1
|
Body Image, Sexuality, and Sexual Functioning in Women With Gynecologic Cancer: An Integrative Review of the Literature and Implications for Research. Cancer Nurs 2020; 44:E252-E286. [PMID: 32332264 DOI: 10.1097/ncc.0000000000000818] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Cervical and uterine cancers are common in women. Diagnosis and treatment of these cancers can lead to significant issues with body image, sexuality, and sexual functioning. A comprehensive review can improve understanding of these 3 concepts, in turn enhancing identification and management. OBJECTIVES To (1) present the qualitative, descriptive, and correlational research literature surrounding body image, sexuality, and sexual functioning in women with uterine and cervical cancer; (2) identify gaps in the literature; and (3) explore the implications of the findings for future research. METHODS A comprehensive search of the literature was undertaken by searching PubMed, CINAHL, and PsycINFO using predetermined subject headings, keywords, and exploded topics. After a comprehensive evaluation using specific criteria, 121 articles were reviewed. RESULTS Qualitative studies provided information about women's issues with body image, sexuality, and sexual functioning, whereas quantitative studies focused primarily on sexual functioning. The literature lacks correlational studies examining body image and sexuality. Significant issues regarding communication and quality of life were noted, and few studies were based on clear conceptual models. CONCLUSION The state of the science gleaned from this review reveals that while much is known about sexual functioning, little is known about body image and sexuality. IMPLICATIONS FOR PRACTICE Further work is warranted to develop conceptual models and research on body image, sexuality, and sexual functioning as a foundation for interventions to improve quality of life.
Collapse
|
2
|
Marangoz Ç, Demir A, Yazgan EÖ. Adaptation of the Sexuality Scale for Women with Gynecologic Cancer for Turkish Patients. Asia Pac J Oncol Nurs 2019; 6:177-186. [PMID: 30931363 PMCID: PMC6371671 DOI: 10.4103/apjon.apjon_49_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Objective: Diagnosis and treatment of gynecologic cancers can have a negative impact on sexuality. Identification of sexual problems and concerns is key to enable appropriate management. Therefore, there is a need for a valid and reliable instrument for evaluating the sexuality of patients. This study aimed to adapt the sexuality scale for women with gynecologic cancer for Turkish patients with gynecologic cancer. Methods: A cross-sectional study of 150 volunteer patients with gynecologic cancer was undertaken in Turkey. The patients completed a semi-structured demographic data form and the sexuality scale for women with gynecologic cancer. We assessed the reliability, language accuracy, and content and construct validities of the Turkish version of the scale. Results: Exploratory and confirmatory factor analyses showed that the scale had four factors. In the exploratory factor analysis, seven items were discarded from the scale because their load values were <0.3. In the confirmatory factor analysis, the coefficients were higher than 0.3. The total Cronbach's α was 0.72. Conclusions: The sexuality scale for women with gynecologic cancer (Turkish version) is a valid and reliable instrument for evaluating the sexuality of Turkish patients with gynecologic cancer.
Collapse
Affiliation(s)
- Çigdem Marangoz
- Department of Rheumatology, Ibni Sina Hospital, Ankara University School of Medicine, Ankara, Turkey
| | - Ayten Demir
- Department of Nursing, Faculty of Nursing, Ankara University, Ankara, Turkey
| | - Eda Özge Yazgan
- Department of Nursing, Faculty of Nursing, Ankara University, Ankara, Turkey
| |
Collapse
|
3
|
Smits A, Lopes A, Das N, Bekkers R, Massuger L, Galaal K. Exercise Programme in Endometrial Cancer; Protocol of the Feasibility and Acceptability Survivorship Trial (EPEC-FAST). BMJ Open 2015; 5:e009291. [PMID: 26674498 PMCID: PMC4691724 DOI: 10.1136/bmjopen-2015-009291] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Obesity has been associated with impaired quality of life and poorer outcomes in endometrial cancer survivors. Lifestyle interventions promoting exercise and weight reduction have been proposed for survivorship care. However, studies evaluating exercise programmes for endometrial cancer survivors are lacking. PURPOSE The objective of this study is to evaluate the feasibility of an individualised exercise intervention for endometrial cancer survivors to improve quality of life. METHODS AND ANALYSIS This is a feasibility study in which women will undergo a 10-week exercise programme with a personal trainer. The study population comprises women with confirmed diagnosis of endometrial cancer, who have completed surgical treatment with curative intent, and are aged 18 years or older. The study will take place at the Royal Cornwall Hospital Trust, UK. Feasibility will be evaluated in terms of recruitment, adherence and compliance to the programme. Secondary outcomes are quality of life, psychological distress, fatigue, pain and complication rates. In addition, the acceptability of the programme will be assessed. ETHICS AND DISSEMINATION Ethical approval was obtained through the Exeter NRES Committee. The study results will be used to optimise the intervention content, and may serve as the foundation for a larger definitive trial. Results will be disseminated through peer-review journals, congresses, relevant clinical groups and presented on the Trust's website. TRIAL REGISTRATION NUMBER NCT02367950; pre-results.
Collapse
Affiliation(s)
- Anke Smits
- Department of Gynaecology, Royal Cornwall Hospital Trust, Truro, Cornwall, UK
| | - Alberto Lopes
- Department of Gynaecology, Royal Cornwall Hospital Trust, Truro, Cornwall, UK
| | - Nagindra Das
- Department of Gynaecology, Royal Cornwall Hospital Trust, Truro, Cornwall, UK
| | - Ruud Bekkers
- Department of Gynaecology, Radboud UMC, Nijmegen, The Netherlands
| | - Leon Massuger
- Department of Gynaecology, Radboud UMC, Nijmegen, The Netherlands
| | - Khadra Galaal
- Department of Gynaecology, Royal Cornwall Hospital Trust, Truro, Cornwall, UK
| |
Collapse
|
4
|
Hammer SM, Brown JC, Segal S, Chu CS, Schmitz KH. Cancer-related impairments influence physical activity in uterine cancer survivors. Med Sci Sports Exerc 2015; 46:2195-201. [PMID: 24781886 DOI: 10.1249/mss.0000000000000360] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION The extent to which physical activity (PA) participation among uterine cancer survivors may be limited by physical and functional impairments (PFI) related to cancer treatment is unknown. We sought to describe PA participation, characterize the prevalence of PFI, and examine the association between PFI status and PA participation within this population. METHODS We conducted a study using a mailed survey among uterine cancer survivors who received treatment at a university hospital. We asked about PA and PFI using validated self-report questionnaires. PA was calculated using MET-hours per week (MET·h·wk). PFI was defined as having one or more of the following symptoms: lower limb lymphedema, general pain, fatigue, or severe bladder, bowel, or pelvic issues. Ordinal logistic regression was used to quantify the odds ratio (OR) between PA and PFI. RESULTS The response rate to our survey was 43%. Among the 213 study participants, 40%, 13%, 13%, 12%, and 23% reported participating in <3.0, 3.0-8.9, 9.0-17.9, 18.0-26.9, and ≥27.0 MET·h·wk of PA, respectively. Walking is the preferred mode of exercise for physically active uterine cancer survivors. Of the survivors, 53% experience at least one PFI. The most common PFI is lower limb lymphedema (36.2%), followed by general pain (22.5%). The OR of PFI decreased as MET-hours per week of PA increased (OR, 0.51; 95% confidence interval, 0.31-0.84; P = 0.009). CONCLUSIONS The majority of uterine cancer survivors experience PFI that significantly reduce the likelihood of PA participation. PA recommendations for uterine cancer survivors should take into account treatment-related impairments that can affect PA participation.
Collapse
Affiliation(s)
- Sean M Hammer
- 1Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA; 2Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology; Department of Surgery (Urology), University of Medicine and Dentistry of New Jersey, New Brunswick, NJ; and 3Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA
| | | | | | | | | |
Collapse
|
5
|
Thornton LM, Levin AO, Dorfman CS, Godiwala N, Heitzmann C, Andersen BL. Emotions and social relationships for breast and gynecologic patients: a qualitative study of coping with recurrence. Psychooncology 2013; 23:382-9. [PMID: 24123502 DOI: 10.1002/pon.3429] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Revised: 09/05/2013] [Accepted: 09/16/2013] [Indexed: 11/08/2022]
Abstract
BACKGROUND In contrast to the large literature on patients' coping with an initial diagnosis of cancer, there have been few quantitative or qualitative studies of patients coping with recurrence. A qualitative study was undertaken to aid in the development of a tailored intervention for these patients. METHODS Individuals (N=35) receiving follow-up care for recurrent breast or gynecologic cancer at a university-affiliated cancer center participated in an individual or a group interview. Transcripts of interviews were analyzed using a coding format with two areas of emphasis. First, we focused on patients' emotions, as there is specificity between emotions and the corresponding ways in which individuals choose to manage them. Secondly, we considered the patients' social environments and relationships, as they too appear key in the adjustment to, and survival from, cancer. RESULTS Patients identified notable differences in their responses to an initial diagnosis of cancer and their current ones to recurrence, including the following: (i) depressive symptoms being problematic; (ii) with the passing years and the women's own aging, there is shrinkage in the size of social networks; and (iii) additional losses come from social support erosion, arising from a) intentional distancing by social contacts, b) friends and family not understanding that cancer recurrence is a chronic illness, and/or c) patients stemming their support requests across time. CONCLUSION The contribution of these findings to the selection of intervention strategies is discussed.
Collapse
Affiliation(s)
- Lisa M Thornton
- Department of Psychology, The Ohio State University, Columbus, OH, USA
| | | | | | | | | | | |
Collapse
|
6
|
Al-Naggar RA, Bobryshev YV, Abdulghani MAMM, Rammohan S, Al-Jashamy K. Knowledge and perceptions of cancer and cancer prevention among Malaysian traditional healers: a qualitative study. Asian Pac J Cancer Prev 2013; 13:3841-50. [PMID: 23098481 DOI: 10.7314/apjcp.2012.13.8.3841] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE The objective of this study was to explore the knowledge and perceptions of Malaysian tradition healers towards cancer and cancer prevention. METHODOLOGY A total of 25 participants agreed to participate in this qualitative study during the period from 20th July 2011 until 24th of September 2011. The proposal of this study was approved by the Ethics Committee of Management and Science University (MSU). Once the participant agreed to be interviewed, date, time and place of the interviews were determined. Consent form was obtained from participants before the interview began. Participants were briefed about the study and its purpose, and after asking their permission, their replies were recorded. The data was organized into themes and analyzed manually. RESULTS Twenty-five Malaysian traditional healers participated in this qualitative study. The age of participants ranged between 26 to 78 years old. The majority were in the age group of 31-60 years old, male, Chinese, degree holders with a monthly income ranging from 1,000-5,000 Ringgit Malaysia (RM) and were married (56%, 80%, 48%, 52%, 68%, 84% respectively). The majority defined cancer as having high cholesterol or abscess accumulation. A few of them defined cancer as a type of cell growth. The majority mentioned that food and unhealthy lifestyles are the primary causes of cancer. Surprisingly some of them mentioned that cancer is caused by interference by ghosts. Regarding the diagnosis of cancer, the majority mentioned that they refer their patients to modern physicians' medical report when it comes to diagnosing or treating patients with cancer. The most common cancers that many patients came to seek treatment were breast cancers, followed by colon cancers, liver and lung cancers. CONCLUSION Despite good knowledge about the causes of cancer among traditional healers, misconceptions still exist. Insufficient knowledge about the definition of cancer was noted among the traditional healers. This urges immediate action by the Ministry of Health of Malaysia to set up a strict regulation and regular monitoring of the traditional healers nationally. Traditional and Complementary Medicine may be integrated into the healthcare system and need to have sustained cooperation for the benefit of patients since about 80% of patients use traditional medicines.
Collapse
Affiliation(s)
- Redhwan A Al-Naggar
- Community Medicine Department, International Medical School, Management and Science University, Malaysia.
| | | | | | | | | |
Collapse
|
7
|
Bjelic-Radisic V, Jensen PT, Vlasic KK, Waldenstrom AC, Singer S, Chie W, Nordin A, Greimel E. Quality of life characteristics inpatients with cervical cancer. Eur J Cancer 2012; 48:3009-18. [PMID: 22683166 DOI: 10.1016/j.ejca.2012.05.011] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2012] [Revised: 05/09/2012] [Accepted: 05/10/2012] [Indexed: 11/12/2022]
Abstract
AIM Annually about 500,000 women worldwide are diagnosed with cervical cancer. For many patients, young age at the time of diagnosis and a good prognosis regarding the disease imply a long life with the side-effects and sequels of various treatment options. The present study investigated the extent to which different quality of life (QoL) domains in patients during and after treatment for cervical cancer are affected according to menopausal status, treatment status and treatment modality. METHODS QoL data from 346 cervical cancer patients from 14 countries who were included in a cervical cancer module validation study of the European Organisation for Research and Treatment of Cancer (EORTC) Quality of life Group were analysed according to menopausal status, treatment status and treatment modality. QOL was assessed using the EORTC Quality of life Questionnaire (QLQ)-C30 and the QLQ-CX24 module. Statistical analyses were performed using descriptive statistics and analysis of covariance. RESULTS Active treatment had the strongest negative impact on 13 different QoL domains: physical, role, emotional, cognitive, social functioning, global health/QoL, fatigue, nausea and emesis, pain, appetite loss, constipation, symptom experience and sexual enjoyment. Irradiation alone ± other therapy was associated with most symptoms of diarrhoea. Age had the most negative impact on sexual activity and the strongest positive effect on sexual worry. CONCLUSION Our results revealed that patients with cervical carcinoma had different side-effects with different impacts on QOL depending on the menopausal status and therapy modalities. Patients should be informed about the possibility that therapy may have a negative impact on QoL.
Collapse
Affiliation(s)
- Vesna Bjelic-Radisic
- Department of Obstetrics and Gynecology, Medical University of Graz, Auenbruggerplatz 14, 8036 Graz, Austria
| | | | | | | | | | | | | | | |
Collapse
|
8
|
Horneber M, Bueschel G, Dennert G, Less D, Ritter E, Zwahlen M. How many cancer patients use complementary and alternative medicine: a systematic review and metaanalysis. Integr Cancer Ther 2011; 11:187-203. [PMID: 22019489 DOI: 10.1177/1534735411423920] [Citation(s) in RCA: 477] [Impact Index Per Article: 36.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND No comprehensive systematic review has been published since 1998 about the frequency with which cancer patients use complementary and alternative medicine (CAM). METHODS MEDLINE, AMED, and Embase databases were searched for surveys published until January 2009. Surveys conducted in Australia, Canada, Europe, New Zealand, and the United States with at least 100 adult cancer patients were included. Detailed information on methods and results was independently extracted by 2 reviewers. Methodological quality was assessed using a criteria list developed according to the STROBE guideline. Exploratory random effects metaanalysis and metaregression were applied. RESULTS Studies from 18 countries (152; >65 000 cancer patients) were included. Heterogeneity of CAM use was high and to some extent explained by differences in survey methods. The combined prevalence for "current use" of CAM across all studies was 40%. The highest was in the United States and the lowest in Italy and the Netherlands. Metaanalysis suggested an increase in CAM use from an estimated 25% in the 1970s and 1980s to more than 32% in the 1990s and to 49% after 2000. CONCLUSIONS The overall prevalence of CAM use found was lower than often claimed. However, there was some evidence that the use has increased considerably over the past years. Therefore, the health care systems ought to implement clear strategies of how to deal with this. To improve the validity and reporting of future surveys, the authors suggest criteria for methodological quality that should be fulfilled and reporting standards that should be required.
Collapse
Affiliation(s)
- Markus Horneber
- Department of Internal Medicine, Division ofOncology/Hematology, Klinikum Nuernberg, Nuernberg, Germany.
| | | | | | | | | | | |
Collapse
|
9
|
Abstract
OBJECTIVE The goal of this research was to examine the extent to which 10-year breast cancer survivors integrated cancer into their self-concept (i.e. survivor centrality), identify predictors of survivor centrality, and determine the relation of survivor centrality to well-being. METHODS Breast cancer survivors (n=240) were interviewed 10 years following the initial diagnosis. They completed measures of survivor centrality, illness valence (i.e. positive or negative views of illness), and well-being (positive and negative affect, mental and physical functioning, psychological distress, benefit finding). RESULTS There were few predictors of the kinds of women who were more likely to integrate breast cancer into their self-concepts, but survivor centrality was related to engaging in behaviors that suggested survivorship was relevant to women's daily lives, such as becoming involved in breast cancer activities. Survivor centrality was related to three markers of negative psychological well-being: more negative affect, poorer mental functioning, and greater psychological distress. However, in the case of negative affect and psychological distress, this relation was moderated by illness valence, such that survivor centrality was only related to negative psychological well-being when the illness was viewed in less positive terms. CONCLUSIONS Women vary in the extent to which they define themselves in terms of the breast cancer experience. Survivor centrality in and of itself is not always indicative of adjustment to disease. When women have a more negative view of being a breast cancer survivor, survivor centrality is more likely to signify potential problems.
Collapse
Affiliation(s)
- Vicki S Helgeson
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA 15213, USA.
| |
Collapse
|
10
|
Abstract
BACKGROUND Purified thymus extracts (pTE) and synthetic thymic peptides (sTP) are thought to enhance the immune system of cancer patients in order to fight the growth of tumour cells and to resist infections due to immunosuppression induced by the disease and antineoplastic therapy. OBJECTIVES To evaluate the effectiveness of pTE and sTP for the management of cancer. SEARCH STRATEGY We searched CENTRAL (The Cochrane Library 2010, Issue 3), MEDLINE, EMBASE, AMED, BIOETHICSLINE, BIOSIS, CATLINE, CISCOM, HEALTHSTAR, HTA, SOMED and LILACS (to February 2010). SELECTION CRITERIA Randomised trials of pTE or sTP in addition to chemotherapy or radiotherapy, or both, compared to the same regimen with placebo or no additional treatment in adult cancer patients. DATA COLLECTION AND ANALYSIS Two authors independently extracted data from published trials. We derived odds ratios (OR) from overall survival (OS) and disease-free survival (DFS) rates, tumour response (TR) rates, and rates of adverse effects (AE) related to antineoplastic treatments. We used a random-effects model for meta-analysis. MAIN RESULTS We identified 26 trials (2736 patients). Twenty trials investigated pTE (thymostimulin or thymosin fraction 5) and six trials investigated sTP (thymopentin or thymosin α(1)). Twenty-one trials reported results for OS, six for DFS, 14 for TR, nine for AE and 10 for safety of pTE and sTP. Addition of pTE conferred no benefit on OS (RR 1.00, 95% CI 0.79 to 1.25); DFS (RR 0.97, 95% CI 0.82 to 1.16); or TR (RR 1.07, 95% CI 0.92 to 1.25). Heterogeneity was moderate to high for all these outcomes. For thymosin α(1) the pooled RR for OS was 1.21 (95% CI 0.94 to 1.56, P = 0.14), with low heterogeneity; and 3.37 (95% CI 0.66 to 17.30, P = 0.15) for DFS, with moderate heterogeneity. The pTE reduced the risk of severe infectious complications (RR 0.54, 95% CI 0.38 to 0.78, P = 0.0008; I² = 0%). The RR for severe neutropenia in patients treated with thymostimulin was 0.55 (95% CI 0.25 to 1.23, P = 0.15). Tolerability of pTE and sTP was good. Most of the trials had at least a moderate risk of bias. AUTHORS' CONCLUSIONS Overall, we found neither evidence that the addition of pTE to antineoplastic treatment reduced the risk of death or disease progression nor that it improved the rate of tumour responses to antineoplastic treatment. For thymosin α(1), there was a trend for a reduced risk of dying and of improved DFS. There was preliminary evidence that pTE lowered the risk of severe infectious complications in patients undergoing chemotherapy or radiotherapy.
Collapse
Affiliation(s)
- Elke Wolf
- Klinikum NordMedizinische Klinik 5‐Schwerpunkt Onkologie/HaematologieProf.‐Ernst‐Nathan‐Str. 1NuernbergGermany90340
| | - Stefania Milazzo
- Paracelsus Medical University, Klinikum NuernbergDepartment of Internal Medicine, Division of Oncology and HematologyProf.‐Ernst‐Nathan‐Str. 1NuernbergGermanyD‐90419
| | - Katja Boehm
- Klinikum NordMedizinische Klinik 5‐Schwerpunkt Onkologie/HaematologieProf.‐Ernst‐Nathan‐Str. 1NuernbergGermany90340
| | - Marcel Zwahlen
- University of BernInstitute of Social and Preventive MedicineFinkelhubelweg11BernSwitzerland3012
| | - Markus Horneber
- Paracelsus Medical University, Klinikum NurembergDepartment of Internal Medicine, Division of Oncology and HematologyProf.‐Ernst‐Nathan‐Str. 1NurembergGermanyD‐90419
| | | |
Collapse
|
11
|
Understanding sexuality in women with gynaecological cancer. Eur J Oncol Nurs 2011; 15:38-45. [DOI: 10.1016/j.ejon.2010.05.008] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2009] [Revised: 03/22/2010] [Accepted: 05/30/2010] [Indexed: 11/23/2022]
|
12
|
Vargens OMDC, Berterö CM. Caring with difficulty: Brazilian nurses' experiences of gynaecological surgery care. Int J Nurs Pract 2010; 16:159-65. [PMID: 20487061 DOI: 10.1111/j.1440-172x.2010.01824.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This study was made by a qualitative approach based on symbolic interactionism and grounded theory. The subject was defined as what mutilation means for nurses who take care of women submitted to gynaecological surgery. The aim was to identify the interaction relationship of nurses as female with the phenomenon of mutilation in gynaecological surgeries and how it affects their relationship with female patients in this situation. Data were obtained by interviews with 16 nurses who work in gynaecology units. The findings present two core categories: speaking as a professional and speaking as female. When they spoke as professional nurses they defined mutilation technically. As females they verbalized their conflict and difficulty in working with mutilation and redefined it as being the loss of something very important for themselves. We conclude that female nurses when confronting female surgery distances themselves behind the professional nurse and performs nursing care as a daily routine. It means that these nurses live a personal conflict that influences directly on how they supply care. They care for, but do not care about; the ethos of biomedicine leads carers on to a technical path from which it is difficult to get off.
Collapse
|
13
|
Bisseling KCHM, Kondalsamy-Chennakesavan S, Bekkers RLM, Janda M, Obermair A. Depression, anxiety and body image after treatment for invasive stage one epithelial ovarian cancer. Aust N Z J Obstet Gynaecol 2010; 49:660-6. [PMID: 20070719 DOI: 10.1111/j.1479-828x.2009.01074.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Diagnosis of epithelial ovarian cancer (EOC) in young women has major implications including those to their reproductive potential. We evaluated depression, anxiety and body image in patients with stage I EOC treated with fertility sparing surgery (FSS) or radical surgery (RS). We also investigated fertility outcomes after FSS. METHODS A retrospective study was undertaken in which 62 patients completed questionnaires related to anxiety, depression, body image and fertility outcomes. Additional information on adjuvant therapy after FSS and RS and demographic details were abstracted from medical records. Both bi- and multivariate regression models were used to assess the relationship between demographic, clinical and pathological results and scores for anxiety, depression and body image. RESULTS Thirty-nine patients underwent RS and the rest, FSS. The percentage of patients reporting elevated anxiety and depression (subscores > or = 11) were 27% and 5% respectively. The median (interquartile range) score for Body Image Scale (BIS) was 6 (3-15). None of the demographic or clinical factors examined showed significant association with anxiety and BIS with the exception of 'time since diagnosis'. For depression, post-menopausal status was the only independent predictor. Among those 23 patients treated by FSS, 14 patients tried to conceive (seven successful), resulting in seven live births, one termination of pregnancy and one miscarriage. CONCLUSION This study shows that psychological issues are common in women treated for stage I EOC. Reproduction after FSS is feasible and led to the birth of healthy babies in about half of patients who wished to have another child. Further prospective studies with standardised instruments are required.
Collapse
|
14
|
Habermann TM, Thompson CA, LaPlant BR, Bauer BA, Janney CA, Clark MM, Rummans TA, Maurer MJ, Sloan JA, Geyer SM, Cerhan JR. Complementary and alternative medicine use among long-term lymphoma survivors: a pilot study. Am J Hematol 2009; 84:795-8. [PMID: 19894247 DOI: 10.1002/ajh.21554] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
No published survey has specifically addressed the beliefs, knowledge, and usage of complementary and alternative medicine (CAM) in long-term (5-20 years) lymphoma survivors alone. In this pilot project, 95 subjects were randomly selected from a population of 2,475 long-term lymphoma survivors and mailed a questionnaire. The median time from lymphoma diagnosis to completion of the questionnaire was 11 years (range 6-20). Overall, 68% (95% CI: 54-80%) of the long-term lymphoma survivors reported that they have used CAM, a rate higher than the estimated usage rate reported for the general population The most commonly used modalities were chiropractic (39%, 95% CI: 27-53%) and massage therapy (21%, 95% CI: 12-34%). Less than 10% used meditation (5%, 95% CI: 1-15%) and relaxation (7%, 95% CI: 2-17%). In terms of common herbal usage, 5% (95% CI: 1-15%) had used St. John's Wort and 7% (95% CI: 2-17%) had used shark cartilage. Although none of the patients reported that CAM usage was directed specifically towards treating their lymphoma, 4% (95% CI: 0-12%) of patients reported that CAM could cure cancer, and 14% (95% CI: 6-26%) reported that CAM could increase their feeling of control over their health. This pilot study suggests that long-term lymphoma survivors appear to use CAM at a rate higher than the general population. The use of potential agents of risk by the survivors and the lack of access to potentially beneficial modalities highlights the need for further study of CAM in this population.
Collapse
Affiliation(s)
- Thomas M Habermann
- Division of Hematology, Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
15
|
Tarteaut MH, Herrmann F, Grandjean R, Toutous-Trellu L. Soins esthétiques aux personnes âgées dans la réhabilitation hospitalière. Rech Soins Infirm 2008. [DOI: 10.3917/rsi.094.0092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
|
16
|
Griffiths J, Willard C, Burgess A, Amir Z, Luker K. Meeting the ongoing needs of survivors of rarer cancer. Eur J Oncol Nurs 2007; 11:434-41. [PMID: 18023615 DOI: 10.1016/j.ejon.2007.09.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2007] [Revised: 09/07/2007] [Accepted: 09/11/2007] [Indexed: 10/22/2022]
Abstract
With more treatment options for people with cancer long-term survivorship is increasing. Physical and psycho-social needs have been identified in survivors of common cancers but very little has been written about the needs of patients with rarer cancers. Patients treated for rarer cancer are discharged to the primary health care team (PHCT), yet little is known about the assessment, management and support of these patients. Thirty-nine semi-structured interviews were conducted with (1) survivors of and (2) people living with rarer cancer (i.e. <5% of cancer burden). Participants were asked about physical and psycho-social needs and service provision. Data were analysed thematically using Atlas ti. Contrary to expectation, disease-free survivors of rarer cancer were indistinguishable from those living with disease in their ability to cope, and range of symptoms and needs. Participants with a clinical nurse specialist (CNS) reported that they were well supported on their return home and their needs were met. Participants without a CNS were referred to the PHCT who were unsure how to assess or support them. These participants felt abandoned. There is a need for the rehabilitation of patients with rarer cancer to strengthen individual coping mechanisms, and family and social support. Although there are resource and training implications, this is a potential role for the PHCT, district nursing in particular, and may lead to more focused and targeted provision of services.
Collapse
Affiliation(s)
- Jane Griffiths
- Department of Nursing Midwifery and Social Work, University of Manchester, Oxford Road, Manchester M13 9PL, UK.
| | | | | | | | | |
Collapse
|
17
|
Andersen BL, Shapiro CL, Farrar WB, Crespin T, Wells-Digregorio S. Psychological responses to cancer recurrence. Cancer 2005; 104:1540-7. [PMID: 16118802 PMCID: PMC2151214 DOI: 10.1002/cncr.21309] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND There is a dearth of knowledge regarding the psychological responses to a diagnosis of cancer recurrence. METHODS An ongoing randomized clinical trial provided the context for prospective study. Women with Stage II/III breast carcinoma (N = 227) were initially assessed after their diagnosis/surgery and before adjuvant therapy and then reassessed every 6 months. Eight years into the trial, 30 patients had recurred (R) and were assessed shortly after receiving their second diagnosis. Their data were compared with a sample of trial patients who had no evidence of disease (disease free [DF]; n = 90). The groups were matched on study arm, disease stage, estrogen receptor status, menopausal status, and time since initial diagnosis. RESULTS As hypothesized, patients' cancer-specific stress at recurrence in the R group was higher (P < 0.05) than stress levels for the DF group at the equivalent point in time. Importantly, the R group reported stress for their recurrent diagnosis equivalent to that reported for their initial diagnosis. Identical results were found for measures of health status and symptomatology. In contrast, analyses for emotional distress and social functioning showed no pattern of disruption for the R group at cancer recurrence and levels equivalent to that of the DF group. CONCLUSIONS To the authors' knowledge, this was the first controlled, prospective psychological analysis of patients' responses to cancer recurrence. The findings were consistent with a learning theory conceptualization of the cancer stressor. Patients' stress was "compartmentalized" and did not, at least in the early weeks, result in diffuse emotional distress and quality of life disruption, underscoring the resilience of patients when confronted with cancer recurrence.
Collapse
Affiliation(s)
- Barbara L Andersen
- Department of Psychology, The Ohio State University, Columbus, Ohio 43210-1222, USA.
| | | | | | | | | |
Collapse
|
18
|
Courneya KS, Karvinen KH, Campbell KL, Pearcey RG, Dundas G, Capstick V, Tonkin KS. Associations among exercise, body weight, and quality of life in a population-based sample of endometrial cancer survivors. Gynecol Oncol 2005; 97:422-30. [PMID: 15863140 DOI: 10.1016/j.ygyno.2005.01.007] [Citation(s) in RCA: 159] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2004] [Revised: 12/20/2004] [Accepted: 01/07/2005] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Lack of exercise and excess body weight may exacerbate treatment-related declines in quality of life (QoL) in endometrial cancer survivors. The primary purpose of this study was to examine the associations among exercise, body weight, and QoL in a population-based sample of endometrial cancer survivors. METHODS Participants were 386 endometrial cancer survivors residing in Alberta, Canada who completed a mailed survey that assessed self-reported exercise, height, and weight to calculate body mass index (BMI) and QoL using the Functional Assessment of Cancer Therapy-Anemia (FACT-An) scale. RESULTS Descriptive data indicated that 70% of the sample were not meeting public health exercise guidelines and 72% were overweight or obese. Multivariate analyses of variance demonstrated that endometrial cancer survivors meeting public health guidelines for exercise and body weight reported significantly better QoL than survivors not meeting guidelines. The differences in QoL between the groups were clinically meaningful and were not altered when controlling for important demographic and medical variables. There were no interactions between exercise, BMI, age, or time since diagnosis. Lastly, multiple regression analysis identified that both exercise (beta = .21; P < .001) and BMI (beta = -.17; P < .001) were independently associated with QoL. CONCLUSIONS These results suggest that exercise and body weight are important independent correlates of QoL in endometrial cancer survivors. Randomized controlled trials designed to test the causal effects of exercise and/or weight loss on QoL in endometrial cancer survivors are warranted.
Collapse
Affiliation(s)
- Kerry S Courneya
- Faculty of Physical Education, University of Alberta, E-424 Van Vliet Center, Edmonton, Alberta, Canada T6G 2H9.
| | | | | | | | | | | | | |
Collapse
|
19
|
Ekman I, Bergbom I, Ekman T, Berthold H, Mahsneh SM. Maintaining normality and support are central issues when receiving chemotherapy for ovarian cancer. Cancer Nurs 2004; 27:177-82. [PMID: 15238804 DOI: 10.1097/00002820-200405000-00002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The aim of this study was to enrich the understanding of patients' perspective of being diagnosed and treated for ovarian cancer. A qualitative approach was used to obtain knowledge and insight into patients' experiences and thoughts. Ten Swedish women, diagnosed with ovarian cancer, participated in a total of 23 interviews on 3 occasions: at the time of diagnosis, during chemotherapy, and after completion of chemotherapy. The results of the interpretation of the interviews were formulated in the form of 3 themes: (1) feeling the same despite radical castrating surgery, (2) accepting chemotherapy, and (3) maintaining normality and support. Suggestions of caring implications from our interpretation of the interview data underscore the need to support these women in learning to cope with their feelings of weakness and anxiety. The findings further indicate the potential in narrative methods to identify important issues in comprehensive cancer care.
Collapse
Affiliation(s)
- Inger Ekman
- Faculty of Health and Caring Sciences, Institute of Nursing, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
| | | | | | | | | |
Collapse
|
20
|
Fitch MI. Psychosocial management of patients with recurrent ovarian cancer: treating the whole patient to improve quality of life. Semin Oncol Nurs 2003; 19:40-53. [PMID: 12971249 DOI: 10.1016/s0749-2081(03)00060-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To describe the psychosocial issues affecting women with recurrent ovarian cancer and provide suggestions for screening to provide appropriate referrals. DATA SOURCES Research articles and textbooks. CONCLUSION Nursing care may involve practical, informational, and emotional support. Screening patients for psychosocial distress can be conducted quickly and is important to identify patients requiring additional interventions. IMPLICATIONS FOR NURSING PRACTICE Nurses should be familiar with the National Comprehensive Cancer Network guidelines regarding distress management. Psychosocial support requires a commitment to addressing the individual psychosocial needs of each patient. Nurses play an invaluable role in helping to improve the quality of life for women with recurrent ovarian cancer.
Collapse
Affiliation(s)
- Margaret I Fitch
- Oncology Nursing and Supportive Care Unit, Toronto-Sunnybrook Regional Cancer Centre, 2075 Bayview Ave, 2nd Floor Reception, Toronto, Ontario, M4N 3M5 Canada
| |
Collapse
|