1
|
Lee AE, McLoone JK, Touyz LM, Wakefield CE, Cohn RJ, Signorelli C. "It just never ends": Childhood cancer survivors' perceived psychosocial impacts of recurrence and second cancer. Palliat Support Care 2024; 22:31-40. [PMID: 36164937 DOI: 10.1017/s1478951522001328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Childhood cancer survivors are at risk of developing primary recurrences and new second cancers. Experiencing a recurrence and/or second cancer can be highly distressing for survivors and families. We aimed to understand the psychological impacts of experiencing a recurrence or second cancer and how this potentially influences survivors' engagement with survivorship care. METHODS We invited childhood cancer survivors or their parents if survivors were ≤16 years of age from 11 tertiary pediatric oncology hospitals across Australia and New Zealand to complete interviews. We conducted a thematic analysis facilitated by NVivo12. RESULTS We interviewed 21 participants of whom 16 had experienced a recurrence, 3 had a second cancer, and 2 had both a recurrence and second cancer. Participants reported that a recurrence/second cancer was a stressful sudden disruption to life, accompanied by strong feelings of uncertainty. Participants tended to be less aware of their second cancer risk than recurrence risk. Some participants reported feelings of anxiousness and despair, describing varying responses such as gratitude or avoidance. Participants shared that the fear of cancer recurrence either motivated them to adopt protective health behaviors or to avoid information and disengage from survivorship care. SIGNIFICANCE OF RESULTS Some survivors and their parents have a poor understanding and expressed reluctance to receive information about their risk of second cancer and other treatment-related late effects. Improving the delivery of information about late effects to families may improve their engagement with survivorship care and surveillance, although care must be taken to balance information provision and survivors' anxieties about their future health.
Collapse
Affiliation(s)
- Andrea E Lee
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, UNSW Medicine and Health, Randwick Clinical Campus, University of New South Wales, Sydney, NSW, Australia
| | - Jordana K McLoone
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, UNSW Medicine and Health, Randwick Clinical Campus, University of New South Wales, Sydney, NSW, Australia
- Kids Cancer Centre, Level 1 South, Sydney Children's Hospital, Randwick, NSW, Australia
| | - Lauren M Touyz
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, UNSW Medicine and Health, Randwick Clinical Campus, University of New South Wales, Sydney, NSW, Australia
- Kids Cancer Centre, Level 1 South, Sydney Children's Hospital, Randwick, NSW, Australia
| | - Claire E Wakefield
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, UNSW Medicine and Health, Randwick Clinical Campus, University of New South Wales, Sydney, NSW, Australia
- Kids Cancer Centre, Level 1 South, Sydney Children's Hospital, Randwick, NSW, Australia
| | - Richard J Cohn
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, UNSW Medicine and Health, Randwick Clinical Campus, University of New South Wales, Sydney, NSW, Australia
- Kids Cancer Centre, Level 1 South, Sydney Children's Hospital, Randwick, NSW, Australia
| | - Christina Signorelli
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, UNSW Medicine and Health, Randwick Clinical Campus, University of New South Wales, Sydney, NSW, Australia
- Kids Cancer Centre, Level 1 South, Sydney Children's Hospital, Randwick, NSW, Australia
| |
Collapse
|
2
|
Larsen MH, Hansson KE, Larsen EH, Fridh MK, Petersen NN, Mellblom AV, Ruud E, Larsen HB, Lie HC. The gap between expectations and reality: A qualitative study of psychosocial challenges of young childhood cancer survivors from the PACCS study. Eur J Cancer Care (Engl) 2022; 31:e13696. [PMID: 36029045 PMCID: PMC9787754 DOI: 10.1111/ecc.13696] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 07/13/2022] [Accepted: 08/12/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE In this sub-study from the 'PACCS' study, we explored the psychosocial experiences of children and adolescents in everyday life post-cancer treatment and the possible factors that can moderate these experiences. METHODS This is a qualitative explorative study using semi-structured interviews with 43 childhood cancer survivors between the ages of nine and 18 from Norway and Denmark. We conducted a secondary thematic analysis using Malterud's systematic text condensation. RESULTS Two main themes were identified: 'The post-treatment gap between expectations and reality' comprised two subthemes: (1) lack of mastery and feeling different and (2) lack of understanding and acceptance. The second main theme, 'Managing the gap', comprised three subthemes: (1) information and knowledge, (2) adjustments and adaptions and (3) social support and openness. The findings reveal that the psychosocial challenges resulted from the remaining ability gap(s). Measures such as tailored information, school adjustments and social support were potential dynamic factors affecting the gap(s) positively or negatively. Psychosocial challenges post-treatment are experiences of lack of acceptance and understanding from others. CONCLUSION To safeguard a positive transition back to everyday life, health care providers should support the survivors' psychosocial care, including getting back to school and re-entering social interactions.
Collapse
Affiliation(s)
- Marie Hamilton Larsen
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of MedicineUniversity of OsloOsloNorway,Department for Postgraduate StudiesLovisenberg Diaconal University CollegeOsloNorway
| | - Kjerstin Enger Hansson
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of MedicineUniversity of OsloOsloNorway
| | - Elna Hamilton Larsen
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of MedicineUniversity of OsloOsloNorway,Department of Paediatric Haematology and Oncology, Division for Paediatric and Adolescent MedicineOslo University Hospital, RikshospitaletOsloNorway
| | - Martin Kaj Fridh
- Department of Pediatrics and Adolescents MedicineUniversity Hospital RigshospitaletCopenhagenDenmark
| | - Natasha Nybro Petersen
- Department of Pediatrics and Adolescents MedicineUniversity Hospital RigshospitaletCopenhagenDenmark
| | - Anneli Victoria Mellblom
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of MedicineUniversity of OsloOsloNorway,Regional Centre for Child and Adolescent Mental Health Eastern and Southern Norway (RBUP)OsloNorway
| | - Ellen Ruud
- Department of Paediatric Haematology and Oncology, Division for Paediatric and Adolescent MedicineOslo University Hospital, RikshospitaletOsloNorway,Institute of Clinical Medicine, Faculty of MedicineUniversity of OsloOsloNorway
| | - Hanne Baekgaard Larsen
- Department of Pediatrics and Adolescents MedicineUniversity Hospital RigshospitaletCopenhagenDenmark,Faculty of Health Sciences, The University of Copenhagen and The Pediatric Clinic, Juliane Marie CentreRigshospitaletCopenhagenDenmark
| | - Hanne Cathrine Lie
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of MedicineUniversity of OsloOsloNorway
| |
Collapse
|
3
|
Arpaci T, Altay N, Yozgat AK, Yaralı HN, Özbek NY. 'Trying to catch up with life': The expectations and views of adolescent survivors of childhood acute lymphoblastic leukaemia about long-term follow-up care: A qualitative research. Eur J Cancer Care (Engl) 2022; 31:e13667. [PMID: 35866542 DOI: 10.1111/ecc.13667] [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: 04/05/2022] [Revised: 06/16/2022] [Accepted: 07/05/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of this study was to explore adolescent survivors' views and expectations about long-term follow-up care. METHODS Semi-structured, in-depth interviews were conducted with 16 adolescent survivors of childhood acute lymphoblastic leukaemia. Survivors who had completed treatment at least 2 years ago were involved in the study. Interviews were audio-recorded and transcribed verbatim. An inductive thematic approach was used to analyse the data. RESULTS Four main themes and sub-themes were identified from the analysis as follows: information needs with three sub-themes 'long-term follow-up, healthy life and social life', support needs with three sub-themes 'psychosocial (peer relations etc.), school related and social-emotional (fear of relapse, body image, self-esteem, etc.)', perceived benefits with two sub-themes 'social-emotional and related to long-term follow-up' and perceived barriers 'medical-hospital related and social life'. CONCLUSIONS Adolescent survivors mainly need support in terms of psychosocial aspects: self-esteem-body image, school, peer relations and social activities during follow-up. Identified barriers related to follow-up were school absence and not able to participate social activities. Adolescents specify health promotion approaches as benefits aspects of follow-up. The findings of this study will guide nurses in the long-term follow-up care of adolescent survivors of acute lymphoblastic leukaemia and provide an opportunity to plan individualised follow-up care.
Collapse
Affiliation(s)
- Tuba Arpaci
- Department of Nursing, Faculty of Health Sciences, Karamanoğlu Mehmetbey University, Karaman, Turkey
| | - Naime Altay
- Department of Nursing, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Ayça Koca Yozgat
- Pediatric Hematology and Oncology Department, Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Hüsniye Neşe Yaralı
- Pediatric Hematology and Oncology Department, Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Namık Yaşar Özbek
- Pediatric Hematology and Oncology Department, Ministry of Health Ankara City Hospital, Ankara, Turkey
| |
Collapse
|
4
|
Thornton CP, Henegan S, Carey LB, Milla K, Cork K, Cooper SL, Jacobson LA, Ruble K, Paré-Blagoev EJ. Addressing Schooling in Children With Cancer-It's Everybody's Job, So It's Nobody's Job: An Explanatory Mixed-Methods Evaluation. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2022; 39:221-230. [PMID: 35791852 DOI: 10.1177/27527530211073295] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Background: Neurocognitive deficits from childhood cancer treatment are common, long-standing, and negatively impact multiple domains of life leading to challenges with schooling and education. The purpose of this study is to describe caregiver-reported experiences of neurocognitive effects from therapy and to understand the roles clinicians play in this domain in the United States. Methods: An explanatory mixed-methods study of 174 caregivers of children with cancer provided insight into how clinicians provided information on neurocognitive effects of treatment and their experiences with school-related resources. Clinicians provided descriptions of how they provide this information and assist families with accessing services or transition back to school after therapy. Results: Caregivers identified that physicians, nurses, and social workers primarily provide information regarding neurocognitive effects of treatment. Over half (55.9%) of families seek additional information elsewhere and 49.4% report doing so because the information they received from their team was inadequate. Nearly 40% of caregivers report accessing school supports feels like a constant fight and over 40% were not offered homebound educational services by their school. Qualitative interviews with providers found that clinicians focus on therapy-related physical symptoms of treatment and only discuss neurocognitive effects when prompted by families or when children are returning to school. Discussion: Clinicians' focus on physical symptoms and just-in-time thinking when it comes to providing education or school-related services may explain why families endorse infrequent education on the topic and challenges with school reintegration. Improved education for clinicians on this topic, integration of interdisciplinary teams, and new clinical practice models may improve the family experience.
Collapse
Affiliation(s)
- Clifton P Thornton
- 23303Herman & Walter Samuelson Children's Hospital at Sinai, 15851Johns Hopkins School of Nursing, Baltimore, MD, USA
| | - Sydney Henegan
- 15851Johns Hopkins School of Nursing, Baltimore, MD, USA
| | - Lisa B Carey
- Department of Neuropsychology, Center for Innovation and Leadership in Special Education, 20870Kennedy Krieger Institute, Baltimore, MD, USA
| | - Kim Milla
- Department of Neuropsychology, 20870Kennedy Krieger Institute, Baltimore, MD, USA
| | - Katrina Cork
- 1466Department of Pediatric Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Stacy L Cooper
- 1466Department of Pediatric Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Lisa A Jacobson
- Department of Neuropsychology, Psychiatry & Behavioral Sciences, Johns Hopkins School of Medicine, 20870Kennedy Krieger Institute, Baltimore, MD, USA
| | - Kathy Ruble
- 1466Department of Pediatric Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | |
Collapse
|
5
|
Mellblom AV, Ruud E, Loge JH, Lie HC, Finset A. From Observation to Action: Developing and Pilot-Testing a Communication Tool for Follow-up Consultations with Adolescent Cancer Survivors. J Adolesc Young Adult Oncol 2021; 11:419-426. [PMID: 34910892 DOI: 10.1089/jayao.2021.0123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: Efficient physician communication with adolescent cancer survivors (ACS) during follow-up consultations is important to enable survivors to take responsibility for their health. The present study had two aims: to develop a communication tool to enhance structured consultations and improve clinician communication in follow-up consultations, and to pilot-test the tool in physicians' consultations with ACS. Methods: Clinicians and communication experts collaborated closely to develop the 7 Memory Hooks (7MH) communication tool and a corresponding coding scheme for scoring communication behavior in consultations. Thirty-seven follow-up consultations between ACS and physicians were video-recorded (22 before intervention and 15 after intervention). The intervention consisted of a didactic lecture, a group workshop, and individual coaching to provide feedback to physicians on the communication skills observed in the pre-intervention videos. We then compared physicians' communication behavior both before and after intervention. Results: Fourteen physicians participated in the 7MH training. The mean total score on the 7MH scheme was significantly higher post-intervention compared with pre-intervention (p = 0.001). Six behaviors changed significantly after the intervention. At a group level, physicians were more likely to be alone with the adolescent (p = 0.004) and to prepare the patient for transition to adult heath care (p = 0.040). They asked more often about the patients' expectations (p = 0.007) and resources ((p = 0.019). And they acknowledged patients' concerns more often (p = 0.016) but talked significantly less about physical activity (p = 0.012). Conclusion: A physician communication tool, designed bottom-up and developed in collaboration with the clinic, shows promising effects on physicians' communication behavior at follow-up consultations with ACS.
Collapse
Affiliation(s)
- Anneli V Mellblom
- Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway.,Regional Centre for Child and Adolescent Mental Health Eastern and Southern Norway Oslo, Oslo, Norway
| | - Ellen Ruud
- Division for Paediatric and Adolescent Medicine, Department of Pediatric Haematology and Oncology, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Jon Håvard Loge
- Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Hanne C Lie
- Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Arnstein Finset
- Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| |
Collapse
|
6
|
Andrés‐Jensen L, Larsen HB, Johansen C, Frandsen TL, Schmiegelow K, Wahlberg A. Everyday life challenges among adolescent and young adult survivors of childhood acute lymphoblastic leukemia: An in‐depth qualitative study. Psychooncology 2020; 29:1630-1637. [DOI: 10.1002/pon.5480] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 06/26/2020] [Accepted: 06/30/2020] [Indexed: 11/08/2022]
Affiliation(s)
- Liv Andrés‐Jensen
- Department of Paediatrics and Adolescent Medicine Copenhagen University Hospital Copenhagen Denmark
| | - Hanne Baekgaard Larsen
- Department of Paediatrics and Adolescent Medicine Copenhagen University Hospital Copenhagen Denmark
- Institute of Clinical Medicine, Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
| | - Christoffer Johansen
- Late Effects Research Unit CASTLE, Finsen Center Copenhagen University Hospital Copenhagen Denmark
- Survivorship Research Unit Danish Cancer Society Center Copenhagen Denmark
| | - Thomas Leth Frandsen
- Department of Paediatrics and Adolescent Medicine Copenhagen University Hospital Copenhagen Denmark
| | - Kjeld Schmiegelow
- Department of Paediatrics and Adolescent Medicine Copenhagen University Hospital Copenhagen Denmark
- Institute of Clinical Medicine, Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
| | - Ayo Wahlberg
- Department of Anthropology University of Copenhagen Copenhagen Denmark
| |
Collapse
|
7
|
Palmer NR, Avis NE, Fino NF, Tooze JA, Weaver KE. Rural cancer survivors' health information needs post-treatment. PATIENT EDUCATION AND COUNSELING 2020; 103:1606-1614. [PMID: 32147307 PMCID: PMC7311274 DOI: 10.1016/j.pec.2020.02.034] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 02/03/2020] [Accepted: 02/26/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVE This study describes the most common cancer-related health information needs among rural cancer survivors and characteristics associated with reporting more information needs. METHODS Rural breast, prostate, and colorectal cancer survivors, two to five years post-diagnosis, identified from an institutional cancer registry, completed a mailed/telephone-administered survey. Respondents were asked about 23 health information needs in eight domains (tests and treatment, side effects and symptoms, health promotion, fertility, interpersonal, occupational, emotional, and insurance). Poisson regression models were used to assess relationships between number of health information needs and demographic and cancer characteristics. RESULTS Participants (n = 170) reported an average of four health information needs, with the most common domains being: side effects and symptoms (58 %), health promotion (54 %), and tests and treatment (41 %). Participants who were younger (compared to 5-year increase, rate ratio [RR] = 1.11, 95 % CI = 1.02-1.21), ethnic minority (RR = 1.89, 95 % CI = 1.17-3.06), less educated (RR = 1.49, 95 % CI = 1.00-2.23), and financially stressed (RR = 1.87, 95 % CI = 1.25-2.81) had a greater number of information needs. CONCLUSIONS Younger, ethnic minority, less educated, and financially strained rural survivors have the greatest need for informational support. PRACTICE IMPLICATIONS The provision of health information for rural cancer survivors should consider type of cancer, treatments received, and sociocultural differences to tailor information provided.
Collapse
Affiliation(s)
- Nynikka R Palmer
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
| | - Nancy E Avis
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Nora F Fino
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Janet A Tooze
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Kathryn E Weaver
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
| |
Collapse
|
8
|
Simensen VC, Smeland KB, Kiserud CE, Dahl AA, Bersvendsen HS, Fluge Ø, Fagerli UM, Fosså A. Survivors' knowledge of their diagnosis, treatment and possible late adverse effects after autologous stem cell transplantation for lymphoma. Acta Oncol 2019; 58:1315-1322. [PMID: 31286808 DOI: 10.1080/0284186x.2019.1637538] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: Lymphoma survivors after high dose therapy with autologous stem cell therapy (HD-ASCT) are at high risk for late adverse effects (AEs). Information patients receive and collect throughout their cancer trajectory about diagnosis, treatment schedule and risks of AEs may influence attitudes and health-related behavior in the years after treatment. The purpose of this study was to explore level of knowledge in lymphoma survivors after HD-ASCT at a median of 12 years after primary diagnosis. Material and methods: From a national study on the effects of HD-ASCT for lymphomas, 269 survivors met for an outpatient examination, including a structured interview addressing knowledge about diagnosis and treatment. Survivors were also asked whether they knew and/or had experienced certain common late AEs. Numbers of recognized and experienced late AEs were presented as sum scores. Factors associated with the level of knowledge of late AEs were analyzed by linear regression analysis. Results: Eighty-one percent of the survivors knew their diagnosis, 99% knew the components of HD-ASCT and 97% correctly recalled having had radiotherapy. Ninety percent reported awareness of late AEs, but the level of knowledge and personal experience with specified AEs varied. Thirty-five percent of survivors stated to have received follow-up for late AEs. In multivariable analysis younger age at diagnosis, having received mediastinal radiotherapy, higher mental health related quality of life, a higher number of self-experienced late AEs and having received follow-up care for late AEs were significantly associated with a higher level of knowledge of AEs. Conclusion: The majority of lymphoma survivors treated with HD-ASCT correctly recalled diagnosis and treatment, while knowledge of late AEs varied. Our findings point to information deficits in survivors at older age and with lower mental health related quality of life. They indicate benefit of follow-up to enhance education on late AEs in lymphoma survivors.
Collapse
Affiliation(s)
- Victoria C. Simensen
- National Advisory Unit for Late Effects after Cancer Treatment, Oslo University Hospital, Oslo, Norway
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Knut B. Smeland
- National Advisory Unit for Late Effects after Cancer Treatment, Oslo University Hospital, Oslo, Norway
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Cecilie E. Kiserud
- National Advisory Unit for Late Effects after Cancer Treatment, Oslo University Hospital, Oslo, Norway
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Alv A. Dahl
- National Advisory Unit for Late Effects after Cancer Treatment, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | - Øystein Fluge
- Department of Oncology, Haukeland University Hospital, Bergen, Norway
| | - Unn-Merete Fagerli
- Department of Oncology, St. Olav’s University Hospital, Trondheim, Norway
- Institute Clinical and Molecular Medicine (IKOM), The Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Alexander Fosså
- National Advisory Unit for Late Effects after Cancer Treatment, Oslo University Hospital, Oslo, Norway
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| |
Collapse
|
9
|
Michel G, Mulder RL, van der Pal HJH, Skinner R, Bárdi E, Brown MC, Vetsch J, Frey E, Windsor R, Kremer LCM, Levitt G. Evidence-based recommendations for the organization of long-term follow-up care for childhood and adolescent cancer survivors: a report from the PanCareSurFup Guidelines Working Group. J Cancer Surviv 2019; 13:759-772. [DOI: 10.1007/s11764-019-00795-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 07/22/2019] [Indexed: 10/26/2022]
|
10
|
Christen S, Weishaupt E, Vetsch J, Rueegg CS, Mader L, Dehler S, Michel G. Perceived information provision and information needs in adolescent and young adult cancer survivors. Eur J Cancer Care (Engl) 2018; 28:e12892. [DOI: 10.1111/ecc.12892] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 04/03/2018] [Accepted: 06/15/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Salome Christen
- Department of Health Sciences and Health Policy; University of Lucerne; Lucerne Switzerland
| | - Esther Weishaupt
- Department of Health Sciences and Health Policy; University of Lucerne; Lucerne Switzerland
| | - Janine Vetsch
- Department of Health Sciences and Health Policy; University of Lucerne; Lucerne Switzerland
- Discipline of Paediatrics; School of Women's and Children's Health; UNSW Medicine; University of New South Wales; Sydney New South Wales Australia
- Kids Cancer Centre; Sydney Children's Hospital; Sydney New South Wales Australia
| | - Corina S. Rueegg
- Department of Health Sciences and Health Policy; University of Lucerne; Lucerne Switzerland
- Oslo Centre for Biostatistics and Epidemiology; Oslo University Hospital, and Institute of Basic Medical Sciences; University of Oslo; Oslo Norway
| | - Luzius Mader
- Department of Health Sciences and Health Policy; University of Lucerne; Lucerne Switzerland
| | - Silvia Dehler
- Departement Gesundheit und Soziales; Abteilung Gesundheit; Aarau Switzerland
- Cancer Registry Zurich and Zug; Institute of Surgical Pathology; University Hospital Zurich; Zurich Switzerland
- Epidemiology, Biostatistics and Prevention Institute; University Zurich; Zurich Switzerland
| | - Gisela Michel
- Department of Health Sciences and Health Policy; University of Lucerne; Lucerne Switzerland
- Institute of Social and Preventive Medicine; University of Bern; Bern Switzerland
| |
Collapse
|
11
|
Greenzang KA, Dauti A, Mack JW. Parent perspectives on information about late effects of childhood cancer treatment and their role in initial treatment decision making. Pediatr Blood Cancer 2018; 65:e26978. [PMID: 29380535 PMCID: PMC5911214 DOI: 10.1002/pbc.26978] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 12/20/2017] [Accepted: 12/22/2017] [Indexed: 12/27/2022]
Abstract
BACKGROUND Though most childhood cancer survivors experience late effects of treatment, we know little about parent preferences for late effects information during therapy, or how parents weigh late effects when making treatment decisions. Our objective was to explore how parents of children with cancer consider late effects in initial treatment decision making and during active cancer treatment. METHODS Semistructured interviews were conducted with 12 parents of children with cancer who were actively receiving treatment at Dana-Farber/Boston Children's Cancer and Blood Disorders Center. Interviews were audio-recorded, transcribed verbatim, and qualitatively analyzed using thematic analysis. RESULTS Ten of 12 parents reported that they had to decide between two or more treatment options for their child's cancer. Of those, 50% (5/10) considered late effects to be an important factor in their decision making. Most parents wanted early and detailed information about their child's risk of late effects to make treatment decisions and to feel prepared for the future. However, a few parents felt too overwhelmed to focus on late effects at diagnosis. While many recalled extensive late effects information in informed consent discussions, some parents felt these issues were minimally addressed. CONCLUSION Parents desire detailed information about late effects to make informed treatment decisions and prepare for the future. Despite the role of late effects in treatment decision making, some parents feel that late effects are either inadequately addressed or too overwhelming to process at diagnosis. Parents may benefit from early assessment of their information needs and a return to these issues over time.
Collapse
Affiliation(s)
- Katie A. Greenzang
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA,Division of Population Sciences, Dana-Farber Cancer Institute, Boston, MA,Division of Pediatric Hematology/Oncology, Boston Children's Hospital, Boston, MA
| | | | - Jennifer W. Mack
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA,Division of Population Sciences, Dana-Farber Cancer Institute, Boston, MA,Division of Pediatric Hematology/Oncology, Boston Children's Hospital, Boston, MA
| |
Collapse
|
12
|
Gorman JR, Standridge DC, Lyons KS, Elliot DL, Winters-Stone K, Julian AK, Weprin J, Storksdieck M, Hayes-Lattin B. Patient-centered communication between adolescent and young adult cancer survivors and their healthcare providers: Identifying research gaps with a scoping review. PATIENT EDUCATION AND COUNSELING 2018; 101:185-194. [PMID: 28882546 DOI: 10.1016/j.pec.2017.08.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 08/23/2017] [Accepted: 08/30/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To conduct a scoping literature review to identify practices or programs that promote AYA patient-centered communication. METHODS Between January and May of 2016, we applied standard scoping review methodology to systematically review articles. We considered peer-reviewed, English language articles written at any phase of intervention research. Both qualitative and quantitative studies were eligible, and no additional search restrictions were applied. We retained articles that included explicit or implicit outcomes for one of the six functions of patient-centered communication in cancer care. At least two independent reviewers assessed the articles. RESULTS We screened a total of 4072 titles and abstracts, retaining 27 for full-text review. Ultimately, eight titles met the review's inclusion criteria. We categorized each publication by the action or setting used to improve patient-centered communication, resulting in five categories. Most studies were not included because they did not include a patient-centered communication outcome. CONCLUSION This area of research is still emerging, as indicated by the small number of eligible studies and predominance of qualitative, descriptive, pilot, and feasibility studies with small sample sizes. PRACTICE IMPLICATIONS Our results suggest a clear need to develop and evaluate interventions focused on improving patient-centered communication between AYA survivors and their healthcare providers.
Collapse
Affiliation(s)
- Jessica R Gorman
- School of Social and Behavioral Health Sciences, Oregon State University, Corvallis, USA.
| | - Danielle C Standridge
- School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR, USA.
| | - Karen S Lyons
- School of Nursing, Oregon Health & Science University, Portland, USA.
| | - Diane L Elliot
- Department of Medicine, Oregon Health & Science University, Portland, USA.
| | | | - Anne K Julian
- School of Social and Behavioral Health Sciences, Oregon State University, Corvallis, USA.
| | - Jennifer Weprin
- School of Nursing, Oregon Health & Science University, Portland, USA.
| | | | | |
Collapse
|
13
|
Wu WW, Liu CY, Jou ST, Hung GY, Liang SY. Development and feasibility of Mandarin-language bone health scales for adolescents with cancer in Taiwan. Nurs Health Sci 2018; 20:197-205. [PMID: 29316107 DOI: 10.1111/nhs.12402] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 09/22/2017] [Accepted: 10/24/2017] [Indexed: 12/27/2022]
Abstract
Cancer during adolescence increases the risk for bone mass deficiency later in life. Adolescents with cancer must learn to improve their bone health to avoid osteoporosis. In the present cross-sectional study, we developed and tested scales to assess the bone health self-efficacy and beliefs of adolescents with cancer in Taiwan. Test development followed three stages: item generation and scale formatting, examination of content validity, and validation of psychometric properties with a sample of 100 adolescents with cancer. Through the validation process, this research generated the seven-item Bone Health Self-Efficacy Scale and the 13-item Bone Health Belief Scale. Multiple indices demonstrated construct validity. Cronbach's alphas (0.809 and 0.705) demonstrated internal consistency. No items caused a drop in Cronbach's alpha of 10%, all inter-item correlations were <0.800, and the factor loadings for all items reached 0.400, demonstrating item appropriateness. The present study provides initial evidence of the scales' accessibility and feasibility for adolescents with cancer who speak Mandarin. These scales might also help clinical nurses evaluate the effectiveness of bone health education provided to adolescents with cancer.
Collapse
Affiliation(s)
- Wei-Wen Wu
- School of Nursing, National Taiwan University, Taipei, Taiwan
| | - Chieh-Yu Liu
- Department of Speech Language Pathology and Audiology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Shiann-Tarng Jou
- Department of Medicine, National Taiwan University, Taipei, Taiwan
| | - Giun-Yi Hung
- Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Pediatrics, National Yang-Ming University, Taipei, Taiwan
| | - Shu-Yuan Liang
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| |
Collapse
|
14
|
Berger C, Casagranda L, Faure-Conter C, Freycon C, Isfan F, Robles A, Trombert-Paviot B, Guichard I, Durieu I, Cathebras P. Long-Term Follow-up Consultation After Childhood Cancer in the Rhône-Alpes Region of France: Feedback From Adult Survivors and Their General Practitioners. J Adolesc Young Adult Oncol 2017; 6:524-534. [PMID: 28541785 DOI: 10.1089/jayao.2017.0019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE We evaluated the satisfaction of adult survivors of childhood cancers and their general practitioners (GP) after a long-term consultation. METHODS The first Long-term Follow-up Study in Oncology (SALTO1) is a prospective cohort study of survivors of childhood cancers (except leukemia) diagnosed between 1987 and 1992 in the Rhône-Alpes and Auvergne regions of France. Of the 481 patients eligible for the study, 150 participated in a long-term consultation with a pediatric oncologist and an internist, after which survivors and their GPs received long-term plans and recommendations based on consultation findings. A year after the consultation, survivors and their GPs assessed their satisfaction with the process. RESULTS Of the 150 survivor participants in the long-term follow-up, 120 (80%) completed the satisfaction form, with 107 (89%) reporting satisfaction. Forty-eight (32%) expressed strengthening their follow-up as a consequence of the consultation. Of the 79 survivors sent recommendations, 76 (96%) reported reading them, most (n = 68; 86%) found them useful, and 56 (71%) followed recommendations. Of the 107 GPs of the survivors, 82 (77%) conceded having been poorly informed about long-term complications for their patients after chemotherapy, and 93 (88%) appreciated having a hospital contact available for these patients. CONCLUSION The long-term consultations ultimately enhanced medical follow-up of survivor participants, improving knowledge of both patients and family physicians regarding the patients' early disease, its treatments, and possible concerns, and offering consultative resources of medical specialists. The levels of participation of survivors and their physicians and reported satisfaction encourage the adoption of such consultations throughout France.
Collapse
Affiliation(s)
- Claire Berger
- 1 Department of Pediatric Hematology and Oncology Unit, University Hospital of Saint-Etienne , Saint-Etienne Cedex 02, France .,2 Childhood Cancer Registry of the Rhône-Alpes Region, University of Saint-Etienne , Saint-Etienne Cedex 02, France .,3 Host Research Team EA4607 SNA-EPIS, PRES Lyon, Jean Monnet University, University Hospital , Saint-Etienne, France
| | - Léonie Casagranda
- 1 Department of Pediatric Hematology and Oncology Unit, University Hospital of Saint-Etienne , Saint-Etienne Cedex 02, France .,2 Childhood Cancer Registry of the Rhône-Alpes Region, University of Saint-Etienne , Saint-Etienne Cedex 02, France .,3 Host Research Team EA4607 SNA-EPIS, PRES Lyon, Jean Monnet University, University Hospital , Saint-Etienne, France
| | | | - Claire Freycon
- 5 Department of Pediatric Hematology and Oncology Unit, University Hospital of Grenoble , Grenoble Cedex 9, France
| | - Florentina Isfan
- 6 Department of Pediatric Hematology and Oncology Unit, University Hospital Estaing of Clermont-Ferrand , Clermont-Ferrand, France
| | - Aurélie Robles
- 7 Department of Internal Medicine Unit, Hospital of Firminy , Firminy, France
| | - Béatrice Trombert-Paviot
- 3 Host Research Team EA4607 SNA-EPIS, PRES Lyon, Jean Monnet University, University Hospital , Saint-Etienne, France .,8 Department of Public Health and Medical Informatics, University of Saint-Etienne , Saint-Etienne Cedex 02, France
| | - Isabelle Guichard
- 9 Department of Internal Medicine Unit, University Hospital of Saint-Etienne , Saint-Etienne Cedex 02, France
| | - Isabelle Durieu
- 10 Department of Internal Medicine and Vascular Pathology Unit, University Hospital of Lyon Sud , Pierre-Bénite, France
| | - Pascal Cathebras
- 9 Department of Internal Medicine Unit, University Hospital of Saint-Etienne , Saint-Etienne Cedex 02, France
| |
Collapse
|
15
|
Wong AWK, Chang TT, Christopher K, Lau SCL, Beaupin LK, Love B, Lipsey KL, Feuerstein M. Patterns of unmet needs in adolescent and young adult (AYA) cancer survivors: in their own words. J Cancer Surviv 2017; 11:751-764. [DOI: 10.1007/s11764-017-0613-4] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 03/09/2017] [Indexed: 12/13/2022]
|
16
|
Lie HC. Mind the Gap: (Unmet) Information needs in cancer care. PATIENT EDUCATION AND COUNSELING 2017; 100:381-382. [PMID: 28288750 DOI: 10.1016/j.pec.2017.02.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Hanne C Lie
- Department of Pediatric Medicine and National Advisory Unit on Late effects after Cancer Treatment, Oslo University Hospital, Oslo, Norway.
| |
Collapse
|
17
|
Lie HC, Mellblom AV, Brekke M, Finset A, Fosså SD, Kiserud CE, Ruud E, Loge JH. Experiences with late effects-related care and preferences for long-term follow-up care among adult survivors of childhood lymphoma. Support Care Cancer 2017; 25:2445-2454. [PMID: 28236146 DOI: 10.1007/s00520-017-3651-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 02/17/2017] [Indexed: 10/20/2022]
Abstract
PURPOSE Given childhood cancer survivors' risk of treatment-induced late effects, long-term follow-up care is recommended. We explored experiences with late effects-related care and preferences for long-term follow-up care among adult survivors of childhood malignant lymphoma in Norway. METHODS We conducted five focus group interviews with 34 survivors (19 females; 21 Hodgkin/13 non-Hodgkin lymphoma survivors; mean age 39 years; mean time from diagnosis 26 years). Data was analyzed using principles of thematic analysis. RESULTS Two main themes were identified: (1) the survivors' experiences with late effects-related care and (2) their preferences for long-term follow-up care. Most of the survivors were dissatisfied with their late effects-related care due to perceptions of poor coordination of healthcare needs in a fragmented system, combined with a perceived lack of knowledge of late effects among themselves and general practitioners (GPs). All survivors valued long-term follow-up care. Oncologists were the preferred care providers, but GPs were considered acceptable providers if they had sufficient knowledge of late effects and routine examinations, short waiting times, and improved GP-oncologist collaboration. CONCLUSIONS Our results suggest that a shared care model of long-term follow-up care involving specialists, GPs, and the survivors themselves is likely to fulfill several of the currently unmet needs among adult survivors of childhood cancers. Improved patient education about late effects and follow-up care would aid self-management. The survivors' concerns regarding lack of sufficient knowledge of late effects among GPs suggest a need for improving access to, and dissemination of, information of late effects.
Collapse
Affiliation(s)
- Hanne C Lie
- Department of Behavioural Sciences in Medicine, Institute for Basic Medical Sciences, Faculty of Medicine, University of Oslo, P.B. 1111 Blindern, 0317, Oslo, Norway. .,Department of Paediatric Medicine, Faculty of Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway. .,National Advisory Unit on Late Effects after Cancer Treatment, Oslo University Hospital, Oslo, Norway.
| | - Anneli V Mellblom
- Department of Behavioural Sciences in Medicine, Institute for Basic Medical Sciences, Faculty of Medicine, University of Oslo, P.B. 1111 Blindern, 0317, Oslo, Norway
| | - Mette Brekke
- Department of General Practice, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Arnstein Finset
- Department of Behavioural Sciences in Medicine, Institute for Basic Medical Sciences, Faculty of Medicine, University of Oslo, P.B. 1111 Blindern, 0317, Oslo, Norway
| | - Sophie D Fosså
- National Advisory Unit on Late Effects after Cancer Treatment, Oslo University Hospital, Oslo, Norway
| | - Cecilie E Kiserud
- National Advisory Unit on Late Effects after Cancer Treatment, Oslo University Hospital, Oslo, Norway
| | - Ellen Ruud
- Department of Paediatric Medicine, Faculty of Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Jon H Loge
- Department of Behavioural Sciences in Medicine, Institute for Basic Medical Sciences, Faculty of Medicine, University of Oslo, P.B. 1111 Blindern, 0317, Oslo, Norway.,Regional Advisory Unit in Palliative Care, Department of Oncology, Oslo University Hospital, Oslo, Norway
| |
Collapse
|
18
|
Pugh G, Hough RE, Gravestock HL, Jackson SE, Fisher A. The Health Behavior Information Needs and Preferences of Teenage and Young Adult Cancer Survivors. J Adolesc Young Adult Oncol 2017; 6:318-326. [PMID: 28165844 DOI: 10.1089/jayao.2016.0089] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE This study aimed to establish teenage and young adult cancer survivors (TYACS') specific interest in receiving information on physical activity, diet, smoking, and alcohol consumption and their preferences regarding the delivery, format, and timing of such health behavior information. METHODS TYACS aged 13-25 years were invited to complete a questionnaire assessing the advice they had received in the past and their preferences on when and how health behavior information should be delivered. RESULTS A total of 216 TYACS (mean age: 20 years; mean age at diagnosis: 16 years) completed the questionnaire. Approximately 40% of TYACS received no advice on physical activity and diet, and more than half (54%) received no advice on weight management. The majority (>70%) reported receiving no advice on smoking or alcohol consumption. Interest in receiving lifestyle advice was high overall (71%) but varied across behaviors, with TYACS reporting a greater level of interest in receiving advice on health protective behaviors (physical activity and diet) than health risk behaviors (smoking and alcohol consumption) (∼85% vs. ∼15%, respectively). TYACS reported seeking health behavior information from health professionals and were most interested in information delivered online or in the form of a mobile app. Similar proportions (18%-29%) felt health behavior information should first be provided before, during, immediately after, and post-treatment. CONCLUSIONS It is evident that there is a need to develop lifestyle interventions in a range of formats available to TYACS throughout the care pathway to address the health behavior information needs of young people with cancer.
Collapse
Affiliation(s)
- Gemma Pugh
- 1 Department of Epidemiology and Public Health, Health Behaviour Research Centre, University College London , London, United Kingdom
| | - Rachael E Hough
- 2 Department of Haematology, University College London Hospital , London, United Kingdom
| | | | - Sarah E Jackson
- 1 Department of Epidemiology and Public Health, Health Behaviour Research Centre, University College London , London, United Kingdom
| | - Abigail Fisher
- 1 Department of Epidemiology and Public Health, Health Behaviour Research Centre, University College London , London, United Kingdom
| |
Collapse
|
19
|
Vetsch J, Fardell JE, Wakefield CE, Signorelli C, Michel G, McLoone JK, Walwyn T, Tapp H, Truscott J, Cohn RJ. "Forewarned and forearmed": Long-term childhood cancer survivors' and parents' information needs and implications for survivorship models of care. PATIENT EDUCATION AND COUNSELING 2017; 100:355-363. [PMID: 27693083 DOI: 10.1016/j.pec.2016.09.013] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 09/02/2016] [Accepted: 09/21/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE This mixed-method study assessed 1) survivors' and parents' information needs; and 2) associations between unmet information needs and clinical and socio-demographic characteristics. METHODS Stage 1: CCS and parents of CCS, >5years post-diagnosis completed a questionnaire on information needs, overall health and perceived risk. Predictors for unmet information needs were assessed by multivariable regression. Stage 2: participants were interviewed in-depth on these topics. RESULTS Questionnaires were completed by 485 participants comprising 322 survivors (mean age: 26.7years, SD=7.9; time since diagnosis: 19.7years, SD=8.8) and 163 parents (child age: 12.9years, SD=2.4; time since diagnosis: 9.7years, SD=2.3), and complemented by 70 interviews. Survivors reported unmet information needs about late effects (57.5%) and parents for fertility issues (62.5%). Survivors had more unmet needs for medical information whereas parents had significantly more regarding sexual issues and lifestyle. Being a parent (p=0.001), dissatisfaction with follow-up care (p=0.003), lower overall health (p=0.014), higher perceived risk of late effects (p<0.001), and greater anxiety/depression (p<0.001) were significantly associated with more unmet needs. CONCLUSION Unmet information needs were common for survivors and parents of CCS. PRACTICE IMPLICATIONS Future efforts towards tailoring information on potential late effects, healthy lifestyles and follow-up care may help to address unmet information needs.
Collapse
Affiliation(s)
- Janine Vetsch
- University of Lucerne, Department of Health Sciences and Health Policy, Lucerne, Switzerland; Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Kensington, NSW, 2031, Australia; Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, 2031, Australia
| | - Joanna E Fardell
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Kensington, NSW, 2031, Australia; Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, 2031, Australia
| | - Claire E Wakefield
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Kensington, NSW, 2031, Australia; Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, 2031, Australia.
| | - Christina Signorelli
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Kensington, NSW, 2031, Australia; Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, 2031, Australia
| | - Gisela Michel
- University of Lucerne, Department of Health Sciences and Health Policy, Lucerne, Switzerland
| | - Jordana K McLoone
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Kensington, NSW, 2031, Australia; Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, 2031, Australia
| | - Thomas Walwyn
- Department of Oncology and Haematology, Princess Margaret Hospital for Children, Subiaco, Western Australia, Australia
| | - Heather Tapp
- Department of Clinical Haematology/Oncology, Women's and Children's Hospital, Adelaide, Australia
| | - Jo Truscott
- Children's Haematology Oncology Centre, Christchurch Hospital, Christchurch, New Zealand
| | - Richard J Cohn
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Kensington, NSW, 2031, Australia; Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, 2031, Australia
| |
Collapse
|
20
|
Lown EA, Phillips F, Schwartz LA, Rosenberg AR, Jones B. Psychosocial Follow-Up in Survivorship as a Standard of Care in Pediatric Oncology. Pediatr Blood Cancer 2015; 62 Suppl 5:S514-84. [PMID: 26700918 PMCID: PMC5242467 DOI: 10.1002/pbc.25783] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 09/08/2015] [Accepted: 09/10/2015] [Indexed: 01/08/2023]
Abstract
Childhood cancer survivors (CCS) have a high risk of medical late effects following cancer therapy. Psychosocial late effects are less often recognized. Many CCS do not receive long-term follow-up (LTFU) care, and those who do are rarely screened for psychosocial late effects. An interdisciplinary team conducted a systematic review of qualitative and quantitative studies to assess social, educational, vocational, psychological, and behavioral outcomes along with factors related to receipt of LTFU care. We propose that psychosocial screening be considered a standard of care in long-term follow-up care and that education be provided to promote the use LTFU care starting early in the treatment trajectory.
Collapse
Affiliation(s)
- E. Anne Lown
- Department of Social and Behavioral Sciences, School of Nursing, University of California, San Francisco, California
| | - Farya Phillips
- School of Social Work, The University of Texas at Austin, Austin, Texas
| | - Lisa A. Schwartz
- The Children’s Hospital of Philadelphia and The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Abby R. Rosenberg
- Cancer and Blood Disorders Center, Seattle Children’s Hospital, Seattle, Washington
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
| | - Barbara Jones
- School of Social Work, The University of Texas at Austin, Austin, Texas
| |
Collapse
|
21
|
Mellblom AV, Korsvold L, Finset A, Loge J, Ruud E, Lie HC. Providing Information About Late Effects During Routine Follow-Up Consultations Between Pediatric Oncologists and Adolescent Survivors: A Video-Based, Observational Study. J Adolesc Young Adult Oncol 2015; 4:200-8. [PMID: 26697269 PMCID: PMC4684659 DOI: 10.1089/jayao.2015.0037] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE Information about late effects is a prerequisite for survivors of childhood cancers to engage in self-management of their health. Yet, many lack such knowledge. This study investigated to what extent: (1) potential late effects were discussed with adolescent and young adult (AYA)-aged survivors (of pediatric cancer), and (2) information about late effects was provided by the pediatric oncologists (POs) during routine follow-up consultations. METHODS Consultations were recorded with 10 POs and 66 adolescents, aged 12-20 years, treated for leukemia (72.7%) or lymphoma (21.2%), or who had received hematopoietic stem-cell transplantation for a benign disease (7.6%). Discussions of potential late effects were identified and coded, and then the amount of information about late effects provided was categorized into three levels: none, basic, and extended information. RESULTS Potential late effects were discussed in 85% of the consultations. Of these, 71% were PO initiated, and 60% concerned existing health problems. The POs provided none, basic, and extended information about late effects in 41%, 30%, and 29% of these discussions. Patients' age, time since treatment, and risk of late effects were not associated with amount of potential late effects discussed, but the type of potential late effect (physical vs. psychosocial and current vs. future risk) and PO were. CONCLUSION Potential late effects were frequently discussed, thus providing ample opportunity to provide information about late effects to adolescent cancer survivors. The observed PO variability in providing such information indicates a need for standardization of information practices.
Collapse
Affiliation(s)
- Anneli V Mellblom
- Department of Behavioral Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo , Oslo, Norway
| | - Live Korsvold
- Department of Behavioral Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo , Oslo, Norway . ; Department of Pediatric Medicine, Women and Children's Unit, Oslo University Hospital , Rikshospitalet, Oslo, Norway
| | - Arnstein Finset
- Department of Behavioral Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo , Oslo, Norway
| | - Jon Loge
- Department of Behavioral Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo , Oslo, Norway . ; Regional Centre for Excellence in Palliative Care, Department of Oncology, Oslo University Hospital (OUS) , Oslo, Norway
| | - Ellen Ruud
- Department of Behavioral Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo , Oslo, Norway
| | - Hanne C Lie
- Department of Behavioral Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo , Oslo, Norway . ; National Resource Centre for Late Effects After Cancer Treatment, Oslo University Hospital , Radiumhospitalet, Oslo, Norway
| |
Collapse
|