1
|
Broadbridge EA, Venetis MK. Examining the role of pre-visit anxiety on patient uncertainty and breast cancer patient-provider communication. Cancer Med 2024; 13:e70003. [PMID: 39031003 PMCID: PMC11258471 DOI: 10.1002/cam4.70003] [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: 02/06/2024] [Revised: 06/14/2024] [Accepted: 06/30/2024] [Indexed: 07/22/2024] Open
Abstract
OBJECTIVE Effective communication between cancer patients and providers is critical for addressing psychological distress, reducing uncertainty, and promoting patient well-being. This is particularly relevant during medical appointments that may elicit uncertainty, such as surgical consultations for newly diagnosed women with breast cancer. This study aimed to evaluate how pre-appointment anxiety and illness uncertainty affect patient-provider communication in breast cancer surgical consultations and subsequent post-appointment well-being. Breast cancer patient anxiety has been studied as an outcome of provider communication, though less is known about the extent to which preexisting anxiety or uncertainty act as antecedents to effective patient-provider communication. METHODS This study analyzed videorecorded breast cancer surgical consultations (N = 51) and corresponding patient surveys to understand how pre-appointment anxiety influences pre-appointment patient uncertainty, patient-provider communication during the appointment, and subsequent post-appointment uncertainty. RESULTS The proposed model achieved good fit to the data such that more pre-appointment anxiety was associated with more pre-appointment uncertainty, more pre-appointment anxiety was associated with more empathic opportunities per minute, and more empathic opportunities were associated with less post-appointment uncertainty. CONCLUSIONS Results indicate breast cancer patients with anxiety pre-appointment are at-risk for more illness uncertainty and are more likely to explicitly provide empathic opportunities. This supports the need for added attention to empathic opportunities to not only address patients emotionally but to also assess whether a patient may be at higher risk of having preexisting anxiety.
Collapse
Affiliation(s)
| | - Maria K. Venetis
- Department of CommunicationRutgers UniversityNew BrunswickNew JerseyUSA
| |
Collapse
|
2
|
Kim SH, Lee J. Development and psychometric evaluation of the adjuvant endocrine therapy beliefs scale for breast cancer survivors. Arch Womens Ment Health 2024:10.1007/s00737-024-01471-z. [PMID: 38771495 DOI: 10.1007/s00737-024-01471-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 05/07/2024] [Indexed: 05/22/2024]
Abstract
PURPOSE Adjuvant endocrine therapy has a vital role in reducing breast cancer mortality. The beliefs in adjuvant endocrine therapy is a very important factor in the medication adherence of breast cancer survivors. Therefore, it is necessary to develop a standardized scale for assessment of adjuvant endocrine therapy. The purpose of this study was to identify the attributes of adjuvant endocrine therapy beliefs, and to evaluate adjuvant endocrine therapy beliefs scale psychometric properties. METHODS A hybrid model was applied to identify the concept of adjuvant endocrine therapy beliefs and measurement question were developed by the scale development process. Statistical analysis using validity analysis and Rasch analysis based on item response theory were performed. A total of 228 breast cancer survivors in South Korea participated in the study. RESULTS The finally developed adjuvant endocrine therapy beliefs scale consisted of 22 items. The items extracted by 4 factors explained 59.72% of the total variance. The model fit showed an acceptable level. The adjuvant endocrine therapy beliefs scale was excellent in convergent and discriminant validity with reliability. CONCLUSION This scale is expected to be practical and useful in identifying adjuvant endocrine therapy beliefs and developing intervention strategies to promote adjuvant endocrine therapy adherence. In addition, continuous education and support should be accompanied so that breast cancer survivors can maintain positive beliefs in adjuvant endocrine therapy adherence.
Collapse
Affiliation(s)
- Sung Hae Kim
- The Department of Nursing, College of Health, Welfare and Education, Tongmyong University, Busan, Republic of Korea
| | - JuHee Lee
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Yonsei Evidence Based Nursing Centre of Korea, A JBI Affiliated Group, Seoul, Republic of Korea, Yonsei-ro 50-1, Seodaemun-gu, 03722, Seoul, Republic of Korea.
| |
Collapse
|
3
|
Zahedi H, Alizadeh-Dibazari Z, Mirghafourvand M, Sahebihagh MH, Hosseinzadeh M. The effectiveness of couple-based interventions on the marital outcomes of women with genital and breast cancer and their partners: a systematic review and meta-analysis. BMC Cancer 2024; 24:391. [PMID: 38539118 PMCID: PMC10976738 DOI: 10.1186/s12885-024-12088-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 03/05/2024] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND Breast cancer and genital cancer are known as cancers that affect people's relationships with their partners. Women with such cancers are emotionally vulnerable and need more support from their partners. The present systematic review and meta-analysis evaluated the effectiveness of couple-based interventions on the marital outcomes of patients with these cancers and their intimate partners. METHODS To perform this systematic review, Google Scholar and databases such as PubMed, Web of Science, Cochrane, Scopus, SID (Scientific Information Database), and Magiran were searched systematically. The reviewed studies included randomized controlled trials and quasiexperimental studies in which the intervention group, couple-based interventions, and the control group received routine care, general education or no intervention for cancer treatment. In this study, the included participants were patients with breast cancer or genital cancer and their intimate partners. The primary outcomes considered in this study included patients' marital adjustment, patients' marital satisfaction, patients' marital intimacy, and patients' marital relationships. The secondary outcomes were partners' marital adjustment, partners' marital satisfaction, partners' marital intimacy, and partners' marital relationships. A meta-analysis was performed with Review Manager v. 5.3 software (The Nordic Cochrane Centre, Cochrane Collaboration, 2014; Copenhagen, Denmark). The intervention impacts on continuous outcomes were measured using standardized mean differences (SMDs) with 95% confidence interval because of the use of various scales to evaluate the outcomes. The quality of evidence presented in the included studies was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. In the subgroup analysis, the studied outcomes were divided into two parts (theory-based and non-theory-based) in terms of the theoretical context of couple-based interventions. RESULTS From a total of 138 retrieved studies, 14 trials were eligible for inclusion in the study. The results of the meta-analysis showed that the patient's marital satisfaction increased significantly with couple-based interventions (SMD 0.46, 95% confidence interval 0.07 to 0.85; 7 trials, 341 patients, very low certainty) compared to the control group, but the evidence was uncertain. However, there were no significant differences between the groups in the partner's marital satisfaction, the patient's and partner's marital adjustment, and the patient's and partner's marital intimacy. Additionally, the results of the subgroup analysis showed that the couple-based interventions significantly increased the patient's marital adjustment (SMD 1.96, 95% CI 0.87 to 3.06; 4 trials, 355 patients, very low certainty), the partner's marital adjustment (SMD 0.53, 95% CI 0.20 to 0.86; 4 trials, 347 partners, very low certainty), the patient's marital satisfaction (SMD 0.89, 95% CI 0.35 to 1.43; 2 trials, 123 patients, very low certainty), and the partner's marital satisfaction (SMD 0.57, 95% CI 0.20 to 0.94; 2 trials, 123 partners, very low certainty) compared to the control group in theory-based studies. In. However, in non-theory-based studies, the results of the meta-analysis revealed no significant differences between the intervention and control groups. CONCLUSIONS The results of this study demonstrated the impact of couple-based interventions on the marital outcomes of patients with breast and genital cancers. Because of the very low confidence in the evidence, high-quality randomized trials with a sufficient sample size should be conducted considering the proper theoretical context.
Collapse
Affiliation(s)
- Hamideh Zahedi
- Department of Community Health Nursing, Nursing & Midwifery Faculty, Student Research Committee, Tabriz University of Medical sciences, Tabriz, Iran
| | - Zohreh Alizadeh-Dibazari
- Midwifery Department, Faculty of Nursing and Midwifery, Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Social determinants of Health Research Center, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Hasan Sahebihagh
- Department of Community Health Nursing, Nursing & Midwifery Faculty, Tabriz University of Medical sciences, Tabriz, Iran
| | - Mina Hosseinzadeh
- Department of Community Health Nursing, Nursing & Midwifery Faculty, Tabriz University of Medical sciences, Tabriz, Iran.
| |
Collapse
|
4
|
Broadbridge E, Venetis MK, Devine KA, Lee LE, Banerjee SC, Greene K. Supporting the support person: Oncologists' roles in reducing support people's uncertainty and facilitating psychological adjustment. Psychooncology 2024; 33:e6313. [PMID: 38446532 PMCID: PMC11046424 DOI: 10.1002/pon.6313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 01/29/2024] [Accepted: 02/16/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVE Support people of cancer patients are at significant risk for psychological distress. Additionally, cancer patients' well-being is reciprocally associated with support peoples' psychological well-being. Informed by Uncertainty in Illness Theory, this study tests whether support person psychological well-being is influenced by provider communication and uncertainty reduction. METHODS We tested a multiple mediation model to investigate how empathic communication facilitates psychological adjustment in support people of cancer patients and how this process is mediated by support peoples' illness uncertainty and caregiver burden. Support people of cancer patients (N = 121; including spouses, adult children, etc.) completed an online questionnaire about their perceptions of oncologists' empathy, uncertainty about the cancer patients' illness, perceived caregiving burden, and their psychological adjustment to diagnoses. RESULTS Path analysis revealed that (1) more perceived oncologist empathy was associated with less illness uncertainty, (2) more illness uncertainty was associated with worse psychological adjustment and more perceived caregiver burden, and (3) more burden was associated with worse adjustment (χ2 (2) = 1.19, p = 0.55; RMSEA < 0.01; CFI = 1.00; SRMR = 0.02). CONCLUSIONS Given the reciprocal nature of well-being between cancer patients and their support people, it is critical to understand and bolster support people's psychological well-being. Results demonstrated how empathic provider communication can support psychological well-being for support people of cancer patients. Additionally, this study offers theoretical contributions to understandings of illness uncertainty in caregiver populations.
Collapse
Affiliation(s)
| | - Maria K. Venetis
- Department of Communication, Rutgers University, New Brunswick, New Jersey, USA
| | - Katie A. Devine
- Division of Pediatric Hematology/Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Lauren E. Lee
- Department of Communication, Rutgers University, New Brunswick, New Jersey, USA
| | - Smita C. Banerjee
- Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Kathryn Greene
- Department of Communication, Rutgers University, New Brunswick, New Jersey, USA
| |
Collapse
|
5
|
Liang M, Ye Z. Patient-reported outcome measures in cancer care: Integration with computerized adaptive testing. Asia Pac J Oncol Nurs 2023; 10:100323. [PMID: 38033390 PMCID: PMC10686812 DOI: 10.1016/j.apjon.2023.100323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 10/19/2023] [Indexed: 12/02/2023] Open
Affiliation(s)
- Minyu Liang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zengjie Ye
- School of Nursing, Guangzhou Medical University, Guangzhou, China
| |
Collapse
|
6
|
Broadbridge E, Greene K, Venetis MK, Lee LE, Banerjee SC, Saraiya B, Devine KA. Facilitating psychological adjustment for breast cancer patients through empathic communication and uncertainty reduction. PATIENT EDUCATION AND COUNSELING 2023; 114:107791. [PMID: 37244129 PMCID: PMC11046425 DOI: 10.1016/j.pec.2023.107791] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 05/01/2023] [Accepted: 05/08/2023] [Indexed: 05/29/2023]
Abstract
OBJECTIVES This study examined the degree to which breast cancer patients' psychological well-being is facilitated through empathic provider communication. We explored symptom/prognostic uncertainty reduction as a mechanism through which provider communication influences patient psychological adjustment. Additionally, we tested if treatment status moderates this relationship. METHODS Informed by uncertainty in illness theory, current (n = 121) and former (n = 187) breast cancer patients completed questionnaires about perceptions of their oncologists' empathy and their symptom burden, uncertainty, and adjustment to their diagnosis. Structural equation modeling (SEM) was conducted to test hypothesized relationships between perceived provider empathic communication, uncertainty, symptom burden, and psychological adjustment. RESULTS SEM supported the following: (1) higher symptom burden was associated with increased uncertainty and reduced psychological adjustment, (2) lower uncertainty was associated with increased adjustment, and (3) increased empathic communication was associated with lower symptom burden and uncertainty for all patients (χ2(139) = 307.33, p < .001; RMSEA = .063 (CI .053, .072); CFI = .966; SRMR = .057). Treatment status moderated these relationships (Δχ2 = 264.07, Δdf = 138, p < .001) such that the strength of the relationship between uncertainty and psychological adjustment was stronger for former patients than for current patients. CONCLUSIONS Results of this study reinforce the importance of perceptions of provider empathic communication as well as the potential benefits of eliciting and addressing patient uncertainty about treatment and prognosis throughout the cancer care continuum. PRACTICE IMPLICATIONS Patient uncertainty should be a priority for cancer-care providers both throughout and post-treatment for breast cancer patients.
Collapse
Affiliation(s)
| | - Kathryn Greene
- Department of Communication, Rutgers University, New Brunswick, NJ, USA.
| | - Maria K Venetis
- Department of Communication, Rutgers University, New Brunswick, NJ, USA
| | - Lauren E Lee
- Department of Communication, Rutgers University, New Brunswick, NJ, USA
| | - Smita C Banerjee
- Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Biren Saraiya
- Division of Medical Oncology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Katie A Devine
- Division of Pediatric Hematology/Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| |
Collapse
|
7
|
Vanhaeverbeek M, Catteau X, Noel JC, Simon P. Comments on: "The positive predictive value of vacuum assisted biopsy (VAB) in predicting final histological diagnosis for breast lesions of uncertain malignancy (B3 lesions): A systematic review and meta-analysis" by C.Cullinane and al. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2023; 49:673-674. [PMID: 36596715 DOI: 10.1016/j.ejso.2022.10.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 10/31/2022] [Indexed: 12/31/2022]
Affiliation(s)
- Michel Vanhaeverbeek
- Laboratoire de Médecine Factuelle, Faculté de Médecine, Université Libre de Bruxelles, CP 610, route de Lennik, 808, 1070, Brussels, Belgium.
| | - Xavier Catteau
- Pathology Department, Hôpital Universitaire de Bruxelles (H.U.B), Université Libre de Bruxelles, CP 610, Route de Lennik, 808, 1070, Brussels, Belgium
| | - Jean-Christophe Noel
- Pathology Department, Hôpital Universitaire de Bruxelles (H.U.B), Université Libre de Bruxelles, CP 610, Route de Lennik, 808, 1070, Brussels, Belgium
| | - Philippe Simon
- Service de Gynécologie, Hôpital Universitaire de Bruxelles (H.U.B), Université Libre de Bruxelles, CP 610, Route de Lennik, 808, 1070, Brussels, Belgium
| |
Collapse
|
8
|
Duque-Ortiz C, Tirado-Otalvaro AF, Guarín-Cardona LF. Vivencia de la espiritualidad en el paciente con cáncer en quimioterapia ambulatoria. REVISTA CIENCIA Y CUIDADO 2023. [DOI: 10.22463/17949831.3360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Objetivo: Analizar la vivencia de la espiritualidad en el paciente con cáncer en tratamiento con quimioterapia ambulatoria. Materiales y métodos: Se realizó una investigación cualitativa con enfoque histórico hermenéutico. Participaron seis personas con diagnóstico de cáncer que se encontraban en tratamiento de quimioterapia ambulatoria en tres centros asistenciales de la ciudad de Medellín, Colombia entre julio de 2020 y julio de 2021. La información se recolectó a través de entrevistas semiestructuradas. El proceso de análisis se realizó utilizando técnicas de la teoría fundamentada de Strauss y Corbin, tales como: microanálisis, codificación abierta, codificación axial y comparación constante. Resultado: La forma como los pacientes con cáncer en tratamiento de quimioterapia ambulatoria viven la espiritualidad se representa a través de las siguientes categorías: “Emociones vividas durante el tratamiento como impulso para seguir adelante”, “Las redes de apoyo, una fuente de fortaleza y esperanza”, “El cáncer, una prueba divina entre las limitaciones y el aprendizaje”, “La empatía del personal de salud, un mecanismo para afrontar la enfermedad y generar bienestar” y “La espiritualidad, una fuerza que cambia la perspectiva de la enfermedad”. Conclusiones: Pese a la connotación negativa del diagnóstico de cáncer, la dimensión espiritual en el paciente con cáncer en tratamiento de quimioterapia ambulatoria contribuye a que la persona vea la enfermedad desde una perspectiva positiva, aumente la fe y la esperanza para continuar luchando, le dé un sentido de que todo ha valido la pena, permite ver más allá y proporciona tranquilidad para enfrentar las adversidades ocasionadas por el cáncer.
Collapse
|