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Chien CH, Liu KL, Chuang CK, Wu CT, Chang YH, Yu KJ. Multimedia-based hormone therapy information program for patients with prostate cancer: the result of a randomized pilot study. Sci Rep 2023; 13:23022. [PMID: 38155164 PMCID: PMC10754917 DOI: 10.1038/s41598-023-50006-6] [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: 09/06/2022] [Accepted: 12/14/2023] [Indexed: 12/30/2023] Open
Abstract
Few studies have explored the feasibility and efficacy of a multimedia information intervention for patients with prostate cancer who are undergoing hormone therapy. Thus, the purpose of the study was to assess the feasibility, acceptability, and the preliminary results of a multimedia-based hormone therapy information program (HTIP) on positive thinking and quality of life (QOL; primary outcomes) as well as social support and self-efficacy (secondary outcomes) of patients with prostate cancer. Patients with prostate cancer who were receiving hormone therapy were recruited from hospitals. After completing the pre-test questionnaire, patients were randomly divided into the multimedia information group (MIG; n = 40) and the control group (CG; n = 40). Patients in the MIG received a multimedia-based HTIP once a week for 6 weeks. Data were collected at 8 and 12 weeks after the pre-test. Measurement variables included positive thinking, QOL, social support, self-efficacy, and satisfaction with the program. The recruitment rate and retention rate were calculated for assessment of feasibility. The study had a 96.3% retention rate, and patients in the MIG were satisfied with the program. Preliminary results showed that, compared with those in the CG, patients in the MIG tended to exhibit higher positive thinking, prostate cancer-specific QOL, and social support at 8 weeks and 12 weeks after pre-test; however, the effect did not reach a statistically significant level. A multimedia-based HTIP is considered feasible and acceptable in patients with prostate cancer who underwent hormone therapy. Further research with a larger sample size, patients with high homogeneity in early-stage disease and long-term follow-up is needed to assess the efficacy of the intervention program.Trial registration: ClinicalTrials.gov (NCT04693910); Registered 05/01/2021.
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Affiliation(s)
- Ching-Hui Chien
- School of Nursing, National Taipei University of Nursing and Health Sciences, No.365, Ming-te Road, Peitou District, Taipei City, 112, Taiwan.
| | - Kuan-Lin Liu
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Keelung, Keelung City, Taiwan
| | - Cheng-Keng Chuang
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Tao-Yuan City, Taiwan
- College of Medicine, Chang Gung University, Tao-Yuan City, Taiwan
| | - Chun-Te Wu
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Tao-Yuan City, Taiwan
- College of Medicine, Chang Gung University, Tao-Yuan City, Taiwan
| | - Ying-Hsu Chang
- College of Medicine, Chang Gung University, Tao-Yuan City, Taiwan
- Division of Urology, Department of Surgery, New Taipei City Municipal TuCheng Hospital, New Taipei City, Taiwan
| | - Kai-Jie Yu
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Tao-Yuan City, Taiwan
- College of Medicine, Chang Gung University, Tao-Yuan City, Taiwan
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Poudel PG, Horan MR, Brinkman TM, Wang Z, Robison LL, Hudson MM, Huang IC. Interventions with Social Integration Components Addressing Psychosocial Outcomes of Young- and Middle-Aged Adult Cancer Individuals: A Systematic Review. Cancers (Basel) 2023; 15:4710. [PMID: 37835404 PMCID: PMC10571739 DOI: 10.3390/cancers15194710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 09/17/2023] [Accepted: 09/20/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND The majority of adult cancer patients/survivors encounter social challenges (e.g., obtaining social support, maintaining social relationships, feelings of social isolation). This systematic review summarizes intervention studies addressing social integration or social connectedness issues among young- and middle-aged cancer patients/survivors. METHODS We searched the PubMed, CINAHL, and Web of Science databases (January 2000-May 2021) to identify intervention studies that addressed social integration, social connectedness, social support, and social isolation for cancer patients/survivors in young- and middle-aged adulthood (18-64.9 years) through a randomized controlled trial (RCT). We categorized the interventions as technology-based, non-technology-based, and mixed-type (technology- and non-technology-based). RESULTS A total of 28 studies were identified. These interventions demonstrated improved social outcomes (e.g., increased social support, decreased loneliness), increased awareness of available cancer-related resources, and better patient-reported outcomes among patients/survivors versus controls. Specifically, the use of internet-based discussion sessions was associated with improved social cohesion and social support. Receiving social support from peers through networking sites was associated with improved physical activity. Additionally, implementing mixed-type interventions led to better social support from peer survivors, less fear of social interactions, and improved social connectedness. CONCLUSIONS Using existing technology- and/or non-technology-based platforms to facilitate social connectedness among cancer patients/survivors in young- or middle-aged adulthood can help them cope with stressful life circumstances and improve quality-of-life. Further interventions targeting social integration (e.g., social network interventions) are needed to improve the complex social integration challenges experienced by cancer patients and survivors.
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Affiliation(s)
- Pragya G. Poudel
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA; (P.G.P.); (M.R.H.); (T.M.B.); (Z.W.); (L.L.R.); (M.M.H.)
| | - Madeline R. Horan
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA; (P.G.P.); (M.R.H.); (T.M.B.); (Z.W.); (L.L.R.); (M.M.H.)
| | - Tara M. Brinkman
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA; (P.G.P.); (M.R.H.); (T.M.B.); (Z.W.); (L.L.R.); (M.M.H.)
- Department of Psychology and Biobehavioral Sciences, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA
| | - Zhaoming Wang
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA; (P.G.P.); (M.R.H.); (T.M.B.); (Z.W.); (L.L.R.); (M.M.H.)
- Department of Computational Biology, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA
| | - Leslie L. Robison
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA; (P.G.P.); (M.R.H.); (T.M.B.); (Z.W.); (L.L.R.); (M.M.H.)
| | - Melissa M. Hudson
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA; (P.G.P.); (M.R.H.); (T.M.B.); (Z.W.); (L.L.R.); (M.M.H.)
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA
| | - I-Chan Huang
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA; (P.G.P.); (M.R.H.); (T.M.B.); (Z.W.); (L.L.R.); (M.M.H.)
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Bluethmann SM, Flores E, Grotte M, Heitzenrater J, Truica CI, Olsen NJ, Sciamanna C, Schmitz KH. Adapting an Evidence-Based Exercise and Education Program for Older Breast Cancer Survivors for the REJOIN Trial. J Aging Phys Act 2023; 31:59-67. [PMID: 35700977 PMCID: PMC10903157 DOI: 10.1123/japa.2022-0013] [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: 01/10/2022] [Revised: 04/11/2022] [Accepted: 04/12/2022] [Indexed: 02/03/2023]
Abstract
Physical activity (PA) promotes survival and mitigates symptoms in older breast cancer survivors (BCS), especially to reduce joint pain associated with adjuvant hormonal treatment. The purpose is to describe the adaptation process for an evidence-based exercise and education curriculum (i.e., Fit & Strong!) to support older BCS participating in the Using Exercise to Relieve Joint Pain and Improve Aromatase Inhibitor Adherence in Older Breast Cancer Survivors trial. We reviewed all educational materials with scientific/clinical experts to identify necessary content changes. Next, we conducted semistructured phone interviews with BCS to review all educational materials and conducted a real-time pretest for the trial. Overall, BCS found the adapted materials and experience acceptable (mean score of 9.2/10 for satisfaction). Content changes included simplifying exercise instructions, prioritizing content related to the trial goals, and updating photographs. Because of COVID, the pretest was conducted via Zoom. Our multistep adaptation process provided an acceptable intervention to meet the needs of older BCS. Lessons learned will be applied to the forthcoming pilot trial.
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Affiliation(s)
- Shirley M Bluethmann
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA,USA
- Milton S. Hershey Medical Center, Cancer Institute, The Pennsylvania State University, Hershey, PA,USA
| | - Eileen Flores
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA,USA
- Milton S. Hershey Medical Center, Cancer Institute, The Pennsylvania State University, Hershey, PA,USA
| | - Meghan Grotte
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA,USA
| | - Jared Heitzenrater
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA,USA
| | - Cristina I Truica
- Milton S. Hershey Medical Center, Cancer Institute, The Pennsylvania State University, Hershey, PA,USA
- Department of Medicine, Milton S. Hershey Medical Center, The Pennsylvania State University College of Medicine, Hershey, PA,USA
| | - Nancy J Olsen
- Milton S. Hershey Medical Center, Cancer Institute, The Pennsylvania State University, Hershey, PA,USA
- Department of Medicine, Milton S. Hershey Medical Center, The Pennsylvania State University College of Medicine, Hershey, PA,USA
| | - Christopher Sciamanna
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA,USA
- Department of Medicine, Milton S. Hershey Medical Center, The Pennsylvania State University College of Medicine, Hershey, PA,USA
| | - Kathryn H Schmitz
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA,USA
- Milton S. Hershey Medical Center, Cancer Institute, The Pennsylvania State University, Hershey, PA,USA
- Department of Kinesiology, College of Health and Human Development, The Pennsylvania State University, State College, Hershey, PA,USA
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Adame H, Wettersten K, Schwinghamer A, Friesen-Janochoski A. Cancer-related fatigue as a mediator between self-efficacy and quality of life for adolescents and young adults impacted by cancer. J Psychosoc Oncol 2022; 41:502-517. [PMID: 36541375 DOI: 10.1080/07347332.2022.2147120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Adolescents and young adults are a unique subpopulation within oncology, with different and often unmet needs. The current study investigated the relationships between cancer-related self-efficacy, cancer-related fatigue, and quality of life, with the hypothesis that fatigue would mediate the negative relationship between self-efficacy and quality of life for adolescents and young adults impacted by cancer. METHODS Structural equation modeling was utilized to examine the pathways between these variables. RESULTS As predicted, results (n = 265, 92.8% female) demonstrated a strong positive relationship between self-efficacy and quality of life. Fatigue partially but significantly mediated the pathway between self-efficacy and quality of life. CONCLUSIONS It appears that cancer-related self-efficacy may work, at least in part, through the mediating variable of fatigue, to influence quality of life for adolescents and young adults.
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Oswald LB, Lyleroehr M, Gudenkauf LM, Armstrong GE, Tometich DB, Sanford SD, Loecher N, Geiss C, Rodriguez Y, Scheel KL, Nieves-Lopez A, Jim HSL, Gonzalez BD, Antoni MH, Penedo FJ, Reed D, Katsanis E, Salsman JM, Victorson D, Fox RS. Development and initial testing of TOGETHER-YA: an eHealth-delivered and group-based psychosocial intervention for young adult cancer survivors. Support Care Cancer 2022; 30:10067-10076. [PMID: 36229547 PMCID: PMC9722531 DOI: 10.1007/s00520-022-07382-y] [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: 07/13/2022] [Accepted: 10/01/2022] [Indexed: 01/31/2023]
Abstract
PURPOSE This study aimed to (1) develop TOGETHER-YA, an e-Health-delivered and group-based health-related quality of life (HRQOL) intervention for young adult (YA) cancer survivors aged 18-39 (Part 1), and (2) determine its initial feasibility and acceptability in a single-arm pilot trial (Part 2). METHODS TOGETHER-YA is a manualized, 10-week intervention for YA survivors that includes elements of relaxation training, cognitive-behavioral therapy, and health education. In Part 1, content was adapted from existing evidence-based interventions with feedback from YAs (N = 22) in four iterative focus groups. In Part 2, YA survivors (N = 11) participated in a single-arm pilot trial of TOGETHER-YA. Intervention groups were led by a trained facilitator over videoconference. Primary outcomes were feasibility (i.e., recruitment, session attendance, retention) and acceptability (i.e., participant satisfaction). RESULTS Focus groups reacted positively to TOGETHER-YA and provided actionable recommendations for enhancing its relevance and acceptability, which were implemented. In initial testing, all feasibility and acceptability benchmarks were met; 58% of eligible YAs were recruited, participants attended M = 6 intervention sessions (SD = 3), and 82% of participants were retained post-intervention. On average, participants "agreed" to "strongly agreed" with positive statements about the weekly sessions and the overall program. CONCLUSION TOGETHER-YA was developed in collaboration with YA cancer survivors and found to be feasible and acceptable in initial testing. TOGETHER-YA is the first HRQOL intervention for a broad range of YA survivors that is eHealth-delivered for convenience and group-based for peer support. Future large-scale trials should test its efficacy for improving HRQOL. TRIAL REGISTRATION NCT05048316, September 17, 2021; NCT05054569, September 23, 2021.
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Affiliation(s)
- Laura B Oswald
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-HOB, 12902 USF Magnolia Drive, MFC-HOB, Tampa, FL, 33612, USA.
| | - Madison Lyleroehr
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Lisa M Gudenkauf
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-HOB, 12902 USF Magnolia Drive, MFC-HOB, Tampa, FL, 33612, USA
| | - Grace E Armstrong
- Department of Counseling, The Family Institute of Northwestern University, Evanston, IL, USA
| | - Danielle B Tometich
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-HOB, 12902 USF Magnolia Drive, MFC-HOB, Tampa, FL, 33612, USA
| | - Stacy D Sanford
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, USA
| | - Nele Loecher
- Department of Mental Health Law and Policy, University of South Florida, Tampa, FL, USA
| | - Carley Geiss
- Participant Research, Interventions, and Measurement Core, Moffitt Cancer Center, Tampa, FL, USA
| | - Yvelise Rodriguez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-HOB, 12902 USF Magnolia Drive, MFC-HOB, Tampa, FL, 33612, USA
| | - Kelsey L Scheel
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-HOB, 12902 USF Magnolia Drive, MFC-HOB, Tampa, FL, 33612, USA
| | - Amarilis Nieves-Lopez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-HOB, 12902 USF Magnolia Drive, MFC-HOB, Tampa, FL, 33612, USA
| | - Heather S L Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-HOB, 12902 USF Magnolia Drive, MFC-HOB, Tampa, FL, 33612, USA
| | - Brian D Gonzalez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-HOB, 12902 USF Magnolia Drive, MFC-HOB, Tampa, FL, 33612, USA
| | - Michael H Antoni
- Department of Psychology, University of Miami, Coral Gables, FL, USA
- Cancer Control Research Program, Sylvester Comprehensive Cancer Center, FL, Miami, USA
| | - Frank J Penedo
- Department of Psychology, University of Miami, Coral Gables, FL, USA
- Cancer Control Research Program, Sylvester Comprehensive Cancer Center, FL, Miami, USA
| | - Damon Reed
- Department of Individualized Cancer Management, Moffitt Cancer Center, Tampa, FL, USA
| | - Emmanuel Katsanis
- Department of Pediatrics, University of Arizona College of Medicine, Tucson, AZ, USA
- University of Arizona Cancer Center, Tucson, AZ, USA
| | - John M Salsman
- Department of Social Sciences and Health Policy, Wake Forest Baptist Comprehensive Cancer Center, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - David Victorson
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, USA
| | - Rina S Fox
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- University of Arizona Cancer Center, Tucson, AZ, USA
- University of Arizona College of Nursing, Tucson, AZ, USA
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Kruisbrink M, Crutzen R, Kempen GIJM, Delbaere K, Ambergen T, Cheung KL, Kendrick D, Iliffe S, Zijlstra GAR. Disentangling interventions to reduce fear of falling in community-dwelling older people: a systematic review and meta-analysis of intervention components. Disabil Rehabil 2022; 44:6247-6257. [PMID: 34511009 DOI: 10.1080/09638288.2021.1969452] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE Fear of falling (FoF) is a common and debilitating problem for older people. Most multicomponent interventions show only moderate effects. Exploring the effective components may help in the optimization of treatments for FoF. MATERIALS AND METHODS In a systematic review of five scientific literature databases, we identified randomized controlled trials with older community-dwelling people that included FoF as an outcome. There was no restriction on types of interventions. Two reviewers extracted information about outcomes and content of interventions. Intervention content was coded with a coding scheme of 68 intervention components. We compared all studies with a component to those without using univariate meta-regressions. RESULTS Sixty-six studies, reporting on 85 interventions, were included in the systematic review. In the meta-regressions (n = 49), few components were associated with intervention effects at the first available follow up after the intervention, but interventions with meditation, holistic exercises (such as Tai Chi or Pilates) or body awareness were significantly more effective than interventions without these components. Interventions with self-monitoring, balance exercises, or tailoring were less effective compared to those without these components. CONCLUSIONS The identified components may be important for the design and optimization of treatments to reduce FoF. Implications for rehabilitationFear of falling (FoF) is a common and debilitating issue among older people and multicomponent interventions usually show only small to moderate effects on FoF.This review and meta-analysis investigated 68 intervention components and their relation to intervention effects on FoF.Interventions with meditation, holistic exercises (such as Tai Chi), or body awareness are more effective than interventions without these components.Clinicians aiming to reduce FoF may recommend selected interventions to older people taking into account the current knowledge of intervention components.
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Affiliation(s)
- Marlot Kruisbrink
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Rik Crutzen
- Department of Health Promotion, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Gertrudis I J M Kempen
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Kim Delbaere
- School of Public Health and Community Medicine, Neuroscience Research Australia, UNSW, Randwick, Australia
| | - Ton Ambergen
- Department of Methodology and Statistics, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Kei Long Cheung
- Department of Health Sciences, College of Health, Medicine and Life Sciences, Brunel University London, London, UK
| | - Denise Kendrick
- Division of Primary Care, School of Medicine, University of Nottingham, Nottingham, UK
| | - Steve Iliffe
- Research Department of Primary Care & Population Health, University College London, London, UK
| | - G A Rixt Zijlstra
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
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Interventions to Improve Self-Efficacy in Colorectal Cancer Patients and/or Caregivers: A Systematic Review and Meta-Analysis. JOURNAL OF ONCOLOGY 2021; 2021:4553613. [PMID: 34707659 PMCID: PMC8545593 DOI: 10.1155/2021/4553613] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 09/28/2021] [Indexed: 01/30/2023]
Abstract
Objective High levels of self-efficacy (SE) in colorectal cancer (CRC) patients and/or caregivers enable patients to cope with cancer, reduce caregiver burden, and promote quality of life (QOL) in patients and caregivers alike. This review aims to (a) identify the SE theory sources covered by SE interventions or interventions, including targeting improved SE for CRC patients and/or caregivers, to guide future development of SE interventions; and (b) explore intervention effects based on SE theory through meta-analysis. Methods Using five electronic databases—CINAHL, Cochrane Library, Embase, PsycINFO, and PubMed—a systematic search was performed in April 2021 to identify English or Chinese literature that studied improving SE interventions for CRC patients and/or caregivers. Manual screening of the articles' references list was also performed. Results A total of 18 studies were found to be suitable and included in this review. Of the 18 studies that were included, 10 randomized controlled trials (RCTs) studies with 917 participants were eligible for meta-analysis. Interventions provide support for SE drawing on different sources of information. Performance accomplishment (PA) is the key source, with vicarious experience (VE) and verbal persuasion (VP) assisting in improving PA. Reducing negative emotional arousal (NEA) and improving positive emotional arousal (PEA) are also indispensable factors in improving SE. The meta-analysis results show that interventions based on the SE theory can bring about positive effects for CRC patients and/or caregivers. Conclusions Different sources of information aimed at improving SE, covered by the interventions, including PA, VE, VP, NEA, and PEA, have been explored. Positive intervention outcomes that focused on improving SE for CRC patients and/or caregivers were identified and highlighted. For future SE interventions, we advocate choosing combination sources of SE information to design interventions. It is recommended that future SE improvement interventions should focus on improving PA, supplemented by increasing VE, while reducing NEA and providing useful VP.
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Reese JB, Zimmaro LA, Bober SL, Sorice K, Handorf E, Wittenberg E, El-Jawahri A, Beach MC, Wolff AC, Daly MB, Izquierdo B, Lepore SJ. Mobile Technology-Based (mLearning) Intervention to Enhance Breast Cancer Clinicians' Communication About Sexual Health: A Pilot Trial. J Natl Compr Canc Netw 2021; 19:1133-1140. [PMID: 34388731 PMCID: PMC8840991 DOI: 10.6004/jnccn.2021.7032] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 03/02/2021] [Indexed: 01/24/2023]
Abstract
BACKGROUND Most breast cancer clinicians lack training to counsel patients about sexual concerns. The purpose of this study was to assess the feasibility, acceptability, and preliminary effects of a mobile learning (mLearning) intervention (improving Sexual Health and Augmenting Relationships through Education [iSHARE]) aimed at enhancing breast cancer clinicians' knowledge of, beliefs about, and comfort with discussing patients' sexual health concerns. METHODS Clinicians listened to a 2-part educational podcast series offering information on breast cancer-related sexual health concerns and effective communication on the topic, which consisted of interviews with expert guests. Intervention feasibility was assessed through rates of enrollment, retention, and intervention completion, with benchmarks of 40%, 70%, and 60%, respectively. Acceptability was assessed through program evaluations, with 75% of clinicians rating the intervention favorably (eg, relevance, satisfaction) signifying acceptability. Clinicians self-reported their knowledge about breast cancer-related sexual health concerns, beliefs (ie, self-efficacy for discussing sexual health concerns), and comfort with discussing sexual concerns measured at preintervention and postintervention. Qualitative analysis examined clinicians' perceptions of lessons learned from the intervention. RESULTS A total of 32 breast cancer clinicians enrolled (46% of those invited; 97% of those who responded and screened eligible), 30 (94%) completed both the intervention and study surveys, and 80% rated the intervention favorably, demonstrating feasibility and acceptability. Results showed positive trends for improvement in clinician knowledge, beliefs, and comfort with discussing sexual health concerns. Clinicians reported key lessons learned, including taking a proactive approach to discussing sexual health concerns, normalizing the topic, addressing vaginal health, sending the message that help is available, and assessing sexual health concerns with patients from different backgrounds. CONCLUSIONS Breast cancer clinicians were amenable to participating in the iSHARE intervention and found it useful. iSHARE showed promise for improving clinician's knowledge and comfort discussing patients' sexual health concerns. A larger trial is required to demonstrate efficacy. Future studies should also examine whether iSHARE can improve patient-clinician communication and address patients' sexual concerns.
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Affiliation(s)
| | | | - Sharon L. Bober
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute,Division of Palliative Medicine, Department of Medicine, Brigham and Women’s Hospital
| | - Kristen Sorice
- Cancer Prevention and Control Program, Fox Chase Cancer Center
| | - Elizabeth Handorf
- Cancer Prevention and Control Program, Fox Chase Cancer Center,Biostatistics and Bioinformatics Facility, Fox Chase Cancer Center
| | - Elaine Wittenberg
- Department of Communication Studies, California State University, Los Angeles
| | - Areej El-Jawahri
- Department of Hematology/Oncology, Massachusetts General Hospital
| | | | - Antonio C. Wolff
- Women’s Malignancies Program, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center
| | - Mary B. Daly
- Department of Clinical Genetics, Fox Chase Cancer Center
| | - Brynna Izquierdo
- Department of Epidemiology and Biostatistics, College of Public Health, Temple University
| | - Stephen J. Lepore
- Cancer Prevention and Control Program, Fox Chase Cancer Center,Department of Social and Behavioral Sciences, College of Public Health, Temple University
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Custal C, Koehn J, Borutta M, Mrochen A, Brandner S, Eyüpoglu IY, Lücking H, Hoelter P, Kuramatsu JB, Kornhuber J, Schwab S, Huttner HB, Gerner ST. Beyond Functional Impairment: Redefining Favorable Outcome in Patients with Subarachnoid Hemorrhage. Cerebrovasc Dis 2021; 50:729-737. [PMID: 34284375 DOI: 10.1159/000517242] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 05/12/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND For outcome assessment in patients surviving subarachnoid hemorrhage (SAH), the modified Rankin scale (mRS) represents the mostly established outcome tool, whereas other dimensions of outcome such as mood disorders and impairments in social life remain unattended so far. OBJECTIVE The aim of our study was to correlate 12-month functional and subjective health outcomes in SAH survivors. METHODS All SAH patients treated over a 5-year period received outcome assessment at 12 months, including functional scores (mRS and Barthel Index [BI]), subjective health measurement (EQ-5D), and whether they returned to work. Analyses - including utility-weighted mRS - were conducted to detect associations and correlations among different outcome measures, especially in patients achieving good functional outcome (i.e., mRS 0-2) at 12 months. RESULTS Of 351 SAH survivors, 287 (81.2%) achieved favorable functional outcome at 12 months. Contrary to the BI, the EQ-5D visual analog scale (VAS) showed a strong association with different mRS grades, accentuated in patients with favorable functional outcome. Despite favorable functional outcome, patients reported a high rate of impairments in activities (24.0%), pain (33.4%), and anxiety/depression (42.5%). Further, multivariable analysis revealed (i) impairments in activities (odds ratio [OR] [95% confidence interval {CI}]: 0.872 [0.817-0.930]), (ii) presence of depression or anxiety (OR [95% CI]: 0.836 [0.760-0.920]), and (iii) return to work (OR [95% CI]: 1.102 [0.1.013-1.198]) to be independently associated with self-reported subjective health. CONCLUSION Established stroke scores mainly focusing on functional outcomes do poorly reflect the high rate of subjective impairments reported in SAH survivors, specifically in those achieving good functional outcome. Further studies are needed to investigate whether psychoeducational approaches aiming at improving coping mechanisms and perceived self-efficacy may result in higher subjective health in these patients.
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Affiliation(s)
- Christina Custal
- Department of Psychiatry, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Julia Koehn
- Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Matthias Borutta
- Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Anne Mrochen
- Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Sebastian Brandner
- Department of Neurosurgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Ilker Y Eyüpoglu
- Department of Neurosurgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Hannes Lücking
- Department of Neuroradiology, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Philip Hoelter
- Department of Neuroradiology, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Joji B Kuramatsu
- Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Johannes Kornhuber
- Department of Psychiatry, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Stefan Schwab
- Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Hagen B Huttner
- Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Stefan T Gerner
- Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany
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Canadian Resources, Programs, and Models of Care to Support Cancer Survivors' Transition beyond Treatment: A Scoping Review. ACTA ACUST UNITED AC 2021; 28:2134-2145. [PMID: 34207635 PMCID: PMC8293069 DOI: 10.3390/curroncol28030198] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 05/27/2021] [Accepted: 06/03/2021] [Indexed: 12/01/2022]
Abstract
(1) Background: One in two Canadians will be diagnosed with cancer in their lifetime, but as a result of the progress in diagnosis and treatment, more individuals are surviving cancer than ever before. However, the impact of cancer does not end with treatment. The objectives of this review are to (1) provide a broad overview of the supportive care interventions and models of care that have been researched to support Canadian post-treatment cancer survivors; and (2) analyze how these supportive care interventions and/or care models align with the practice recommendations put forth by Cancer Care Ontario (CCO) and the Canadian Association of Psychosocial Oncology/Canadian Partnership Against Cancer (CAPO/CPAC). (2) Methods: An electronic search was completed in MEDLINE, Embase, PsycINFO, and CINAHL in January 2021. Included studies described supportive care interventions or models of care utilized by adult Canadian cancer survivors. (3) Results: Forty-two articles were included. Survivors utilized a multitude of supportive care interventions, with peer support and physical activity programs being most frequently cited. Four models of follow-up care were identified: primary care, oncology care, shared-care, and transition clinics. The supportive care interventions and models of care variably aligned with the recommendations set by CCO and CAPO/CPAC. The most commonly followed recommendation was the promotion of self-management and quality resources for patients. (4) Conclusions: Results indicate an inconsistency in access to supportive care interventions and the delivery of survivorship care for cancer survivors across Canada. Current efforts are being made to implement the recommendations by CCO and CAPO/CPAC; however, provision of these guidelines remains varied.
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Bluethmann SM, Truica C, Klepin HD, Olsen N, Sciamanna C, Chinchilli VM, Schmitz KH. Study design and methods for the using exercise to relieve joint pain and improve AI adherence in older breast cancer survivors (REJOIN) trial. J Geriatr Oncol 2021; 12:1146-1153. [PMID: 34049837 DOI: 10.1016/j.jgo.2021.05.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 05/19/2021] [Indexed: 01/12/2023]
Abstract
BACKGROUND Aromatase Inhibitors (AIs) are recommended for survival in post-menopausal breast cancer survivors (BCS) with hormone-sensitive disease. AI Adherence is suboptimal, especially in older BCS. Joint pain is a common AI-related symptom that is associated with low AI adherence. The Using Exercise to Relieve Joint Pain in Older Breast Cancer Survivors (REJOIN) Trial will evaluate the efficacy of a self-management intervention (exercise + education) to increase knowledge/self-efficacy for symptom management, reduce joint pain and potentially increase AI adherence in older BCS planning to take AIs. METHODS This randomized controlled pilot trial will include sedentary BCS, 65 years and older, diagnosed with stage I-III hormone-sensitive breast cancer, who have completed primary cancer treatment and are planning to initiate AIs. We will adapt an evidence-based physical activity program for older adults that includes bi-weekly, supervised exercise sessions plus 30 min of education. The 16-week intervention program includes: 8-weeks of supervised sessions plus 8-weeks of self-guided home sessions with periodic phone coaching. We will conduct geriatric assessments plus measurements of exercise, joint pain, and AI adherence (baseline, 4, 6 and 12 months). DISCUSSION REJOIN is one of the first trials to exclusively target older BCS using a self-management intervention, informed by geriatric assessment and exercise physiology, to improve health outcomes in survivorship. The REJOIN trial could lay the foundation for transdisciplinary research that bridges the gap between clinical and public health perspectives in healthy aging, with the opportunity to translate clinical interventions into non-pharmacological tools for a growing, yet underserved population of older survivors. TRIAL REGISTRATION NCT03955627.
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Affiliation(s)
- Shirley M Bluethmann
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA, United States of America; Cancer Institute, The Pennsylvania State University, Milton S. Hershey Medical Center, Hershey, PA, United States of America.
| | - Cristina Truica
- Cancer Institute, The Pennsylvania State University, Milton S. Hershey Medical Center, Hershey, PA, United States of America; Department of Medicine, The Pennsylvania State University, College of Medicine, Milton S. Hershey Medical Center, Hershey, PA, United States of America
| | - Heidi D Klepin
- Department of Internal Medicine, Section on Hematology and Oncology, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
| | - Nancy Olsen
- Cancer Institute, The Pennsylvania State University, Milton S. Hershey Medical Center, Hershey, PA, United States of America; Department of Medicine, The Pennsylvania State University, College of Medicine, Milton S. Hershey Medical Center, Hershey, PA, United States of America
| | - Christopher Sciamanna
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA, United States of America; Department of Medicine, The Pennsylvania State University, College of Medicine, Milton S. Hershey Medical Center, Hershey, PA, United States of America
| | - Vernon M Chinchilli
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA, United States of America
| | - Kathryn H Schmitz
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA, United States of America; Cancer Institute, The Pennsylvania State University, Milton S. Hershey Medical Center, Hershey, PA, United States of America; Department of Kinesiology, College of Health and Human Development, The Pennsylvania State University, State College, PA, United States of America
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12
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Savioni L, Triberti S, Durosini I, Sebri V, Pravettoni G. Cancer patients' participation and commitment to psychological interventions: a scoping review. Psychol Health 2021; 37:1022-1055. [PMID: 33966548 DOI: 10.1080/08870446.2021.1916494] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Some psychological interventions have been developed to improve cancer patients' and survivors' quality of life, well-being, and health engagement. However, studies are usually focused on effectiveness and less on factors influencing survivors' decision to participate, both subjective (e.g., needs) and contingent (e.g., factors related to participation/non participation). This scoping review identifies factors influencing participation, decline to participate, attrition and adherence in psychological interventions. METHODS 3 electronic databases were searched for published studies on psychological interventions. Retrieved publications were scanned by authors against inclusion criteria and forty-two articles were selected. Relevant information were summarized narratively. RESULTS More information is available on attrition and factors related to participation/non participation, so that future psychological interventions may employ ad-hoc tools to take into consideration patients' reasons to adhere to psychological interventions. Secondarily, non-participation/dropout is often linked to factors related to intervention' commitment and its interference with daily life. On the contrary, patients' reasons to participate often identify with the value they find in the intervention according to their personal needs and experience of illness. CONCLUSION We suggest that future research should analyze patients' representation of psychological interventions and take them into account to tailor the interventions on participants' lived experience, to improve participation.
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Affiliation(s)
- Lucrezia Savioni
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.,Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Stefano Triberti
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.,Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Ilaria Durosini
- Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Valeria Sebri
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.,Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.,Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan, Italy
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Health-Related Quality of Life and Its Associated Factors in Prostate Cancer Patients Who Receive Androgen Deprivation Therapy. Cancer Nurs 2021; 44:E34-E42. [PMID: 31743152 DOI: 10.1097/ncc.0000000000000752] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Presently, few studies have examined the impact of positive thinking on the HRQoL of prostate cancer patients who receive androgen deprivation therapy (ADT). OBJECTIVES We explored the factors that affect health-related quality of life (HRQoL), particularly positive thinking, of prostate cancer patients who receive ADT. METHODS A cross-sectional design was used. A total of 132 prostate cancer patients, drawn from outpatient clinics of 2 medical centers, who were receiving ADT were included. Structured questionnaires, including a basic information sheet, the Positive Thinking Scale, Social Support Scale, and Functional Assessment of Cancer Therapy-Prostate (FACT-P), were used for data collection. Statistical analysis was performed by using independent-sample t tests, one-way analysis of variance, Pearson correlation, and multiple regression. RESULTS Prostate cancer patients who were receiving ADT were more likely to engage in positive thinking, which was correlated with better social/family well-being, emotional well-being, functional well-being, prostate cancer concern, and a higher score on the FACT-P. Improved self-reported health status was correlated better with all subdimensions of HRQoL and better scores on the FACT-P. Greater social support was correlated with high social/family well-being. CONCLUSIONS Positive thinking, self-reported health status, and social support are important associated factors of HRQoL in prostate cancer patients who receive ADT. IMPLICATIONS FOR PRACTICE Oncology nurses can improve HRQoL by improving positive thinking, self-reported health status, and social support of prostate cancer patients who receive ADT.
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14
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Doughty H, Oliver K, Veríssimo D, Lee JSH, Milner‐Gulland EJ. Using theory and evidence to design behaviour change interventions for reducing unsustainable wildlife consumption. PEOPLE AND NATURE 2021. [DOI: 10.1002/pan3.10189] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Affiliation(s)
- Hunter Doughty
- Department of Zoology University of Oxford Oxford UK
- Oxford Martin Programme on the Illegal Wildlife Trade University of Oxford Oxford UK
| | - Kathryn Oliver
- Faculty of Public Health and PolicyLondon School of Hygiene and Tropical Medicine London UK
| | - Diogo Veríssimo
- Department of Zoology University of Oxford Oxford UK
- Oxford Martin Programme on the Illegal Wildlife Trade University of Oxford Oxford UK
- Institute for Conservation ResearchSan Diego Zoo Escondido CA USA
| | - Janice Ser Huay Lee
- Asian School of the EnvironmentEarth Observatory SingaporeNanyang Technological University of Singapore Singapore Singapore
| | - E. J. Milner‐Gulland
- Department of Zoology University of Oxford Oxford UK
- Oxford Martin Programme on the Illegal Wildlife Trade University of Oxford Oxford UK
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15
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Systematic Review of Behaviour Change Theories Implementation in Dietary Interventions for People Who Have Survived Cancer. Nutrients 2021; 13:nu13020612. [PMID: 33668596 PMCID: PMC7917689 DOI: 10.3390/nu13020612] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 02/10/2021] [Indexed: 12/26/2022] Open
Abstract
Background: An increasing number of dietary interventions for cancer survivors have been based on the behaviour change theory framework. The purpose of this study is to review the use and implementation of behaviour change theories in dietary interventions for people after cancer and assess their effects on the reported outcomes. Methods: The search strategy from a Cochrane review on dietary interventions for cancer survivors was expanded to incorporate an additional criterion on the use of behaviour change theory and updated to September 2020. Randomised controlled trials (RCT) testing a dietary intervention compared to the control were included. Standard Cochrane methodological procedures were used. Results: Nineteen RCTs, with 6261 participants (age range 44.6 to 73.1 years), were included in the review. The Social Cognitive Theory was the most frequently used theory (15 studies, 79%). Studies included between 4 to 17 behaviour change techniques. Due to limited information on the mediators of intervention and large heterogeneity between studies, no meta-analyses was conducted to assess which theoretical components of the interventions are effective. Conclusions: Whilst researchers have incorporated behaviour change theories into dietary interventions for cancer survivors, due to inconsistencies in design, evaluation and reporting, the effect of theories on survivors’ outcomes remains unclear.
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Gonella S, Delfino C, Rolfo M, Rizzo A, Esposito V, Berchialla P, Campagna S. Effects of a Video-Based Preoperative Educational Intervention Plus Nurse-Led Reinforcement Discussion on Knowledge, Self-Efficacy, and Resilience in Patients Undergoing Major Surgery. Clin Nurs Res 2021; 30:753-761. [PMID: 33403866 DOI: 10.1177/1054773820986916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study aimed to verify the feasibility of a video-based preoperative educational intervention plus one-to-one, nurse-led reinforcement discussion in patients undergoing elective major surgery and to assess the impact of this combined intervention on patient- and nurse-perceived patient knowledge, self-efficacy, and resilience. Patients received written material at pre-admission and were offered the intervention at admission. Patients reported their knowledge and self-efficacy at pre-admission and after the intervention, and resilience at pre-admission and discharge. Nurses assessed patients' knowledge and self-efficacy after the intervention. In all, 88/97 (90.7%) patients completed the intervention. The 80 patients with complete data reported a significant increase in their knowledge (p < .001) and self-efficacy (p < .001), but no difference in resilience (p = .72). Nurse-perceived patient knowledge agreed with patients' perceptions (p = .57) but nurses scored patients' self-efficacy lower (p < .001). The combined intervention was feasible, and patients perceived an improvement in their knowledge and self-efficacy. Nurses' assessment partially agreed with patients' perceptions.
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17
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Oktay JS, Rohan EA, Burruss K, Callahan C, Schapmire TJ, Zebrack B. Oncology social work intervention index (OSWii): An instrument to measure oncology social work interventions to advance research. J Psychosoc Oncol 2020; 39:143-160. [PMID: 33481691 PMCID: PMC8790712 DOI: 10.1080/07347332.2020.1857897] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND/PURPOSE There is much interest in screening for and treating psychosocial distress in cancer patients; however, little is known about if and how psychosocial services are provided for patients demonstrating significant levels of distress. Oncology social workers (OSWs) are the primary providers of psychosocial care for cancer patients and their families, yet there is no widely-used and empirically-validated instrument that captures the range of interventions provided by OSWs. The purpose of this paper is to describe the development of the Oncology Social Work Intervention Index (OSWii), designed to measure interventions provided by OSWs, and the results of testing the instrument. METHODS We conducted a content analysis of data collected by the Association of Oncology Social Work's Project to Assure Quality Cancer Care (APAQCC). We analyzed 3,194 responses from an open-ended question that described social work interventions following a distress screen. Five investigators coded the data in an iterative process to enhance instrument validity. The resulting instrument measuring OSWii was piloted with 38 oncology social workers across 156 individual cases. RESULTS OSWs who piloted the OSWii spent a majority of time (72%) engaging in clinical interventions. The user assessment revealed that data entry was rapid, the instrument was easy to use, and the content was relevant to the cancer treatment setting. CONCLUSIONS AND IMPLICATIONS Using a standardized instrument that reflects OSWs' clinical interventions is critical for researchers to examine the impact of psychosocial interventions on patient outcomes. This index may also advance the translation of scientific findings into patient-centered psychosocial cancer care. This pilot test suggests that the OSWii is both scalable and useful.
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Affiliation(s)
| | - Elizabeth A. Rohan
- Centers for Disease Control and Prevention, Division of Cancer Prevention and Control, Atlanta, GA, USA
| | - Karen Burruss
- University of Maryland School of Social Work, Baltimore, MD, USA
| | | | - Tara J. Schapmire
- University of Louisville Schools of Medicine and Social Work, Louisville, KY, USA
| | - Brad Zebrack
- University of Michigan School of Social Work, Ann Arbor, MI, USA
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18
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Wells RE, Kerr C, Dossett ML, Danhauer SC, Sohl SJ, Sachs BC, Feeley JW, Wolkin J, Wall R, Kaptchuk T, Press DZ, Phillips RS, Yeh GY. Can Adults with Mild Cognitive Impairment Build Cognitive Reserve and Learn Mindfulness Meditation? Qualitative Theme Analyses from a Small Pilot Study. J Alzheimers Dis 2020; 70:825-842. [PMID: 31282418 DOI: 10.3233/jad-190191] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND/OBJECTIVE High levels of chronic stress negatively impact the hippocampus and are associated with increased incidence of mild cognitive impairment (MCI) and Alzheimer's disease. While mindfulness meditation may mitigate the effects of chronic stress, it is uncertain if adults with MCI have the capacity to learn mindfulness meditation. METHODS 14 adults with MCI were randomized 2:1 to Mindfulness Based Stress Reduction (MBSR) or a wait-list control group. We conducted qualitative interviews with those who completed MBSR. Transcribed interviews were: a) coded using an emergent themes inductive approach informed by grounded theory; b) rated 0-10, with higher scores reflecting greater perceived benefit from, and understanding of, mindfulness meditation. Ratings were correlated with daily home practice times and baseline level of cognitive function. RESULTS Seven themes emerged from the interviews: positive perceptions of class; development of mindfulness skills, including meta-cognition; importance of the group experience; enhanced well-being; shift in MCI perspective; decreased stress reactivity and increased relaxation; improvement in interpersonal skills. Ratings of perceived benefit and understanding ranged from 2-10 (mean = 7) and of 0-9.5 (mean = 6), respectively. Many participants experienced substantial benefit/understanding, some had moderate, and a few had minimal benefit/understanding. Understanding the key concepts of mindfulness was highly positively correlated with ≥20 minutes/day of home practice (r = 0.90) but not with baseline cognitive function (r = 0.13). CONCLUSIONS Most adults with MCI were able to learn mindfulness meditation and had improved MCI acceptance, self-efficacy, and social engagement. Cognitive reserve may be enhanced through a mindfulness meditation program even in patients with MCI.
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Affiliation(s)
- Rebecca Erwin Wells
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Catherine Kerr
- Department of Family Medicine and Mindfulness-Wellness Program, Brown University School of Medicine, Providence, RI, USA
| | - Michelle L Dossett
- Department of Medicine and Benson-Henry Institute for Mind Body Medicine, Division of General Internal Medicine, Massachusetts General Hospital; and Harvard Medical School, Boston, MA, USA
| | - Suzanne C Danhauer
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston Salem, NC, USA
| | - Stephanie J Sohl
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston Salem, NC, USA
| | - Bonnie C Sachs
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Jacquelyn Walsh Feeley
- Graduate School of Nursing, University of Massachusetts Medical School, Worcester, MA, USA
| | | | - Robert Wall
- Mclean Hospital Borden Cottage, Camden, ME, USA
| | - Ted Kaptchuk
- Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Daniel Z Press
- Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Russell S Phillips
- Department of Medicine, Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Gloria Y Yeh
- Department of Medicine, Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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Aydın Sayılan A, Demir Doğan M. Illness perception, perceived social support and quality of life in patients with diagnosis of cancer. Eur J Cancer Care (Engl) 2020; 29:e13252. [PMID: 32495471 DOI: 10.1111/ecc.13252] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 02/03/2020] [Accepted: 04/16/2020] [Indexed: 12/31/2022]
Affiliation(s)
- Aylin Aydın Sayılan
- Surgical Nursing Department The Faculty of Health Sciences Kırklareli University Kırklareli Turkey
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20
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Huang X, Liu Q, Li WW, Wu L, Yan A. Effects of magnanimous therapy on emotional, psychosomatic and immune functions of lung cancer patients. J Health Psychol 2020; 26:1096-1108. [PMID: 32009442 DOI: 10.1177/1359105319901312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study was a randomised controlled study on the effects of the individual computer magnanimous therapy and group computer magnanimous therapy on emotional, psychosomatic and immune function among advanced lung cancer patients. Patients were examined at baseline and 2 weeks later using the Psychosomatic Status Scale for Cancer Patients, Hospital Anxiety Depression Scale and IgA, IgG, IgM and natural killer cell functions. The results showed that individual computer magnanimous therapy and group computer magnanimous therapy were beneficial for advanced lung cancer patients in improving depression, anxiety, psychosomatic status and immune functions. The improvements of immune functions may be related to the improvements of the participants' emotional and psychosocial status.
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Affiliation(s)
- Xuewei Huang
- The First Affiliated Hospital, College of Clinical Medicine of Guangdong Pharmaceutical University, China
| | - Qianyu Liu
- Tungwah Hospital of Sun Yat-sen University, China
| | | | - Lanlan Wu
- The People's Hospital of Nanhai District, China
| | - Anni Yan
- Zhongshan People's Hospital, China
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21
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Merluzzi TV, Pustejovsky JE, Philip EJ, Sohl SJ, Berendsen M, Salsman JM. Interventions to enhance self-efficacy in cancer patients: A meta-analysis of randomized controlled trials. Psychooncology 2019; 28:1781-1790. [PMID: 31206917 PMCID: PMC6731146 DOI: 10.1002/pon.5148] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 05/27/2019] [Accepted: 06/06/2019] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Self-efficacy expectations are associated with improvements in problematic outcomes widely considered clinically significant (ie, emotional distress, fatigue, and pain), related to positive health behaviors, and as a type of personal agency, inherently valuable. Self-efficacy expectancies, estimates of confidence to execute behaviors, are important in that changes in self-efficacy expectations are positively related to future behaviors that promote health and well-being. The current meta-analysis investigated the impact of psychological interventions on self-efficacy expectations for a variety of health behaviors among cancer patients. METHODS Ovid Medline, PsycINFO, CINAHL, EMBASE, Cochrane Library, and Web of Science were searched with specific search terms for identifying randomized controlled trials (RCTs) that focused on psychologically based interventions. Included studies had (a) an adult cancer sample, (b) a self-efficacy expectation measure of specific behaviors, and (c) an RCT design. Standard screening and reliability procedures were used for selecting and coding studies. Coding included theoretically informed moderator variables. RESULTS Across 79 RCTs, 223 effect sizes, and 8678 participants, the weighted average effect of self-efficacy expectations was estimated as g = 0.274 (P < .001). Consistent with the self-efficacy theory, the average effect for in-person intervention delivery (g = 0.329) was significantly greater than for all other formats (g = 0.154, P = .023; eg, audiovisual, print, telephone, and Web/internet). CONCLUSIONS The results establish the impact of psychological interventions on self-efficacy expectations as comparable in effect size with commonly reported outcomes (distress, fatigue, pain). Additionally, the result that in-person interventions achieved the largest effect is supported by the social learning theory and could inform research related to the development and evaluation of interventions.
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Affiliation(s)
| | | | - E. J. Philip
- Department of Psychology, University of Notre Dame
| | - S. J. Sohl
- Department of Social Science and Health Policy, Wake Forest School of Medicine
| | - M. Berendsen
- Northwestern University Feinberg School of Medicine
| | - J. M. Salsman
- Department of Social Science and Health Policy, Wake Forest School of Medicine
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Skeen S, Laurenzi CA, Gordon SL, du Toit S, Tomlinson M, Dua T, Fleischmann A, Kohl K, Ross D, Servili C, Brand AS, Dowdall N, Lund C, van der Westhuizen C, Carvajal-Aguirre L, Eriksson de Carvalho C, Melendez-Torres GJ. Adolescent Mental Health Program Components and Behavior Risk Reduction: A Meta-analysis. Pediatrics 2019; 144:peds.2018-3488. [PMID: 31262779 DOI: 10.1542/peds.2018-3488] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/30/2019] [Indexed: 11/24/2022] Open
Abstract
CONTEXT Although adolescent mental health interventions are widely implemented, little consensus exists about elements comprising successful models. OBJECTIVE We aimed to identify effective program components of interventions to promote mental health and prevent mental disorders and risk behaviors during adolescence and to match these components across these key health outcomes to inform future multicomponent intervention development. DATA SOURCES A total of 14 600 records were identified, and 158 studies were included. STUDY SELECTION Studies included universally delivered psychosocial interventions administered to adolescents ages 10 to 19. We included studies published between 2000 and 2018, using PubMed, Medline, PsycINFO, Scopus, Embase, and Applied Social Sciences Index Abstracts databases. We included randomized controlled, cluster randomized controlled, factorial, and crossover trials. Outcomes included positive mental health, depressive and anxious symptomatology, violence perpetration and bullying, and alcohol and other substance use. DATA EXTRACTION Data were extracted by 3 researchers who identified core components and relevant outcomes. Interventions were separated by modality; data were analyzed by using a robust variance estimation meta-analysis model, and we estimated a series of single-predictor meta-regression models using random effects. RESULTS Universally delivered interventions can improve adolescent mental health and reduce risk behavior. Of 7 components with consistent signals of effectiveness, 3 had significant effects over multiple outcomes (interpersonal skills, emotional regulation, and alcohol and drug education). LIMITATIONS Most included studies were from high-income settings, limiting the applicability of these findings to low- and middle-income countries. Our sample included only trials. CONCLUSIONS Three program components emerged as consistently effective across different outcomes, providing a basis for developing future multioutcome intervention programs.
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Affiliation(s)
- Sarah Skeen
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa;
| | - Christina A Laurenzi
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Sarah L Gordon
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Stefani du Toit
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Mark Tomlinson
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,School of Nursing and Midwifery, Queens University, Belfast, United Kingdom
| | - Tarun Dua
- World Health Organization, Geneva, Switzerland
| | | | - Kid Kohl
- World Health Organization, Geneva, Switzerland
| | - David Ross
- World Health Organization, Geneva, Switzerland
| | | | - Amanda S Brand
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Nicholas Dowdall
- Department of Social Policy and Interventions, Oxford University, Oxford, United Kingdom
| | - Crick Lund
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Claire van der Westhuizen
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | | | - Cristina Eriksson de Carvalho
- Department of Maternal, Newborn, Child and Adolescent Health, United Nations Children's Fund, New York, New York; and
| | - G J Melendez-Torres
- Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement, School of Social Sciences, Cardiff University, Cardiff, United Kingdom
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Ndibu Muntu Keba Kebe N, Chiocchio F, Bamvita JM, Fleury MJ. Profiling mental health professionals in relation to perceived interprofessional collaboration on teams. SAGE Open Med 2019; 7:2050312119841467. [PMID: 30956791 PMCID: PMC6444404 DOI: 10.1177/2050312119841467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 03/12/2019] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES This study aims at identifying profiles of mental health professionals based on individual, interactional, structural and professional role characteristics related to interprofessional collaboration. METHODS Mental health professionals (N = 315) working in primary health care and specialized mental health teams in four Quebec local service networks completed a self-administered questionnaire eliciting information on individual, interactional, structural and professional role characteristics. RESULTS Cluster analysis identified four profiles of mental health professionals. Those with the highest interprofessional collaboration scores comprised two profiles labeled "highly collaborative female professionals with fewer conflicts and more knowledge sharing and integration" and "highly collaborative male professionals with fewer conflicts, more participation in decision-making and mutual trust." By contrast, the profile labeled "slightly collaborative professionals with high seniority, many conflicts and less knowledge integration and mutual trust" had the lowest interprofessional collaboration score. Another profile positioned between these groups was identified as "moderately collaborative female psychosocial professionals with less participation in decision-making." DISCUSSION AND CONCLUSION Organizational support, participation in decision-making, knowledge sharing, knowledge integration, mutual trust, affective commitment toward the team, professional diversity and belief in the benefits of interdisciplinary collaboration were features associated with profiles where perceived interprofessional collaboration was higher. These team qualities should be strongly encouraged by mental health managers for improving interprofessional collaboration. Training is also needed to promote improvement in interprofessional collaboration competencies.
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Affiliation(s)
- Nicolas Ndibu Muntu Keba Kebe
- Department of Management, Evaluation and Health Policy, School of Public Health, Université de Montréal, Montreal, QC, Canada
| | | | - Jean-Marie Bamvita
- Douglas Hospital Research Centre, Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Marie-Josée Fleury
- Department of Psychiatry, McGill University, Douglas Hospital Research Centre, Douglas Mental Health University Institute, Montreal, QC, Canada
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Hall KL, Oh A, Perez LG, Rice EL, Patel M, Czajkowski S, Klesges L. The ecology of multilevel intervention research. Transl Behav Med 2019; 8:968-978. [PMID: 30428073 DOI: 10.1093/tbm/iby102] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Behavior change research to promote health and prevent disease increasingly relies on a complex set of interacting characteristics across levels of influence such as biological, psychological, behavioral, interpersonal, and environmental. How to best develop health-related interventions that incorporate the individual, the macro-environment, and their interactions remains a challenge. This article considers a set of key dimensions that constitute what we refer to as the ecology of research across a broad context of multilevel research (MLR), spanning fundamental multilevel research (FMLR), multilevel intervention research (MLIR), and multilevel implementation science (MIS). With the goal of promoting improvements in MLIR, we describe the inherent interdependencies among aspects of research and consider how the growth and development of evidence and resources influence the cross-talk among researchers from different perspectives (e.g., disciplines and domains). We propose a framework that highlights opportunities to reduce barriers and address gaps in areas critical to generating an evidence base through MLR, MLIR, and MIS. Overall, we aim to support strategic decisions that can accelerate our understanding of ML health outcomes and interactions among factors within and across levels, with the goal of strengthening the effectiveness of ML interventions across health-related outcomes.
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Affiliation(s)
- Kara L Hall
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - April Oh
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Lilian G Perez
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Elise L Rice
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Minal Patel
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Susan Czajkowski
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Lisa Klesges
- Division of Epidemiology, Biostatistics and Environmental Health, University of Memphis, Memphis, TN, USA
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Reese JB, Lepore SJ, Daly MB, Handorf E, Sorice KA, Porter LS, Tulsky JA, Beach MC. A brief intervention to enhance breast cancer clinicians' communication about sexual health: Feasibility, acceptability, and preliminary outcomes. Psychooncology 2019; 28:872-879. [PMID: 30811732 DOI: 10.1002/pon.5036] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 02/01/2019] [Accepted: 02/21/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Sexual concerns are often unaddressed for breast cancer patients; one reason is inadequate clinician training. We examined the feasibility, acceptability, and potential benefits of a novel intervention, improving Sexual Health and Augmenting Relationships through Education (iSHARE) for breast cancer clinicians. METHODS Clinicians received training in communicating about sexual concerns with breast cancer patients. Intervention feasibility and acceptability were measured through enrollment/participation and postintervention program evaluations, respectively. Intervention effects were assessed through (1) clinician self-reported beliefs about sexual health communication, assessed at baseline, post-intervention, and 1- or 6-month follow-up, (2) clinical communication coded from audio recorded, transcribed clinic encounters at preintervention or postintervention, and (3) patient satisfaction with clinical care, reported immediately after the clinic visit. Patients also reported sociodemographic characteristics and level of sexual concerns. RESULTS Seven breast cancer clinicians enrolled (88% participation), completed the intervention, and were audio recorded in clinic encounters with 134 breast cancer outpatients (67 each at preintervention or postintervention). Program evaluations supported intervention acceptability. Effect sizes suggest iSHARE increased clinicians' self-efficacy (d = 0.27) and outcome expectancies for communicating about sexual concerns (d = 0.69) and reduced communication barriers (d = -0.14). Clinicians' sexual health communication behaviors increased from baseline to postintervention, including for raising the topic (28% vs 48%), asking questions (33% vs 45%), and offering information (18% vs 24%). Neither patient satisfaction nor duration of sexual health communication changed (mean duration less than 1 minute at both time points). CONCLUSIONS The iSHARE intervention was feasible and well received by clinicians and may change breast cancer clinicians' beliefs and communication behaviors regarding sexual health.
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Affiliation(s)
- Jennifer Barsky Reese
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, Pennsylvania.,Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, Pennsylvania
| | - Stephen J Lepore
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, Pennsylvania.,Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, Pennsylvania
| | - Mary B Daly
- Department of Clinical Genetics, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Elizabeth Handorf
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Kristen A Sorice
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Laura S Porter
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina
| | - James A Tulsky
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Mary Catherine Beach
- Department of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
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27
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Hurtado-de-Mendoza A, Serrano A, Zhu Q, Graves K, Fernández N, Fernández A, Rodriguez-de-Liebana P, Massarelli V, Campos C, González F, Gómez Trillos S, Sheppard VB. Engaging Latina breast cancer survivors in research: building a social network research registry. Transl Behav Med 2018; 8:565-574. [PMID: 30016517 DOI: 10.1093/tbm/ibx053] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Disparities persist in breast cancer outcomes between Latina survivors and non-Hispanic Whites. Identifying methods to ensure that Latinas participate in and benefit from translational behavioral medicine research is important to reduce disparities. We developed a "Social Network Research Registry" to enhance Latina survivors' engagement in research and explored the social networks and research/cancer organization participation in this population. We initially recruited 30 Latina breast cancer survivors ("seeds") from community organizations and identified other survivors through snowball sampling. Guided by Social Network Analysis, we assessed the structural (e.g., size) and functional (e.g., social support) characteristics of the network, willingness to join the registry, prior research participation, involvement in cancer organizations, and interest in different types of research and roles in research. The resulting network size was 98, including 53 women who enrolled in the study and 45 who were listed in the network but did not enroll. All enrolled participants (N = 53) agreed to be part of the registry. We identified 15 participants who occupied strategic positions as hubs and/or bridges. Women who were currently involved in cancer organizations were more likely to have participated in research (70.3% vs. 18.8%); χ2 (1, 53) = 11.97, p = .001. Most were interested in surveys/interviews (98%), behavioral interventions (96%), and becoming health promoters (79%). The Social Network Research Registry is an acceptable and feasible strategy to engage underrepresented Latina survivors in research. Social network analysis can be useful to identify members who occupy key positions to enhance recruitment and translational efforts.
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Affiliation(s)
| | | | - Qi Zhu
- Georgetown University Medical Center, Washington, DC, USA
| | - Kristi Graves
- Georgetown University Medical Center, Washington, DC, USA
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Doherty M, Miller-Sonet E, Gardner D, Epstein I. Exploring the role of psychosocial care in value-based oncology: Results from a survey of 3000 cancer patients and survivors. J Psychosoc Oncol 2018; 37:441-455. [PMID: 30451102 DOI: 10.1080/07347332.2018.1504851] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE To explore the psychosocial needs of cancer patients and survivors across the United States and their implications for value-based oncology. DESIGN A secondary analysis of findings from a cross-sectional national online survey. SAMPLE Respondents were sampled and stratified by cancer type and geographic region to approximate the cancer-affected population of the United States. Breast, prostate, and colorectal were the most common cancers reported. Across surveys, the majority of respondents were female (57%), over 55 (60%), and white (70%) and had at least some college (36%). METHODS Six online surveys were administered to cohorts of approximately 500 unique cancer patients and survivors. Survey topics included: (1) diagnosis, (2) treatment planning, (3) communication with providers, (4) insurance and financial concerns, (5) quality of life, side effects, and symptoms, and (6) survivorship and end-of-life. Descriptive analyses were used to explore psychosocial needs and experiences across three domains of patient-centered value in oncology. FINDINGS Each survey received 500-527 responses. Respondents most commonly reported needing more information regarding their insurance coverage and out-of-pocket costs (65%), access to clinical trials (89%), and support organizations (45%). Forty-one percent were very or extremely distressed about cancer's impact on their ability to work and over 25% reported high-levels of cancer-related financial hardship. CONCLUSIONS Patients and survivors reported significant unmet informational needs, financial hardship, distress, and symptoms or treatment side effects that interfered with daily life. Implications for Psychosocial Providers or Policy: Providers and payment reform advocates can improve value in oncology by ensuring access to comprehensive psychosocial care and informational support.
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Affiliation(s)
- Meredith Doherty
- a Graduate Center of the City University of New York , New York , NY , USA
| | | | - Daniel Gardner
- c Silberman School of Social Work at Hunter College , City University of New York , New York , NY , USA
| | - Irwin Epstein
- c Silberman School of Social Work at Hunter College , City University of New York , New York , NY , USA
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Molina Y. A conceptual model of social networks and mechanisms of cancer mortality, and potential strategies to improve survival: an invited commentary. Transl Behav Med 2018; 8:643-648. [PMID: 30016525 DOI: 10.1093/tbm/iby076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
In this article, the importance of social factors for cancer survivorship has been theoretically considered and empirically studied. This commentary and Kroenke's narrative review highlight how social network theory and methods may innovatively expand this substantive body of work. First, we add to a new understanding of cancer survivorship through: (a) discussing the delineation and differences between multiple social factors of interest across existing conceptual models; (b) characterizing their relationships to each other and to cancer survivorship through a social network lens; and (c) overall, sharing terminology and strengthening connections within this diverse body of literature. Second, we note opportunities for future research in terms of (a) simultaneous measurement of multiple social factors at different levels and (b) adaptation of designs to leverage and measure the theorized mechanisms. This commentary describes how incorporation of social network research can optimize research, practice, and policy contributions regarding cancer survival and survivorship.
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Affiliation(s)
- Yamilé Molina
- School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
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Bíró É, Veres-Balajti I, Ádány R, Kósa K. Social cognitive intervention reduces stress in Hungarian university students. Health Promot Int 2018; 32:73-78. [PMID: 28180254 DOI: 10.1093/heapro/dau006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Summary A social cognitive intervention was developed and delivered as a credit course to improve mental distress of university students, based on findings in a previous health survey showing notable mental distress among future teachers in Hungary in 2007. The intervention included increasing information on psychoactive substances used for stress reduction; skills development in stress reduction methods; improving skills in communication and problem-solving. All students who participated in the previous health survey were targeted. Mental status of the participants was assessed by a questionnaire before (n: 128, 22% male, mean age 23.21 years) and after (n: 148, 30% male, mean age 23.54 years) the intervention. Specifically, self-efficacy as outcome was approximated by a trait measure (sense of coherence); psychological distress was measured by the 12-item General Health Questionnaire (Goldberg et al., 1997. The validity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychological Medicine, 27, 191–197) after the intervention compared with that before. After the intervention, psychological distress was reduced among the participants (p: 0.013). Non-significant improvement occurred in the mean score for sense of coherence (from a mean 60.8 points before to 61.4 points after, p: 0.688). The intervention produced a modest but significant decrease in psychological distress in students at a cost of 54 US$ per 1 point improvement in mental distress. The intervention, a first example of the translation of the social cognitive theory into practice among students in higher education can be integrated into the curriculum as a standardized optional course.
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Affiliation(s)
- Éva Bíró
- Division of Health Promotion, Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Kassai st. 26/b., H-4028, Debrecen, Hungary
| | - Ilona Veres-Balajti
- Division of Physiotherapy, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - Róza Ádány
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - Karolina Kósa
- Division of Health Promotion, Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Kassai st. 26/b., H-4028, Debrecen, Hungary
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Alleviation of Side Effects and Distress in Breast Cancer Patients by Cognitive-Behavioral Interventions: A Systematic Review and Meta-analysis. J Clin Psychol Med Settings 2018; 25:335-355. [DOI: 10.1007/s10880-017-9526-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Huang FF, Yang Q, Zhang J, Han XY, Zhang JP, Ye M. A self-efficacy enhancing intervention for pulmonary rehabilitation based on motivational interviewing for postoperative lung cancers patients: modeling and randomized exploratory trial. PSYCHOL HEALTH MED 2018; 23:804-822. [PMID: 29384705 DOI: 10.1080/13548506.2018.1434216] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The objective of this study was to evaluate the feasibility and preliminary efficacy of a self-efficacy enhancing intervention designed for pulmonary rehabilitation based on motivational interviewing (MI) for postsurgical non-small cell lung cancer (NSCLC) patients. This study was a 2-arm pilot randomized controlled trial and was conducted in two cardiothoracic surgery departments, a tertiary hospital in Fuzhou, China. 28 postsurgical NSCLC patients were randomized to a 3 month (6 session) self-efficacy enhancing intervention based on MI or usual care (UC). Data were measured at baseline and after intervention. The MI based self-efficacy enhancing intervention group was superior to the UC group for reducing anxiety and depression, improving self-efficacy, quality of life, confrontational coping, social support and functional capacity. However, no statistically significant difference was observed in subjective well-being, posttraumatic growth, body mass index and pulmonary function between the two groups. This pilot study demonstrated the feasibility of MI based self-efficacy enhancing intervention for postsurgical NSCLC patients. A larger randomized trial would demonstrate a more rigorous test of efficacy.
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Affiliation(s)
- Fei-Fei Huang
- a School of Nursing , Fujian Medical University , Fuzhou , China
| | - Qing Yang
- b Department of Anesthesia , Massachusetts General Hospital , Boston , MA , USA
| | - Juan Zhang
- c Department of Cardiothoracic Surgery , Nanjing General Hospital , Fuzhou , China
| | - Xuan Ye Han
- d Department of Neurosurgery , Second Affiliated Hospital of Harbin Medical University , Harbin , China
| | - Jing-Ping Zhang
- e Xiangya School of Nursing , Central South University , Changsha , China
| | - Man Ye
- f Department of Nursing, Thoracic Surgery Department , The Second Xiangya Hospital of Central South University , Changsha , China
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Kim EJ, Han JW. The Effects of Stress and Stress Coping on Life Quality in Cancer Patients and Caregivers: A Dyadic Analysis Using an Actor-Partner Interdependence Model. ASIAN ONCOLOGY NURSING 2018. [DOI: 10.5388/aon.2018.18.3.135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Eun-Jung Kim
- Department of Nursing, InJe University Busan Paik Hospital, Busan, Korea
| | - Jeong Won Han
- College of Nursing Science, Kyung Hee University, Seoul, Korea
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Grether T, Sowislo JF, Wiese BS. Top-down or bottom-up? Prospective relations between general and domain-specific self-efficacy beliefs during a work-family transition. PERSONALITY AND INDIVIDUAL DIFFERENCES 2018. [DOI: 10.1016/j.paid.2017.09.021] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Stickney Ferguson S, Randall J, Dabney J, Kalbacker ME, Boyle N, Thao V, Murphy EA, Denzen EM. Perceived Workforce Challenges among Clinical Social Workers in Hematopoietic Cell Transplantation Programs. Biol Blood Marrow Transplant 2017; 24:1063-1068. [PMID: 29288820 DOI: 10.1016/j.bbmt.2017.12.793] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Accepted: 12/20/2017] [Indexed: 11/24/2022]
Abstract
Clinical social workers are psychosocial care experts who provide interventions that aim to address the emotional, relational, financial, and logistical challenges that arise throughout the hematopoietic cell transplantation (HCT) treatment and recovery process. Interventions that contribute to better patient outcomes can include cognitive behavioral therapy and counseling for adaptation to illness, family planning for 24/7 caregiver availability and strategies to support patient activities of daily living, instruction on guided imagery and relaxation techniques for symptom management and to decrease anxiety, psychoeducation on the treatment trajectory, and linkage with financial resources. A Social Work Workforce Group (SWG) was established through the System Capacity Initiative, led by the National Marrow Donor Program/Be The Match, to characterize the current social work workforce capacity and challenges. The SWG conducted a web-based survey of HCT clinical social workers in the United States. The response rate was 57% (n = 90), representing 76 transplant centers. Survey results indicated that the clinical social worker role and scope of practice varies significantly between centers; less than half of respondents reported that their clinical social work expertise was used to its fullest potential. With an estimated 3-fold increase in HCT patient volume by 2020, the need for specialized psychosocial health services will increase. The SWG makes recommendations to build capacity for the psychosocial care of HCT patients and to more fully integrate the social worker as a core member of the HCT team. The SWG created a Blood and Marrow Transplant (BMT) Clinical Social Worker role description that can be used by transplant centers to educate healthcare professionals, benchmark utilization of clinical social workers, and improve comprehensive psychosocial health programs.
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Affiliation(s)
- Stacy Stickney Ferguson
- Patient and Health Professional Services, National Marrow Donor Program/Be The Match, Minneapolis, Minnesota.
| | - Jill Randall
- Kent School of Social Work, University of Louisville, Louisville, Kentucky
| | - Jane Dabney
- The Blood and Marrow Transplant Program, Taussig Cancer Institute, The Cleveland Clinic Foundation, Cleveland, Ohio
| | - Marion E Kalbacker
- Pediatric Blood and Marrow Transplant Program, Duke University Medical Center, Durham, North Carolina
| | - Nancy Boyle
- Center for Hematologic Malignancy, Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon
| | - Viengneesee Thao
- School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Elizabeth A Murphy
- Patient and Health Professional Services, National Marrow Donor Program/Be The Match, Minneapolis, Minnesota
| | - Ellen M Denzen
- Patient and Health Professional Services, National Marrow Donor Program/Be The Match, Minneapolis, Minnesota
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Zebrack B, Kayser K, Oktay J, Sundstrom L, Mayer Sachs A. The Association of Oncology Social Work's Project to Assure Quality Cancer Care (APAQCC). J Psychosoc Oncol 2017; 36:19-30. [DOI: 10.1080/07347332.2017.1397832] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Brad Zebrack
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Karen Kayser
- School of Social Work, Dr. LaRocca Chair in Oncology Social Work, University of Louisville, Kent School of Social Work, Louisville, KY, USA
| | - Julianne Oktay
- School of Social Work, University of Maryland, College Park, MD, USA
| | - Laura Sundstrom
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Alison Mayer Sachs
- Community Outreach & Cancer Support Services, Eisenhower Lucy Curci Cancer Center, Rancho Mirage, CA, USA
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Czajkowska Z, Hall NC, Sewitch M, Wang B, Körner A. The role of patient education and physician support in self-efficacy for skin self-examination among patients with melanoma. PATIENT EDUCATION AND COUNSELING 2017; 100:1505-1510. [PMID: 28268053 DOI: 10.1016/j.pec.2017.02.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 01/24/2017] [Accepted: 02/21/2017] [Indexed: 06/06/2023]
Abstract
OBJECTIVE This project aims to elucidate the relationships between skin self-examination (SSE), perceived physician support of SSE, and self-efficacy for SSE among melanoma patients. METHODS A longitudinal study of patients diagnosed with melanoma was conducted over the span of 18 months. Participants filled out questionnaires at four assessment points and participated in an SSE education about the early signs of melanoma. RESULTS Among the 242 patients enrolled, the level of self-efficacy for SSE was 23% higher immediately after the educational intervention (p<.001) and the increase was retained three months (p<.001) and twelve months later (p<.001). Additionally, a one-way repeated measures ANOVA revealed that the perceived physician support of SSE positively corresponded to the level of patient self-efficacy with higher patient-reported physician support being related to higher self-efficacy (p=.001). CONCLUSION Patient education and perceived physician support of SSE are positively associated with patients' level of self-efficacy. PRACTICE IMPLICATIONS Physicians caring for melanoma survivors should be aware that, both SSE education and patients' perception of high physician support of SSE may be associated with higher self-efficacy for checking one's own skin for signs of cancer recurrence.
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Affiliation(s)
- Z Czajkowska
- McGill University, Dept. of Educational and Counselling Psychology, 3700 rue McTavish, Room 614, Montreal, Quebec H3A 1Y2, Canada.
| | - N C Hall
- McGill University, Dept. of Educational and Counselling Psychology, 3700 rue McTavish, Room 543, Montreal, Quebec H3A 1Y2, Canada.
| | - M Sewitch
- McGill University Health Centre, Div. of Clinical Epidemiology, V-building Room V2.15, 687, Avenue des Pins Ouest, Montreal, Quebec H3A 1A1, Canada.
| | - B Wang
- McGill University Health Centre, Melanoma Clinic, Royal Victoria Hospital, 1001 Decarie Boulevard, Montreal, Quebec H4A 3J1, Canada.
| | - A Körner
- McGill University, Dept. of Educational and Counselling Psychology, 3700 rue McTavish, Room 614, Montreal, Quebec H3A 1Y2, Canada.
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Bozo Ö, Akıncı İ, Akyüz C. The Psychometric Properties of Cancer Behavior Inventory as a Predictor of Quality of Life in Turkish Cancer Patients. CURRENT PSYCHOLOGY 2017. [DOI: 10.1007/s12144-017-9609-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Szalai M, Szirmai A, Füge K, Makai A, Erdélyi G, Prémusz V, Bódis J. Special aspects of social support: Qualitative analysis of oncologic rehabilitation through a belly dancing peer support group. Eur J Cancer Care (Engl) 2017; 26. [PMID: 28194904 DOI: 10.1111/ecc.12656] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2016] [Indexed: 11/29/2022]
Abstract
Tumour-related peer support groups (PSGs) show long-term development in quality of life and coping, and decrease distress in cancer care. To clarify channels of social support in oncologic rehabilitation by combined exercise and psychosocial therapy, individual semi-structured interviews were conducted after 1 year additional belly dance rehabilitation in a closed PSG among 51 patients with malignant tumour diagnosis in Budapest, Hungary. Interview data were transcribed and analysed using qualitative content analysis (ATLAS.ti 6 Win). Results suggest that group experience provides emotional-, practical- and informational support. We could point out specific social effects of "role model" function and extend the coping model. The group dispose all the features of effective suggestion and may be effectively applied as additional therapy for patients with malignancies. The extended coping model and the introduction of "role model" function could be useful for PSGs' efficacy assessment.
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Affiliation(s)
- M Szalai
- Department of Head and Neck Surgery, National Institute of Oncology, Budapest, Hungary.,Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
| | - A Szirmai
- Doctoral School of Psychology, Faculty of Humanities, Eötvös Loránd University, Budapest, Hungary
| | - K Füge
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
| | - A Makai
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
| | - G Erdélyi
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
| | - V Prémusz
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
| | - J Bódis
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Pécs, Hungary.,Department of Obstetrics and Gynaecology, Medical School, University of Pécs, Pécs, Hungary
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Stage Validity of the Health Action Process Approach in African American Breast Cancer Survivors. J Immigr Minor Health 2016; 20:147-154. [PMID: 27785639 DOI: 10.1007/s10903-016-0520-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The Health Action Process Approach (HAPA) has been applied in a number of populations because it proposes to overcome limitations from previous health behavior theories. However, it has yet to be applied to cancer survivors or racial/ethnic minorities. In this study, we examined the construct validity of the HAPA phase and stage algorithms in a sample of African American breast cancer survivors. A total of 259 African American breast cancer survivors (mean age = 54 years) participated in a Web-based survey that assessed sociodemographic and medical characteristics, physical activity, and HAPA constructs. Analysis of covariance was used to compare mean differences between HAPA phase/stage. Statistical significance was determined at p < 0.017 due to multiple comparisons. Phase and stage inconsistencies were observed for most constructs. However, adequate distinctions were made for motivational self-efficacy and intentions (i.e., P = I < A) by phase, and both action and coping planning (i.e., P < I < A) by stage. Our data indicate partial support of the HAPA algorithm to classify African American breast cancer survivors according to stage or phase. Modifying the staging algorithm or constructs are needed if stage- or phase-based interventions can be designed for this population.
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Pereira MG, Baia V, Machado JC. Coping and quality of life in patients with skin tumors in the follow-up stage: The mediating role of body image and psychological morbidity. J Psychosoc Oncol 2016; 34:400-12. [DOI: 10.1080/07347332.2016.1196807] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Miller Smedema S, Catalano D, Ebener DJ. The Relationship of Coping, Self-Worth, and Subjective Well-Being: A Structural Equation Model. REHABILITATION COUNSELING BULLETIN 2016. [DOI: 10.1177/0034355209358272] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of this study was to determine the relationship between various coping-related variables and the evaluation of self-worth and subjective well-being among persons with spinal cord injury. Positive coping variables included hope, proactive coping style, and sense of humor, whereas negative coping variables included perceptions of stress, dysfunctional attitudes, and catastrophizing. Evaluations of self-worth were determined by measures of self-esteem and acceptance of disability. Quality of life and life satisfaction were indicators of subjective well-being. The results of the study indicate that negative coping has a negative association with both positive self-worth and subjective well-being. Feelings of positive self-worth were found to be positively associated with subjective well-being. In addition, positive coping appears to influence subjective well-being positively by first increasing feelings of positive self-worth. The findings indicate that coping strategies play an important role in the psychosocial adjustment of individuals with disabilities, and subsequently, in their quality of life. The implications for counseling individuals with disabilities are discussed.
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Duggleby W, Williams A, Ghosh S, Moquin H, Ploeg J, Markle-Reid M, Peacock S. Factors influencing changes in health related quality of life of caregivers of persons with multiple chronic conditions. Health Qual Life Outcomes 2016; 14:81. [PMID: 27229926 PMCID: PMC4882862 DOI: 10.1186/s12955-016-0486-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 05/20/2016] [Indexed: 11/19/2022] Open
Abstract
Background The majority of care for older adults with multiple chronic conditions (MCC) is provided by family (including friends) caregivers. Although caregivers have reported positive benefits to caregiving they also experience decreases in their physical and mental health. As there is a critical need for supportive interventions for this population, it is important to know what influences the health of family caregivers of persons with MCC. This research examined relationships among the changes from baseline to 6 months in health related quality of life (SF12v2) of family caregivers caring for older adults with multiple chronic conditions and the following factors: a) demographic variables, b) gender identity [Bem Sex Role Inventory (BSRI)] c) changes in general self-efficacy [General Self Efficacy Scale (GSES) (baseline to 6 months) and d)) changes in caregiver burden [Zarit Burden Inventory (ZBI)] baseline to 6 months. Specific hypothesis were based on a conceptual framework generated from a literature review. Methods This is a secondary analysis of a study of 194 family caregivers who were recruited from two Canadian provinces Alberta and Ontario. Data were collected in-person, by telephone, by Skype or by mail at two time periods spaced 6 months apart. The sample size for this secondary analysis was n = 185, as 9 participants had dropped out of the study at 6 months. Changes in the scores between the two time periods were calculated for SF12v2 physical component score (PCS) and mental component score (MCS) and the other main variables. Generalized Linear Modeling was then used to determine factors associated with changes in HRQL. Results Participants who had significantly positive increases in their MCS (baseline to 6 months) reported lower burden (ZBI, p < 0.001), and higher general self-efficacy (GSES, p < 0.001) and Masculine BSRI (p = 0.025). There were no significant associations among variables and changes in PCS (baseline to 6 months). Conclusions Our findings suggest that a masculine gender identity (which incorporates assertive and instrumental approaches to caregiving), and confidence in the ability to deal with difficult situations was positively related to improvement in mental health for caregivers of persons with MCC. Decreases in perceptions of burden in this populations was also associated with improvements in mental health. Further research is needed to explore ways to support caregivers of older persons with multiple chronic conditions living at home.
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Affiliation(s)
- Wendy Duggleby
- Faculty of Nursing, University of Alberta, 3rd Level ECHA, 11405 - 87th Ave, Edmonton, AB, T6G 1C9, Canada.
| | - Allison Williams
- School of Geography and Earth Sciences, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada
| | - Sunita Ghosh
- Alberta Health Services-Cancer Care, University of Alberta, Edmonton, AB, Canada
| | - Heather Moquin
- Faculty of Nursing, University of Alberta, 3rd Level ECHA, 11405 - 87th Ave, Edmonton, AB, T6G 1C9, Canada
| | - Jenny Ploeg
- School of Nursing, McMaster University, Room HSc3N25C, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada
| | - Maureen Markle-Reid
- School of Nursing, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada
| | - Shelley Peacock
- College of Nursing, University of Saskatchewan, E-Wing, 4340, 104 Clinic Place, Saskatoon, SK, S7N 2Z4, Canada
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Adams RN, Mosher CE, Cohee AA, Stump TE, Monahan PO, Sledge GW, Cella D, Champion VL. Avoidant coping and self-efficacy mediate relationships between perceived social constraints and symptoms among long-term breast cancer survivors. Psychooncology 2016; 26:982-990. [PMID: 26969374 DOI: 10.1002/pon.4119] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 01/07/2016] [Accepted: 02/16/2016] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Many breast cancer survivors feel constrained in discussing their cancer experience with others. Limited evidence suggests that social constraints (e.g., avoidance and criticism) from loved ones may negatively impact breast cancer survivors' global health, but research has yet to examine relationships between social constraints and common physical symptoms. Informed by social cognitive processing theory, this study examined whether perceived social constraints from partners and healthcare providers (HCPs) were associated with fatigue, sleep disturbance, and attentional functioning among long-term breast cancer survivors (N = 1052). In addition, avoidant coping and self-efficacy for symptom management were examined as potential mediators of these relationships. METHODS Long-term breast cancer survivors (mean years since diagnosis = 6) completed questionnaires assessing social constraints from partners and HCPs, avoidant coping, self-efficacy for symptom management, and symptoms (i.e., fatigue, sleep disturbance, and attentional functioning). Structural equation modeling was used to evaluate the hypothesized relationships among variables in two models: one focused on social constraints from partners and one focused on social constraints from HCPs. RESULTS Both models demonstrated good fit. Consistent with theory and prior research, greater social constraints from both partners and HCPs were associated with greater symptom burden (i.e., greater fatigue and sleep disturbance, poorer attentional functioning). In addition, all relationships were mediated by avoidant coping and self-efficacy for symptom management. CONCLUSIONS Findings are consistent with social cognitive processing theory and suggest that symptom management interventions may be enhanced by addressing the impact of social constraints from survivors' partners and HCPs on their coping and self-efficacy. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Rebecca N Adams
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - Catherine E Mosher
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - Andrea A Cohee
- Indiana University School of Nursing, Indianapolis, IN, USA
| | - Timothy E Stump
- Department of Biostatistics, Indiana University School of Medicine and School of Public Health, Indianapolis, IN, USA
| | - Patrick O Monahan
- Department of Biostatistics, Indiana University School of Medicine and School of Public Health, Indianapolis, IN, USA
| | | | - David Cella
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
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Kershaw T, Ellis KR, Yoon H, Schafenacker A, Katapodi M, Northouse L. The Interdependence of Advanced Cancer Patients' and Their Family Caregivers' Mental Health, Physical Health, and Self-Efficacy over Time. Ann Behav Med 2015; 49:901-11. [PMID: 26489843 PMCID: PMC4825326 DOI: 10.1007/s12160-015-9743-y] [Citation(s) in RCA: 132] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND The challenges of advanced cancer have health implications for patients and their family caregivers from diagnosis through end of life. The nature of the patient/caregiver experience suggests that their mental and physical health maybe interdependent, but limited empirical evidence exists. PURPOSE This study used social cognitive theory as a framework to investigate individual and interpersonal influences on patients' and their family caregivers' mental health, physical health, and self-efficacy as individuals to manage the challenges of advanced disease over time. METHODS Patients and caregivers (484 patient-caregiver dyads) completed surveys at baseline, 3 and 6 months. Longitudinal dyadic analysis techniques were used to examine (i)the influence that patients and caregivers had on their own mental health, physical health, and self-efficacy (actor effects)and (ii) the influence that they had on each other's health outcomes (partner effects). We also examined the influence of self-efficacy on mental and physical health over time. RESULTS Consistent with our hypotheses, each person's mental health, physical health, and self-efficacy had significant effects on their own outcomes over time (actor effects). Patients and caregivers influenced one another's mental and physical health (partner effects), but not their self-efficacy. In addition, patients and caregivers with higher self-efficacy had better mental health, and their partners had better physical health. CONCLUSIONS Patients' and caregivers' mental and physical health were interdependent. Each person's cancer-related self-efficacy influenced their own mental and physical health. However, a person's self-efficacy did not influence the other person's self-efficacy.
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Affiliation(s)
| | - Katrina R. Ellis
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill
| | - Hyojin Yoon
- Marcella Niehoff School of Nursing, Loyola University
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DeRouen MC, Smith AW, Tao L, Bellizzi KM, Lynch CF, Parsons HM, Kent EE, Keegan THM. Cancer-related information needs and cancer's impact on control over life influence health-related quality of life among adolescents and young adults with cancer. Psychooncology 2015; 24:1104-15. [PMID: 25611943 PMCID: PMC4510026 DOI: 10.1002/pon.3730] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Revised: 09/13/2014] [Accepted: 11/05/2014] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Adolescents and young adults (AYAs) diagnosed with cancer between 15 and 39 years of age often report need for greater amounts of cancer-related information and perceive that cancer has had a negative impact on control over their life. We examined whether unmet information need and perceived control over life are associated with health-related quality of life (HRQOL). METHODS We examined data from 484 AYA cancer survivors recruited from population-based cancer registries in 2007-2008. Participants completed surveys a median of 11 months after diagnosis. Multivariable linear regression analyses estimated associations of unmet cancer-related information needs and impact of cancer on control over life on HRQOL (SF-12). RESULTS Two-thirds of AYAs reported an intermediate or high level of unmet information need, and half (47%) reported a negative impact of cancer on control. Greater unmet information need was associated with lower overall mental and physical HRQOL and lower levels of all HRQOL subscales except vitality. A negative impact on control over life was associated with lower overall mental HRQOL as well as lower HRQOL across all subscales except general health perceptions (all p <0.05). In multivariable analyses, perceived control and unmet information need were independently associated with HRQOL (p-values for interaction >0.1). CONCLUSIONS Adolescent and young adult patients with cancer have high levels of unmet cancer-related information needs and perceived negative impact of cancer on control over life; both were independently associated with lower HRQOL. Addressing unmet information needs among AYA cancer survivors and finding ways to increase their sense of control may help improve HRQOL in this understudied population.
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Affiliation(s)
- Mindy C. DeRouen
- Cancer Prevention Institute of California, 2001 Walnut Ave, Suite 300, Fremont, CA 94538
| | - Ashley Wilder Smith
- Control and Population Sciences, National Cancer Institute, National Institutes of Health, 6130 Executive Blvd, Bethesda, MD 20892
| | - Li Tao
- Cancer Prevention Institute of California, 2001 Walnut Ave, Suite 300, Fremont, CA 94538
- Department of Medicine, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA 94305-5110
| | - Keith M. Bellizzi
- Department of Human Development and Family Studies, University of Connecticut, 348 Mansfield Rd, Storrs, CT 06269
| | - Charles F. Lynch
- Department of Epidemiology, University of Iowa, 105 River St, Iowa City, IA 52242
| | - Helen M. Parsons
- Department of Epidemiology and Biostatistics, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, Mail Code 7933, San Antonio, TX 78229
| | - Erin E. Kent
- Outcomes Research Branch, Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, 6130 Executive Blvd, Bethesda, MD 20892
| | - Theresa H. M. Keegan
- Cancer Prevention Institute of California, 2001 Walnut Ave, Suite 300, Fremont, CA 94538
- Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA
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Kimmick G, Edmond SN, Bosworth HB, Peppercorn J, Marcom PK, Blackwell K, Keefe FJ, Shelby RA. Medication taking behaviors among breast cancer patients on adjuvant endocrine therapy. Breast 2015; 24:630-6. [PMID: 26189978 DOI: 10.1016/j.breast.2015.06.010] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2014] [Revised: 05/28/2015] [Accepted: 06/26/2015] [Indexed: 01/15/2023] Open
Abstract
PURPOSE To explore how symptoms and psychosocial factors are related to intentional and unintentional non-adherent medication taking behaviors. METHODS Included were postmenopausal women with hormone receptor positive, stage I-IIIA breast cancer, who had completed surgery, chemotherapy, and radiation, and were taking endocrine therapy. Self-administered, standardized measures were completed during a routine clinic visit: Brief Fatigue Inventory, Brief Pain Inventory, Menopause Specific Quality of Life Questionnaire, Functional Assessment of Cancer Therapy General and Neurotoxicity scales, and Self-Efficacy for Appropriate Medication Use Scale. Regression analyses were performed to determine the degree to which demographic, medical, symptom, and psychosocial variables, explain intentional, such as changing one's doses or stopping medication, and unintentional, such as forgetting to take one's medication, non-adherent behaviors. RESULTS Participants were 112 women: mean age 64 (SD = 9) years; 81% white; mean time from surgery 40 (SD = 28) months; 49% received chemotherapy (39% including a taxane); mean time on endocrine therapy, 35 (SD = 29.6) months; 82% taking an aromatase inhibitor. Intentional and unintentional non-adherent behaviors were described in 33.9% and 58.9% of participants, respectively. Multivariate analysis showed that higher self-efficacy for taking medication was associated with lower levels of unintentional (p = 0.002) and intentional (p = 0.004) non-adherent behaviors. The presence of symptoms (p = 0.03) and lower self-efficacy for physician communication (p = 0.009) were associated with higher levels of intentional non-adherent behaviors. CONCLUSIONS These results suggest that women who report greater symptoms, lower self-efficacy for communicating with their physician, and lower self-efficacy for taking their medication are more likely to engage in both intentional and unintentional non-adherent behaviors.
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Affiliation(s)
- Gretchen Kimmick
- Duke Cancer Institute, Duke University Medical Center, DUMC Box 3204, Durham, NC 27710, USA.
| | - Sara N Edmond
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, USA
| | - Hayden B Bosworth
- Department of Medicine, Psychiatry, and School of Nursing, Duke University Medical Center; Center for Health Services Research, Durham VAMC, USA
| | - Jeffrey Peppercorn
- Duke Cancer Institute, Duke University Medical Center, DUMC Box 3204, Durham, NC 27710, USA
| | - Paul K Marcom
- Duke Cancer Institute, Duke University Medical Center, DUMC Box 3204, Durham, NC 27710, USA
| | - Kimberly Blackwell
- Duke Cancer Institute, Duke University Medical Center, DUMC Box 3204, Durham, NC 27710, USA
| | - Francis J Keefe
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, USA
| | - Rebecca A Shelby
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, USA
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Salmoirago-Blotcher E, Wayne P, Bock BC, Dunsiger S, Wu WC, Stabile L, Yeh G. Design and methods of the Gentle Cardiac Rehabilitation Study--A behavioral study of tai chi exercise for patients not attending cardiac rehabilitation. Contemp Clin Trials 2015; 43:243-51. [PMID: 26115880 DOI: 10.1016/j.cct.2015.06.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 06/18/2015] [Accepted: 06/20/2015] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Cardiac rehabilitation (CR) programs reduce overall and cardiovascular mortality in patients with a history of acute coronary events or revascularization procedures, but only 30% of patients enroll in CR and attrition rates reach up to 60%. Tai chi, a mind-body practice based on light/moderate aerobic exercise accompanied by meditative components could be a possible exercise option for patients who do not attend CR. METHODS/DESIGN Sixty patients will be randomized to a "LITE" condition (one tai chi session twice weekly for 12 weeks) or to a "PLUS" condition (one tai chi session 3 times weekly for 12 weeks, followed by maintenance classes 1-2 times weekly for an additional 12 weeks). Measurements will be conducted at baseline, 3-, 6-, and 9 months after enrollment. The primary outcome is to determine the feasibility, acceptability and safety of each dose. Secondary outcomes include estimates of effect size of each dose on accelerometry-assessed physical activity; the proportion of patients meeting current recommendations for physical activity; and measures of fitness, quality of life, body weight, and sleep. In addition, we will collect exploratory information on possible mediators (exercise self-efficacy, perceived social support, resilience, mindfulness, and depression). CONCLUSIONS Findings from this pilot study will provide preliminary indications about the usefulness of tai chi as an exercise option for patients not attending traditional CR programs. Results will also shed light on the possible mechanisms by which tai chi practice may improve overall physical activity among patients with atherosclerotic coronary heart disease.
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Affiliation(s)
| | - Peter Wayne
- Osher Center for Integrative Medicine, Brigham and Women Hospital, Harvard Medical School, United States
| | - Beth C Bock
- The Miriam Hospital, The Warren Alpert Medical School of Brown University, United States
| | - Shira Dunsiger
- The Miriam Hospital, The Warren Alpert Medical School of Brown University, United States
| | - Wen-Chih Wu
- The Miriam Hospital, The Warren Alpert Medical School of Brown University, United States
| | | | - Gloria Yeh
- Beth Israel Deaconess Medical Center, Harvard Medical School, United States
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Schofield P, Chambers S. Effective, clinically feasible and sustainable: Key design features of psycho-educational and supportive care interventions to promote individualised self-management in cancer care. Acta Oncol 2015; 54:805-12. [PMID: 25813474 DOI: 10.3109/0284186x.2015.1010016] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
UNLABELLED As the global burden of cancer increases healthcare services will face increasing challenges in meet the complex needs of these patients, their families and the communities in which they live. This raises the question of how to meet patient need where direct clinical contact may be constrained or not readily available. Patients and families require resources and skills to manage their illness outside of the hospital setting within their own communities. AIM To propose a framework for the development and delivery of psycho-educational and supportive care interventions drawing on theoretical principles of behaviour change and evidence-based interventions, and based on extensive experience in developing and testing complex interventions in oncology. APPROACH At the core of this intervention framework are considerations of efficiency: interventions are designed to cater for individuals' unique needs; to place minimal demands on the health system infrastructure and to be rapidly disseminated into usual care if successful. There are seven key features: 1) Targeting cancer type and stage; 2) Tailoring to unique individual needs; 3) Promotion of patient self-management of their disease and treatment side effects; 4) Efficient delivery of the intervention; 5) Training and adherence to protocol; 6) Ensuring the intervention is evidence-based; 7) Confirming stakeholder acceptability of the intervention. APPLICATION A case study of a randomised controlled trial which tested psycho-educational oncology interventions using this framework is presented. These interventions were designed to cater for individuals' unique needs and promote self-management while placing minimal demands on the acute health care setting. DISCUSSION Innovative ways to realise the potentially major impact that psycho-educational and supportive care interventions can have on psychological morbidity, coping, symptoms and quality of life in serious and chronic illness are needed. This framework, which is driven by theory, evidence, and experience, is designed to ensure that interventions are effective, clinically feasible and sustainable.
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Affiliation(s)
- Penelope Schofield
- Department of Psychology, Swinburne University of Technology , Melbourne, Victoria , Australia
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The quality of life of male spouses of women with breast cancer: hope, self-efficacy, and perceptions of guilt. Cancer Nurs 2015; 37:E28-35. [PMID: 23348665 DOI: 10.1097/ncc.0b013e31827ca807] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND The quality of life of male spouses of partners with breast cancer may determine the support they are able to give their wives. Little is known about the factors associated with their quality of life. OBJECTIVE The purpose of this study was to examine the relationship of the quality of life of male spouses of partners with breast cancer with the following factors: (a) demographic variables of male spouses and their partners, (b) levels of hope of male spouses and their partners, (c) self-efficacy and loss and grief of male spouses, and (d) quality of life of partners with breast cancer. METHODS Six hundred surveys were mailed to women with breast cancer (stage 1-3) and their male spouses. A total of 110 surveys were completed. RESULTS With the use of generalized linear modeling, participating male spouses with higher quality of life scores: (a) were older (P = .01), (b) had higher hope scores (P = .01), (c) had lower feelings of guilt scores (P < .01) (subscale of loss and grief), (d) had higher general self-efficacy scores (P < .01), and (e) had partners with breast cancer with higher quality of life scores (P < .01). CONCLUSIONS Hope, self-efficacy, feelings of guilt, age, and their partners' quality of life were significantly related to quality of life of the male spouses of women with breast cancer. IMPLICATIONS FOR PRACTICE The findings underscore the importance of assessing for and fostering hope and self-efficacy as well as decreasing guilt in male spouses of women with breast cancer to improve their quality of life.
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