SO, Hillingsø J. Physical and psychological symptom burden in patients and caregivers during follow-up care after curative surgery for cancers in the pancreas, bile ducts or duodenum. Acta Oncol 2023; 62:782-793. [PMID: 36877198 DOI: 10.1080/0284186x.2023.2185541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 02/24/2023] [Indexed: 03/07/2023]
Abstract
BACKGROUND The primary aim was to assess Health Related Quality of Life (HRQoL), anxiety and depression in patients and caregivers during follow-up care after curative treatment for cancer in the pancreas, duodenum, or bile ducts. The secondary aim was to assess dyadic coping and the burden of being a caregiver. MATERIALS AND METHODS In this prospective observational cohort study, we included patients and caregivers at first follow-up visit to conduct the following: Demographic characteristics, The European Organization for Research and Treatment of Cancer Quality of Life, the pancreas and bile duct module, EQ5D 3L, GAD-7 and PHQ-9 at baseline, and at six and nine-months follow-up visit. Demographic characteristics, Dyadic Coping Inventory and Zarit Caregiver Burden Questionnaire were conducted at baseline and at nine-months of follow-up visit. RESULTS The response rate was 42% with 104 of the 248 invited patients completing the questionnaires at baseline: 78 (75% of 104) after six and 69 (66% of 104) after nine months. The median (Q25,75) time for inclusion was 33.6 (13.4, 38) and 29.1 (18.3, 36) weeks after surgery for patients with pancreatic or duodenal cancer, and bile duct cancer, respectively. The response rate of caregivers was 88% with 75 of 85 completing the questionnaires. Fifty percent of patients with pancreatic or duodenal cancer had diarrhea at baseline. After six and nine months, this increased to 75%. Fatigue was the most prominent symptom in patients with bile duct cancer after nine months with 25% of patients scoring this as a clinical symptom. CONCLUSIONS The study highlights the need to systematically screen physical and psychological symptoms in patients and caregivers during follow-up care after treatment for cancer in the pancreas, duodenum and bile ducts. Symptom management during follow-up care should be prioritized by clinicians.
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Affiliation(s)
- Kristine Elberg Dengsø
- Department of Surgical Gastroenterology, Rigshospitalet, Copenhagen University, Copenhagen, Denmark
| | - Thordis Thomsen
- Department of Anaesthesiology, Herlev Acute, Critical and Emergency Care Science Unit, Herlev and Gentofte Hospital, Herlev, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Bo Marcel Christensen
- Department of Surgical Gastroenterology, Rigshospitalet, Copenhagen University, Copenhagen, Denmark
| | - Carina Lund Sørensen
- Department of Surgical Gastroenterology, Rigshospitalet, Copenhagen University, Copenhagen, Denmark
| | - Michael Galanakis
- Statistics and Data Analysis, Danish Cancer Society Research Centre, Danish Cancer Society, Copenhagen, Denmark
| | - Susanne Oksbjerg Dalton
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Survivorship & Inequality in Cancer, Danish Cancer Society Research Centre, Danish Cancer Society, Copenhagen, Denmark
- Department of Clinical Oncology & Palliative Care, Zealand University Hospital, Naestved, Denmark
| | - Jens Hillingsø
- Department of Surgical Gastroenterology, Rigshospitalet, Copenhagen University, Copenhagen, Denmark
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16
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Wang Y, Bao S, Chen Y. How does social media use influence the mental health of pancreatic cancer patients: a chain mediating effect of online social support and psychological resilience. Front Public Health 2023; 11:1166776. [PMID: 37441643 PMCID: PMC10333754 DOI: 10.3389/fpubh.2023.1166776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 06/12/2023] [Indexed: 07/15/2023] Open
Abstract
Background Pancreatic cancer is an extremely malignant disease that poses a serious threat to the mental health of patients. Many cancer patients now use social media for online social support. However, the impact of social media on mental health is currently inconsistent in the academic community. Therefore, this study aimed to examine the mediating effects of online social support and psychological resilience in the relationship between social media use and mental health of pancreatic cancer patients. Methods Four hundred and twenty-five valid questionnaires were collected through convenience sampling. All data were processed using SPSS 26.0 and AMOS 26.0. We examine the influence relationships among latent variables by constructing a structural equation model. Then SPSS Process Macro was used to test the chain mediating effect of the model. Results The results showed that (1) anxiety situations occurred in 22.2% of participants (N = 94), while the incidence of depression was 20.2% (N = 86). (2) Social media use positively influenced online social support (β = 0.990, p < 0.001), psychological resilience (β = 0.504, p < 0.001), and mental health (β = 0.330, p < 0.001); online social support positively influenced psychological resilience (β = 0.535, p < 0.001) and mental health (β = 0.354, p < 0.001); psychological resilience significantly and positively influenced mental health (β = 0.243, p < 0.001). (3) The chain mediating effect of online social support and psychological resilience was significant at 0.253 with a confidence interval of [0.178, 0.340]. Conclusion Pancreatic cancer patients in China are exposed to a high burden of anxiety and depression, which requires urgent attention. Meanwhile, online social support and psychological resilience played a chain mediating role between social media use and mental health (anxiety and depression), and our results provide new insights and ways to support the mental health improvement of pancreatic cancer patients.
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Affiliation(s)
| | - Sheng Bao
- School of Journalism and Communication, Huaqiao University, Xiamen, China
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17
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Brown G, Bliss J. How pancreatic cancer impacts carers in the UK: why do we know so little? Br J Community Nurs 2023; 28:302-305. [PMID: 37261987 DOI: 10.12968/bjcn.2023.28.6.302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Pancreatic cancer is a disease with poor life expectancy and high symptom burden. The experiences of the spouses, family and friends who care for this group is poorly understood, especially during palliative care and within the UK. AIMS To highlight the current gaps within research and provide some insight into the challenges faced by carers assisting those living with pancreatic cancer, and how community nurses can support this group. METHODS A total of five research databases were searched using the terms 'pancreatic cancer', 'carer' and 'experience'. Cancer and palliative charity websites were also referenced for grey literature. FINDINGS There is limited research exploring pancreatic cancer carers experiences in the UK healthcare system and community. Available information suggests that this group is likely to face significant psychological and physical challenges to caring. CONCLUSIONS It is vital for community nurses to have an awareness of challenges this group face, to better recognise and support these vulnerable carers.
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Affiliation(s)
| | - Julie Bliss
- Reader in Nursing Education, King's College London, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care; Chair Association of District Nurse and Community Nurse Educators
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18
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Sharp L, Mentor K, Deane J, Watson E, Roberts KJ, Silva M, Phillips M, Siriwardena AK, Hammond J, Bradshaw A, Exley C, Pandanaboyana S. Assessing impact, needs and quality-of-life among informal carers of people with pancreatic cancer, a prospective study: the PAN-CARER study protocol. BMJ Open 2023; 13:e068178. [PMID: 37188466 DOI: 10.1136/bmjopen-2022-068178] [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: 05/17/2023] Open
Abstract
INTRODUCTION Approximately 10 300 people are diagnosed with pancreatic cancer each year in the UK. The cancer and its treatment inflict a significant physical, functional and emotional burden on patients. Research suggests that patients have many ongoing needs for support and care, but that these needs are not met by existing services. Family members often step in to fill this gap and provide support and care during and after treatment. Research in other cancers shows that this informal caregiving can place a very heavy burden on carers. However, there are few studies in the international literature that have focused on informal carers in pancreatic cancer; none have been conducted in the UK. METHODS AND ANALYSIS Two complementary research methods will be utilised. First, a longitudinal quantitative study of 300 carers investigating, using validated questionnaires to assess the impact of caregiving (Caregiver Reaction Assessment), the unmet needs of carers (Supportive Care Needs Survey) and the quality-of-life (Short Form 12-item health survey), will be conducted. Second, qualitative interviews will be conducted with up to 30 carers to explore their experiences in more depth. Mixed-effects regression models will be applied to survey results to determine how impact, needs and quality-of-life vary over time, compare outcomes between carers of patients with operable and inoperable disease and identify social factors which affect outcomes. Interview data will undergo reflexive thematic analysis. ETHICS AND DISSEMINATION The protocol has been approved by the Health Research Authority of the UK (Ethical approval IRAS ID 309503). Findings will be published in peer-reviewed journals and presented at national and international conferences.
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Affiliation(s)
- Linda Sharp
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Keno Mentor
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
- HPB and Transplant Unit, Freeman Hospital, Newcastle upon Tyne, UK
| | - Jennifer Deane
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Eila Watson
- Clinical Health Care, Oxford Brookes University, Oxford, UK
| | - Keith J Roberts
- Liver Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Michael Silva
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | | | | | - John Hammond
- HPB and Transplant unit, Freeman Hospital, Newcastle upon Tyne, UK
| | - Alex Bradshaw
- Sunderland Royal Hospital, Sunderland, Tyne and Wear, UK
| | - Catherine Exley
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Sanjay Pandanaboyana
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
- HPB and Transplant unit, Freeman Hospital, Newcastle upon Tyne, UK
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19
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Chang VT, Sandifer C, Zhong F. GI Symptoms in Pancreatic Cancer. Clin Colorectal Cancer 2023; 22:24-33. [PMID: 36623952 DOI: 10.1016/j.clcc.2022.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 12/21/2022] [Indexed: 12/31/2022]
Abstract
This review will apply a multidisciplinary approach to GI symptoms with attention to symptom assessment (instruments and qualitative aspects), differential diagnosis, and recent findings relevant to management of symptoms and underlying diseases. We conclude that further development of supportive interventions for GI symptoms for both patient and caregivers has the potential to reduce distress from GI symptoms, and anticipate better symptom control with advances in scientific knowledge and improvement of the evidence base.
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Affiliation(s)
- Victor T Chang
- Section Hematology Oncology (111), VA New Jersey Health Care System, East Orange, NJ; Department of Medicine, Rutgers - New Jersey Medical School, Newark, NJ.
| | | | - Fengming Zhong
- Section Hematology Oncology (111), VA New Jersey Health Care System, East Orange, NJ; Department of Medicine, Rutgers - New Jersey Medical School, Newark, NJ
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20
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Li J, Liu L, Chen M, Su W, Yao T, Li X. Effect of intimacy and dyadic coping on psychological distress in pancreatic cancer patients and spousal caregivers. Front Psychol 2023; 14:1040460. [PMID: 36818110 PMCID: PMC9932960 DOI: 10.3389/fpsyg.2023.1040460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 01/10/2023] [Indexed: 02/05/2023] Open
Abstract
Aims The aim of this study was to investigate the effect of intimacy and dyadic coping on anxiety and depression in patients with pancreatic cancer and their spousal caregivers. Methods This study conducted from October 2021 to June 2022, included 277 pancreatic cancer patients and their spousal caregivers. This research used actor-partner interdependence mediation model to explore the relationship of intimacy, dyadic coping, and psychological distress among pancreatic cancer patients and their spousal caregivers. Results The results of this study showed that there were two actor effects: the satisfaction of intimate relationship between pancreatic cancer patients and their spouse caregivers had a positive predictive effect on their dyadic coping (β = 1.787, p < 0.001) and (β = 1.587, p < 0.001). The dyadic coping of pancreatic cancer patients and their spouse caregivers had a negative predictive effect on their own anxiety and depression (β = -0.253, p < 0.001) and (β = -0.293, p < 0.001). The results of this study showed that there was a partner effect: intimate relationship satisfaction of pancreatic cancer patients had a positive predictive effect on dyadic coping of their spousal caregivers (β = 0.574, p < 0.05). Conclusion This study demonstrates the interdependence of pancreatic cancer patients and their spousal caregivers in coping with the disease. The healthy intimate relationship and effective dyadic coping styles are essential to alleviating disease pressure and lowering the psychological burden on cancer families.
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Affiliation(s)
- Jiarong Li
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Linglong Liu
- School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Mingxia Chen
- School of Nursing, Nanjing Medical University, Nanjing, China,*Correspondence: Mingxia Chen, ✉
| | - Wang Su
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Tianying Yao
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Xiaoxuan Li
- School of Nursing, Nanjing Medical University, Nanjing, China
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21
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Chong E, Crowe L, Mentor K, Pandanaboyana S, Sharp L. Systematic review of caregiver burden, unmet needs and quality-of-life among informal caregivers of patients with pancreatic cancer. Support Care Cancer 2023; 31:74. [PMID: 36544073 PMCID: PMC9771849 DOI: 10.1007/s00520-022-07468-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 11/07/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE Informal caregivers play an important supportive care role for patients with cancer. This may be especially true for pancreatic cancer which is often diagnosed late, has a poor prognosis and is associated with a significant symptom burden. We systematically reviewed the evidence on caregiver burden, unmet needs and quality-of-life of informal caregivers to patients with pancreatic cancer. METHOD PubMed, Medline, CINAHL and Embase databases were systematically searched on 31 August 2021. Qualitative and quantitative data on informal caregivers' experiences were extracted and coded into themes of burden, unmet needs or quality-of-life with narrative synthesis of the data undertaken. RESULTS Nine studies (five qualitative, four quantitative), including 6023 informal caregivers, were included in the review. We categorised data into three key themes: caregiver burden, unmet needs and quality-of-life. Data on caregiver burden was organised into a single subtheme relating to symptom management as a source of burden. Data on unmet needs was organised into three subthemes need for: better clinical communication; support and briefings for caregivers; and help with navigating the health care system. Data on quality-of-life indicate large proportions of informal caregivers experience clinical levels of anxiety (33%) or depression (12%-32%). All five qualitative studies were graded as good quality; three quantitative studies were poor quality, and one was fair quality. CONCLUSION High-quality pancreatic cancer care should consider the impacts of informal caregiving. Prospective longitudinal studies examining multiple dimensions of caregiver burden, needs, and quality-of-life would be valuable at informing supportive care cancer delivery to pancreatic cancer informal caregivers.
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Affiliation(s)
- Eric Chong
- Surgical and Translational Research Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Lisa Crowe
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle, UK
| | - Keno Mentor
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle, UK ,Department of Hepatobiliary, Pancreatic and Transplant Surgery, Freeman Hospital, Tyne and Wear, Newcastle Upon Tyne, UK
| | - Sanjay Pandanaboyana
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle, UK ,Department of Hepatobiliary, Pancreatic and Transplant Surgery, Freeman Hospital, Tyne and Wear, Newcastle Upon Tyne, UK
| | - Linda Sharp
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle, UK
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Khalid S, Abbas I, Javed S. Psychological Support for Cancer Patients. Cancer Treat Res 2023; 185:255-283. [PMID: 37306913 DOI: 10.1007/978-3-031-27156-4_13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
From the time a person is diagnosed with cancer, a psychological sequalae of intense emotional challenges emerge for the patient as well as family members. Different stages require different types of psychosocial support including those for previvors, survivors, and people who need palliative care. Currently, there is an emphasis on not only providing psychological assistance to cope with emotional, interpersonal, and economic stresses, but training programs specially designed to activate personal and social resources to find happiness and meaning in adversity. Within this perspective, the chapter is divided into three sections, each considering the common mental health issues and positive changes and intervention and therapies for cancer patients, family members, caregivers, onco-staff, and professionals.
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Affiliation(s)
- Shazia Khalid
- Department of Psychology, National University of Medical Sciences (NUMS), Rawalpindi, Pakistan.
| | - Imran Abbas
- Oncoplastic Breast Surgeon, Royal Cornwall Hospitals, NHS Trust, Cornwall, UK
| | - Saira Javed
- Department of Psychology, National University of Medical Sciences (NUMS), Rawalpindi, Pakistan
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Hue JJ, Graor HJ, Zarei M, Katayama ES, Ji K, Hajihassani O, Loftus AW, Vaziri-Gohar A, Winter JM. IDO1 Is a Therapeutic Target for Pancreatic Cancer-Associated Depression. Mol Cancer Ther 2022; 21:1810-1822. [PMID: 36190971 DOI: 10.1158/1535-7163.mct-22-0055] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 09/09/2022] [Accepted: 09/27/2022] [Indexed: 01/12/2023]
Abstract
Metabolites of tryptophan degradation are known to alter mood. Their effects have only been superficially examined in the context of pancreatic cancer. Herein, we study the role of indoleamine 2,3-dioxygenase 1 (IDO1), an enzyme important in the conversion of tryptophan to kynurenine, in a murine model of pancreatic cancer-associated depression. Behavioral tests (open field, forced swim, tail suspension, and elevated plus maze) and biochemical assays (LC-MS metabolomics) were used to characterize a depressive-phenotype in tumor-bearing mice (relative to non-tumor-bearing mice). In addition, we determine whether pharmacologic blockade of IDO1 affects mood in tumor-bearing mice. Immunocompetent mice bearing orthotopic pancreatic tumors exhibit depressive-like behavior relative to non-tumor-bearing mice. Pancreatic tumors strongly express IDO1. Consequently, serum kynurenine levels in tumor-bearing mice are elevated relative to non-tumor-bearing mice. Tumor-bearing mice treated with epacadostat, an IDO1 inhibitor, exhibited improved mood relative to mice receiving vehicle. There was a 95% reduction in serum kynurenine levels in mice receiving epacadostat relative to mice treated with vehicle. As confirmatory evidence of on-target activity, tumors of mice treated with epacadostat exhibited a compensatory increase in IDO1 protein levels. Escitalopram, an approved antidepressant, was ineffective at improving mood in tumor-bearing mice as measured by behavioral assays and did not affect kynurenine levels. Neither epacadostat, nor escitalopram, affected overall survival relative to vehicle. Mice with pancreatic cancer exhibit depressive-like behavior. Epacadostat was effective as an antidepressant for pancreatic cancer-associated depression in mice. These data offer a rationale to consider IDO1 inhibition as a therapeutic strategy to mitigate depressive symptoms in patients with pancreatic cancer.
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Affiliation(s)
- Jonathan J Hue
- Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Hallie J Graor
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio
| | - Mehrdad Zarei
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio
| | | | - Karen Ji
- Case Western Reserve University, Cleveland, Ohio
| | - Omid Hajihassani
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio
| | - Alexander W Loftus
- Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Ali Vaziri-Gohar
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio
| | - Jordan M Winter
- Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio.,Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio
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Kirk DL, Kabdebo I, Whitehead L. Prevalence of distress and its associated factors among caregivers of people diagnosed with cancer: A cross-sectional study. J Clin Nurs 2022; 31:3402-3413. [PMID: 34894019 PMCID: PMC9787485 DOI: 10.1111/jocn.16167] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 11/17/2021] [Accepted: 12/01/2021] [Indexed: 12/30/2022]
Abstract
AIMS AND OBJECTIVES To (i) determine prevalence of distress among caregivers of people living with cancer, (ii) describe caregivers' most commonly reported problems and (iii) investigate which factors were associated with caregivers' distress. BACKGROUND The psychological distress associated with a cancer diagnosis jointly impacts those living with cancer and their caregivers(s). As the provision of clinical support moves towards a dyadic model, understanding the factors associated with caregivers' distress is increasingly important. DESIGN Cross-sectional study. METHODS Distress screening data were analysed for 956 caregivers (family and friends) of cancer patients accessing the Cancer Council Western Australia information and support line between 1 January 2016 and 31 December 2018. These data included caregivers' demographics and reported problems and their level of distress. Information related to their care recipient's cancer diagnosis was also captured. Caregivers' reported problems and levels of distress were measured using the distress thermometer and accompanying problem list (PL) developed by the National Comprehensive Cancer Network. A partial-proportional logistic regression model was used to investigate which demographic factors and PL items were associated with increasing levels of caregiver distress. Pearlin's model of caregiving and stress process was used as a framework for discussion. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist was followed. RESULTS Nearly all caregivers (96.24%) recorded a clinically significant level of distress (≥4/10) and two thirds (66.74%) as severely distressed (≥7/10). Being female, self-reporting sadness, a loss of interest in usual activities, sleep problems or problems with a partner or children were all significantly associated with increased levels of distress. CONCLUSIONS Caregivers of people with cancer reporting emotional or familial problems may be at greater risk of moderate and severe distress. RELEVANCE TO CLINICAL PRACTICE Awareness and recognition of caregiver distress are vital, and referral pathways for caregivers are the important area of development.
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Affiliation(s)
- Deborah L. Kirk
- School of Nursing and MidwiferyEdith Cowan UniversityJoondalupWestern AustraliaAustralia
| | - Istvan Kabdebo
- School of Nursing and MidwiferyEdith Cowan UniversityJoondalupWestern AustraliaAustralia
| | - Lisa Whitehead
- School of Nursing and MidwiferyEdith Cowan UniversityJoondalupWestern AustraliaAustralia
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25
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Qiao T, Gao D, Tong J, Shen Y, Ma J, Lv Z, Li D. Anxiety and depression status prior to radioactive iodine therapy among differentiated thyroid cancer patients during the COVID‑19 pandemic. Support Care Cancer 2022; 30:10169-10177. [PMID: 36326909 PMCID: PMC9631608 DOI: 10.1007/s00520-022-07422-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 10/14/2022] [Indexed: 11/06/2022]
Abstract
Objection The psychological health of thyroid cancer patients cannot be ignored; however, few studies have been conducted on the psychological status and influencing factors of thyroid cancer patients before radioactive iodine (RAI) therapy. The aim of this study was to investigate the incidence and risk factors for anxiety and depression in thyroid cancer patients prior to RAI therapy. Methods Clinical data were collected from patients with differentiated thyroid cancer (DTC) patients preparing for RAI therapy. Anxiety and depression were measured before RAI therapy using the Generalized Anxiety Disorder Questionnaire (GAD-7) and Patient Health Questionnaire (PHQ-9). We used the chi-square test and logistic regression analysis to identify independent risk factors for anxiety and depression. Results A total of 112 patients with thyroid cancer were included. Of these, 72.32% (n = 81) were female, with a mean age of 41.50 years. Anxiety and depression were reported by 46 (41.08%) and 38 (33.93%) patients, respectively. Based on the chi-square test and univariate logistic regression analysis, being female and having ever-experienced RAI therapy were significant risk factors for anxiety and depression among DTCs prior to RAI therapy. On multivariable analysis, the results of model 2 which included age, sex, education level, and ever suffering radioactive iodine therapy showed that being female was markedly associated with anxiety and depression in these patients, while having ever undergone RAI therapy was significantly related to anxiety but not depression. Conclusions The incidence of anxiety and depression among patients with DTC prior to RAI therapy were 41.08% and 33.93%, respectively. Being female and having ever experienced RAI therapy significantly influenced anxiety and depression. Based on these findings, anxiety and depression assessment should be an important part of pre-RAI therapy in patients with DTC, and appropriate psychological nursing intervention can be carried out for key patients. Supplementary information The online version contains supplementary material available at 10.1007/s00520-022-07422-7.
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Affiliation(s)
- Tingting Qiao
- Department of Nuclear Medicine, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
| | - Dingwei Gao
- Department of Nuclear Medicine, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
| | - Junyu Tong
- Department of Nuclear Medicine, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yun Shen
- Department of Nuclear Medicine, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jiayue Ma
- Department of Nuclear Medicine, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
| | - Zhongwei Lv
- Department of Nuclear Medicine, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
| | - Dan Li
- Department of Nuclear Medicine, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
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26
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Khan NN, Basrai H, Evans SM, Ioannou LJ, Pilgrim CHC, Zalcberg JR, Jones GM, Hanson S. Landscape of clinical trials across the pancreatic cancer care continuum: an Australian perspective. Med J Aust 2022; 217:505-509. [PMID: 36309955 PMCID: PMC9828406 DOI: 10.5694/mja2.51756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 08/17/2022] [Accepted: 08/23/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Nadia N Khan
- Cancer Research ProgramMonash UniversityMelbourneVIC
| | | | - Sue M Evans
- Cancer Research ProgramMonash UniversityMelbourneVIC
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MicroRNAs and long non-coding RNAs in pancreatic cancer: From epigenetics to potential clinical applications. Transl Oncol 2022; 27:101579. [PMID: 36332600 PMCID: PMC9637816 DOI: 10.1016/j.tranon.2022.101579] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/05/2022] [Accepted: 10/18/2022] [Indexed: 11/08/2022] Open
Abstract
MicroRNAs (miRNAs) and long non-coding RNAs (lncRNAs) are two relevant classes of non-coding RNAs (ncRNAs) that play a pivotal role in a number of molecular processes through different epigenetic regulatory mechanisms of gene expression. As a matter of fact, the altered expression of these types of RNAs leads to the development and progression of a varied range of multifactorial human diseases. Several recent reports elucidated that miRNA and lncRNAs have been implicated in pancreatic cancer (PC). For instance, dysregulation of such ncRNAs has been found to be associated with chemoresistance, apoptosis, autophagy, cell differentiation, tumor suppression, tumor growth, cancer cell proliferation, migration, and invasion in PC. Moreover, several aberrantly expressed miRNAs and lncRNAs have the potential to be used as biomarkers for accurate PC diagnosis. Additionally, miRNAs and lncRNAs are considered as promising clinical targets for PC. Therefore, in this review, we discuss recent experimental evidence regarding the clinical implications of miRNAs and lncRNAs in the pathophysiology of PC, their future potential, as well as the challenges that have arisen in this field of study in order to drive forward the design of ncRNA-based diagnostics and therapeutics for PC.
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The Impact of Depression on Quality of Life in Caregivers of Cancer Patients: A Moderated Mediation Model of Spousal Relationship and Caring Burden. Curr Oncol 2022; 29:8093-8102. [PMID: 36354699 PMCID: PMC9688944 DOI: 10.3390/curroncol29110639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/14/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022] Open
Abstract
Family caregivers play an important role in managing and supporting cancer patients. Although depression in family caregivers is known to negatively affect caregiver health, the mechanism by which it affects caregivers is not clear. The purpose of this study was to explore the influence of depression on quality of life (QoL) in family caregivers of patients with cancer. Specifically, this study examined (1) whether caring burden mediates the relationship between depression and QoL, and (2) how this mediating effect varies depending on the caregiver's relationship with the patient. This study performed a secondary analysis on cross-sectional survey data. Ninety-three family caregivers of cancer patients were included in the study. Moderated mediation analyses were conducted using PROCESS macro with the regression bootstrapping method. The moderated mediation models and the indirect effect of caregiver depression on QoL through caring burden were significantly different depending on caregivers' relationships with patients (i.e., spousal or non-spousal). Specifically, the indirect effect of caregiver depression on QoL was greater for the patient's spouse than for other family caregivers. Healthcare providers should focus on identifying caregivers' depression and relationship with the patient and offer tailored support and intervention to mitigate the caring burden and improve the caregivers' QoL.
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29
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Xia BT, Otto AK, Allenson K, Kocab M, Fan W, Mo Q, Denbo JW, Malafa MP, Permuth JB, Kim DW, Fleming JB, Reblin M, Hodul PJ. Patient-caregiver dyads in pancreatic cancer: identification of patient and caregiver factors associated with caregiver well-being. J Behav Med 2022; 45:935-946. [DOI: 10.1007/s10865-022-00354-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 07/27/2022] [Indexed: 11/28/2022]
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Davis NE, Hue JJ, Kyasaram RK, Elshami M, Graor HJ, Zarei M, Ji K, Katayama ES, Hajihassani O, Loftus AW, Shanahan J, Vaziri-Gohar A, Rothermel LD, Winter JM. Prodromal depression and anxiety are associated with worse treatment compliance and survival among patients with pancreatic cancer. Psychooncology 2022; 31:1390-1398. [PMID: 35470512 DOI: 10.1002/pon.5945] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 04/09/2022] [Accepted: 04/11/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To determine the frequency of depression or anxiety preceding a diagnosis of pancreatic cancer (PC). Further, to examine the association of PC-associated depression or anxiety with treatment compliance and survival. METHODS 856 patients with PC from a single institution were identified using International Classification of Diseases (ICD) codes. For each case, two non-cancer age- and sex-matched controls were included. Dates of depression or anxiety diagnosis identified using ICD codes were compared to the date of PC diagnosis. The medical record was queried to further explore psychiatric symptoms. Multivariable analyses were performed to examine if prediagnosis depression or anxiety was associated with receipt of treatment or survival. RESULTS A greater proportion of patients with PC experienced depression or anxiety in the year preceding diagnosis than the overall frequency in controls (4.6% vs. 2.6%, p = 0.005) based on ICD codes. Patients with PC exhibited signs of prodromal depression or anxiety based on ICD codes, clinical documentation of psychiatric symptoms, or initiation of new psychiatric medications more often than controls (20.7% vs. 6.7%, p < 0.001). Prediagnosis depression or anxiety was associated with a reduced likelihood of receiving chemotherapy (OR = 0.58, p = 0.04). There was an associated decrease in overall survival among patients with metastatic disease who experienced depression or anxiety before PC diagnosis (HR = 1.32, p = 0.04). CONCLUSIONS The frequency of depression or anxiety among patients with PC was higher than the general population. Prediagnosis psychiatric symptoms were associated with reduced chemotherapy utilization and worse overall survival. Thus, timely identification and treatment of these symptoms may improve outcomes.
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Affiliation(s)
- Nathaniel E Davis
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Jonathan J Hue
- Department of Surgery, Division of Surgical Oncology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Ravi K Kyasaram
- Department of Surgery, Division of Surgical Oncology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Mohamedraed Elshami
- Department of Surgery, Division of Surgical Oncology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Hallie J Graor
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, USA
| | - Mehrdad Zarei
- Department of Surgery, Division of Surgical Oncology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, USA
| | - Karen Ji
- Case Western Reserve University, Cleveland, Ohio, USA
| | | | - Omid Hajihassani
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, USA
| | - Alexander W Loftus
- Department of Surgery, Division of Surgical Oncology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - John Shanahan
- Department of Surgery, Division of Surgical Oncology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Ali Vaziri-Gohar
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, USA
| | - Luke D Rothermel
- Department of Surgery, Division of Surgical Oncology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, USA
| | - Jordan M Winter
- Department of Surgery, Division of Surgical Oncology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, USA
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Mosher CE, Secinti E, Wu W, Kashy DA, Kroenke K, Bricker JB, Helft PR, Turk AA, Loehrer PJ, Sehdev A, Al-Hader AA, Champion VL, Johns SA. Acceptance and commitment therapy for patient fatigue interference and caregiver burden in advanced gastrointestinal cancer: Results of a pilot randomized trial. Palliat Med 2022; 36:1104-1117. [PMID: 35637615 PMCID: PMC9396957 DOI: 10.1177/02692163221099610] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Fatigue often interferes with functioning in patients with advanced cancer, resulting in increased family caregiver burden. Acceptance and commitment therapy, a promising intervention for cancer-related suffering, has rarely been applied to dyads coping with advanced cancer. AIM To examine the feasibility, acceptability, and preliminary efficacy of acceptance and commitment therapy for patient-caregiver dyads coping with advanced gastrointestinal cancer. Primary outcomes were patient fatigue interference and caregiver burden. DESIGN In this pilot trial, dyads were randomized to six weekly sessions of telephone-delivered acceptance and commitment therapy or education/support, an attention control. Outcomes were assessed at baseline and at 2 weeks and 3 months post-intervention. SETTING/PARTICIPANTS Forty patients with stage III-IV gastrointestinal cancer and fatigue interference and family caregivers with burden or distress were recruited from two oncology clinics and randomized. RESULTS The eligibility screening rate (54%) and retention rate (81% at 2 weeks post-intervention) demonstrated feasibility. At 2 weeks post-intervention, acceptance and commitment therapy participants reported high intervention helpfulness (mean = 4.25/5.00). Group differences in outcomes were not statistically significant. However, when examining within-group change, acceptance and commitment therapy patients showed moderate decline in fatigue interference at both follow-ups, whereas education/support patients did not show improvement at either follow-up. Acceptance and commitment therapy caregivers showed medium decline in burden at 2 weeks that was not sustained at 3 months, whereas education/support caregivers showed little change in burden. CONCLUSIONS Acceptance and commitment therapy showed strong feasibility, acceptability, and promise and warrants further testing. TRIAL REGISTRATION ClinicalTrials.gov NCT04010227. Registered 8 July 2019, https://clinicaltrials.gov/ct2/show/NCT04010227?term=catherine+mosher&draw=2&rank=1.
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Affiliation(s)
- Catherine E Mosher
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - Ekin Secinti
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - Wei Wu
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | | | - Kurt Kroenke
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Jonathan B Bricker
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, USA
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - Paul R Helft
- Indiana University School of Medicine, Indiana Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, IN, USA
| | - Anita A Turk
- Indiana University School of Medicine, Indiana Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, IN, USA
| | - Patrick J Loehrer
- Indiana University School of Medicine, Indiana Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, IN, USA
| | - Amikar Sehdev
- Indiana University School of Medicine, Indiana Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, IN, USA
| | - Ahmad A Al-Hader
- Indiana University School of Medicine, Indiana Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, IN, USA
| | | | - Shelley A Johns
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
- Regenstrief Institute Center for Health Services Research, Indianapolis, IN, USA
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João RB, Nogueira MH, Morita-Sherman ME, Alvim MKM, Johnny S, Pereira H, Pinheiro HP, Cendes F, Yasuda CL. The Relationship Between Depression and Anxiety Symptoms of Adult PWE and Caregivers in a Tertiary Center. Front Neurol 2022; 13:766009. [PMID: 35356450 PMCID: PMC8959587 DOI: 10.3389/fneur.2022.766009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 02/14/2022] [Indexed: 11/24/2022] Open
Abstract
Background Although several studies have emphasized the association between epilepsy and psychiatric disorders, fewer have investigated the impact of epilepsy on caregivers' emotional status, mainly in adult people with epilepsy (PWE). Here we investigated depressive symptoms, suicidal ideation, and anxiety symptoms in a large group of adult PWE and their caregivers. Methods We analyzed symptoms of depression [with the Beck Depression Inventory-II (BDI-II)], suicidal ideation (with BDI-II item 9), and anxiety symptoms (with the Beck Anxiety Inventory) in a large group of adult PWE [N = 548 (60% women; median age 41)] and caregivers [N = 191 (72% women; median age 47)] from a Brazilian tertiary center, considering sociodemographic and clinical aspects. We also applied the Liverpool Adverse Events Profile to assess anti-seizure drugs adverse events. Results While the presence (p = 0.026) (and intensity, p = 0.007) of depressive symptoms and suicidal ideation (p = 0.02) were higher in PWE compared to caregivers, the proportion of clinical anxiety symptoms (p = 0.32) (and the intensity, p = 0.13) was similar in both groups. Although the rates of suicidal ideation were higher in focal epilepsy (20%), both generalized genetic epilepsy and caregivers also presented elevated frequencies (11%) of suicidal ideation. The analyses of 120 patient-caregiver dyads revealed that the intensity of depressive symptoms in PWE (but not anxiety) correlated with the intensity of depressive (r = 0.35; p < 0.001) and anxiety (r = 0.25; p = 0.01) symptoms in their caregivers. In the multivariate analyses of PWE, focal epilepsy (compared to GGE) was associated with clinical depressive symptoms (odds ratio, OR 2.1) and suicidal ideation (OR 3.2), while recurrent seizures (compared to the seizure-free group) were associated with suicidal ideation (OR 2.6) and anxiety symptoms (OR 2.1). Also, caregivers with anxiety symptoms were 8 times more likely to exhibit depressive symptoms, and those with depressive symptoms were 8 times more likely to present anxiety symptoms. Conclusion Our study suggests that specific attention for the caregivers' mental health is as essential as PWE. There is an urgent need for more studies involving caregivers to identify their emotional distress and provide adequate treatment.
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Affiliation(s)
- Rafael Batista João
- Neuroimaging Laboratory, Department of Neurology, University of Campinas, Campinas, Brazil
- The Brazilian Institute of Neuroscience and Neurotechnology, University of Campinas, Campinas, Brazil
| | - Mateus Henrique Nogueira
- Neuroimaging Laboratory, Department of Neurology, University of Campinas, Campinas, Brazil
- The Brazilian Institute of Neuroscience and Neurotechnology, University of Campinas, Campinas, Brazil
| | - Márcia Elisabete Morita-Sherman
- Neuroimaging Laboratory, Department of Neurology, University of Campinas, Campinas, Brazil
- The Brazilian Institute of Neuroscience and Neurotechnology, University of Campinas, Campinas, Brazil
| | - Marina Koutsodontis Machado Alvim
- Neuroimaging Laboratory, Department of Neurology, University of Campinas, Campinas, Brazil
- The Brazilian Institute of Neuroscience and Neurotechnology, University of Campinas, Campinas, Brazil
| | - Steven Johnny
- Neuroimaging Laboratory, Department of Neurology, University of Campinas, Campinas, Brazil
- The Brazilian Institute of Neuroscience and Neurotechnology, University of Campinas, Campinas, Brazil
| | - Haryton Pereira
- Neuroimaging Laboratory, Department of Neurology, University of Campinas, Campinas, Brazil
- The Brazilian Institute of Neuroscience and Neurotechnology, University of Campinas, Campinas, Brazil
| | - Hildete Prisco Pinheiro
- Institute of Mathematics, Statistics and Scientific Computing, University of Campinas, Campinas, Brazil
| | - Fernando Cendes
- Neuroimaging Laboratory, Department of Neurology, University of Campinas, Campinas, Brazil
- The Brazilian Institute of Neuroscience and Neurotechnology, University of Campinas, Campinas, Brazil
| | - Clarissa Lin Yasuda
- Neuroimaging Laboratory, Department of Neurology, University of Campinas, Campinas, Brazil
- The Brazilian Institute of Neuroscience and Neurotechnology, University of Campinas, Campinas, Brazil
- *Correspondence: Clarissa Lin Yasuda
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Vergo MT, Klassen-Landis M, Li Z, Jiang M, Arnold RM. Getting Creative: Pilot Study of a Coached Writing Intervention in Patients with Advanced Cancer at a Rural Academic Medical Center. J Palliat Med 2022; 25:472-478. [PMID: 34941445 PMCID: PMC10771883 DOI: 10.1089/jpm.2021.0335] [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] [Accepted: 11/30/2021] [Indexed: 11/12/2022] Open
Abstract
Background: Unfacilitated writing activities, such as expressive writing, have not shown benefit in people with advanced cancer, but facilitated writing activities have yet to be fully explored. Objectives: To assess the feasibility and acceptability of facilitated writing activities determined by a writing coach in people with advanced incurable cancer. Design: This is a single-arm pilot study. Settings/Subjects: Adult patients with advanced incurable solid malignancies from a U.S. rural comprehensive cancer program met with a writing coach monthly for at least three months for facilitated writing activities. Measurements: Feasibility was assessed by enrollment and postinclusion attrition rate. Acceptability was assessed by (1) <15% drop out rate due to the intervention, (2) <15% elevated anxiety or depression due to the intervention, and (3) patient qualitative comments. Results: In total, 22 out of 63 patients consented (35%). Postinclusion attrition rate was 18% (n = 4) at three months with 82% completing at least three months of the writing coach intervention. No participants dropped out or had elevated anxiety/depression due to the intervention. The majority of patients wanted the whole intervention continued. Conclusions: A writing coach using facilitated writing activities was feasible and acceptable in patients with advanced incurable cancer, but further studies are needed to assess impact. Clinical Trial Registration Number NCT 025 75898.
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Affiliation(s)
- Maxwell T. Vergo
- Department of Medicine and Section of Palliative Medicine, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
| | - Marv Klassen-Landis
- Family Support Services, Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Zhigang Li
- Department of Biostatistics, University of Florida, Gainesville, Florida, USA
| | - Meilin Jiang
- Department of Biostatistics, University of Florida, Gainesville, Florida, USA
| | - Robert M. Arnold
- Section of Palliative Care and Medical Ethics, UPMC Health Systems, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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Caring experiences of family caregivers of patients with pancreatic cancer: an integrative literature review. Support Care Cancer 2022; 30:3691-3700. [PMID: 34993653 DOI: 10.1007/s00520-021-06793-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 12/30/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE This review summarizes and synthesizes the available empirical literature on the experiences concerned with the problems and challenges faced by caregivers of patients with pancreatic cancer. METHODS An integrative review method was used, and a literature search was conducted using five databases. We searched the terms "pancreatic cancer," "caregiver," and "experience," and used the Boolean operators OR and AND to combine them. The Joanna Briggs Institute critical appraisal tools were used to assess the quality of the included studies. RESULTS Four qualitative studies, one mixed method, and three quantitative studies met the selection criteria and were included in the review. Informal family caregivers of patients with pancreatic cancer experienced multifaceted roles, lack of information, difficulties in maintaining emotional well-being, and positive coping. The factors associated with their caring experience included the caregivers' demographics, patients' psychological status, and clinical characteristics. CONCLUSION Caregivers of patients with pancreatic cancer have various experiences while providing care. Health care providers should offer opportunities for caregivers to recognize their feelings, provide sufficient information and psychological support, and foster coping strategies to maintain the physical and psychosocial well-being of caregivers.
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Pan YC, Lin YS. Systematic Review and Meta-Analysis of Prevalence of Depression Among Caregivers of Cancer Patients. Front Psychiatry 2022; 13:817936. [PMID: 35633789 PMCID: PMC9133351 DOI: 10.3389/fpsyt.2022.817936] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 03/03/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Caregivers of cancer patients commonly experience depressive symptoms due to the heavy burden of caregiving responsibility. OBJECTIVE This meta-analysis examined the prevalence of depression among caregivers of cancer patients. METHODS We included 85 studies covering 23,317 participants published between 2001 and 2021 (25 countries) that reported the prevalence of depression among caregivers of cancer patients. We examined the pooled prevalence of depression and hypothesized moderators, including year, age, sex, geographic regions, percentage of spousal caregivers, depression measures, and cancer stage. RESULTS All 85 effect sizes included 6,077 caregivers of patients with depression. The weighted average prevalence of depression was 25.14% (95% CI, 21.42-29.27%) among caregivers. The prevalence rates were moderated by geographic region, patients' cancer stage, and measures for depression. The prevalence rates also varied among the different measures assessing depression. The prevalence rate decreased with the mean age of the caregivers and the percentage of spousal caregivers. CONCLUSIONS This study revealed a high prevalence of depression among caregivers of cancer patients. The prevalence rates also varied with the study design, demographics of caregivers, and patients' medical information. These findings highlight that psychological support and intervention may be crucial for patients and their caregivers in clinical practice.
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Affiliation(s)
- Yuan-Chien Pan
- Department of Psychology, National Taiwan University, Taipei, Taiwan
| | - Yaw-Sheng Lin
- Department of Psychology, National Taiwan University, Taipei, Taiwan
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Guo X, Lin L, Qiu X, Tian M, Zhu J. Do clinical trials affect anxiety, depression, and quality of life in the caregivers of patients with cancer? Front Psychiatry 2022; 13:950787. [PMID: 36506449 PMCID: PMC9726870 DOI: 10.3389/fpsyt.2022.950787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 10/25/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To investigate the effect of clinical trials on anxiety, depression, and the quality of life experienced by the family caregivers (FCs) of cancer patients. MATERIALS AND METHODS We screened the FCs of patients who were participating in clinical trials and FCs of patients who were not participating in clinical trials [group FCs-GCP (FG) and group FCs-non-GCP (FNG) at Cancer Center of West China Hospital]. We assessed the anxiety, depression, and quality of life of the FCs using the Hospital Anxiety and Depression Scale and SF-12. The demographic characteristics of FCs and patients were analyzed. RESULTS The prevalences of anxiety and depression showed no significant difference between FG and FNG (46.3 vs. 51.5%, P = 0.604; 36.6 vs. 51.5%, P = 0.131, respectively). Physical Component Scores (PCS) were 48.87 ± 7.67 for FG and 48.01 ± 8.12 for FNG (P = 0.618) while Mental Component Scores (MCS) were 48.92 ± 7.78 and 44.89 ± 11.42, respectively (P = 0.031). The anxiety of FCs was positively associated with patients' advanced disease (HR 4.292 [1.409, 13.072], P = 0.010) and initial treatment (HR 3.105 [1.014, 9.515], P = 0.047). Depression was positively related to advanced disease (HR 3.347 [1.140, 9.832], P = 0.028), and negatively related to patients participating in clinical trials (HR 0.421 [0.180, 0.985], P = 0.046) and the education degree of FCs (HR 0.355 [0.149, 0.843], P = 0.019). MCS was positively associated with patients participating in clinical trials (β = 5.067, 95% CI [0.817, 9.317], P = 0.020) and negatively associated with advanced disease (β = -8.055, 95% CI [-19.804, 6.528], P = 0.002). CONCLUSION The FCs of the cancer patients who participated in clinical trials showed a comparable worrying situation of anxiety and depression to the FCs of regular cancer patients. This indicates that more concern and attention should be given to this population, and further study on them is warranted.
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Affiliation(s)
- Xiaotong Guo
- Department of Thoracic Oncology, West China Hospital, West China Medical Center, Sichuan University, Chengdu, China
| | - Lede Lin
- Laboratory of Reconstructive Urology, Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaohua Qiu
- Department of Thoracic Oncology, West China Hospital, Sichuan University, Chengdu, China
| | - Meng Tian
- Law School of Sichuan University, Chengdu, China
| | - Jiang Zhu
- Department of Thoracic Oncology, West China Hospital, Sichuan University, Chengdu, China.,Department of Medical Oncology, Shangjin Nanfu Hospital, Chengdu, China
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A feasibility study of a peer discussion group intervention for patients with pancreatobiliary cancer and their caregivers. Palliat Support Care 2021; 20:527-534. [PMID: 34593073 DOI: 10.1017/s1478951521001474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES The purpose of this feasibility study was to examine the impacts of a peer discussion group intervention called "the pancreatobiliary cancer salon" on psychological distress among patients with pancreatobiliary cancer and their caregivers. METHODS We recruited patients with pancreatic or biliary tract cancer and their caregivers. We conducted a within-group pre-post comparison study. Participants were grouped by the type of cancer and treatment. Each group consisted of four to five patients or caregivers. Hospital staff members facilitated group discussions where participants freely talked for 1 h. We evaluated participants' psychological condition using the Profile of Mood States (POMS) and their impressions of the pancreatobiliary cancer salon. RESULTS We analyzed data from 42 patients and 27 caregivers who joined the salon for the first time. Thirty-five patients (83.3%) had pancreatic cancer. Thirty-one patients (71.4%) had unresectable pancreatobiliary cancer and 14 patients (33.3%) were being treated with second-line or third-line chemotherapy at the time of the survey. Twenty-two patients (52.4%) participated in the salon within 6 months after diagnosis. Most participating caregivers were the patient's spouse/partner (51.9%) or child (34.6%). Both patients and caregivers experienced high levels of satisfaction with the pancreatobiliary cancer salon. Both patients and caregivers had significantly lower psychological distress as assessed by POMS after the salon. SIGNIFICANCE OF RESULTS A peer discussion group intervention might be well-received and has potential to benefit for patients with pancreatobiliary cancer and their caregivers.
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Chen M, Gong J, Cao Q, Luo X, Li J, Li Q. A literature review of the relationship between dyadic coping and dyadic outcomes in cancer couples. Eur J Oncol Nurs 2021; 54:102035. [PMID: 34520996 DOI: 10.1016/j.ejon.2021.102035] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 09/02/2021] [Accepted: 09/04/2021] [Indexed: 11/19/2022]
Abstract
PURPOSE Couples are usually affected by cancer as patient-partner dyads, and they may react as a unit rather than as individuals, i.e., dyadic coping. This paper aims to comprehensively summarise the relationship between dyadic coping and dyadic outcomes (relationship satisfaction, quality of life, and psychological adjustment) in cancer couples, and provide valuable evidence to guide future research. METHOD A systematic search of five online databases, e.g., Cochrane Library, Embase, Medline, PubMed, and PsycINFO, was conducted to identify cancer couple-based studies published in English or Chinese from January 1990 to March 2021. A manual search was also performed on the article reference lists. RESULTS Twenty-eight studies met the inclusion criteria. We found that communication, supportive dyadic coping, delegated dyadic coping and common dyadic coping might strengthen marital bonds, alleviate couples' stress, and facilitate mental health, but on the other hand, they possibly increase patients' and/or partners' physical or psychological burden. Negative dyadic coping and protective buffering were related to lower relationship satisfaction, worse quality of life, and more depressive symptoms. Patients reported more self-emotional disclosure, common dyadic coping, and negative dyadic coping than partners, while partners showed more holding back, supportive dyadic coping, delegated dyadic coping, and protective buffering. Moreover, patients were more susceptible to dyadic coping strategies. CONCLUSIONS This review provides a comprehensive overview of the relationship between dyadic coping and dyadic outcomes. Based on the available evidence, the development of personalised interventions for improving dyadic coping is required to help couples live better with cancer.
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Affiliation(s)
- Meizhen Chen
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China.
| | - Jiali Gong
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China.
| | - Qian Cao
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China.
| | - Xingjuan Luo
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China.
| | - Jieyu Li
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China.
| | - Qiuping Li
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China.
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Palmer Kelly E, Hyer JM, Paredes AZ, Tsilimigras D, Meyer B, Newberry H, Pawlik TM. Provision of supportive spiritual care for hepatopancreatic cancer patients: an unmet need? HPB (Oxford) 2021; 23:1400-1409. [PMID: 33642211 DOI: 10.1016/j.hpb.2021.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 11/16/2020] [Accepted: 02/02/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Among patients with a serious cancer diagnosis, like hepatopancreatic (HP) cancer, spiritual distress needs to be addressed, as these psychosocial-spiritual symptoms are often more burdensome than some physical symptoms. The objective of the current study was to characterize supportive spiritual care utilization among patients with HP cancers. METHODS Patients with HP cancer were identified from the electronic medical record at a large comprehensive cancer center; data on patients with breast/prostate cancer (non-HP) were collected for comparison. Associations between patient characteristics and receipt of supportive spiritual care were evaluated within the overall sample and end-of-life subsample. RESULTS Among 8,961 individuals (nHP=1,419, nnon-HP =7,542), 51.7% of HP patients utilized supportive spiritual care versus 19.8% of non-HP patients (p<0.001). Younger age and religious identity were associated with receiving spiritual care (p<0.001). HP patients had higher odds of receiving spiritual care versus non-HP patients (OR 2.41, 95%CI: 2.10, 2.78). Within the end-of-life subsample, HP patients more frequently received spiritual care to "accept their illness" (39.5% vs. 22.5%, p<0.001), while non-HP patients needed support to "define their purpose in life" (13.1% vs. 4.5%, p=0.001). DISCUSSION Supportive spiritual care was important to a large subset of HP patients and should be integrated into their care.
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Affiliation(s)
- Elizabeth Palmer Kelly
- Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, OH, USA
| | - J Madison Hyer
- Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, OH, USA
| | - Anghela Z Paredes
- Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, OH, USA
| | - Diamantis Tsilimigras
- Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, OH, USA
| | - Bonnie Meyer
- The Ohio State University Wexner Medical Center Department of Chaplaincy and Clinical Pastoral Education, USA
| | - Hanci Newberry
- The Ohio State University Wexner Medical Center Department of Chaplaincy and Clinical Pastoral Education, USA
| | - Timothy M Pawlik
- Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, OH, USA.
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Morishita J, Inoue T. Determining desire to live among patients with advanced hepatobiliary-pancreatic cancer for whom curative treatment is not indicated. Glob Health Med 2021; 3:163-170. [PMID: 34250292 DOI: 10.35772/ghm.2021.01017] [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: 02/10/2021] [Revised: 04/06/2021] [Accepted: 04/09/2021] [Indexed: 11/08/2022]
Abstract
This study aimed to evaluate the desire to live among patients with advanced hepatobiliary-pancreatic cancer who were excluded from radical treatment and to examine the ideal nursing support for them. We recruited 18 patients in a department specializing in the treatment of hepatobiliary-pancreatic cancer at a university hospital in the metropolitan area of Japan. We included those with advanced hepatobiliary-pancreatic cancer who received a treatment other than definitive treatment. We conducted semi-structured interviews, and the responses were analyzed qualitatively and descriptively. Events experienced by patients with advanced hepatobiliary-pancreatic cancer and out of indication for radical treatment were divided into five major phases, while desire to live was divided into 11 categories. Two of these categories were represented by the word "death". The desire to live was present in all phases, and the expressions of these desires were diverse. Patients suppressed expressing their desire to live because they understood that their situation was challenging. In addition, there was a tendency to avoid expressing their desire to live to medical staff and their families. We found that nurses need to establish a medical relationship in which patients can express their desire to live and become connected to nursing support.
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Dengsø KE, Thomsen T, Andersen EW, Hansen CP, Christensen BM, Hillingsø J, Dalton SO. The psychological symptom burden in partners of pancreatic cancer patients: a population-based cohort study. Support Care Cancer 2021; 29:6689-6699. [PMID: 33963908 DOI: 10.1007/s00520-021-06251-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 04/26/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE Pancreatic cancer (PC) has high morbidity and mortality and is stressful for patients and their partners. We investigated the psychological symptom burden in partners of PC patients. METHODS We followed 5774 partners of PC patients diagnosed from 2000 to 2016 up for first redeemed prescriptions of antidepressants or hospital admission, anxiolytics, and hypnotics as proxies for clinical depression, anxiety, and insomnia and compared them with 59,099 partners of cancer-free spouses. Data were analysed using Cox regression and multistate Markov models. RESULTS The cumulative incidence proportion of first depression was higher in partners of PC patients compared to comparisons. The highest adjusted HR of first depression was seen the first year after diagnosis (HR 3.2 (95% CI: 2.9; 3.7)). Educational level, chronic morbidity, and bereavement status were associated with an increased risk of first depression. There was a significantly higher first acute use (1 prescription only) of both anxiolytics and hypnotics and chronic use (3+ prescriptions) of hypnotics in partners of PC patients than in comparisons. CONCLUSION Being a partner to a PC patient carries a substantial psychological symptom burden and increases the risk for first depression and anxiolytic use and long-term use of hypnotics. Attention should be given to the psychological symptom burden of partners of PC patients, as this may pose a barrier for the optimal informal care and support of the PC patient, as well as a risk for non-optimal management of symptoms in the partner.
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Affiliation(s)
- Kristine Elberg Dengsø
- Department of Surgery, Rigshospitalet, Copenhagen University, Copenhagen, Denmark.
- Unit of Survivorship & Inequality in Cancer, Danish Cancer Society Research Centre, Danish Cancer Society, Copenhagen, Denmark.
| | - Thordis Thomsen
- Herlev Acute, Critical and Emergency Care Science Unit, Department of Anaesthesiology, Herlev and Gentofte Hospital, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Elisabeth Wreford Andersen
- Statistics and Data Analysis, Danish Cancer Society Research Centre, Danish Cancer Society, Copenhagen, Denmark
| | | | | | - Jens Hillingsø
- Department of Surgery, Rigshospitalet, Copenhagen University, Copenhagen, Denmark
| | - Susanne Oksbjerg Dalton
- Unit of Survivorship & Inequality in Cancer, Danish Cancer Society Research Centre, Danish Cancer Society, Copenhagen, Denmark
- Department of Clinical Oncology & Palliative Care, Zealand University Hospital, Naestved, Denmark
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Mosher CE, Secinti E, Kroenke K, Helft PR, Turk AA, Loehrer PJ, Sehdev A, Al-Hader AA, Champion VL, Johns SA. Acceptance and commitment therapy for fatigue interference in advanced gastrointestinal cancer and caregiver burden: protocol of a pilot randomized controlled trial. Pilot Feasibility Stud 2021; 7:99. [PMID: 33879253 PMCID: PMC8056101 DOI: 10.1186/s40814-021-00837-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 04/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Fatigue interference with activities, mood, and cognition is one of the most prevalent and bothersome concerns of advanced gastrointestinal (GI) cancer patients. As fatigue interferes with patient functioning, family caregivers often report feeling burdened by increasing responsibilities. Evidence-based interventions jointly addressing cancer patient fatigue interference and caregiver burden are lacking. In pilot studies, acceptance and commitment therapy (ACT) has shown promise for addressing symptom-related suffering in cancer patients. The current pilot trial seeks to test a novel, dyadic ACT intervention for both advanced GI cancer patients with moderate-to-severe fatigue interference and their family caregivers with significant caregiving burden or distress. METHODS A minimum of 40 patient-caregiver dyads will be randomly assigned to either the ACT intervention or an education/support control condition. Dyads in both conditions attend six weekly 50-min telephone sessions. Outcomes are assessed at baseline as well as 2 weeks and 3 months post-intervention. We will evaluate the feasibility, acceptability, and preliminary efficacy of ACT for improving patient fatigue interference and caregiver burden. Secondary outcomes include patient sleep interference and patient and caregiver engagement in daily activities, psychological flexibility, and quality of life. We will also explore the effects of ACT on patient and caregiver physical and mental health service use. DISCUSSION Findings will inform a large-scale trial of intervention efficacy. Results will also lay the groundwork for further novel applications of ACT to symptom interference with functioning and caregiver burden in advanced cancer. TRIAL REGISTRATION ClinicalTrials.gov , NCT04010227 . Registered 8 July 2019.
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Affiliation(s)
- Catherine E. Mosher
- Department of Psychology, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, LD 124, Indianapolis, IN 46202 USA
| | - Ekin Secinti
- Department of Psychology, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, LD 124, Indianapolis, IN 46202 USA
| | - Kurt Kroenke
- Indiana University School of Medicine, Center for Health Services Research, Regenstrief Institute, 1101 W. 10th Street, Indianapolis, IN 46202 USA
| | - Paul R. Helft
- Indiana University School of Medicine, Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indiana Cancer Pavilion, 535 Barnhill Drive, Suite 473, Indianapolis, IN 46202 USA
| | - Anita A. Turk
- Indiana University School of Medicine, Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indiana Cancer Pavilion, 535 Barnhill Drive, Suite 473, Indianapolis, IN 46202 USA
| | - Patrick J. Loehrer
- Indiana University School of Medicine, Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indiana Cancer Pavilion, 535 Barnhill Drive, Suite 473, Indianapolis, IN 46202 USA
| | - Amikar Sehdev
- Indiana University School of Medicine, Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indiana Cancer Pavilion, 535 Barnhill Drive, Suite 473, Indianapolis, IN 46202 USA
| | - Ahmad A. Al-Hader
- Indiana University School of Medicine, Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indiana Cancer Pavilion, 535 Barnhill Drive, Suite 473, Indianapolis, IN 46202 USA
| | - Victoria L. Champion
- Indiana University School of Nursing, 1111 Middle Drive, NU 340G, Indianapolis, IN 46202 USA
| | - Shelley A. Johns
- Indiana University School of Medicine, Center for Health Services Research, Regenstrief Institute, 1101 W. 10th Street, Indianapolis, IN 46202 USA
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Wang Y, Yan J, Chen J, Wang C, Lin Y, Wu Y, Hu R. Comparison of the anxiety, depression and their relationship to quality of life among adult acute leukemia patients and their family caregivers: a cross-sectional study in China. Qual Life Res 2021; 30:1891-1901. [PMID: 33595826 DOI: 10.1007/s11136-021-02785-6] [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] [Accepted: 01/29/2021] [Indexed: 12/17/2022]
Abstract
PURPOSE To compare the anxiety, depression and explore their relationship to quality of life (QoL) among adult acute leukemia (AL) patients and family caregivers (FCs) in China. METHODS A multicenter cross-sectional study was conducted from April 2017 to January 2018. The sample comprised 207 dyads of adult AL patients and FCs. The participants were required to complete socio-demographic information and the Hospital Anxiety and Depression Scale (HADS). The Functional Assessment of Cancer Therapy-Leukemia (FACT-Leu, only for patients) and MOS 36-item Short-Form Health Survey (SF-36, only for FCs) were used to measure QoL. RESULTS The mean scores of anxiety and depression for AL patients were 7.89 ± 3.85 and 7.18 ± 4.23, respectively. For FCs, the mean scores of anxiety and depression were 9.96 ± 3.73 and 8.64 ± 3.74. In this study, adult AL Patients' sex, patients' depression score, whether patients achieving a CR or not, education, FCs' depression score, patients' social/family well-being and emotional well-being were significantly associated with patients' anxiety or depression (p < 0.05). For FCs, depression was significantly related to the physical component summary (β = 0.127, p = 0.008). There were significant differences in anxiety (t = - 5.92, p < 0.001) and depression (t = - 4.19, p < 0.001) between patients and FCs. CONCLUSIONS AL patients' FCs showed higher score of anxiety and depression than that of patients. The psychological health may have a potential relationship between AL patients and their FCs. Healthcare professionals can conduct family-center interventions to improve mental health and QoL of AL patients and FCs.
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Affiliation(s)
- Ying Wang
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Jie Yan
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - JingYi Chen
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - ChunFeng Wang
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - YingChun Lin
- Department of Hematology, The First Affiliated Hospital of Fujian University, NO.1 Xueyuan Road, Shangjie Town, Minhou County, Fuzhou City, 350122, Fujian Province, China
| | - Yong Wu
- Department of Hematology, Fujian Medical University Union Hospital, Fujian Institute of Hematology, 29 Xinquan Road, Fuzhou, 350001, China.
| | - Rong Hu
- The School of Nursing, Fujian Medical University, Fuzhou, China.
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Avancini A, Trestini I, Tregnago D, Cavallo A, Bragato M, Bonaiuto C, Lanza M, Milella M, Pilotto S. Multidisciplinary lifestyle intervention to manage pancreatic cancer-related cachexia: a case report. Future Sci OA 2020; 7:FSO659. [PMID: 33437520 PMCID: PMC7787172 DOI: 10.2144/fsoa-2020-0165] [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: 09/25/2020] [Accepted: 10/27/2020] [Indexed: 01/06/2023] Open
Abstract
Pancreatic cancer remains an aggressive disease, with a poor prognosis and a high risk of incurring into cachexia. Supportive care, such as exercise, nutritional and psychological support, may be effective in reducing functional loss, psychological distress and improving nutritional status. We report the effect of 12 weeks of multimodal lifestyle intervention in a 55-year-old female, diagnosed with unresectable body/tail pancreatic cancer and metastasis in the liver, bone, lymph node and lung, to counteract cachexia. The multimodal program resulted safe and feasible. Over 12 weeks, considerable improvements were found in body weight, health-related physical fitness, nutritional status, distress scores, anxiety and depression levels. These findings highlight the potential role of integrated supportive interventions to manage metastatic cancer and cancer-induced cachexia.
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Affiliation(s)
- Alice Avancini
- Department of Medicine, Biomedical, Clinical & Experimental Sciences, University of Verona Hospital Trust, Verona 37134, Italy
| | - Ilaria Trestini
- Department of Medicine, Medical Oncology, University of Verona Hospital Trust, Verona 37134, Italy
| | - Daniela Tregnago
- Department of Medicine, Medical Oncology, University of Verona Hospital Trust, Verona 37134, Italy
| | - Alessandro Cavallo
- Department of Neurosciences, Biomedicine & Movement Sciences, University of Verona, Verona 37134, Italy
| | - Marco Bragato
- Department of Neurosciences, Biomedicine & Movement Sciences, University of Verona, Verona 37134, Italy
| | - Clelia Bonaiuto
- Department of Medicine, Medical Oncology, University of Verona Hospital Trust, Verona 37134, Italy
| | - Massimo Lanza
- Department of Neurosciences, Biomedicine & Movement Sciences, University of Verona, Verona 37134, Italy
| | - Michele Milella
- Department of Medicine, Medical Oncology, University of Verona Hospital Trust, Verona 37134, Italy
| | - Sara Pilotto
- Department of Medicine, Medical Oncology, University of Verona Hospital Trust, Verona 37134, Italy
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The experiences of family caregivers who participated in a family involvement program after cancer surgery: A qualitative study. Eur J Oncol Nurs 2020; 49:101835. [PMID: 33120217 DOI: 10.1016/j.ejon.2020.101835] [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: 05/26/2020] [Revised: 09/09/2020] [Accepted: 09/14/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE As recovery time after oncological surgery can be long, family caregivers often play an important role in the delivery of care after patients' discharge. To prepare carers for this role, we developed a family involvement program (FIP) to enhance their active involvement in post-surgical oncology care during hospitalization. The purpose of this qualitative study was to explore family caregivers experience of participating in a FIP. METHODS We conducted semi-structured interviews with 12 family caregivers who participated in the family involvement program. The program is comprised of two main components (1) training and coaching of physicians and nurses; (2) active involvement of family caregivers in fundamental care activities. This active involvement included six activities. Data were analyzed using interpretative phenomenological analysis. RESULTS Family caregivers positively valued the program. Active participation in post-surgical care was experienced as an acceptable burden. The program gave participants the ability to simply be present ('being there') which was considered as essential and improved their understanding of care, although family caregivers sometimes experienced emotional moments. Active involvement strengthened existent relationship between the family caregiver and the patient. Participants thought clinical supervision. by nurses is important. CONCLUSIONS Physical proximity appeared as an essential part of the family involvement program. It helped carers to feel they made a meaningful contribution to their loved ones' wellbeing. Asking families to participate in fundamental care activities in post-surgical oncology care was acceptable, and not over-demanding for caregivers.
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Streck BP, Wardell DW, LoBiondo-Wood G, Beauchamp JES. Interdependence of physical and psychological morbidity among patients with cancer and family caregivers: Review of the literature. Psychooncology 2020; 29:974-989. [PMID: 32227401 DOI: 10.1002/pon.5382] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 03/01/2020] [Accepted: 03/13/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Caregivers for patients with cancer have an integral role in maintaining patients' health. Although patients and caregivers experience the impact of cancer individually, studies suggest their health is interdependent. The objective of this review was to synthesize the literature on interdependent physical and psychological morbidity in patient-caregiver dyads published since 2016. METHODS A search of PubMed, CINAHL, Embase, and PsycInfo databases was performed using Cooper's recommendations and the Preferred Reporting Items for Systematic Reviews And Meta-Analyses Guidelines. Studies were included if they measured individual physical or psychological morbidity in cancer patient-caregiver dyads, evaluated interdependence, and were published in a peer-reviewed journal. RESULTS Twenty-three studies met criteria, characterized by mainly spousal dyads. Studies included a variety of cancers and methodologies. Findings were inconsistent, indicating varying interdependence. However, the studies demonstrated a stronger relationship between patients' and caregivers' psychological morbidity than between their physical morbidity. CONCLUSIONS This review revealed a need for continued exploration of dyadic health interdependence. Future studies should consider samples of patients with a single type of cancer, testing cultural mediators/moderators, and using longitudinal designs.
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Dengsø KE, Andersen EW, Thomsen T, Hansen CP, Christensen BM, Hillingsø J, Dalton SO. Increased psychological symptom burden in patients with pancreatic cancer: A population-based cohort study. Pancreatology 2020; 20:511-521. [PMID: 31973981 DOI: 10.1016/j.pan.2020.01.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 01/02/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND/OBJECTIVE To investigate the psychological symptom burden in patients with pancreatic cancer. METHODS We used Danish population-based registries to identify 10,793 pancreatic cancer patients and 109,238 age and gender matched cancer-free comparison persons between the years 2000-2016. The cohorts were followed up to five years for first prescription for antidepressants, anxiolytics or hypnotics as proxies for the psychological symptom burden of depression, anxiety or insomnia. Cumulated incidence proportions were analysed using the pseudo-value approach and hazards were estimated with Cox regression models adjusted for potential confounders. RESULTS The highest HR for first antidepressant use was seen in the first six months after diagnosis (HR 8.73 (95% CI: 7.57; 10.06)). Within the first two years the overall estimated cumulated probability of 12.9% (95% CI: 12%; 13.8%) in pancreatic cancer patients, and 4.6% (95% CI: 4.5%; 4.8%) in comparisons, and 20.4% and 31.4% patients received first prescription of anxiolytics or hypnotics, respectively. We found no difference in HRs of first antidepressant by gender, year of diagnosis, cohabitation, education or comorbidity in the patient cohort, however younger age (<59 years) was associated with depression. CONCLUSIONS Pancreatic cancer patients are at risk for first antidepressant, anxiolytic and hypnotic use up to five years after diagnosis. Patients younger than 59 years, newly diagnosed with advanced pancreatic cancer, and not treated with surgery were more likely to have first antidepressant use. The study calls for interventions to reduce the psychological burden in advanced pancreatic cancer patients which may improve quality of life and survival.
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Affiliation(s)
| | - Elisabeth Wreford Andersen
- Statistics and Data Analysis, Danish Cancer Society Research Centre, Danish Cancer Society, Copenhagen, Denmark
| | - Thordis Thomsen
- Herlev Acute, Critical and Emergency Care Science Unit, Department of Anaesthesiology, Herlev and Gentofte Hospital, Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Carsten Palnæs Hansen
- Department of Surgery, Rigshospitalet, Inge Lehmanns Vej 7, 2100, Copenhagen, Denmark
| | - Bo Marcel Christensen
- Department of Surgery, Rigshospitalet, Inge Lehmanns Vej 7, 2100, Copenhagen, Denmark
| | - Jens Hillingsø
- Department of Surgery, Rigshospitalet, Inge Lehmanns Vej 7, 2100, Copenhagen, Denmark
| | - Susanne Oksbjerg Dalton
- Unit of Survivorship, Danish Cancer Society & Department of Clinical Oncology & Palliative Care, Zealand University Hospital, Naestved, Denmark
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Beesley VL, Turner J, Chan RJ, Yates P, Gordon LG, Burge M, Eastgate MA, Staneva AA, Northfield S, Beebe H, Wyld DK, Neale RE. Supporting patients and carers affected by pancreatic cancer: A feasibility study of a counselling intervention. Eur J Oncol Nurs 2020; 46:101729. [PMID: 32339910 DOI: 10.1016/j.ejon.2020.101729] [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: 10/17/2019] [Revised: 02/04/2020] [Accepted: 02/05/2020] [Indexed: 11/17/2022]
Abstract
PURPOSE Patients with pancreatic cancer have extremely high unmet psychological and physical needs. Family carers of these patients have even higher levels of distress than patients. Our purpose was to assess the feasibility and acceptability of a counselling intervention in patients diagnosed with pancreatic cancer and their carers. METHODS We conducted a single-arm feasibility study of the PREPARES (Patients and RElatives affected by PAncreatic cancer: Referral, Education and Support) pilot intervention. Patient and carer participants received up to nine counselling sessions delivered by a trained nurse via telephone and/or telehealth technology. The intervention, informed by self-efficacy theory, involved components to assess and address care needs, and provide feedback to clinicians. Feasibility was measured using participation and retention rates. Participants completed semi-structured interviews at the end of the intervention about acceptability. These were analysed using thematic analysis. RESULTS Twelve people participated: five patients and seven carers (38% and 50% participation rates respectively). Most participants (eight) completed all nine counselling sessions; two chose to receive fewer sessions and two were discontinued requiring more intensive psychiatric support. The intervention was highly acceptable. Participants unanimously preferred the telephone over video-conferencing and to receive counselling separately from their carer/patient. The main perceived benefits were emotional support, the nurse-counsellors' knowledge, care coordination and personalised care. Suggested improvements included a welcome pack about their nurse-counsellor and that sessions should continue beyond nine sessions if required. CONCLUSIONS The PREPARES intervention was feasible and highly acceptable. This low-cost intervention provided much-needed support to people affected by this devastating disease.
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Affiliation(s)
- Vanessa L Beesley
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia; School of Nursing and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.
| | - Jane Turner
- Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Raymond J Chan
- School of Nursing and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia; Division of Cancer Services, Princess Alexandra Hospital, Metro South Hospital and Health Services, Brisbane, Australia
| | - Patsy Yates
- School of Nursing and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia; Cancer Care Services, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Services, Brisbane, Australia
| | - Louisa G Gordon
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia; School of Nursing and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia; Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Matthew Burge
- Faculty of Medicine, University of Queensland, Brisbane, Australia; Cancer Care Services, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Services, Brisbane, Australia
| | - Melissa A Eastgate
- Faculty of Medicine, University of Queensland, Brisbane, Australia; Cancer Care Services, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Services, Brisbane, Australia
| | - Aleksandra A Staneva
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Sarah Northfield
- Cancer Care Services, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Services, Brisbane, Australia
| | - Hanna Beebe
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - David K Wyld
- School of Nursing and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia; Faculty of Medicine, University of Queensland, Brisbane, Australia; Cancer Care Services, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Services, Brisbane, Australia
| | - Rachel E Neale
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia; Faculty of Medicine, University of Queensland, Brisbane, Australia
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Mowforth OD, Davies BM, Kotter MR. Quality of Life Among Informal Caregivers of Patients With Degenerative Cervical Myelopathy: Cross-Sectional Questionnaire Study. Interact J Med Res 2019; 8:e12381. [PMID: 31697240 PMCID: PMC6914271 DOI: 10.2196/12381] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 06/13/2019] [Accepted: 07/19/2019] [Indexed: 12/12/2022] Open
Abstract
Background Degenerative cervical myelopathy (DCM) is a common, chronic neurological condition that severely affects individuals by causing a range of disabling symptoms, frequently at a time around the peak of their careers. Subsequently, individuals with DCM often become dependent on informal care arrangements. The significant economic contribution of informal care and its burden on care providers are becoming increasingly recognized. Objective This study aimed to measure the quality of life of DCM informal caregivers and provide preliminary insight into possible contributing factors. Methods Carers of individuals with DCM completed a Web-based survey hosted by Myelopathy.org, an international DCM charity. Carer quality of life was assessed in the form of caregiver happiness and 7 dimensions of carer burden using the Care-Related Quality of Life (CarerQol) instrument. The relationships between patient disease severity, patient pain, and carer quality of life were investigated. Differences in carer quality of life were assessed across patient and carer demographic groups, including between UK and US carers. Results DCM caregivers experienced substantial burden as a result of their caregiving (mean CarerQol-7D=64.1; 95% CI 58.8-69.5) and low happiness (mean CarerQol-VAS [Visual Analog Scale]=6.3; 95% CI 5.7-6.9). Burden was high and happiness was low in DCM carers when compared with a large, mixed-disease study of adult informal carers where CarerQol-7D was 79.1 and CarerQol-VAS was 7.1. No significant relationship was found between DCM carer quality of life and patient disease severity and pain scores. DCM carer quality of life appeared uniform across all patient and carer demographic groups. Conclusions Caring for individuals with DCM is associated with reduced quality of life in the form of significant burden and reduced happiness. Reductions appear greater in DCM than in other diseases investigated. However, no simple relationship was identified between individual patient or carer factors and carer quality of life.
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Affiliation(s)
- Oliver Daniel Mowforth
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - Benjamin Marshall Davies
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - Mark Reinhard Kotter
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
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Watson EK, Brett J, Hay H, Witwicki C, Perris A, Poots AJ, Sizmur S, Soonawalla Z, Tallett A. Experiences and supportive care needs of UK patients with pancreatic cancer: a cross-sectional questionnaire survey. BMJ Open 2019; 9:e032681. [PMID: 31690609 PMCID: PMC6858107 DOI: 10.1136/bmjopen-2019-032681] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES Patients diagnosed with pancreatic cancer have the poorest survival prognosis of any cancer. This survey aimed to describe their experiences of care and supportive care needs to inform future service provision. DESIGN Cross-sectional questionnaire survey of patients with pancreatic cancer in the UK. SETTING Individuals at any stage along the care pathway were recruited via five National Health Service sites in the UK, and online, from January to June 2018. PARTICIPANTS 274 individuals completed the questionnaire (78% (215) were completed online). Approximately half of participants were diagnosed within the last year (133/274). Of 212 providing gender details, 82 were male and 130 were female. Ninety per cent (192/213) described themselves as White British. PRIMARY OUTCOME MEASURES Experiences of communication and information; involvement in treatment decisions; supportive care needs. RESULTS Communication with, and care received from, clinical staff were generally reported positively. However, 29% (75/260) of respondents did not receive enough information at diagnosis, and 10% (25/253) felt they were not involved in decisions about their treatment, but would have liked to be. Supportive care needs were greatest in psychological and physical/daily living domains. 49% (108/221) of respondents reported one or more moderate/high unmet needs within the last month, of which the most commonly reported were: dealing with uncertainty about the future; fears about the cancer spreading; not being able to do things they used to; concerns about those close to them; lack of energy; anxiety; feelings of sadness and feeling down/depressed. Experiences were poorer, and unmet supportive care needs greater, in patients with unresectable disease. CONCLUSIONS Patients with pancreatic cancer have unmet information and support needs across the cancer trajectory. Psychological and physical support appears to be the biggest gap in care. Needs should be assessed and supportive care interventions implemented from the point of diagnosis, and monitored regularly to help patients live as good a quality of life as possible.
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Affiliation(s)
- Eila K Watson
- Oxford Institute of Nursing, Midwifery and Allied Health Research, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Jo Brett
- Oxford Institute of Nursing, Midwifery and Allied Health Research, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
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