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Brown S, Hind D, Strong E, Bradburn M, Din FVN, Lee E, Lee MJ, Lund J, Moffatt C, Morton J, Senapati A, Shackley P, Vaughan-Shaw P, Wysocki AP, Callaghan T, Jones H, Wickramasekera N. Treatment options for patients with pilonidal sinus disease: PITSTOP, a mixed-methods evaluation. Health Technol Assess 2024; 28:1-113. [PMID: 39045854 PMCID: PMC11284621 DOI: 10.3310/kfdq2017] [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] [Indexed: 07/25/2024] Open
Abstract
Background There is no consensus on optimal management of pilonidal disease. Surgical practice is varied, and existing literature is mainly single-centre cohort studies of varied disease severity, interventions and outcome assessments. Objectives A prospective cohort study to determine: • disease severity and intervention relationship • most valued outcomes and treatment preference by patients • recommendations for policy and future research. Design Observational cohort study with nested mixed-methods case study. Discrete choice experiment. Clinician survey. Three-stage Delphi survey for patients and clinicians. Inter-rater reliability of classification system. Setting Thirty-one National Health Service trusts. Participants Patients aged > 16 years referred for elective surgical treatment of pilonidal disease. Interventions Surgery. Main outcome measures Pain postoperative days 1 and 7, time to healing and return to normal activities, complications, recurrence. Outcomes compared between major and minor procedures using regression modelling, propensity score-based approaches and augmented inverse probability weighting to account for measured potential confounding features. Results Clinician survey: There was significant heterogeneity in surgeon practice preference. Limited training opportunities may impede efforts to improve practice. Cohort study: Over half of patients (60%; N = 667) had a major procedure. For these procedures, pain was greater on day 1 and day 7 (mean difference day 1 pain 1.58 points, 95% confidence interval 1.14 to 2.01 points, n = 536; mean difference day 7 pain 1.53 points, 95% confidence interval 1.12 to 1.95 points, n = 512). There were higher complication rates (adjusted risk difference 17.5%, 95% confidence interval 9.1 to 25.9%, n = 579), lower recurrence (adjusted risk difference -10.1%, 95% confidence interval -18.1 to -2.1%, n = 575), and longer time to healing (>34 days estimated difference) and time to return to normal activities (difference 25.9 days, 95% confidence interval 18.4 to 33.4 days). Mixed-methods analysis: Patient decision-making was influenced by prior experience of disease and anticipated recovery time. The burden involved in wound care and the gap between expected and actual time for recovery were the principal reasons given for decision regret. Discrete choice experiment: The strongest predictors of patient treatment choice were risk of infection/persistence (attribute importance 70%), and shorter recovery time (attribute importance 30%). Patients were willing to trade off these attributes. Those aged over 30 years had a higher risk tolerance (22.35-34.67%) for treatment failure if they could experience rapid recovery. There was no strong evidence that younger patients were willing to accept higher risk of treatment failure in exchange for a faster recovery. Patients were uniform in rejecting excision-and-leave-open because of the protracted nursing care it entailed. Wysocki classification analysis: There was acceptable inter-rater agreement (κ = 0.52, 95% confidence interval 0.42 to 0.61). Consensus exercise: Five research and practice priorities were identified. The top research priority was that a comparative trial should broadly group interventions. The top practice priority was that any interventions should be less disruptive than the disease itself. Limitations Incomplete recruitment and follow-up data were an issue, particularly given the multiple interventions. Assumptions were made regarding risk adjustment. Conclusions and future work Results suggest the burden of pilonidal surgery is greater than reported previously. This can be mitigated with better selection of intervention according to disease type and patient desired goals. Results indicate a framework for future higher-quality trials that stratify disease and utilise broad groupings of common interventions with development of a patient-centred core outcome set. Trial registration This trial is registered as ISRCTN95551898. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 17/17/02) and is published in full in Health Technology Assessment; Vol. 28, No. 33. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
- Steven Brown
- Department of General Surgery, Northern General Hospital, Sheffield, UK
| | - Daniel Hind
- Sheffield Clinical Trials Research Unit, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Emily Strong
- Sheffield Clinical Trials Research Unit, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Mike Bradburn
- Sheffield Clinical Trials Research Unit, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Farhat Vanessa Nasim Din
- Academic Coloproctology, Institute of Genetics and Cancer, University of Edinburgh, Western General Hospital, Edinburgh, UK
| | - Ellen Lee
- Sheffield Clinical Trials Research Unit, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Matthew J Lee
- Department of Oncology and Metabolism, The Medical School, University of Sheffield, Sheffield, UK
| | - Jonathan Lund
- Derby Royal Infirmary, University Hospitals of Derby and Burton, Derby, UK
| | | | - Jonathan Morton
- Addenbrookes Hospital, Cambridge University Hospitals, Cambridge, UK
| | - Asha Senapati
- St Mark's Hospital, London, UK; Queen Alexandra Hospital, Portsmouth, UK
| | - Philip Shackley
- School of Health and Related Research, Regent Court, Sheffield, UK
| | - Peter Vaughan-Shaw
- Department of Colorectal Surgery, Western General Hospital, Edinburgh, UK
| | | | - Tia Callaghan
- Sheffield Clinical Trials Research Unit, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Helen Jones
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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Donmez E, Kilic B, Dulger Z, Ozdas T. Innovative Cancer Follow-Up with Telehealth: A New Method for Oncology Nurses. Semin Oncol Nurs 2024; 40:151649. [PMID: 38734572 DOI: 10.1016/j.soncn.2024.151649] [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: 02/19/2024] [Revised: 03/31/2024] [Accepted: 04/14/2024] [Indexed: 05/13/2024]
Abstract
OBJECTIVES Telenavigation (TN) is an innovative cancer follow-up method for oncology nurses. Little is known about the effectiveness of tele-navigation on cancer patients. This study investigated the opinions of healthcare providers (HCPs) and colorectal cancer patients' experience regarding patient follow-up with TN. DATA SOURCES This is a phenomenological qualitative study. Semistructured interviews were conducted with fifteen patients and eight healthcare providers. Participants were selected by purposive sampling. Data were collected from March to October 2022 and analyzed by thematic content analysis. CONCLUSION Six themes emerged that described the experiences of TN: (1) beneficial; (2) psychological state; (3) level of knowledge, (4) technology, (5) health care system, and (6) recommendations. Patients and HCPs found TN practice helpful and reassuring and they recommended expanding these practices within the health system. As a result of the research, the TN program is described as beneficial to patients and healthcare providers. IMPLICATIONS FOR NURSING PRACTICE The TN follow-up is a beneficial implication for colorectal cancer patients undergoing treatment, and it deserves to be more widely deployed. It brings reassurance regarding psychological, reliable data access, and home follow-up. Patients and HCPs reported positive views on telephone follow-up. There is a recommendation that the innovative follow-up technique should be disseminated to the healthcare system and that cancer nurses should be more familiar with this method.
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Affiliation(s)
- Elif Donmez
- Department of Oncology Nursing, Hamidiye Nursing Faculty, University of Health Sciences, Üsküdar, Istanbul, Turkiye.
| | - Bulent Kilic
- Department of Public Health, Medical Faculty, Dokuz Eylul University, Izmir, Turkiye
| | - Zeynep Dulger
- Department of Oncology Nursing, Hamidiye Nursing Faculty, University of Health Sciences, Üsküdar, Istanbul, Turkiye
| | - Turkan Ozdas
- Department of Oncology Nursing, Hamidiye Nursing Faculty, University of Health Sciences, Üsküdar, Istanbul, Turkiye
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Roberts C, Toohey K, Paterson C. The Experiences and Unmet Supportive Care Needs of Partners of Men Diagnosed With Prostate Cancer: A Meta-aggregation Systematic Review. Cancer Nurs 2024:00002820-990000000-00074. [PMID: 36480350 DOI: 10.1097/ncc.0000000000001172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Partners of men diagnosed with prostate cancer face their own emotional struggles as they navigate additional caregiver responsibilities while concurrently adjusting to the diagnosis and coping with greater illness uncertainty for their loved one. OBJECTIVE This qualitative systematic review examined the unmet supportive care needs of partners affected by prostate cancer. INTERVENTIONS/METHODS A meta-aggregation was conducted. Four electronic databases were searched using key words. The methodology followed the Joanna Briggs Institute for qualitative evidence synthesis. The review process followed a registered priori review protocol and was reported using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analysis) guidelines. Data extraction and quality assessment were conducted in parallel. RESULTS Twenty-one publications were included. A total of 239 findings and 32 categories were synthesized into 7 domains of unmet needs as experienced by partners. The domains of needs expressed by the participants included interpersonal/intimacy, physical/daily living, healthcare service, family-related, psychological/emotional needs, and spiritual and social needs. CONCLUSIONS There are gaps in clinical service support, despite routine clinical consultation with healthcare professionals. Partners may diminish their social networks to protect their husband at the cost to their own self-preservation and well-being. IMPLICATIONS FOR PRACTICE Cancer organizations, policy makers, healthcare care professionals, and researchers are slowly making progress to acknowledge the unique support needs of partners affected by cancer. Healthcare professionals should encourage partners to be included in models of prehabilitation to access timely support to address informational, intimacy, spiritual, and daily living needs support.
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Affiliation(s)
- Cara Roberts
- Author Affiliations: Faculty of Health (Drs Paterson and Toohey and Ms Roberts) and Prehabilitation, Activity, Cancer, Exercise, and Survivorship (PACES) Research Group (Dr Paterson, Dr Toohey and Ms Roberts), University of Canberra, Bruce; and Canberra Health Services & ACT Health, SYNERGY Nursing and Midwifery Research Centre, ACT Health Directorate Level 3, Canberra Hospital, Garran (Dr Paterson), Australian Capital Territory, Australia; and Robert Gordon University, Aberdeen, Scotland, United Kingdom (Dr Paterson)
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Mikaelsson Midlöv E, Lindberg T, Sterner T, Skär L. Support given by health professionals before and after a patient's death to relatives involved in general palliative care at home in Sweden: Findings from the Swedish Register of Palliative Care. Palliat Support Care 2023:1-8. [PMID: 37746762 DOI: 10.1017/s1478951523001323] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
OBJECTIVES General palliative care (PC) is provided more at home, leading to increased involvement of relatives. Although support for relatives is a fundamental component of PC, there are deficiencies in the support provided to relatives when general PC is provided at home. This study aimed to describe the support provided by health professionals before and after a patient's death to relatives involved in general PC at home. METHODS A cross-sectional register study was implemented, with data from the Swedish Register of Palliative care. The sample consisted of 160 completed surveys from relatives who had been involved in general PC at home, with 160 related surveys answered by health professionals. Only the questions about support to relatives were used from the surveys. RESULTS The findings showed that although many relatives appear to receive support in general PC at home, not all relatives receive optimal support before or after a patient's death. The findings also indicated differences in whether relatives received some support before and after a patient's death depending on the type of relative. There were also differences in responses between health professionals and relatives regarding if relatives received counseling from a doctor about whether the patient was dying. SIGNIFICANCE OF RESULTS There is potential for improvements regarding support for relatives, especially after a patient's death, which has been confirmed in previous studies. The differences in whether relatives received support before and after a patient's death depending on the type of relative highlight the need for future research on how to support different types of relatives before and after a patient's death when general PC is provided at home.
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Affiliation(s)
- Elina Mikaelsson Midlöv
- Faculty of Engineering, Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden
- Faculty of Health and Society, Department of Care Science, Malmö University, Malmö, Sweden
| | - Terese Lindberg
- Faculty of Engineering, Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden
| | - Therese Sterner
- Faculty of Health and Society, Department of Care Science, Malmö University, Malmö, Sweden
| | - Lisa Skär
- Faculty of Engineering, Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden
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Hashimoto H, Takahashi K, Imai Y. Nursing practice to fulfill the information needs of parents of hospitalized children with cancer and related factors. J Pediatr Nurs 2023; 72:e98-e104. [PMID: 37414625 DOI: 10.1016/j.pedn.2023.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 06/08/2023] [Accepted: 06/08/2023] [Indexed: 07/08/2023]
Abstract
PURPOSE This study aimed to clarify the current status of nursing practice to fulfill the information needs of parents of hospitalized children with cancer and to determine the associated factors. DESIGN AND METHODS A cross-sectional survey using a questionnaire was administered to nurses working on wards admitting children with cancer in Japan. Data were analyzed using logistic regression analysis, after exploratory factor analysis. RESULTS Three factors were extracted as nursing practice: "provision of information that supports the child's future and other family members' daily lives" (factor 1), "provision of information regarding care for the child in the treatment process" (factor 2), "provision of information regarding the child's disease and treatment" (factor 3). Among these three factors, factor 1 achieved the lowest score for the level of practice. Logistic regression analysis indicated that interprofessional information sharing increased the scores of factors 1 and 3 (Odds ratio: 6.150, and 4.932, respectively); assessment of parental information needs increased the scores of factors 1, 2, and 3 (Odds ratio: 3.993, 3.654, and 3.671, respectively); and participation in training increased the score of factor 2 (Odds ratio: 3.078). CONCLUSIONS Nursing practice to fulfill the parents' information needs consisted of three factors. The degree of practice varied according to the information content and was primarily influenced by assessment of parental information needs, interprofessional information sharing, and participation in training. PRACTICE IMPLICATIONS It is necessary for nurses to accurately assess parents' needs, and interprofessional sharing of information is important to fulfill the information needs of parents.
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Affiliation(s)
- Hiroko Hashimoto
- Department of Child Health and Nursing, Institute of Biomedical Sciences, Tokushima University Graduate School, Japan.
| | - Kumi Takahashi
- Department of Child Health and Nursing, Institute of Biomedical Sciences, Tokushima University Graduate School, Japan
| | - Yoshie Imai
- Department of Oncology Nursing, Institute of Biomedical Sciences, Tokushima University Graduate School, Japan
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Premanandan S, Ahmad A, Cajander Å, Ågerfalk P, van Gemert-Pijnen L. Designing and Evaluating IT Applications for Informal Caregivers: Protocol for a Scoping Review. JMIR Res Protoc 2023; 12:e47650. [PMID: 37410533 PMCID: PMC10360011 DOI: 10.2196/47650] [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: 03/28/2023] [Revised: 05/17/2023] [Accepted: 06/01/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND A growing number of informal caregivers in many countries are important for effective functioning of health care in our society. Hence, they must receive the required support and services to continue providing care. IT applications can be used to support informal caregivers in their caregiving activities. However, evidence-informed guidelines for developing such IT applications and their evaluation are scarce. Hence, this scoping review can aid researchers and designers by providing design recommendations for IT apps for caregivers and potentially improve the design of IT applications for caregivers to meet their needs better. OBJECTIVE This study aims to describe the proposal for a scoping review of current practices and recommendations in designing and evaluating IT applications for informal caregivers. The scoping review will also discuss the opportunities and challenges in designing these IT applications. METHODS We will use a 5-step scoping review methodology to map relevant literature published as follows: (1) identify the research question, (2) identify relevant studies, (3) select relevant studies for review, (4) chart the data from selected literature, and (5) summarize and report results. A structured search will be conducted in PubMed, Scopus, IEEE digital library, Web of Science, and ACM Digital Library databases. In addition, hand searches of reference lists and keyword searches in Google Scholar will also be conducted. Inclusion criteria will be researched (journal and conference) articles focused on IT applications designed for use by informal caregivers and study type to be qualitative studies. Two reviewers will independently identify articles for review and extract data. Conflicts will be discussed, and a third reviewer will be consulted if a consensus cannot be reached. These data will be analyzed using thematic analysis. RESULTS The results from this scoping review will be presented in a narrative form, and additional data on study characteristics will be presented in diagrams or tabular format. Uppsala University first initiated this scoping review protocol in December 2021 as part of the European Union-funded project ENTWINE. This work was also supported by the Swedish Research Council and the Swedish Cancer Society. The results will be presented in August 2023 and will be disseminated through a report to the European Union and a peer-reviewed journal publication. In addition, the team plans to share its findings on various public platforms, including social media, blog posts, and relevant conferences and workshops. CONCLUSIONS This is, to our knowledge, the first study to map the literature on the design and evaluation of IT applications for informal caregivers. The scoping review's results will detail the requirements, design suggestions, and user preferences, as well as the usability criteria and features of IT applications for informal caregivers. A mapping of studies could inform the design and implementation of future IT applications for informal caregivers. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/47650.
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Affiliation(s)
- Shweta Premanandan
- Department of Informatics and Media, Uppsala University, Uppsala, Sweden
| | - Awais Ahmad
- Division of Visual Information and Interaction, Department of Information Technology, Uppsala University, Uppsala, Sweden
| | - Åsa Cajander
- Division of Visual Information and Interaction, Department of Information Technology, Uppsala University, Uppsala, Sweden
| | - Pär Ågerfalk
- Department of Informatics and Media, Uppsala University, Uppsala, Sweden
| | - Lisette van Gemert-Pijnen
- Centre for eHealth and Wellbeing Research, Department of Psychology, Health & Technology, University of Twente, Enschede, Netherlands
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Ilic A, Sievers Y, Roser K, Scheinemann K, Michel G. The information needs of relatives of childhood cancer patients and survivors: A systematic review of qualitative evidence. PATIENT EDUCATION AND COUNSELING 2023; 114:107840. [PMID: 37321115 DOI: 10.1016/j.pec.2023.107840] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 05/25/2023] [Accepted: 06/05/2023] [Indexed: 06/17/2023]
Abstract
OBJECTIVES To synthesize qualitative research on the information needs of relatives of childhood cancer patients and survivors. METHODS Systematic searches of PubMed, PsycINFO, CINAHL, and Scopus identified relevant literature. Extracted data were combined using thematic synthesis. Methodological quality was assessed using the JBI critical appraisal tool for qualitative research. RESULTS The review included 27 publications, with most research focusing on parents or primary caregivers. Five areas of information needs were identified: treatment, medication, and care; general information about cancer; coping and support; follow-up, late effects, and rehabilitation; and parenting and everyday life. Appropriateness of information depended on health care professionals' aptitude, message characteristics, communication setting, and relatives' personal factors. Preferences for form, sources, and timing for information provision varied. CONCLUSION The review identified information needs, communication barriers, and preferences among caregivers and siblings of childhood cancer patients and survivors, highlighting areas requiring further research and clinical consideration in addressing the identified challenges. PRACTICE IMPLICATIONS Caregivers and siblings have unique but similar information needs regarding childhood cancer. To ensure that these needs are met, health care professionals could use eHealth and mHealth technologies, assess each family member's knowledge, and create a safe and supportive environment for questions and feedback.
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Affiliation(s)
- Anica Ilic
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland; Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA; Aflac Cancer & Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Yara Sievers
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Katharina Roser
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Katrin Scheinemann
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland; Center for Pediatric Hematology/Oncology, East Swiss Children's Hospital, St. Gallen, Switzerland; Department of Pediatrics, McMaster Children's Hospital and McMaster University, Hamilton, Canada
| | - Gisela Michel
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.
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Tan YXF, Lim STY, Lim JL, Ng TTM, Chng HT. Drug information-seeking behaviours of physicians, nurses and pharmacists: A systematic literature review. Health Info Libr J 2023; 40:125-168. [PMID: 36655603 DOI: 10.1111/hir.12472] [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: 08/06/2021] [Revised: 11/09/2022] [Accepted: 11/30/2022] [Indexed: 01/20/2023]
Abstract
BACKGROUND Medication use typically involves physicians prescribing, pharmacists reviewing, and nurses administering medications to patients. Drug information (DI) is often required during the process, with the various health care professionals (HCPs) seeking information differently according to their needs and familiarity with various resources. OBJECTIVE This systematic literature review aims to evaluate studies on drug information-seeking behaviour (ISB) of physicians, nurses and pharmacists to ascertain their DI needs, DI sources used, facilitators and barriers to DI-seeking. METHODS A systematic search was conducted on PubMed, Embase.com, Scopus, PsycINFO, CINAHL and Cochrane Library to identify eligible primary research articles published between January 2000 and May 2020. RESULTS The reviewed studies (N = 48) revealed that HCPs have a wide range of DI needs, with the top needs being similar across the three HCPs. Information sources used most often by all three groups were tertiary, followed by human and primary sources. Factors relating to the source characteristics were the most reported facilitators and barriers to DI-seeking. Some differences in drug ISB were also identified. CONCLUSION Our findings can also guide information providers and educators to optimize information provision. It may also facilitate effective communication amongst HCPs when obtaining DI from or providing DI to one another.
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Affiliation(s)
- Yu Xin Fiona Tan
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | - Suzanne Tze Yin Lim
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | - Jun Liang Lim
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | | | - Hui Ting Chng
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
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Ahmad A, Premanandan S, Langegård U, Cajander Å, Johansson B, Carlsson M, Tiblom Ehrsson Y. Positive Design Framework for Carer eSupport: Qualitative Study to Support Informal Caregivers of Patients With Head and Neck Cancer in Sweden. JMIR Cancer 2023; 9:e45748. [PMID: 37252765 DOI: 10.2196/45748] [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: 01/15/2023] [Revised: 03/13/2023] [Accepted: 04/18/2023] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND Informal caregivers of patients with head and neck cancer (HNC), such as the patient's spouse, other close relatives, or friends, can play an important role in home-based treatment and health care. Research shows that informal caregivers are usually unprepared for this responsibility and need support with taking care of patients and other daily life activities. These circumstances place them in a vulnerable position, and their well-being may be compromised. This study is part of our ongoing project Carer eSupport, which aims to develop a web-based intervention to facilitate informal caregivers in the home environment. OBJECTIVE This study aimed to explore the situation and context of informal caregivers of patients with HNC and their needs for designing and developing a web-based intervention (Carer eSupport). In addition, we proposed a novel framework for the development of a web-based intervention aimed at promoting the well-being of informal caregivers. METHODS Focus groups were conducted with 15 informal caregivers and 13 health care professionals. Both informal caregivers and health care professionals were recruited from 3 university hospitals in Sweden. We adopted a thematic data analysis process to analyze the data. RESULTS We investigated informal caregivers' needs, critical factors for adoption, and desired functionalities of Carer eSupport. A total of 4 major themes, including information, web-based forum, virtual meeting place, and chatbot, emerged and were discussed by informal caregivers and health care professionals for Carer eSupport. However, most study participants did not like the idea of a chatbot for asking questions and retrieving information and expressed their concerns such as a lack of trust in robotic technologies and missing human contact while communicating with chatbots. The results from the focus groups were discussed through the lens of positive design research approaches. CONCLUSIONS This study provided an in-depth understanding of informal caregivers' contexts and their preferred functions for a web-based intervention (Carer eSupport). Using the theoretical foundation of designing for well-being and positive design in the informal caregiving context, we proposed a positive design framework to support informal caregivers' well-being. Our proposed framework might be helpful for human-computer interaction and user experience researchers to design meaningful eHealth interventions with a clear focus on users' well-being and positive emotions, especially for informal caregivers of patients with HNC. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1136/bmjopen-2021-057442.
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Affiliation(s)
- Awais Ahmad
- Division of Visual Information and Interaction, Department of Information Technology, Uppsala University, Uppsala, Sweden
| | - Shweta Premanandan
- Department of Informatics and Media, Uppsala University, Uppsala, Sweden
| | - Ulrica Langegård
- Genetics and Patology, Experimental and Clinical Oncology, Department of Immunology, Uppsala University, Uppsala, Sweden
| | - Åsa Cajander
- Division of Visual Information and Interaction, Department of Information Technology, Uppsala University, Uppsala, Sweden
| | - Birgitta Johansson
- Genetics and Patology, Experimental and Clinical Oncology, Department of Immunology, Uppsala University, Uppsala, Sweden
| | - Maria Carlsson
- Lifestyle and Rehabilitation in Long-Term Illness, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Ylva Tiblom Ehrsson
- Otorhinolaryngology and Head and Neck Surgery, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
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Jin R, Lim HJ, Hamilton S, Ingledew PA. Viral Disease Goes Viral: Characterizing How Cancer Patients Use Internet Resources for COVID-19 Information. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023; 38:431-439. [PMID: 35022989 PMCID: PMC8755408 DOI: 10.1007/s13187-022-02136-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/07/2022] [Indexed: 05/20/2023]
Abstract
This study aims to evaluate the usage of Internet resources for COVID-19 information among cancer patients. Specifically, to understand where patients are seeking information, what topics are most frequently searched, and how physicians and web developers can improve clinical conversations and digital resources, respectively, to support cancer patients' needs. From May to June 2021, cancer patients who were attending follow-up at a tertiary cancer center completed a survey consisting of 28 closed and open-ended questions. Quantitative results were evaluated using descriptive statistics and qualitative responses were evaluated using a grounded-theory approach. Fifty-seven surveys were distributed, and fifty-two surveys were received (91% response rate). The majority of respondents (96%) were Internet users. Seventy percent used the Internet as a source of information about COVID-19 and cancer personally, with another 15% reporting that friends and family accessed online information on their behalf. The vast majority used Google as their choice of search engine, with COVID-19 rates and vaccine information being the most frequently searched topics. Three quarters (74%) considered Internet information easy to understand, and 90% stated that the Internet increased their understanding of COVID-19 and cancer. Only 15% of patients had been recommended online resource(s) by a physician, yet 100% of those patients found the physician-recommended sites useful. Most cancer patients use the Internet to search for COVID-19 information. Healthcare professionals (HCPs) should help guide patients towards credible online sources and address knowledge gaps to improve physician-patient communication and support educational needs.
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Affiliation(s)
- Ruijia Jin
- Faculty of Medicine, MD Undergraduate Program, University of British Columbia, 317-2194 Health Sciences Mall, Vancouver, V6T 1Z3, Canada
| | - Howard J Lim
- Medical Oncology, Vancouver Centre, BC Cancer Agency, 600 West 10th Avenue, Vancouver, V5Z 4E6, Canada
- Division of Medicine, Faculty of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, V5Z 1M9, Canada
| | - Sarah Hamilton
- Radiation Oncology, Vancouver Centre, BC Cancer Agency, 600 West 10th Avenue, Vancouver, V5Z 4E6, Canada
- Division of Surgery, Faculty of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, V5Z 1M9, Canada
| | - Paris-Ann Ingledew
- Radiation Oncology, Vancouver Centre, BC Cancer Agency, 600 West 10th Avenue, Vancouver, V5Z 4E6, Canada.
- Division of Surgery, Faculty of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, V5Z 1M9, Canada.
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Wolyniec K, O'Callaghan C, Fisher K, Jessica S, Tothill RW, Bowtell D, Linda M, Schofield P, Wolyniec K, O'Callaghan C, Fisher K, Sharp J, Tothill R, Bowtell D, Mileshkin L, Schofield P. A qualitative study of patients with Cancer of Unknown Primary: Perceptions of communication, understanding of diagnosis and genomic testing, and information needs. Psychooncology 2023; 32:589-596. [PMID: 36690922 DOI: 10.1002/pon.6104] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/10/2023] [Accepted: 01/16/2023] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Patients with Cancer of Unknown Primary (CUP) commonly report poor understanding of their illness and high levels of psychological distress. Despite the potential benefits to CUP patients, there is a paucity of research exploring the reasons behind poor understanding of a CUP diagnosis. The aim of this study was to understand patients' experiences of communication with doctors, their understanding of diagnosis and the role of genomic testing, as well as their information needs. METHODS Semi-structured interviews explored CUP patients' perceptions of communication with their doctors, understanding of their illness, and their needs regarding medical information. Qualitative inductive thematic analysis of transcribed audio-recordings was employed. SETTING/PARTICIPANTS Nineteen patients were recruited from within a prospective cohort study involving routine genomic testing of CUP patients. RESULTS CUP patients had varied perceptions of communication with doctors as well as different levels of need, readiness, and capacity for information. Some patients felt well understood and supported by their doctors while others did not. Many patients reported feeling overwhelmed and shocked when receiving their cancer diagnosis and emphasized the importance of family support in receiving and understanding medical information. While patients understood the implications of genomic testing for treatment and diagnosis, few had a detailed understanding of genomic testing. CONCLUSIONS Patients' experience of communication and understanding of CUP could be potentially improved by clinicians' assessment of the communication style preferred by each patient and their family and the development of online resources to meet their evolving information needs.
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Affiliation(s)
- Kamil Wolyniec
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Clare O'Callaghan
- Caritas Christi and Psychosocial Cancer Care, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.,Department of Medicine, St Vincent's Hospital, The University of Melbourne, Fitzroy, Victoria, Australia
| | - Krista Fisher
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Sharp Jessica
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Richard W Tothill
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia.,Department of Clinical Pathology and University of Melbourne Centre for Cancer Research, Melbourne, Victoria, Australia
| | - David Bowtell
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
| | - Mileshkin Linda
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
| | - Penelope Schofield
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
| | - Kamil Wolyniec
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Clare O'Callaghan
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Krista Fisher
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Jessica Sharp
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Richard Tothill
- St Vincent's Hospital Melbourne, Caritas Christi and Psychosocial Cancer Care, Victoria, Australia
| | - David Bowtell
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Linda Mileshkin
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Penelope Schofield
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
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12
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Gasteiger C, Perera A, Yielder R, Scholz U, Dalbeth N, Petrie KJ. Using family-centered communication to optimize patient-provider-companion encounters about changing to biosimilars: A randomized controlled trial. PATIENT EDUCATION AND COUNSELING 2023; 106:142-150. [PMID: 36400636 DOI: 10.1016/j.pec.2022.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 10/27/2022] [Accepted: 11/07/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To explore whether family-centered communication impacts decisions and optimizes patient-companion-provider consultations. METHODS A parallel, two-arm randomized controlled trial was conducted with 108 participants acting as patients with inflammatory arthritis or companions. Pairs attended a mock consultation where a physician explained the change from a bio-originator to a biosimilar using family-centered or patient-only communication. Participants reported their willingness to transition, risk perceptions, understanding and social support, and completed various scales including the Patient Perception Scale. Interviews helped understand perceptions towards the consultation. RESULTS Family-centered communication did not impact willingness to change or cognitive risk perceptions compared to patient-only communication. However, it improved emotional risk perceptions (p = 0.047, Cohen's d=.55) and satisfaction with communication (p = 0.015, Cohen's d=.71). Feeling the explanation was reassuring was associated with less worry (p = 0.004). Receiving emotional support (p = 0.014) and companions asking fewer questions (p = 0.046) were associated with higher recall. The intervention improved companion involvement (p < 0.001, Cohen's d= 1.23) and support (p = 0.002, Cohen's d=.86). Interviews showed that encouraging questions, inclusive body language, and acknowledging companions facilitated involvement. CONCLUSION Family-centered communication augments patient-companion-provider encounters but does not influence willingness to change treatment. PRACTICE IMPLICATIONS Practitioners can use family-centered communication when discussing biosimilars but should provide reassurance, encourage emotional support, and summarize key points to improve understanding.
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Affiliation(s)
- Chiara Gasteiger
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
| | - Anna Perera
- School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Rachael Yielder
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Urte Scholz
- University Research Priority Program "Dynamics of Healthy Aging," University of Zurich, Zurich, Switzerland; Department of Psychology - Applied Social and Health Psychology, University of Zurich, Zurich, Switzerland
| | - Nicola Dalbeth
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; Department of Rheumatology, Auckland District Health Board, Auckland, New Zealand
| | - Keith J Petrie
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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13
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The significance of home-based portable pump chemotherapy for family caregivers to newly diagnosed patients with acute myeloid leukemia: A qualitative thematic analysis. Eur J Oncol Nurs 2022; 61:102200. [DOI: 10.1016/j.ejon.2022.102200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 08/17/2022] [Accepted: 09/14/2022] [Indexed: 11/30/2022]
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14
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Lim CAR, Ingledew PA, Yang F, Thiessen B, Cashman R, Lalani N, Kipfer S. Analysis of Internet-Based Search Patterns Utilized by Glioma Patients as Information Source. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:1349-1356. [PMID: 33496934 DOI: 10.1007/s13187-021-01960-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/07/2021] [Indexed: 06/12/2023]
Abstract
The aim of this study is to assess the Internet usage pattern amongst glioma patients and to characterize its impact in their decision-making and clinical interactions. Glioma patients attending a tertiary cancer center between June and December 2019 were invited to participate in this study. A 26-item survey consisting of closed and open-ended questions was distributed with a unique identifier. Quantitative data were analyzed with descriptive statistics using SPSS Statistical package, and qualitative data with grounded theory approach. Thirty-two patients completed the survey. Demographics varied in age, time since diagnosis, glioma type, and level of education. Eighty-one percent were identified as "Internet users" who sought online glioma information. Google was the most popular search engine (96%), with "glioma" being the most frequent search term. The selection of websites often relied on perceived credibility and top search hits. The most searched topic was prognosis (73%). The majority of patients found that online information was easy to understand, and this did not vary significantly amongst age groups. Website quality was always assessed by 60% of patients. Only 62% patients found the Internet a useful resource, and 70% patients found it facilitated their understanding. Most patients discussed their Internet findings with a physician, largely regarding concerns about reliability. There is variable glioma information available online. Patients with glioma use the Internet as a resource, with variable impact on their interactions and decision-making. This information can be used by physicians, educators, and website developers to support glioma patients' needs.
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Affiliation(s)
- Chloe Ah-Ryung Lim
- MD Undergraduate Program, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
| | - Paris-Ann Ingledew
- Radiation Oncology, BC Cancer Agency, Vancouver Centre, Vancouver, BC, Canada
- Faculty of Medicine, Department of Surgery, University of British Columbia, Vancouver, BC, Canada
| | - Fan Yang
- Radiation Oncology, University of Alberta, Edmonton, AB, Canada
| | - Brian Thiessen
- Medical Oncology, BC Cancer Agency, Vancouver Centre, Vancouver, BC, Canada
| | - Rosemary Cashman
- Medical Oncology, BC Cancer Agency, Vancouver Centre, Vancouver, BC, Canada
| | - Nafisha Lalani
- Radiation Oncology, BC Cancer Agency, Vancouver Centre, Vancouver, BC, Canada
- Faculty of Medicine, Department of Surgery, University of British Columbia, Vancouver, BC, Canada
| | - Sharon Kipfer
- MD Undergraduate Program, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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15
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Bruun A, Oostendorp L, Bloch S, White N, Mitchinson L, Sisk AR, Stone P. Prognostic decision-making about imminent death within multidisciplinary teams: a scoping review. BMJ Open 2022; 12:e057194. [PMID: 35383077 PMCID: PMC8984043 DOI: 10.1136/bmjopen-2021-057194] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To summarise evidence on how multidisciplinary team (MDTs) make decisions about identification of imminently dying patients. DESIGN Scoping review. SETTING Any clinical setting providing care for imminently dying patients, excluding studies conducted solely in acute care settings. DATA SOURCES The databases AMED, CINAHL, Embase, MEDLINE, PsychINFO and Web of Science were searched from inception to May 2021.Included studies presented original study data written in English and reported on the process or content of MDT discussions about identifying imminently dying adult patients. RESULTS 40 studies were included in the review. Studies were primarily conducted using interviews and qualitative analysis of themes.MDT members involved in decision-making were usually doctors and nurses. Some decisions focused on professionals recognising that patients were dying, other decisions focused on initiating specific end-of-life care pathways or clarifying care goals. Most decisions provided evidence for a partial collaborative approach, with information-sharing being more common than joint decision-making. Issues with decision-making included disagreement between staff members and the fact that doctors were often regarded as final or sole decision-makers. CONCLUSIONS Prognostic decision-making was often not the main focus of included studies. Based on review findings, research explicitly focusing on MDT prognostication by analysing team discussions is needed. The role of allied and other types of healthcare professionals in prognostication needs further investigation as well. A focus on specialist palliative care settings is also necessary.
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Affiliation(s)
- Andrea Bruun
- Marie Curie Palliative Care Research Department, Division of Psychiatry, UCL, London, UK
| | - Linda Oostendorp
- Marie Curie Palliative Care Research Department, Division of Psychiatry, UCL, London, UK
| | - Steven Bloch
- Department of Language and Cognition, Division of Psychology and Language Sciences, UCL, London, UK
| | - Nicola White
- Marie Curie Palliative Care Research Department, Division of Psychiatry, UCL, London, UK
| | - Lucy Mitchinson
- Marie Curie Palliative Care Research Department, Division of Psychiatry, UCL, London, UK
| | - Ali-Rose Sisk
- Marie Curie Palliative Care Research Department, Division of Psychiatry, UCL, London, UK
| | - Patrick Stone
- Marie Curie Palliative Care Research Department, Division of Psychiatry, UCL, London, UK
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16
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Zhang Y, Yi S, Trace CB, Williams-Brown MY. Understanding the Information Needs of Patients With Ovarian Cancer Regarding Genetic Testing to Inform Intervention Design: Interview Study. JMIR Cancer 2022; 8:e31263. [PMID: 35133282 PMCID: PMC8864522 DOI: 10.2196/31263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 09/30/2021] [Accepted: 11/22/2021] [Indexed: 11/13/2022] Open
Abstract
Background Experts in gynecological cancer care recommend that all patients with invasive or high-grade ovarian cancer (OC) undergo genetic testing. However, even patients who intend to take or have taken genetic tests have many unaddressed information needs regarding genetic testing. Existing genetic counseling falls short of adequately addressing this challenge. Objective This study aims to investigate the genetic testing–related information needs of patients with OC to inform the design of interactive technology-based interventions that can enhance communication of genetic testing information to patients. Methods We interviewed 20 patients with OC who had taken genetic tests and gathered genetic testing–related messages from an active OC web-based community. The interview transcripts and web-based community messages were analyzed using the qualitative content analysis method. Results Data analyses produced a comprehensive taxonomy of the genetic testing–related information needs of patients with OC, which included five major topic clusters: knowledge of genetic testing as a medical test, genetic testing process, genetic testing implications for patients, implications for family members, and medical terminology. Findings indicated that patients wanted to receive information that was relevant, understandable, concise, usable, appropriate, sympathetic, and available when needed. They also preferred various channels to receive information, including internet-based technologies, print, and conversations with health care providers. Conclusions Patients with OC need a range of information to address the uncertainties and challenges that they encounter while taking genetic tests. Their preferences for channels to receive information vary widely. A multichannel information delivery solution that combines both provider-led and peer-to-peer education models is needed to supplement existing genetic counseling to effectively meet the genetic testing–related information needs of patients with OC.
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Affiliation(s)
- Yan Zhang
- School of Information, The University of Texas at Austin, Austin, TX, United States
- Center for Health Communication, Moody College of Communication and Dell Medical School, The University of Texas at Austin, Austin, TX, United States
| | - Siqi Yi
- School of Information, The University of Texas at Austin, Austin, TX, United States
| | - Ciaran B Trace
- School of Information, The University of Texas at Austin, Austin, TX, United States
- Center for Health Communication, Moody College of Communication and Dell Medical School, The University of Texas at Austin, Austin, TX, United States
| | - Marian Yvette Williams-Brown
- Department of Women's Health, Dell Medical School, The University of Texas at Austin, Austin, TX, United States
- Department of Oncology, Dell Medical School, The University of Texas at Austin, Austin, TX, United States
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17
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Ginossar T, Diaz Fuentes C, Oetzel J. Understanding Willingness to Participate in Cancer Clinical Trials Among Patients and Caregivers Attending a Minority-Serving Academic Cancer Center. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:179-187. [PMID: 32666504 PMCID: PMC10685662 DOI: 10.1007/s13187-020-01802-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Advances in cancer treatment are impeded by low accrual rates of patients to cancer clinical trials (CCTs). The national rates of recruitment of underserved groups, including racial/ethnic minorities, are limiting the generalizability of research findings and are likely to enhance inequities in cancer outcomes. The goal of this study was to examine willingness to participate (WTP) in CCTs and factors associated with this willingness among patients and caregivers attending a minority-serving university cancer center in the Southwest. A cross-sectional survey design was utilized (n = 236, 135 patients and 101 caregivers). Fear was the strongest predictor of WTP in CCTs. The only ethnic differences observed related to Spanish-speaking patients exhibiting increased WTP in CCTs, and Spanish-speaking caregivers' decreased WTP, compared to others. These results underscore the importance of future interventions to reduce CCT-related fear among patients and caregivers, with particular need for family-focused tailored interventions designed to meet the needs of Spanish-speaking patients and caregivers.
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Affiliation(s)
- Tamar Ginossar
- Department of Communication and Journalism, University of New Mexico, Albuquerque, NM, 87103, USA.
| | | | - John Oetzel
- Waikato Management School, University of Waikato, Hamilton, 3240, New Zealand
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18
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The Needs of Parents of Children Suffering from Cancer—Continuation of Research. CHILDREN 2022; 9:children9020144. [PMID: 35204865 PMCID: PMC8870376 DOI: 10.3390/children9020144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/17/2022] [Accepted: 01/19/2022] [Indexed: 02/02/2023]
Abstract
Background: Parents experience many healthcare needs when caring for their sick children. Research shows that parents of oncological children have a high level of unmet needs, including psychosocial, emotional, physical, informational, financial, educational, and spiritual needs. To date, little quantitative research has been carried out on the specific needs of parents of children with cancer, which creates uncertainty about what areas should be addressed in care. This study investigated the prevalence of unmet needs among parents of children with cancer. Methods: A population survey was conducted between 2015 and 2020. Caregivers of children diagnosed with cancer were invited to participate in the study to assess their problems and needs. Results: The analysis found that 97% of the participants experienced some level of need for one or more items, and 73% of the respondents reported a moderate or high need for one or more items. In the field of medical information, 70% of respondents had moderate or high needs, 55% of parents reported a moderate or high level of need for help in the psychological or emotional field, and 30% in the financial domain. The prevalence of moderate or high need in the remaining domains ranged from 10% to 15%. Conclusions: Parents of children with cancer experience a high level of needs, especially psychological, emotional, and information. These data suggest that the existing healthcare system does not meet the needs of parents of sick children. The results show the need to investigate the mechanisms by which healthcare providers can use the healthcare system to identify and meet needs.
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19
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Tavabie S, Hargreaves A, Tookman A, Stone P. Clinician estimates of prognosis: accuracy and impact-a retrospective inpatient hospice study. BMJ Support Palliat Care 2021:bmjspcare-2021-003326. [PMID: 34872951 DOI: 10.1136/bmjspcare-2021-003326] [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: 08/15/2021] [Accepted: 10/21/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To evaluate the accuracy and impact of clinicians' estimates of prognosis (CEP) in patients referred for hospice inpatient care. METHODS Retrospective review of 12 months' referrals to a London hospice unit. Data extracted included date of referral, admission and death and CEP. RESULTS N=383. Mean age 72 years (range 24-101). CEP accuracy: Median survival where CEP was 'days' (n=141) was 7 days (0-164); CEP 'weeks' (n=167) was 14 days (1-538); CEP 'months' (n=75) was 32 days (2-507). Kaplan-Meier survival curves showed significant difference between CEP of 'months' and 'weeks' (p<0.0001); 'months' and 'days' (p<0.0001); but not 'days' and 'weeks' (p=0.1). CEP impact: admission waiting time increased with increasing CEP: CEP 'days' (n=105) median 1 day (0-14); CEP 'weeks' (n=154) median 2 days (0-46); CEP 'months' (n=69) median 3 days (0-46). No significant difference was demonstrated in the number of discharge planning conversations between groups (0.9/patient). CONCLUSIONS CEP was accurate in over half of the cases but did not adequately discriminate between those with prognoses of days or weeks. CEP may affect the prioritisation given to patients by hospices. Inaccurate CEP on referral forms may influence other aspects of care; however, further research is needed.
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Affiliation(s)
- Simon Tavabie
- Palliative Medicine, Barts Health NHS Trust, London, UK
| | - Anya Hargreaves
- General internal medicine, West Hertfordshire NHS Trust, London, UK
| | | | - Patrick Stone
- Marie Curie Palliative Care Research Department, University College London, London, UK
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20
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Hiatt J, Young A, Brown T, Banks M, Bauer J. Exploring dyadic management of nutrition care throughout and beyond head and neck cancer treatment. J Clin Nurs 2021; 31:2774-2783. [PMID: 34693575 DOI: 10.1111/jocn.16096] [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: 09/01/2021] [Revised: 10/10/2021] [Accepted: 10/12/2021] [Indexed: 11/26/2022]
Abstract
AIMS AND OBJECTIVES To identify how patients and carers collaborate to manage nutrition care throughout and beyond head and neck cancer (HNC) treatment as a step towards identifying changes to service delivery that are inclusive of the needs of the patient-carer dyad. BACKGROUND Research in the field of dyadic interventions in cancer care is emerging, and there has been little work exploring patient-carer dyad needs in the provision of nutrition care in HNC. DESIGN A qualitative study design was used. METHODS Narrative interviews were completed with 13 patients and 15 carers over a 12-month period (prior to treatment commencing, and 2 weeks, 3 months and 12 months post-treatment completion). Deductive analysis of interview transcripts was performed using directed content analysis guided by the Theory of Dyadic Illness Management (TDIM). COREQ guidelines were used. RESULTS Seven themes across four TDIM constructs were identified: (1) understanding and adapting to physical challenges impacting nutrition intake, (2) adjusting to emotional impact of changes to eating and drinking, (3) providing practical support, (4) intrapersonal characteristics, (5) interpersonal characteristics, (6) healthcare culture and (7) managing carer burnout. CONCLUSION This study highlights the importance of healthcare professionals recognising the patient and carer dyad as a team to enhance engagement in nutrition care and to ensure that their physical and psychological support needs across the cancer continuum are met. RELEVANCE TO CLINICAL PRACTICE It is important that healthcare professionals understand information and support needs and preferences within patient-carer dyads prior to HNC treatment commencing and adapt care and interventions based on their changing needs throughout and beyond the treatment period.
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Affiliation(s)
- Joanne Hiatt
- School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, Qld, Australia
- Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Herston, Qld, Australia
| | - Adrienne Young
- School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, Qld, Australia
- Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Herston, Qld, Australia
| | - Teresa Brown
- School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, Qld, Australia
- Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Herston, Qld, Australia
| | - Merrilyn Banks
- School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, Qld, Australia
- Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Herston, Qld, Australia
| | - Judith Bauer
- School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, Qld, Australia
- Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Herston, Qld, Australia
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21
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Stone P, White N, Oostendorp LJM, Llewellyn H, Vickerstaff V. Comparing the performance of the palliative prognostic (PaP) score with clinical predictions of survival: A systematic review. Eur J Cancer 2021; 158:27-35. [PMID: 34649086 DOI: 10.1016/j.ejca.2021.08.049] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 08/31/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND In patients with advanced cancer, prognosis is usually determined using clinicians' predictions of survival (CPS). The palliative prognostic (PaP) score is a prognostic algorithm that was developed to predict survival in patients with advanced cancer. The score categorises patients into three risk groups in accordance with their probability of surviving for 30 days. The relative accuracy of PaP and CPS is unclear. DESIGN This was a systematic review of MEDLINE, Embase, AMED, CINAHL Plus and the Cochrane Database of Systematic Reviews and Trials from inception up to June 2021. The inclusion criteria were studies in adults with advanced cancer reporting data on performance of both PaP and CPS. Data were extracted on accuracy of prognoses and where available on discrimination (area under the receiver operating characteristic curve or C-index) and/or diagnostic performance (sensitivity, specificity). RESULTS Eleven studies were included. One study reported a direct comparison between PaP risk groups and equivalent risk groups defined by CPS and found that PaP was as accurate as CPS. Five studies reported discrimination of PaP as a continuous total score (rather than using the previously validated risk categories) and reported C-statistics that ranged from 0.64 (95% confidence interval [CI] 0.54, 0.74) up to 0.90 (95% CI 0.87, 0.92). Other studies compared PaP against CPS using non-equivalent metrics (e.g. comparing probability estimates against length of survival estimates). CONCLUSIONS PaP risk categories and CPS are equally able to discriminate between patients with different survival probabilities. Total PaP scores show good discrimination between patients in accordance with their length of survival. The role of PaP in clinical practice still needs to be defined. TRIAL REGISTRATION PROSPERO (CRD42021241074, 5th March 2021).
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Affiliation(s)
- Patrick Stone
- Marie Curie Palliative Care Research Department, Division of Psychiatry, UCL, London, UK.
| | - Nicola White
- Marie Curie Palliative Care Research Department, Division of Psychiatry, UCL, London, UK
| | - Linda J M Oostendorp
- Marie Curie Palliative Care Research Department, Division of Psychiatry, UCL, London, UK
| | - Henry Llewellyn
- Marie Curie Palliative Care Research Department, Division of Psychiatry, UCL, London, UK
| | - Victoria Vickerstaff
- Marie Curie Palliative Care Research Department, Division of Psychiatry, UCL, London, UK; Primary Care and Population Health, Institute of Epidemiology and Health Care, University College London (UCL), London, UK
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22
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Gasteiger C, Groom KM, Lobo M, Scholz U, Dalbeth N, Petrie KJ. Is Three a Crowd? The Influence of Companions on a Patient's Decision to Transition to a Biosimilar. Ann Behav Med 2021; 56:512-522. [PMID: 34453530 DOI: 10.1093/abm/kaab082] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Involving patients in treatment decisions is commonplace in healthcare, and patients are frequently accompanied by a companion (support person). Companions are often actively involved in medical consultations, yet their impact on decisions to change medications is unknown. PURPOSE This study examines the influence of companions on a patient's decision to transition from their bio-originator therapy to a biosimilar. METHODS A parallel, two-arm randomized controlled trial was conducted with 79 patients taking a bio-originator for rheumatic diseases who regularly attend clinic with a companion. Patients were randomized to receive an explanation about a hypothetical transition to a biosimilar alone or with their companion. Patients reported willingness to transition, risk perceptions, difficulty understanding, social support, and completed the Decisional Conflict Scale and Satisfaction with Decision Scale. RESULTS Companions did not influence decisions to transition to biosimilars or cognitive and affective risk perceptions. Accompanied patients reported more difficulty understanding the explanation (p = .006, Cohen's d = .64) but thought it was more important to receive information with companions (p = .023, Cohen's d = -.52). Companions did not impact decision satisfaction or decisional conflict. Receiving emotional, but not practical support, was associated with less decisional conflict in accompanied patients (p = .038, r 2 = 0.20). CONCLUSIONS The presence of companions does not seem to influence risk perceptions or decisions about transitioning to biosimilars. Companions, however, impact the patient's reporting of their ability to understand treatment explanations. Providers should check understanding in all patients but may need to provide additional time or educational resources to accompanied patients and companions. TRIAL REGISTRATION Australian New Zealand Clinical Trial Registry: ACTRN12619001435178.
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Affiliation(s)
- Chiara Gasteiger
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Katie M Groom
- Liggins Institute, University of Auckland, Auckland, New Zealand.,National Women's Health, Auckland District Health Board, Auckland, New Zealand
| | - Maria Lobo
- Department of Rheumatology, Auckland District Health Board, Auckland, New Zealand
| | - Urte Scholz
- University Research Priority Program "Dynamics of Healthy Aging," University of Zurich, Zurich, Switzerland.,Department of Psychology - Applied Social and Health Psychology, University of Zurich, Zurich, Switzerland
| | - Nicola Dalbeth
- Department of Rheumatology, Auckland District Health Board, Auckland, New Zealand.,Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Keith J Petrie
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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23
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Wang T, Molassiotis A, Chung BPM, Zheng SL, Huang HQ, Tan JYB. A qualitative exploration of the unmet information needs of Chinese advanced cancer patients and their informal caregivers. BMC Palliat Care 2021; 20:83. [PMID: 34098905 PMCID: PMC8186148 DOI: 10.1186/s12904-021-00774-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 05/11/2021] [Indexed: 12/23/2022] Open
Abstract
Background Studies in the West have demonstrated that appropriate informational support is a vital component of cancer care, with positive effects on both patients and their informal caregivers. Since little is known about the information needs of advanced cancer patients and informal caregivers in China, where ‘silence as virtue’ is much more valued and the communication style is less open, this study was therefore conducted to elaborate the information needs of advanced cancer patients and informal caregivers as well as to explore their perceptions and experiences regarding their unmet information needs in the Chinese context. Methods This sub-study of a previous cross-sectional survey utilized a qualitative descriptive study design. The approach involved semi-structured interviews that followed an interview guide to collect data. Eligible participants were the advanced cancer patients and informal caregivers who had participated in the previous cross-sectional survey and reported unmet information needs. Each interview was audio-recorded and transcribed verbatim. Descriptive content analysis was used to analyze the data. Results Seventeen advanced cancer patients and 15 informal caregivers with unmet information needs participated in the semi-structured interviews, with ages ranging from 32 to 63 years old for patients and from 32 to 70 for informal caregivers. Four categories were extracted from the interviews with the patients and caregivers: (1) types of unmet information needs; (2) reasons for information needs not being met; (3) preferences for the provision of information; and (4) meaning and role of information. Each category had two to four sub-categories for both the patients and the caregivers, which were similar but not completely the same. Conclusion The findings indicated that the provision of appropriate information could promote informed decision-making and greater satisfaction with treatment options, reductions in psychological disturbances, and enhanced confidence and ability in self-management and capacity in caregiving. Moreover, information on Traditional Chinese Medicine and food therapy should be increased, particularly for patients at the follow-up stage, while the amount of information on prognosis should be flexible as it could increase patients’ and caregivers’ psychological burden. Healthcare professionals were the most preferred information provider, although their heavy workload resulted in time constraints. In this case, they should provide information to patients and caregivers together as a ‘whole unit.’ At the same time, the value of separate conversations should also be recognized as some caregivers preferred to conceal unpleasant information from the patient.
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Affiliation(s)
- Tao Wang
- College of Nursing and Midwifery Brisbane Centre, Charles Darwin University, Brisbane, Australia.,School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, Hong Kong
| | - Alex Molassiotis
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, Hong Kong
| | - Betty Pui Man Chung
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, Hong Kong
| | - Si-Lin Zheng
- Department of Nursing, The Affiliated Hospital of Southwest Medical University, Luzhou, People's Republic of China.
| | - Hou-Qiang Huang
- Department of Nursing, The Affiliated Hospital of Southwest Medical University, Luzhou, People's Republic of China
| | - Jing-Yu Benjamin Tan
- College of Nursing and Midwifery Brisbane Centre, Charles Darwin University, Brisbane, Australia
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24
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Strong E, Callaghan T, Beal E, Moffatt C, Wickramasekera N, Brown S, Lee MJ, Winton C, Hind D. Patient decision-making and regret in pilonidal sinus surgery: a mixed-methods study. Colorectal Dis 2021; 23:1487-1498. [PMID: 33645880 DOI: 10.1111/codi.15606] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/05/2021] [Accepted: 02/09/2021] [Indexed: 12/11/2022]
Abstract
AIM Little is known about optimal management strategies for pilonidal sinus disease (PSD). We conducted a mixed-methods study to understand why patients make, and sometimes regret, treatment decisions. METHOD We conducted longitudinal semi-structured interviews at the time of surgery and 6 months later with 20 patients from 13 UK hospitals. Framework analysis was performed, and themes were mapped to (1) the coping in deliberation framework and (2) an acceptability framework. Results were triangulated with those from structured survey instruments evaluating shared decision-making (SDM, best = 9) at baseline and decision regret (DR, most regret = 100) at 6 months. RESULTS Nine of 20 patients were not offered a choice of treatment, but this was not necessarily seen as negative (SDM median 4; range 2-4). Factors that influenced decision-making included previous experience and anticipated recovery time. Median (range) DR was 5 (0-50). Those with the highest DR (scores 40-50) were, paradoxically, also amongst the highest scores on SDM (scores 4). Burden of wound care and the disparity between anticipated and actual recovery time were the main reasons for decision regret. CONCLUSION To minimize regret about surgical decisions, people with PSD need better information about the burden of wound care and the risks of recurrence associated with different surgical approaches.
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Affiliation(s)
- Emily Strong
- Clinical Trials Research Unit, University of Sheffield, Sheffield, UK
| | - Tia Callaghan
- Clinical Trials Research Unit, University of Sheffield, Sheffield, UK
| | - Erin Beal
- University of Liverpool, Liverpool, UK
| | - Christine Moffatt
- School of Social Sciences, Nottingham Trent University, Nottingham, UK
| | | | - Steven Brown
- Clinical Trials Research Unit, University of Sheffield, Sheffield, UK.,Department of General Surgery, Northern General Hospital, Sheffield, South Yorkshire, UK
| | - Matthew J Lee
- Department of General Surgery, Northern General Hospital, Sheffield, South Yorkshire, UK.,Department of Oncology and Metabolism, The Medical School, University of Sheffield, Sheffield, South Yorkshire, UK
| | - Catherine Winton
- Clinical Trials Research Unit, University of Sheffield, Sheffield, UK
| | - Daniel Hind
- Clinical Trials Research Unit, University of Sheffield, Sheffield, UK
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25
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Fringer A, Stängle S, Bischofberger I, Büche D, Praxmarer R, Ch Ott S, Schnepp W. Experiences of relatives with outpatient palliative care: a cross-sectional study. Int J Palliat Nurs 2021; 26:230-237. [PMID: 32584687 DOI: 10.12968/ijpn.2020.26.5.230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
AIM The authors aimed to evaluate the experiences of the relatives of dying people, both in regard to benefits and special needs, when supported by a mobile palliative care bridging service (MPCBS), which exists to enable dying people to stay at home and to support patients' relatives. DESIGN A cross-sectional survey. METHODS A standardised survey was performed, asking 106 relatives of dying people about their experiences with the MPCBS (response rate=47.3%). Descriptive statistics were analysed using SPSS 23. FINDINGS Many relatives (62.5%) reported that their dying relations when discharged from a facility to stay at home were not symptom-free. The MPCBS helped relatives maintain home care, and this was reported to be helpful. Support provided by the MPCBS made it easier for 77.6% of relatives to adjust care as soon as situations changed, and helped ensure that symptoms could be better controlled, at least for 68.2% of relatives. Younger relatives felt more encouraged by the MPCBS to care for their relatives dying at home.
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Affiliation(s)
- André Fringer
- Professor for Family-Centered Care; Co-Head MSc Nursing and Co-Head Research Unit Nursing, ZHAW Zurich University of Applied Sciences, School of Health Professions, Institute of Nursing, Winterthur, Switzerland and Witten/Herdecke University, Faculty of Health, Department of Nursing Science, Witten, Germany
| | - Sabrina Stängle
- Research Associate, ZHAW Zurich University of Applied Sciences, School of Health Professions, Institute of Nursing, Winterthur, Switzerland and Witten/Herdecke University, Faculty of Health, Department of Nursing Science, Witten, Germany
| | - Iren Bischofberger
- Professor for Applied Research and Clinical Excellence in Nursing, Kalaidos University of Applied Sciences, Department of Health Science, Zurich, Switzerland
| | - Daniel Büche
- Head Physician Palliative Care Centre, Cantonal Hospital St.Gallen, St. Gallen, Switzerland
| | - Renate Praxmarer
- Co-Head of Palliative Bridge Service, Cancer League of Eastern Switzerland, Bern, Switzerland
| | - Stefan Ch Ott
- Professor of Economics, FHS St.Gallen University of Applied Sciences, Department of Economics, St.Gallen, Switzerland
| | - Wilfried Schnepp
- Head of the Department for Family-Oriented and Community Care, Witten/Herdecke University, Faculty of Health, Department of Nursing Science, Witten, Germany
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Abstract
Stoma surgery is an intrusive operation, with outcomes that can impact seriously on daily life, not just in the immediate postoperative and recovery period, but for the rest of the patient's life. There are changes in bodily function, altered body image, physicality and personal care needs. These changes require acceptance and adaptation and can necessitate a re-ordering of daily life, socially, emotionally and in terms of work. Assessing the patient's needs through the trajectory of diagnosis, surgery and a stoma, is not just important during the treatment phase but needs to continue throughout the lifespan. Traditionally, patient outcome measures after bowel surgery have included overall self-efficacy, checking for stoma complications, clinical health status, function and psychological status. However, over the past three decades there has been increasing recognition that quality of life (QoL), which is now regarded as a key measurement, needs further consideration. Patients report difficulties when explaining to health professionals the challenges they face, and their reactions as they try to make the adjustments to their new normal of life with a stoma. This article examines stoma patients' perceptions of their outcomes from recent research. It discusses how more can be done by health professionals to support stoma patients through their initial transition to life with a stoma and for the rest of their life.
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Affiliation(s)
- Patricia Black
- Freelance Consultant/Associate Lecturer, Birmingham City University
| | - Joy Notter
- Professor of Community Health Care Studies, Birmingham City University
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27
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Ma D, Zuo M, Liu L. The Information Needs of Chinese Family members of Cancer Patients in the Online Health Community: What and Why? Inf Process Manag 2021. [DOI: 10.1016/j.ipm.2021.102517] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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28
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Stone P, Kalpakidou A, Todd C, Griffiths J, Keeley V, Spencer K, Buckle P, Finlay DA, Vickerstaff V, Omar RZ. Prognostic models of survival in patients with advanced incurable cancer: the PiPS2 observational study. Health Technol Assess 2021; 25:1-118. [PMID: 34018486 PMCID: PMC8182445 DOI: 10.3310/hta25280] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The Prognosis in Palliative care Study (PiPS) prognostic survival models predict survival in patients with incurable cancer. PiPS-A (Prognosis in Palliative care Study - All), which involved clinical observations only, and PiPS-B (Prognosis in Palliative care Study - Blood), which additionally required blood test results, consist of 14- and 56-day models that combine to create survival risk categories: 'days', 'weeks' and 'months+'. OBJECTIVES The primary objectives were to compare PIPS-B risk categories against agreed multiprofessional estimates of survival and to validate PiPS-A and PiPS-B. The secondary objectives were to validate other prognostic models, to assess the acceptability of the models to patients, carers and health-care professionals and to identify barriers to and facilitators of clinical use. DESIGN This was a national, multicentre, prospective, observational, cohort study with a nested qualitative substudy using interviews with patients, carers and health-care professionals. SETTING Community, hospital and hospice palliative care services across England and Wales. PARTICIPANTS For the validation study, the participants were adults with incurable cancer, with or without capacity to consent, who had been recently referred to palliative care services and had sufficient English language. For the qualitative substudy, a subset of participants in the validation study took part, along with informal carers, patients who declined to participate in the main study and health-care professionals. MAIN OUTCOME MEASURES For the validation study, the primary outcomes were survival, clinical prediction of survival and PiPS-B risk category predictions. The secondary outcomes were predictions of PiPS-A and other prognostic models. For the qualitative substudy, the main outcomes were participants' views about prognostication and the use of prognostic models. RESULTS For the validation study, 1833 participants were recruited. PiPS-B risk categories were as accurate as agreed multiprofessional estimates of survival (61%; p = 0.851). Discrimination of the PiPS-B 14-day model (c-statistic 0.837, 95% confidence interval 0.810 to 0.863) and the PiPS-B 56-day model (c-statistic 0.810, 95% confidence interval 0.788 to 0.832) was excellent. The PiPS-B 14-day model showed some overfitting (calibration in the large -0.202, 95% confidence interval -0.364 to -0.039; calibration slope 0.840, 95% confidence interval 0.730 to 0.950). The PiPS-B 56-day model was well-calibrated (calibration in the large 0.152, 95% confidence interval 0.030 to 0.273; calibration slope 0.914, 95% confidence interval 0.808 to 1.02). PiPS-A risk categories were less accurate than agreed multiprofessional estimates of survival (p < 0.001). The PiPS-A 14-day model (c-statistic 0.825, 95% confidence interval 0.803 to 0.848; calibration in the large -0.037, 95% confidence interval -0.168 to 0.095; calibration slope 0.981, 95% confidence interval 0.872 to 1.09) and the PiPS-A 56-day model (c-statistic 0.776, 95% confidence interval 0.755 to 0.797; calibration in the large 0.109, 95% confidence interval 0.002 to 0.215; calibration slope 0.946, 95% confidence interval 0.842 to 1.05) had excellent or reasonably good discrimination and calibration. Other prognostic models were also validated. Where comparisons were possible, the other prognostic models performed less well than PiPS-B. For the qualitative substudy, 32 health-care professionals, 29 patients and 20 carers were interviewed. The majority of patients and carers expressed a desire for prognostic information and said that PiPS could be helpful. Health-care professionals said that PiPS was user friendly and may be helpful for decision-making and care-planning. The need for a blood test for PiPS-B was considered a limitation. LIMITATIONS The results may not be generalisable to other populations. CONCLUSIONS PiPS-B risk categories are as accurate as agreed multiprofessional estimates of survival. PiPS-A categories are less accurate. Patients, carers and health-care professionals regard PiPS as potentially helpful in clinical practice. FUTURE WORK A study to evaluate the impact of introducing PiPS into routine clinical practice is needed. TRIAL REGISTRATION Current Controlled Trials ISRCTN13688211. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 25, No. 28. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Patrick Stone
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK
| | - Anastasia Kalpakidou
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK
| | - Chris Todd
- School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Jane Griffiths
- School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Vaughan Keeley
- Palliative Medicine Department, Derby Teaching Hospitals NHS Foundation Trust, Derby, UK
| | - Karen Spencer
- School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Peter Buckle
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK
| | - Dori-Anne Finlay
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK
| | - Victoria Vickerstaff
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK
| | - Rumana Z Omar
- Department of Statistical Science, University College London, London, UK
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McKeague B, Maguire R. "The effects of cancer on a family are way beyond the person who's had it": The experience and effect of a familial cancer diagnosis on the health behaviours of family members. Eur J Oncol Nurs 2021; 51:101905. [PMID: 33601195 DOI: 10.1016/j.ejon.2021.101905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 01/27/2021] [Accepted: 01/28/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE People who are first-degree relatives of cancer patients are at an increased risk of developing cancer themselves. Despite this, relatives of cancer patients do not always make beneficial changes to their health behaviours. This study aimed to answer the following questions: (1) do the health behaviours of people who are first-degree relatives of cancer survivors change following cancer diagnosis, and if so, how, and why, (2) what motivations/barriers exist for first-degree relatives when seeking to engage with health promoting behaviours, and (3) what do first-degree relatives believe healthcare organisations can do to improve uptake of healthy lifestyle changes. METHOD Nine biological first-degree relatives of cancer survivors living in Ireland (6 children, 2 siblings, 1 parent) participated in semi-structured interviews which were later thematically analysed. RESULTS Findings revealed four superordinate themes: Being Conscious/Aware, Limited Lifestyle Changes, Psychosocial Consequences of Experience, and Unmet Needs, with each of these themes having two to three subordinate themes. Patient and public involvement emphasised Unmet Needs, including needs for information and family support, as the theme that was most reflective of participants' lived experience. CONCLUSIONS Results suggest that while family members tend not to change their lifestyle behaviours following cancer diagnosis, they do seem to make changes to their medical behaviours. Additionally, they can be negatively impacted by the experience in several other ways. Identifying means of support will allow relatives to cope better post diagnosis.
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Affiliation(s)
- Beth McKeague
- Department of Psychology, Maynooth University, Maynooth, County Kildare, Ireland.
| | - Rebecca Maguire
- Department of Psychology, Maynooth University, Maynooth, County Kildare, Ireland.
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30
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Development of a Health Literacy Program for Parents of Children with Cancer: A Mixed-Methods Study Protocol. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2021. [DOI: 10.5812/ijcm.108332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Objectives: Parents’ health literacy plays an important role in the proper management of symptoms and providing appropriate care for their children living with cancer. However, studies conducted on health literacy in Iranian culture is very limited. Therefore, this study will identify the health literacy needs of parents of children with cancer and will design a program for promoting their health literacy. Methods: This exploratory mixed-methods study, using qualitative-quantitative methods including 4 consecutive phases. In the first phase, the literature review will be carried out to conceptualize and determine the domains of health literacy. In the second phase, a qualitative study will be conducted to identify and determine the needs and strategies for promoting the health literacy of parents using deep semi-structured interviews. Participants will be selected by purposive and snowball sampling methods and data will be analyzed using the directed content analysis method. In the third phase, participants’ needs will be prioritized using a panel of experts and the initial draft of the program will be designed. In the fourth phase, the modified Delphi method will be used to prioritize program strategies and select the final program. Discussion: Developing a program using a qualitative method and literature review can provide some evidence for promoting health literacy in parents of children living with cancer. Moreover, it is expected that this program promotes knowledge and empowerment of health team members, especially nurses to provide family-centered care for children with cancer. This, in turn, will increase the quality of provided treatment and care and will decrease the costs.
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31
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Chang K, Berthelet E, Grubbs E, Hamilton S, Karvat A, Tran E, Wu J, Ingledew PA. Websites, Websites Everywhere: How Thyroid Cancer Patients Use the Internet. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2020; 35:1177-1183. [PMID: 31332622 DOI: 10.1007/s13187-019-01576-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Thyroid cancer incidence rates and Internet use are both increasing. Thyroid cancer is common in young patients, who are likely to use the Internet. This study aims to characterize thyroid cancer patient Internet use and search patterns, usability of online resources, and effects on clinical care. From May to December 2017, inclusive, patients with thyroid cancer attending two tertiary cancer centers were invited to complete a survey about Internet use. Thirty-nine of 72 questionnaires were returned (54%). Ninety-seven percent of participants used the Internet, and 87% had looked for thyroid cancer information. The majority (94%) searched on Google. Patients most often looked for information about treatment (94%) and symptom management (76%). Many patients evaluated content quality by comparing several resources (71%), discussing with a physician (56%) or using a credible academic or government site (53%). Online information was somewhat hard to understand for 32%, but 91% found it useful. Over half (60%) of treatment decisions were affected by web resources, and information helped 50% of patients make decisions with their physicians. Respondents highlighted a lack of resources on survivorship and uncommon tumors such as medullary or anaplastic cancer. Physicians should recognize that patients overwhelmingly access online information, which often impacts patients' decision-making. Clinicians can guide thyroid cancer patients through abundant web-based information and assist in interpreting this information. Educators can use this information to guide resource development, tailoring content and design to thyroid cancer patients' needs.
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Affiliation(s)
- Kimberley Chang
- University of British Columbia, MD Undergraduate Program, Faculty of Medicine, 317 - 2194 Health Sciences Mall, Vancouver, V6T 1Z3, BC, Canada
| | - Eric Berthelet
- BC Cancer - Vancouver; Division of Radiation Oncology, Department of Surgery, University of British Columbia, 600 West 10th Avenue, Vancouver, BC, V5Z 4E6, Canada
| | - Elizabeth Grubbs
- Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, 1400 Pressler St., Houston, TX, 77030-4009, USA
| | - Sarah Hamilton
- BC Cancer - Vancouver; Division of Radiation Oncology, Department of Surgery, University of British Columbia, 600 West 10th Avenue, Vancouver, BC, V5Z 4E6, Canada
| | - Anand Karvat
- BC Cancer - Surrey; Division of Radiation Oncology, Department of Surgery, University of British Columbia, 13750 96th Avenue, Surrey, BC, V3V 1Z2, Canada
| | - Eric Tran
- BC Cancer - Vancouver; Division of Radiation Oncology, Department of Surgery, University of British Columbia, 600 West 10th Avenue, Vancouver, BC, V5Z 4E6, Canada
| | - Jonn Wu
- BC Cancer - Vancouver; Division of Radiation Oncology, Department of Surgery, University of British Columbia, 600 West 10th Avenue, Vancouver, BC, V5Z 4E6, Canada
| | - Paris-Ann Ingledew
- BC Cancer - Vancouver; Division of Radiation Oncology, Department of Surgery, University of British Columbia, 600 West 10th Avenue, Vancouver, BC, V5Z 4E6, Canada.
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32
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Siltanen H, Jylhä V, Holopainen A, Paavilainen E. Family members' experiences and expectations of self-management counseling while caring for a person with chronic obstructive pulmonary disease: a systematic review of qualitative evidence. ACTA ACUST UNITED AC 2020; 17:2214-2247. [PMID: 31567526 DOI: 10.11124/jbisrir-d-19-00056] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE The objective of this review was to identify and synthesize existing evidence on the experiences and expectations of self-management counseling of adult family members who are informal caregivers of a person with chronic obstructive pulmonary disease (COPD) in the context of inpatient or outpatient care. INTRODUCTION Chronic obstructive pulmonary disease is the fourth leading cause of mortality and morbidity worldwide. It is a progressive, lifelong and unpredictable disease. As the disease progresses, both the people with COPD and their family members require information and practical skills to manage the disease. The role of family members is particularly important at the advanced stage of COPD. This systematic review examined family members' experiences and expectations of self-management counseling. INCLUSION CRITERIA This review considered qualitative studies that investigated adult (older than18 years) family members' experiences or expectations of COPD self-management counseling in the context of inpatient or outpatient care. "Family member" refers to a person who is an informal caregiver because of his or her relationship to the person with COPD. METHODS A three-step search strategy was utilized in this review. The search strategy aimed to find published and unpublished studies in English and Finnish. The databases MEDLINE, CINAHL, PsycINFO, Scopus and the Finnish medical bibliographic database, Medic, were searched. The search was conducted in December 2015 and updated in September 2018. Titles and abstracts were screened by two independent reviewers for the review's inclusion criteria. Eligible studies were then critically appraised by two independent reviewers for methodological quality. The findings and illustrations of the findings were extracted and assigned a level of credibility. The qualitative research findings were pooled using the JBI method of meta-aggregation. RESULTS Ten papers were selected for inclusion in this review. These studies were published from 2002 to 2017. The quality of all included studies was at least moderate. Each study had a total score between 7 and 10 on the JBI Critical Appraisal Checklist for Qualitative Research. The following four synthesized findings were aggregated from nine categories and 39 study findings: i) Family members' experiences with unresponsive behavior from health professionals, ii) Family members' experiences of unmet needs in self-management counseling, iii) Family members' information needs concerning COPD management, and iv) Family members' information needs concerning coping strategies. CONCLUSIONS The synthesized findings indicate that family members are frustrated by the shortcomings of self-management counseling. They also feel unprepared for and uncertain about their caring role. They need more information about COPD and coping strategies for COPD. Counseling is essential to high-quality care and should be offered to family members caring for a loved one at any stage of COPD.
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Affiliation(s)
- Hannele Siltanen
- Department of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland.,Nursing Research Foundation, Helsinki, Finland.,Finnish Centre for Evidence-Based Health Care: a Joanna Briggs Institute Affiliated Group
| | - Virpi Jylhä
- Finnish Centre for Evidence-Based Health Care: a Joanna Briggs Institute Affiliated Group.,Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland
| | - Arja Holopainen
- Nursing Research Foundation, Helsinki, Finland.,Finnish Centre for Evidence-Based Health Care: a Joanna Briggs Institute Affiliated Group
| | - Eija Paavilainen
- Department of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland.,Etelä-Pohjanmaa Hospital District, Seinäjoki, Finland
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33
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dos Santos ATC, da Silva RP, de Almeida LM, Bosi MLM, de Menezes MDFB, Skaba MMVF, Nigenda G, Arruda CAM, Pinheiro CPO, González-Robledo MC, Knaul FM. Cancer survivorship needs in Brazil: Patient and family perspective. PLoS One 2020; 15:e0239811. [PMID: 33031426 PMCID: PMC7544129 DOI: 10.1371/journal.pone.0239811] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 09/14/2020] [Indexed: 11/18/2022] Open
Abstract
Introduction Cancer Survivorship is a growing public health challenge. Effective responses from health care and social services depend on appropriate identification of survivors and their families´ specific needs. There are few studies on survivorship in low and middle-income countries, therefore, more evidence-based studies are necessary to develop a comprehensive approach to cancer survivorship. Objectives Identify the needs of cancer survivors and their relatives, specifically those of individuals with breast, cervical or prostate cancer, and with acute lymphocytic leukemia (ALL). Methods A qualitative, exploratory study conducted in two referral institutions in Brazil, located in Rio de Janeiro (Southeast region) and Fortaleza (Northeast region). The study included 47 patients of public and private health services and 12 family members. We used script-based semi-structured interviews. The discursive material obtained was categorized and analyzed using the Thematic Analysis approach. Results The analysis identified three central themes: 1) consequences of cancer treatment; 2) Changes in daily life associated with cancer survivorship; and 3) Unmet structural needs in cancer survivorship. Conclusion Social and cancer control policies in Brazil should provide resources, specific care standards and clinical, psychological and social support. Cancer survivors should also receive rehabilitation and work reintegration guidelines. This matter requires broader access to qualified cancer information, development of an integrated patient-centered care and care model, and more research resources for the country's post-treatment cancer period.
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Affiliation(s)
- Antonio Tadeu Cheriff dos Santos
- Population Research Division, Nucleus of Research and Qualitative Studies, National Cancer Institute, Rio de Janeiro, Brazil
- * E-mail:
| | - Rildo Pereira da Silva
- Population Research Division, Nucleus of Research and Qualitative Studies, National Cancer Institute, Rio de Janeiro, Brazil
| | - Liz Maria de Almeida
- Division of Population Research, National Cancer Institute, Rio de Janeiro, Brazil
| | - Maria Lúcia Magalhães Bosi
- Laboratory of Qualitative Research and Evaluation in Health, Federal University of Ceara, Fortaleza, Ceará, Brazil
| | | | | | - Gustavo Nigenda
- National School of Nursing and Obstetrics, National Autonomous University of México, México City, México
| | - Carlos André Moura Arruda
- Laboratory of Qualitative Research and Evaluation in Health, Federal University of Ceara, Fortaleza, Ceará, Brazil
| | | | | | - Felícia Marie Knaul
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Coral Gables, Florida, United States of America
- Institute for Advanced Study of the Americas, University of Miami, Coral Gables, Florida, United States of America
- Programa Universalidad y Competitividad en Salud, Fundación Mexicana para la Salud, Mexico City, Mexico
- Tómatelo a Pecho, Mexico City, Mexico
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Zhang Y, Kwekkeboom KL. A Feasibility Study of an Uncertainty Management Intervention for Patient-Partner Dyads Experiencing Breast Cancer. Oncol Nurs Forum 2020; 47:595-608. [PMID: 32830807 DOI: 10.1188/20.onf.595-608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To examine the feasibility, acceptability, and effects of a dyad-based uncertainty management intervention for breast cancer, including tailored information and coping skills training. SAMPLE & SETTING 16 patient-partner dyads experiencing breast cancer were enrolled from a midwestern comprehensive cancer center. METHODS & VARIABLES A single-group pre-/post-test design was used, and descriptive statistics and Cohen's d were calculated. Measures were completed before the intervention and during each treatment cycle. Feasibility, acceptability, fidelity, uptake, and outcome variables (uncertainty, dyadic coping, family functioning) were included. RESULTS 16 dyads were enrolled during a 13-month period; 15 dyads completed the training for the study, and 13 dyads completed all study activities. Overall, participants reported satisfaction with the intervention. Small to medium effect sizes were observed across the outcomes. IMPLICATIONS FOR NURSING This study highlights the need for nurses to help couples manage uncertainty related to new cancer treatment. Tailored interventions can allow nurses to use their time efficiently by focusing on individuals' actual needs.
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Crotty BH, Asan O, Holt J, Tyszka J, Erickson J, Stolley M, Pezzin LE, Nattinger AB. Qualitative Assessment of Unmet Information Management Needs of Informal Cancer Caregivers: Four Themes to Inform Oncology Practice. JCO Clin Cancer Inform 2020; 4:521-528. [PMID: 32530708 DOI: 10.1200/cci.19.00159] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Family and friends often provide informal care for patients with cancer, coordinating care and supporting patients at home. Stress, depression, and burnout are increasingly recognized among these informal caregivers. Although past research has described a range of needs, including the need for information, details about unmet informational needs for caregivers have not been fully described. We sought to assess unmet information management needs for informal caregivers in the digital era. METHODS This was a qualitative research study with semistructured interviews and focus groups of nonprofessional caregivers for patients with cancer, facilitated using a discussion guide. Eligible caregivers supported patients in the community who were in treatment (chemotherapy or radiotherapy) or completed treatment within 3 years. Participants were recruited using informational flyers at an academic cancer center and in the local community of metropolitan Milwaukee, Wisconsin. Sessions were transcribed verbatim and analyzed inductively to identify themes. RESULTS Thirteen caregivers participated, the majority between 41 and 60 years of age: seven of 13, 53.8%, were predominantly women; 10 of 13 (76.9%) were educated, 10 of 13 (76.9%) had graduated from college; and of modest means, six of 13 (46.2%) had household incomes < $35,000. Four themes emerged: (1) the information overload paradox, where caregivers felt overloaded by information yet had unmet informational needs; (2) navigating volatility as a caregiver, with changing or unknown expectations; (3) caregivers as information brokers, which placed new burdens on caregivers to seek, share, and protect information; and (4) care for the caregiver, including unmet information needs related to self-care. CONCLUSION This study identified several informational challenges affecting caregivers. Caregivers have dynamic and evolving informational needs, and strategies that support caregivers through just-in-time information availability or dedicated caregiver check-ins may provide relief within the stress of caregiving.
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Affiliation(s)
| | - Onur Asan
- Stevens Institute of Technology, Hoboken, NJ
| | - Jeana Holt
- Medical College of Wisconsin, Milwaukee, WI
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Litzkendorf S, Frank M, Babac A, Rosenfeldt D, Schauer F, Hartz T, Graf von der Schulenburg JM. Use and importance of different information sources among patients with rare diseases and their relatives over time: a qualitative study. BMC Public Health 2020; 20:860. [PMID: 32503483 PMCID: PMC7275578 DOI: 10.1186/s12889-020-08926-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 05/17/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Finding reliable information on one of more than 7000 rare diseases is a major challenge for those affected. Since rare diseases are defined only by the prevalence criterion, a multitude of heterogeneous diseases are included. Common to all, however, are difficulties regarding information access. Even though various quantitative studies have analyzed the use of different information sources for specific rare diseases, little is known about the use of information sources for different rare diseases, how users rate these information sources based on their experiences, and how the use and importance of these information sources change over time. METHODS Fifty-five patients with a variety of rare diseases and 13 close relatives participated in qualitative interviews. For these interviews, a semi-structured guideline was developed, piloted, and revised. Data analysis involved a qualitative content analysis developed by Philipp Mayring. RESULTS The participants considered internet as the most important and widespread information source, especially for early information. Although patients have difficulty dealing with information obtained online, they consider online searching a quick and practical option to gather information. During the course of the disease, personal contact partners, especially self-help associations and specialized doctors, become more important. This is also because information provided online is sometimes insufficiently detailed to answer their information needs, which can be complemented by information from doctors and self-help. CONCLUSIONS People rarely use just one type of source, but rather refer to different sources and informants. The source used depends on the type of information sought as well as other person-related factors such as preexisting knowledge and the disease stage. To improve people's information searching and connect them with medical specialists in rare diseases, a central information portal on rare diseases might be a suitable access point to provide free and quality assured information for patients, caregivers, and physicians. This would allow not only patients but also doctors to find quality assured information on symptoms and therapies as well as patient associations and specialized doctors.
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Affiliation(s)
- Svenja Litzkendorf
- Center for Health Economics Research Hannover (CHERH), Leibniz University Hannover, Otto-Brenner-Straße 7, 30159, Hannover, Germany.
| | - Martin Frank
- Faculty of Public Health Services, Ostfalia University of Applied Science, Rothenfelder Straße 10, 38440, Wolfsburg, Germany
| | - Ana Babac
- Center for Health Economics Research Hannover (CHERH), Leibniz University Hannover, Otto-Brenner-Straße 7, 30159, Hannover, Germany
| | - Daniel Rosenfeldt
- Center for Health Economics Research Hannover (CHERH), Leibniz University Hannover, Otto-Brenner-Straße 7, 30159, Hannover, Germany
| | - Franziska Schauer
- Department of Dermatology, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstraße 7, 79104, Freiburg, Germany
| | - Tobias Hartz
- Clinical Cancer Registry of Lower Saxony, Sutelstraße 2, 30659, Hannover, Germany
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Michaelides A, Constantinou C. Integration of longitudinal psychoeducation programmes during the phases of diagnosis, management and survivorship of breast cancer patients: A narrative review. J Cancer Policy 2020. [DOI: 10.1016/j.jcpo.2019.100214] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Zhang J, Zhang C, Li Q, Zhang J, Gu X, Zhao W, Chen M, Liu M, Zhang Z, Liao X, Cheng W. C-Reactive Protein/Albumin Ratio Is an Independent Prognostic Predictor of Survival in Advanced Cancer Patients Receiving Palliative Care. J Palliat Med 2019; 22:1536-1545. [DOI: 10.1089/jpm.2019.0102] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Affiliation(s)
- Jing Zhang
- Department of Integrated Therapy, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Chenbo Zhang
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China
| | - Qingxian Li
- Department of Gynecology, Putuo Central Hospital, Shanghai, China
| | - Jiawen Zhang
- Department of Obstetrics and Gynecology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xiaoli Gu
- Department of Integrated Therapy, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Weiwei Zhao
- Department of Integrated Therapy, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Menglei Chen
- Department of Integrated Therapy, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Minghui Liu
- Department of Integrated Therapy, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Zhe Zhang
- Department of Integrated Therapy, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xinghe Liao
- Department of Integrated Therapy, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Wenwu Cheng
- Department of Integrated Therapy, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
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Grondhuis Palacios LA, Hendriks N, den Ouden MEM, Reisman Y, Beck JJH, den Oudsten BL, Ek GF, Putter H, Pelger RCM, Elzevier HW. Investigating the effect of a symposium on sexual health care in prostate cancer among Dutch healthcare professionals. J Clin Nurs 2019; 28:4357-4366. [DOI: 10.1111/jocn.15012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 06/11/2019] [Accepted: 06/30/2019] [Indexed: 11/28/2022]
Affiliation(s)
| | - Nora Hendriks
- Department of Urology Leiden University Medical Center Leiden The Netherlands
| | | | - Yacov Reisman
- Department of Urology Amstelland Ziekenhuis Amstelveen The Netherlands
| | - Jack J. H. Beck
- Department of Urology Sint Antonius Hospital Nieuwegein The Netherlands
| | - Brenda L. den Oudsten
- Department of Medical and Clinical Psychology Tilburg University Tilburg The Netherlands
| | - Gaby F. Ek
- Department of Urology Leiden University Medical Center Leiden The Netherlands
| | - Hein Putter
- Department of Medical Statistics Leiden University Medical Center Leiden The Netherlands
| | - Rob C. M. Pelger
- Department of Urology Leiden University Medical Center Leiden The Netherlands
| | - Henk W. Elzevier
- Department of Urology Leiden University Medical Center Leiden The Netherlands
- Department of Medical Decision Making Leiden University Medical Center Leiden The Netherlands
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Rosset M, Reifegerste D, Baumann E, Kludt E, Weg-Remers S. [Trends in cancer information services over 25 years : An analysis of inquiries from patients and relatives made to the Cancer Information Service of the German Cancer Research Center from 1992 to 2016]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2019; 62:1120-1128. [PMID: 31410522 DOI: 10.1007/s00103-019-02996-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Cancer information services (CISs) are a valuable source of evidence-based information. Previous studies in the field of CISs often investigate only short periods of time. However, there is a need for long-term analyses to identify changes in the use of CISs. OBJECTIVES The purpose of this study was to analyze trends in the inquiries of patients and surrogate seekers to a CIS. METHOD We conducted a secondary data analysis of the inquiry records of the German CIS (Krebsinformationsdienst, KID) hosted by the German Cancer Research Center from 1992 until 2016 (N = 545,070). Trends in the number of inquiries were described using the whole sample, while the description of further characteristics is based on a sample (n = 55,046) of patients, their family members, and friends. RESULTS The inquiries increased in the period examined (1992: 11,344 inquiries; 2016: 34,869 inquiries). Since 2005, a greater share of patients (between 52 and 60%) than surrogate seekers have been contacting the CIS. The mean age of both self-seeking and supported patients increased from under 55 years between 1992 and 2000 up to over 60 years in the year 2016. Breast cancer is at all times the most frequently inquired cancer type (patients: n = 11,319, 39%; surrogate seekers: n = 4173, 17%). Even after the implementation of e‑mail as an additional communication channel, the majority of inquirers still prefer contact by phone (between 80 and 98%). CONCLUSIONS Changes in the utilization of a CIS over time are discussed against the background of structural changes, such as shifts in prevalence rates, family structures, or media environments.
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Affiliation(s)
- Magdalena Rosset
- Institut für Journalistik und Kommunikationsforschung, Hochschule für Musik, Theater und Medien Hannover, Expo Plaza 12, 30539, Hannover, Deutschland.
| | - Doreen Reifegerste
- Seminar für Medien- und Kommunikationswissenschaft, Universität Erfurt, Erfurt, Deutschland
| | - Eva Baumann
- Institut für Journalistik und Kommunikationsforschung, Hochschule für Musik, Theater und Medien Hannover, Expo Plaza 12, 30539, Hannover, Deutschland
| | - Evelyn Kludt
- Krebsinformationsdienst (KID) des Deutschen Krebsforschungszentrums (DKFZ), Heidelberg, Deutschland
| | - Susanne Weg-Remers
- Krebsinformationsdienst (KID) des Deutschen Krebsforschungszentrums (DKFZ), Heidelberg, Deutschland
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Jepsen LØ, Friis LS, Hansen DG, Marcher CW, Høybye MT. Living with outpatient management as spouse to intensively treated acute leukemia patients. PLoS One 2019; 14:e0216821. [PMID: 31091285 PMCID: PMC6519813 DOI: 10.1371/journal.pone.0216821] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 04/29/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Spouses have a key position in the treatment of patients with acute leukemia (AL) who are increasingly managed in an outpatient setting. Patients live at home but appear at the hospital every second day for follow-up visits. Patients must adhere to specific precautions due to an impaired immune system, which challenges and influence the life of the whole family. This qualitative study, based on individual and group interviews with spouses to AL patients in curative intended treatment, elucidates how the intense and substantial caregiver role affects the everyday lives of spouses to AL patients in curative intended treatment. METHODS Qualitative semi-structured group interviews (n = 6) and individual interviews (n = 5) with spouses to AL patients were conducted at different time points during the whole course of treatment. Theories of everyday life served as the theoretical framework. RESULTS The spouses described their life as a constant state of vigilance and attention as a consequence of the responsibility they felt arising from the treatment in the outpatient setting. These made them experience their role as a burden. The social life of the spouses and the families suffered substantially due to the precautions that were instated in the home. However, many experienced that relations in the family were developed positively. CONCLUSIONS Close relatives experience additional psychosocial burdens instigated by the outpatient management regimens. This is important knowledge for the health care system to include in future development of AL outpatient settings, to prioritize and support offers to the relatives that recognize their sense of burden. This could apply not only to relatives of AL patients but to the relatives of other severely ill patients as well.
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Affiliation(s)
| | | | - Dorte Gilså Hansen
- Research Unit of General Practice, University of Southern Denmark, Odense, Denmark
| | | | - Mette Terp Høybye
- Interdisciplinary Research Unit, Elective Surgery Center, Silkeborg Regional Hospital, Silkeborg, Denmark
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Bonacasa M, Rosa E, Camps C, Martínez-Rubio D. A translational approach to design effective intervention tools for informal caregivers of dependent cancer patients. Public Health 2019; 168:50-58. [DOI: 10.1016/j.puhe.2018.11.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 11/12/2018] [Accepted: 11/27/2018] [Indexed: 10/27/2022]
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van Eenbergen MC, van Engelen H, Ezendam NPM, van de Poll-Franse LV, Tates K, Krahmer EJ. Paying attention to relatives of cancer patients: What can we learn from their online writings? PATIENT EDUCATION AND COUNSELING 2019; 102:404-410. [PMID: 30448046 DOI: 10.1016/j.pec.2018.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 10/22/2018] [Accepted: 11/05/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Relatives of cancer patients often play a crucial role in care, while their own needs generally receive scant attention. We investigate those topics on which relatives share information online. METHODS We coded user-generated content written by 185 relatives on a major Dutch cancer site (kanker.nl), into three main categories: 'Disease', 'Well-being' and 'Other subjects'. In addition, we analysed five websites (from five countries) for which content they provide that is relevant for relatives. RESULTS Our analysis showed that across cancer types, relatives share online information and emotions. Quantitative analysis showed that they mainly write about topics related to their own well-being (blog posters: 45% of the posts and group posters 64%). Blog posters found the disease-related topics more important than the group posters (45% and 29%). CONCLUSIONS This study has shown that relatives share different kinds of user-generatedcontent related to their own situation. This could be a valuable resource for further research into the needs of relatives, and a very useful source for identification of emotional and informational topics. PRACTICE IMPLICATIONS It is crucial that relatives are enabled to occupy their own space in the disease-and-treatment process appropriate to their needs and to help avoid caregiver burden.
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Affiliation(s)
- Mies C van Eenbergen
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands.
| | - Hanneke van Engelen
- Tilburg Center for Cognition and Communication, Tilburg University, Tilburg, the Netherlands
| | - Nicole P M Ezendam
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands; Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands
| | - Lonneke V van de Poll-Franse
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands; Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, the Netherlands; Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands
| | - Kiek Tates
- Tilburg Center for Cognition and Communication, Tilburg University, Tilburg, the Netherlands
| | - Emiel J Krahmer
- Tilburg Center for Cognition and Communication, Tilburg University, Tilburg, the Netherlands
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Schaffler JL, Tremblay S, Laizner AM, Lambert S. Developing education materials for caregivers of culturally and linguistically diverse patients: Insights from a qualitative analysis of caregivers' needs, access and understanding of information. Health Expect 2019; 22:444-456. [PMID: 30767349 PMCID: PMC6543161 DOI: 10.1111/hex.12867] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 11/28/2018] [Accepted: 12/13/2018] [Indexed: 12/05/2022] Open
Abstract
Objectives To explore the information needs of caregivers of culturally and linguistically diverse (CALD) patients, and how they access and understand health information related to the management of their care person's chronic illness(es). Background Caregivers of CALD patients experience greater unmet needs compared to the general caregiver population. They experience many challenges in identifying resources and accessing formal supports to aid in self‐management behaviours. Methods Eleven caregivers were recruited from outpatient clinics in Québec, Canada. Consenting caregivers participated in one face‐to‐face or phone interview. A qualitative descriptive design and inductive content analysis were used to identify themes. Results Caregivers described a “village” approach to caregiving in which more than one individual was involved in patient care. The specific roles ascribed to caregivers defined their information needs. Caregivers described two categories of information needs: perceived and unperceived. Perceived information needs were explicit, and centred on the medical management of illnesses. Unperceived needs were unrecognized knowledge gaps that emerged during interviews and focused on self‐care. Conclusion Although caregivers' perceived needs are often met, their unperceived needs remain unmet. Health‐care providers should perform need assessments to identify caregivers' unperceived needs, with the aims of providing culturally competent care and ongoing support.
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Affiliation(s)
- Jamie L Schaffler
- Ingram School of Nursing, McGill University, Montréal, Québec, Canada
| | - Sarah Tremblay
- Ingram School of Nursing, McGill University, Montréal, Québec, Canada
| | - Andréa M Laizner
- Ingram School of Nursing, McGill University, Montréal, Québec, Canada.,McGill University Health Centre, Montréal, Québec, Canada.,Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
| | - Sylvie Lambert
- Ingram School of Nursing, McGill University, Montréal, Québec, Canada.,St. Mary's Research Centre, Montréal, Québec, Canada
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Reifegerste D, Czerwinski F, Rosset M, Baumann E, Kludt E, Weg-Remers S. Demographic and cancer-related differences between self-seeking patients and supported patients: Analysis of cancer information-service data. Psychooncology 2019; 28:759-766. [PMID: 30707476 DOI: 10.1002/pon.5016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 01/14/2019] [Accepted: 01/28/2019] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Surrogate information seeking is quite common, and several studies have presented data on caregivers, family members, and friends who seek health information on the Internet or from a cancer-information service (CIS) on behalf of cancer patients. However, these studies provide little information about the patients who are supported by surrogate seekers. Therefore, this study analyzed demographic and cancer-related differences, including diverse informational needs, between self-seeking patients and patients who benefited from surrogate seekers (ie, caregivers, family, or friends) requesting information on their behalf. METHODS We conducted a retrospective audit of phone and e-mail inquiries to a German CIS between January and December 2016 from self-seeking patients (n = 13 723) and surrogate information seekers, as well as the corresponding supported patients (n = 6696). RESULTS Supported patients were more likely to be males (P < 0.001), older than self-seeking patients (P < 0.001), and older than the corresponding surrogate seekers (P < 0.001). They were also more likely to be in the diagnostic or palliative stage (P < 0.001) and were less likely to suffer from breast cancer or prostate cancer (P < 0.001) than self-seeking patients. There were significant differences in the CIS requests of self-seekers and surrogate seekers. CONCLUSIONS The results point to different support needs of self-seekers and surrogate seekers. Thus, surrogate seekers and their corresponding supported patients should be seen as a separate target group to self-seeking patients, with the former requiring informational and emotional support on diverging topics and at different disease stages.
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Affiliation(s)
- Doreen Reifegerste
- Department of Communication Studies, University of Erfurt, Erfurt, Germany
| | - Fabian Czerwinski
- Department of Journalism and Communication Research, Hanover University of Music, Drama and Media, Hannover, Germany
| | - Magdalena Rosset
- Department of Journalism and Communication Research, Hanover University of Music, Drama and Media, Hannover, Germany
| | - Eva Baumann
- Department of Journalism and Communication Research, Hanover University of Music, Drama and Media, Hannover, Germany
| | - Evelyn Kludt
- Cancer Information Service, German Cancer Research Center, Heidelberg, Germany
| | - Susanne Weg-Remers
- Cancer Information Service, German Cancer Research Center, Heidelberg, Germany
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Preisler M, Rohrmoser A, Goerling U, Kendel F, Bär K, Riemer M, Heuse S, Letsch A. Early palliative care for those who care: A qualitative exploration of cancer caregivers’ information needs during hospital stays. Eur J Cancer Care (Engl) 2019; 28:e12990. [DOI: 10.1111/ecc.12990] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 10/08/2018] [Accepted: 12/16/2018] [Indexed: 01/02/2023]
Affiliation(s)
- Martina Preisler
- Medical Department, Division of Hematology and Oncology; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health; Berlin Germany
| | - Amy Rohrmoser
- Medical Department, Charité Comprehensive Cancer Center; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health; Berlin Germany
| | - Ute Goerling
- Medical Department, Charité Comprehensive Cancer Center; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health; Berlin Germany
| | - Friederike Kendel
- Institute of Medical Psychology; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Berlin Germany
| | - Konrad Bär
- Medical Department, Division of Hematology and Oncology; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health; Berlin Germany
| | - Manuel Riemer
- Wilfrid Laurier University; Department of Psychology; Waterloo Ontario Canada
| | - Silke Heuse
- Institute of Medical Psychology; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Berlin Germany
| | - Anne Letsch
- Medical Department, Division of Hematology and Oncology; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health; Berlin Germany
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Marcotte J, Tremblay D, Turcotte A, Michaud C. Needs-focused interventions for family caregivers of older adults with cancer: a descriptive interpretive study. Support Care Cancer 2018; 27:2771-2781. [PMID: 30519734 DOI: 10.1007/s00520-018-4573-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 11/22/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE Although family caregivers (FCs) of older adults with cancer (OACs) provide invaluable assistance by fulfilling multiple tasks along the cancer trajectory, evidence suggests that their needs are poorly assessed, and there is a scarcity of supportive interventions that influence their well-being. Viewing these issues as opportunities for improvement, we conducted this qualitative study to understand FCs' needs and identify promising needs-focused interventions. METHODS This descriptive interpretive qualitative study was conducted in Quebec, Canada, in a French Canadian Oncology Clinic. Participants were FCs who were spouses or adult children (n = 25) of OACs aged 70 years or older. Data were collected via focus groups and were analyzed using an ongoing analytic process following each interview. RESULTS Three types of needs were of particular importance: information, relationships between FC and others, and care for oneself. The need for information was described in terms of the content, timeliness, and modalities in which information should be verbalized and delivered. The need for relationships specifically targeted health care providers (HCPs), family members, and OACs. The need to care for oneself was recognized as important throughout the cancer trajectory but also represented a challenge. Participants proposed innovative ideas for interventions, resources, and strategies for each type of need. CONCLUSIONS According to our results, HCPs should systematically include FCs into OACs' care plan through the use of concrete actions such as the "family systems approach" suggested by Duhamel, and integrate a systematic FC's needs assessment.
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Affiliation(s)
- Jade Marcotte
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, QC, Canada.,Centre de recherche Charles-Le Moyne - Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Greenfield Park, QC, Canada
| | - Dominique Tremblay
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, QC, Canada. .,Centre de recherche Charles-Le Moyne - Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Greenfield Park, QC, Canada.
| | - Annie Turcotte
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, QC, Canada.,Centre de recherche Charles-Le Moyne - Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Greenfield Park, QC, Canada
| | - Cécile Michaud
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, QC, Canada.,Centre de recherche Charles-Le Moyne - Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Greenfield Park, QC, Canada
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The application of the palliative prognostic index in predicting the life expectancy of patients in palliative care: a systematic review and meta-analysis. Aging Clin Exp Res 2018; 30:1417-1428. [PMID: 29572610 DOI: 10.1007/s40520-018-0928-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 03/05/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND The palliative prognostic index (PPI) is a commonly used tool to predict the life expectancy in palliative care patients. However, there is no universal cutoff, and the accuracy of different cutoffs varies. Therefore, we conducted this meta-analysis to explore the validity and accuracy of different PPI scores for different survival time in palliative care setting. METHODS PubMed, Embase, Cochrane, Scopus and Chinese CNKI databases were searched to identify studies using the PPI as a prognostic tool to predict survival time in palliative care. We calculated pooled hazard ratios (HRs) with corresponding 95% confidence intervals (CIs), and subgroup analyses were also conducted by different cutoffs. After extracting data, we estimated the pooled sensitivity, specificity, positive predictive value, and negative predictive value. RESULTS We identified 15 studies with 7455 assessments. Seven of these studies were synthesized for a combined HR. The pooled HR was 1.94 (95% CI 1.54-2.44) when cutoffs were 2 and 4, and 2.34 (95% CI 1.50-3.66) when cutoffs were 4 and 6. Of all the studies, 13 studies reported their accuracy, of which four studies were assessed by meta-analysis. The sensitivity of the PPI for 3-week survival ranged from 51 to 92% and specificity ranged from 60.0 to 94.0%, respectively. The sensitivity and specificity of the PPI for 6-week survival were from 46.0 to 89.1% and from 51.7 to 84.4%, respectively. The pooled sensitivity and specificity of the PPI for 3-week survival were 68% (6 as cutoff) and 76% (6 as cutoff), respectively. As for 6-week survival prediction, the pooled sensitivity and specificity were 68% (4 as cutoff) and 82% (4 as cutoff), respectively. CONCLUSION The PPI is a useful prognosticator of life expectancy of patients in palliative care, especially for patients with short survival time. However, there were no universal cutoff, and the predicted life span varies. Our data eliminated that using 4 and 6 as cutoffs can better predict the patients' survival time for 3 or 6 weeks. Due to small number of studies and poor qualities of them, result may alter as more studies with better quality are enrolled in the future.
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The Effects on Children’s Anxiety and Quality of Life of a Psychoeducational Program for Families Living With Parental Cancer and Their Network. Cancer Nurs 2018; 41:473-483. [DOI: 10.1097/ncc.0000000000000529] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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