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van Zijl AC, Obermann-Borst SA, Hogeveen M, Verweij EJ, de Vries WB, Geurtzen R, Labrie NH. Mind the gap: Comparing parents' information needs about impending preterm birth to current clinical practices using a mixed methods approach. PEC INNOVATION 2024; 4:100297. [PMID: 38962499 PMCID: PMC11219962 DOI: 10.1016/j.pecinn.2024.100297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 05/16/2024] [Accepted: 05/29/2024] [Indexed: 07/05/2024]
Abstract
Objective To identify parents' information needs about impending very preterm birth and compare these needs to current information practices in the Netherlands. Methods Step 1: We surveyed N = 203 parents of preterm infants to assess their information needs. Data were analyzed using inductive thematic analysis. Step 2a: We collected information resources from hospitals (N = 9 NICUs) and via an online search. These materials were analyzed using deductive thematic analysis. Step 2b: We compared findings from Steps 1-2a. Results We identified four themes pertaining to parents' information needs: (1) participation in care, (2) emotional wellbeing, (3) experience/success stories, and (4) practical information about prematurity. Clinicians' communicative skills and time were considered prerequisites for optimal information-provision. Notably, hospital resources provided mainly medical information about prematurity with some emphasis on participation in care, while parent associations mainly focused on emotional wellbeing and experience/success stories. Conclusion While parents demonstrate clear information needs about impending very preterm birth, current information resources satisfy these partially. Innovation Our multidisciplinary research team included both scholars and veteran NICU parents. As such, we identified parents' information needs bottom-up. These parent-driven insights will be used to design an innovative, tailored information platform for parents about impending very preterm birth.
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Affiliation(s)
- Angela C.M. van Zijl
- Department of Neonatology, Wilhelmina Children's Hospital, Lundlaan 6, 3582 EA Utrecht, the Netherlands
| | - Sylvia A. Obermann-Borst
- Care4Neo, Neonatal Patient and Parent Advocacy Organization, Marshallweg 13 (unit 2), 3068 JN Rotterdam, the Netherlands
| | - Marije Hogeveen
- Department of Neonatology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, the Netherlands
| | - E.J.T. Joanne Verweij
- Department of Obstetrics, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands
| | - Willem B. de Vries
- Department of Pediatrics, Emma Children's Hospital, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands
| | - Rosa Geurtzen
- Department of Neonatology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, the Netherlands
| | - Nanon H.M. Labrie
- Department of Language, Literature & Communication, Vrije Universiteit Amsterdam, De Boelelaan 1105, 1081 HV Amsterdam, the Netherlands
- Department of Pediatrics|Neonatology, OLVG Amsterdam, Jan Tooropstraat 164, 1061 AE Amsterdam, the Netherlands
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Dalla Via J, Andrew CR, Baguley BJ, Stewart N, Hodgson JM, Lewis JR, Stanley M, Kennedy MA. Exercise and diet support in breast and prostate cancer survivors: findings from focus groups. Support Care Cancer 2024; 32:440. [PMID: 38888665 PMCID: PMC11189317 DOI: 10.1007/s00520-024-08652-7] [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: 02/13/2024] [Accepted: 06/11/2024] [Indexed: 06/20/2024]
Abstract
PURPOSE Cancer survival is improving, making optimal management of long-term treatment-related adverse effects increasingly important. Exercise and a healthy diet are beneficial and regularly recommended in cancer survivorship guidelines; however, few cancer survivors meet these recommendations so there is a need to explore why. This study aimed to understand experiences receiving exercise and diet support among Australian breast and prostate cancer survivors during and following treatment, and to explore what support they would like to receive. METHODS Adults who completed active treatment for breast or prostate cancer were recruited via a private cancer care centre. Using a qualitative descriptive study design, participants attended in-person focus groups that were recorded, transcribed, then analysed using reflexive thematic analysis. RESULTS In total, 26 cancer survivors (15 breast, 11 prostate) participated in one of seven focus groups (4 breast, 3 prostate). Two themes were developed: 1) It was just brushed over, and 2) Wanting more. Theme 1 reports that exercise, and especially diet, were rarely discussed. If they were, it was often limited to general recommendations. Theme 2 shows that participants wanted more specific and personalised support, and information about how exercise and/or diet could benefit their cancer treatment. CONCLUSION Despite strong interest in receiving personalised exercise and diet support, neither are routinely provided to Western Australian breast and prostate cancer survivors. If support was provided, there was inconsistency in the level and type of support provided. These findings identify important gaps in exercise and diet support provision to cancer survivors and will inform future strategies aiming to improve cancer survivorship care.
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Affiliation(s)
- Jack Dalla Via
- Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia.
| | - Christopher R Andrew
- Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
| | - Brenton J Baguley
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Nina Stewart
- Radiation Oncology, GenesisCare, Perth, WA, Australia
| | - Jonathan M Hodgson
- Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
- Medical School, The University of Western Australia, Perth, WA, Australia
| | - Joshua R Lewis
- Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
- Medical School, The University of Western Australia, Perth, WA, Australia
| | - Mandy Stanley
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
| | - Mary A Kennedy
- Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
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Swire-Thompson B, Johnson S. Cancer: A model topic for misinformation researchers. Curr Opin Psychol 2024; 56:101775. [PMID: 38101247 PMCID: PMC10939853 DOI: 10.1016/j.copsyc.2023.101775] [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: 10/04/2023] [Revised: 11/22/2023] [Accepted: 11/24/2023] [Indexed: 12/17/2023]
Abstract
Although cancer might seem like a niche subject, we argue that it is a model topic for misinformation researchers, and an ideal area of application given its importance for society. We first discuss the prevalence of cancer misinformation online and how it has the potential to cause harm. We next examine the financial incentives for those who profit from disinformation dissemination, how people with cancer are a uniquely vulnerable population, and why trust in science and medical professionals is particularly relevant to this topic. We finally discuss how belief in cancer misinformation has clear objective consequences and can be measured with treatment adherence and health outcomes such as mortality. In sum, cancer misinformation could assist the characterization of misinformation beliefs and be used to develop tools to combat misinformation in general.
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Affiliation(s)
- Briony Swire-Thompson
- Northeastern University, Network Science Institute, Department of Political Science, Department of Psychology, 177 Huntington Ave, Boston, USA.
| | - Skyler Johnson
- University of Utah, Huntsman Cancer Institute, 1950 Circle of Hope Dr, Salt Lake City, USA
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Livingstone A, Murphy A, Bucholc J, Engel L, Lane K, Spence D, McCaffrey N. Exploring important service characteristics of telephone cancer information and support services for callers: protocol for a systematic review of qualitative research. BMJ Open 2024; 14:e078399. [PMID: 38296271 PMCID: PMC10831442 DOI: 10.1136/bmjopen-2023-078399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 01/18/2024] [Indexed: 02/03/2024] Open
Abstract
INTRODUCTION As cancer incidence continues to rise, challenges remain in how to communicate accurate, timely information to people with cancer, their families and healthcare professionals. One option is to provide support and comprehensive, tailored information via a telephone cancer information and support service (CISS). This systematic review aims to summarise the service characteristics of telephone CISS and identify what aspects of services are important from callers' perspectives. METHODS AND ANALYSIS A comprehensive literature search will be conducted for articles published from database inception to 30 March 2023 (OVID MEDLINE, EMBASE, CINAHL, PsycINFO and SocINDEX). Published, peer-reviewed, articles reporting qualitative research on the service characteristics of telephone CISS important to callers in any language will be included. One researcher will complete the searches, two researchers will independently screen results for eligible studies and a third researcher will resolve any disagreement. A narrative and thematic synthesis of studies will be provided. Study characteristics will be independently extracted by one researcher and checked by a second. Included studies' methodological quality will be evaluated independently by two researchers using the 2022 Critical Appraisal Skills Programme Qualitative Studies Checklist. Grading of Recommendations Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative research tool will assess the confidence of the review findings. ETHICS AND DISSEMINATION Ethics approval is not required for this research as it is a planned systematic review of published literature. Findings will be presented at leading cancer, health economic and supportive care conferences, published in a peer-reviewed journal, and disseminated via websites and social media. PROSPERO REGISTRATION NUMBER CRD42023413897.
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Affiliation(s)
- Ann Livingstone
- Deakin University, Geelong, Institute for Health Transformation, Deakin Health Economics, School of Health and Social Development, Faculty of Health, Victoria, Australia
| | - April Murphy
- Deakin University, Geelong, Institute for Health Transformation, Deakin Health Economics, School of Health and Social Development, Faculty of Health, Victoria, Australia
| | - Jessica Bucholc
- Deakin University, Geelong, Institute for Health Transformation, Deakin Health Economics, School of Health and Social Development, Faculty of Health, Victoria, Australia
- Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Lidia Engel
- School of Public Health and Preventive Medicine, Monash University Health Economics Group (MUHEG), Monash University, Melbourne, Victoria, Australia
| | | | | | - Nikki McCaffrey
- Deakin University, Geelong, Institute for Health Transformation, Deakin Health Economics, School of Health and Social Development, Faculty of Health, Victoria, Australia
- Cancer Council Victoria, Melbourne, Victoria, Australia
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Ferraris G, Coppini V, Ferrari MV, Monzani D, Grasso R, Pravettoni G. Understanding Reasons for Cancer Disparities in Italy: A Qualitative Study of Barriers and Needs of Cancer Patients and Healthcare Providers. Cancer Control 2024; 31:10732748241258589. [PMID: 38897992 PMCID: PMC11189013 DOI: 10.1177/10732748241258589] [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: 02/21/2024] [Revised: 04/16/2024] [Accepted: 05/10/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND The second leading cause of death in Italy is cancer. Substantial disparities persist in the level of care and outcomes for cancer patients across various communities, hospitals, and regions in Italy. While substantial progress has been made in medical research and treatment options, these advancements tend to disproportionately benefit the wealthier, better-educated, and more privileged areas and portions of the population. Therefore, the primary aim of the current study is to explore possible reasons for inequalities in access to and utilisation of care from the perspective of cancer patients, who are recipients of these treatments, and healthcare providers, who are responsible for their administration. METHODS After being recruited through social media platforms, patients' organisations, and hospital websites, cancer patients (n = 22) and healthcare providers (n = 16) from various Italian regions participated in online focus group discussions on disparities in access to and provision of care. Video and audio recordings of the interviews were analysed using Thematic analysis. RESULTS Among cancer patients, 7 themes were identified, while 6 themes emerged from the healthcare providers highlighting encountered barriers and unmet needs in cancer care. Most of these emerging themes are common to both groups, such as geographical disparities, information deficiencies, and the importance of psycho-oncological support. However, several themes are specific to each group, for instance, cancer patients highlight the financial burden and the poor interactions with healthcare providers, while healthcare providers emphasise the necessity of establishing a stronger specialists' network and integrating clinical practice and research. CONCLUSION Current findings reveal persistent challenges in cancer care, including long waiting lists and regional disparities, highlighting the need for inclusive healthcare strategies. The value of psycho-oncological support is underscored, as well as the potential of the Internet's use for informational needs, emphasising the imperative for improved awareness and communication to overcome disparities in cancer care.
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Affiliation(s)
- Giulia Ferraris
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Veronica Coppini
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Maria Vittoria Ferrari
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Dario Monzani
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Laboratory of Behavioral Observation and Research on Human Development, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Roberto Grasso
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Gabriella Pravettoni
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
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Pedrosa AJ, Demel L, Riera Knorrenschild J, Seifart C, von Blanckenburg P. Cancer patients' expectations of advance care planning: A typological content analysis of qualitative interviews. Psychooncology 2023; 32:1867-1875. [PMID: 37905904 DOI: 10.1002/pon.6234] [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: 06/13/2023] [Revised: 10/04/2023] [Accepted: 10/12/2023] [Indexed: 11/02/2023]
Abstract
BACKGROUND Advance care planning (ACP) can help to elicit cancer patients' preferences in a discussion process to promote person-centred medical decision-making. Expectations are known to be highly relevant determinants of decisional processes. So far, however, little is known about cancer patients' expectations of ACP that lead to acceptance or refusal of the programme. The presented study, therefore, aims to explore cancer patients' expectations of ACP. METHODS Semi-structured interviews were conducted with a purposeful sample of 27 cancer patients consenting to or refusing a newly implemented ACP programme in a German university hospital. Data were analysed using typological content analysis. RESULTS We identified five different expectation clusters in relation to ACP. Consenting participants held expectations about the impact of ACP that were either 'ego-centred' or 'family-centred'. Refusers had expectations based on ignorance and misinformation, or-if they had already completed an advance directive-expectations to avoid unpleasant redundancy, perceiving no additional benefit but a burden from ACP. Finally, refusers in particular expressed expectations of delegated responsibility at the end of life, including anticipation of proxy decision-making. CONCLUSION Our study results suggest that expectation-modifying measures could be taken to positively influence cancer patients' expectations and thus the acceptance of ACP. In this respect, reducing ignorance and misguided expectations plays a decisive role. Especially in family constellations with expected delegation of responsibility and dependence at the end of life, it might be important to promote ACP as a family-intervention to improve family outcomes.
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Affiliation(s)
- Anna J Pedrosa
- Research Group Medical Ethics, Philipps-University Marburg, Marburg, Germany
- Department of Neurology, University Hospital of Giessen and Marburg, Marburg, Germany
| | - Lara Demel
- Research Group Medical Ethics, Philipps-University Marburg, Marburg, Germany
| | - Jorge Riera Knorrenschild
- Department of Haematology, Oncology and Immunology, University Hospital of Giessen and Marburg, Marburg, Germany
| | - Carola Seifart
- Research Group Medical Ethics, Philipps-University Marburg, Marburg, Germany
| | - Pia von Blanckenburg
- Department of Clinical Psychology and Psychotherapy, Philipps-University Marburg, Marburg, Germany
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Forbes Shepherd R, Bradford A, Lieschke M, Shackleton K, Hyatt A. Patient communication and experiences in cancer clinical drug trials: a mixed-method study at a specialist clinical trials unit. Trials 2023; 24:400. [PMID: 37312206 DOI: 10.1186/s13063-023-07284-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 03/29/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND As cancer therapies increase in their complexity, effective communication among patients, physicians, and research staff is critical for optimal clinical trial management. Currently, we understand little about on-trial communication practices and patient trial experiences over time. This mixed-method study explored patient experiences of participating in a clinical drug trial at different time points, focussing on patient communication with trial staff. METHODS Patients enrolled in clinical drug trials conducted at the Parkville Cancer Clinical Trials Unit were invited to complete a tailored online survey and/or a qualitative interview. Patients were recruited to three cohorts based on time since the first trial treatment: new (≥ 1 to ≤ 13 weeks), mid- (≥ 14 to ≤ 26 weeks), and long-term (≥ 52 weeks) trial patients. Descriptive statistics were calculated for survey responses. Interview data were analysed thematically with a team-based approach. Survey and interview data were integrated at the intepretation stage. RESULTS From May to June 2021, 210 patients completed a survey (response rate 64%, 60% male), 20 completed interviews (60% male), and 18 completed both. More long-term trial patients (46%) participated than new (29%) and mid-trial patients (26%). Survey data showed high (> 90%) patient satisfaction with the provision of trial information and communication with trial staff across trial stages, and many reported trial experiences as above and beyond standard care. Interview data indicated that written trial information could be overwhelming, and verbal communication with the staff and physicians was highly valued, especially for enrolment and side effect management among long-term patients. Patients described the key points along the clinical trial trajectory that merit close attention: clear and well-communicated randomisation practices, reliable pathways for side effect reporting and prompt response from the trial staff, and end-of-trial transition management to avoid a sense of abandonment. CONCLUSION Patients reported high overall satisfaction with trial management but outlined key pinch points requiring improved communication practices. Establishing a range of effective communication practices among trial staff and physicians with patients in cancer clinical trials may have a wide range of positive effects on patient accrual, retention, and satisfaction.
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Affiliation(s)
- Rowan Forbes Shepherd
- Department of Health Services Research and Implementation Science, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia.
| | - Ashleigh Bradford
- Department of Health Services Research and Implementation Science, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia
| | - Marian Lieschke
- Parkville Cancer Clinical Trials Unit, Peter MacCallum Cancer Centre, Melbourne, VIC, 3000, Australia
| | - Kylie Shackleton
- Parkville Cancer Clinical Trials Unit, Peter MacCallum Cancer Centre, Melbourne, VIC, 3000, Australia
| | - Amelia Hyatt
- Department of Health Services Research and Implementation Science, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia.
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Victoria, 3010, Australia.
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Wittenberg E, Goldsmith JV, Savage MW, Sullivan SS. Exploring Differences in Caregiver Communication in Serious Illness. J Palliat Med 2023. [PMID: 36603111 DOI: 10.1089/jpm.2022.0406] [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: 01/07/2023] Open
Abstract
Background: Demographic factors, such as disease context and family relationships, are communication mediators and moderators; however, little is known about how understanding these factors can improve caregiver communication with providers. Recognition of communication differences among caregivers may aid the development of approaches to improve serious illness communication. Objective: To explore whether caregiver communication differs by disease context (cancer vs. dementia) and caregiver communication type (Manager, Carrier, Partner, and Lone). Caregiver communication type is based on communication patterns between the care recipient and caregiver. Design and Measurements: Caregivers of persons with cancer and/or dementia were surveyed from a U.S. national research registry website. Measures of caregiver communication included information needs, communication confidence, perception of provider understanding of the caregiver, perceived frequency of caregiver assessment, and caregiver stress. Analysis of variance (ANOVA) determined significant differences between caregiver communication (p < 0.05) based on disease context and caregiver communication type. Results: Cancer caregivers reported higher unrecognized-demanded information states (i.e., not recognizing information was needed), more communication confidence, and more frequent caregiver assessment compared to dementia caregivers. Among caregiver communication types, Manager caregiver types were more confident communicating than other caregiver types and perceived greater understanding by providers than the Lone caregiver type. Manager caregivers reported significantly less stress than other caregiver communication types. Conclusions: Understanding disease context and caregiver communication type may help improve caregiver communication with health care providers.
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Affiliation(s)
- Elaine Wittenberg
- Department of Communication Studies, California State University, Los Angeles, Los Angeles, California, USA
| | - Joy V Goldsmith
- Department of Communication and Film, University of Memphis, Memphis, Tennessee, USA
| | - Matthew W Savage
- School of Communication, San Diego State University, San Diego, California, USA
| | - Suzanne S Sullivan
- School of Nursing, University at Buffalo, State University of New York, Buffalo, New York, USA
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Turon H, Hobden B, Fakes K, Clapham M, Proietto A, Sanson-Fisher R. Preparation for Cancer Treatment: A Cross-Sectional Study Examining Patient Self-Reported Experiences and Correlates. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10167. [PMID: 36011803 PMCID: PMC9407820 DOI: 10.3390/ijerph191610167] [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: 07/18/2022] [Revised: 08/15/2022] [Accepted: 08/16/2022] [Indexed: 06/15/2023]
Abstract
Given the significant physical and psychosocial side-effects cancer treatment has on individuals, it is important to ensure patients receive adequate preparation prior to treatment. The purpose of this study was to explore, among Australian oncology patients, (i) the self-reported treatment preparation information they received; and (ii) the patient characteristics associated with the treatment preparation information received. Patients in the early stages of cancer treatment were invited to complete a survey exploring their receipt of information about treatment preparation. Items assessed patients' self-report of whether they had received information about the treatment process. A total of 165 participants completed the survey. Patients most frequently reported receiving information about how they might feel physically (94%) and what side effects to watch for (93%). One in five patients reported not receiving information about how to cope with any stress or worry related to treatment. Females reported receiving significantly fewer items of care compared to males (p = 0.0083). This study suggests that while self-reported preparation for cancer treatment is generally high, components of preparation related to psychosocial concerns could be improved. Survey data could be used as a feedback tool for centres to monitor delivery of care.
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Affiliation(s)
- Heidi Turon
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia
- Priority Research Centre for Health Behaviour, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, New Lambton, NSW 2305, Australia
| | - Breanne Hobden
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia
- Priority Research Centre for Health Behaviour, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, New Lambton, NSW 2305, Australia
| | - Kristy Fakes
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia
- Priority Research Centre for Health Behaviour, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, New Lambton, NSW 2305, Australia
| | - Matthew Clapham
- Clinical Research Design and Statistics, Hunter Medical Research Institute, New Lambton, NSW 2305, Australia
| | - Anthony Proietto
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia
- Priority Research Centre for Health Behaviour, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, New Lambton, NSW 2305, Australia
| | - Rob Sanson-Fisher
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia
- Priority Research Centre for Health Behaviour, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, New Lambton, NSW 2305, Australia
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