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Lieb M, Madl M, Vogelhuber M, Beckmann MW, Erim Y. Psycho-Oncological Self-Help Groups in Bavaria: The Current Situation and Suggestions for Improvement. Oncol Res Treat 2024; 47:177-188. [PMID: 38461814 DOI: 10.1159/000538248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 03/04/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND Self-help groups (SHGs) are an important cornerstone of the German health care system. Especially collaborations of SHGs with cancer centers enable active patient involvement in cancer care. We investigated the current situation and unmet needs of Bavarian SHGs in order to point out possible options of action. METHODS We conducted a cross-sectional study with Bavarian psycho-oncological SHGs. Via e-mail, an online survey was sent to 150 SHGs registered at the BZKF (Bavarian Cancer Research Center). We assessed activities and needs of the SHGs as well as the nature of collaborations with cancer centers. We focused on adaptations during the COVID-19 pandemic and the inclusion of migrants. RESULTS 46 (33.66%) SHGs participated, while 39 (84.78%) completed the questionnaire. During the COVID-19 pandemic, 50% of the SHGs reported less meetings. 22.7% changed to online meetings or other formats (43.2%). 20.9% of the SHGs had regular meetings with the cancer center, and 23.1% with the psycho-oncology. 51.2% evaluated the psycho-oncological services as neutral to dissatisfying due to lack of information, availability, and long waiting times. The SHGs indicated needs concerning interventions (coping strategies, digital applications, etc.), information, and better communication. Efforts for overcoming inequalities seemed rare: only 13.6% of the SHGs and 16.2% of the cancer centers had services for migrants. CONCLUSIONS This study gave an overview of current activities and needs of Bavarian SHGs. The implementation of patient guides, comprehensive information material, and low-threshold psycho-oncological services should be objectives in future care to increase patient satisfaction. The needs for services for migrants should be investigated in more detail.
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Affiliation(s)
- Marietta Lieb
- Department of Psychosomatic Medicine and Psychotherapy, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Martina Madl
- Department of Psychosomatic Medicine and Psychotherapy, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Martin Vogelhuber
- Department of Internal Medicine III, Hematology and Internal Oncology, University Hospital Regensburg, Regensburg, Germany
| | - Matthias W Beckmann
- Department of Obstetrics and Gynecology, University Hospital Erlangen, Erlangen, Germany
- Comprehensive Cancer Center Erlangen-Europäische Metropolregion Nuremberg, Erlangen, Germany
- Bavarian Cancer Research Center (BZKF), Partner Site Erlangen, Erlangen, Germany
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
- Comprehensive Cancer Center Erlangen-Europäische Metropolregion Nuremberg, Erlangen, Germany
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Finlayson CS, Rosa WE, Mathew S, Applebaum A, Squires A, Fu MR. Awareness of Disease Status Among Patients With Cancer: An Integrative Review. Cancer Nurs 2023; 47:00002820-990000000-00091. [PMID: 36728162 PMCID: PMC10349894 DOI: 10.1097/ncc.0000000000001170] [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] [Indexed: 02/03/2023]
Abstract
BACKGROUND As the quality of cancer care improves, oncology patients face a rapidly increasing number of treatment options. Thus, it is vital that they are full and active partners in the treatment decision-making process. Awareness of disease status has been investigated in the literature; it has been inconsistently conceptualized and operationalized. OBJECTIVE The aim of this integrative review was to develop a conceptual definition and model of the awareness of disease status among patients with cancer. METHODS Whittemore and Knafl's integrative review methodology guided this article. We obtained data through a systematic search of 8 databases. Key terms utilized were awareness, perception, truth disclosure, diagnosis, prognosis, terminal illness, status, neoplasm, and metastasis. Dates through January 2020 were searched to capture all relevant articles. Sixty-nine articles met inclusion criteria. RESULTS The integrative review methodology guided the development of a conceptual definition and model. The concept of "awareness of disease status" was defined as the individual patient's understanding of being diagnosed and treated for cancer based on the multifactorial components of individual patient characteristics and contextually driven communication practices of healthcare providers. This understanding is dynamic and changes throughout the disease trajectory. CONCLUSION These findings will inform consistency in the literature. Such consistency may improve person-centered clinical communication, care planning practices, and, ultimately, cancer-related outcomes. IMPLICATIONS FOR PRACTICE With a greater understanding of the complexity of patients' awareness of disease status, nurses will be able to guide their patients to make informed decisions throughout their disease trajectory.
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Affiliation(s)
- Catherine S Finlayson
- Author Affiliations: Department of PhD in Nursing, Pace University Lienhard School of Nursing, Pleasantville (Dr Finlayson and Ms Mathew); and Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center (Drs Rosa and Applebaum); New York University Rory Meyers College of Nursing (Dr Squires), New York; and Rutgers, The State University of New Jersey School of Nursing, New Brunswick, New Jersey (Dr Fu)
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Naftali T, Richter V, Mari A, Khoury T, Shirin H, Broide E. Do inflammatory bowel disease patient preferences from treatment outcomes differ by ethnicity and gender? A cross-sectional observational study. World J Clin Cases 2022; 10:12899-12908. [PMID: 36569023 PMCID: PMC9782943 DOI: 10.12998/wjcc.v10.i35.12899] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 05/05/2022] [Accepted: 08/21/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Inflammatory bowel disease (IBD) patients’ expectations of treatment outcomes may differ by ethnicity.
AIM To investigate treatment preferences of Jewish and Arabs patients.
METHODS This prospective survey ranked outcomes treatment preferences among Arab IBD patients, based on the 10 IBD-disk items compared to historical data of Jews. An anonymous questionnaire in either Arabic or Hebrew was distributed among IBD patients. Patients were required to rank 10 statements describing different aspects of IBD according to their importance to the patients as treatment goals. Answers were compared to the answers of a historical group of Jewish patients.
RESULTS IBD-disk items of 121 Arabs were compared to 240 Jewish patients. The Jewish patients included more females, [151 (62.9%) vs 52 (43.3%); P < 0.001], higher education level (P = 0.02), more urban residence [188 (78.3%) vs 54 (45.4%); P < 0.001], less unemployment [52 (21.7%) vs 41 (33.9%); P = 0.012], higher income level (P < 0.001), and more in a partnership [162 (67.8%) vs 55 (45.4%); P < 0.001]. Expectations regarding disease symptoms: abdominal pain, energy, and regular defecation ranked highest for both groups. Arabs gave significantly lower rankings (range 4.29–6.69) than Jewish patients (range 6.25–9.03) regarding all items, except for body image. Compared to Arab women, Jewish women attached higher priority to abdominal pain, energy, education/work, sleep, and joint pain. Multivariable regression analysis revealed that higher patient preferences were associated with Jewish ethnicity (OR 4.77; 95%CI 2.36–9.61, P < 0.001) and disease activity. The more active the disease, the greater the odds ratio for higher ranking of the questionnaire items (1-2 attacks per year: OR 2.13; 95%CI 1.02–4.45, P = 0.043; and primarily active disease: OR 5.29; 95%CI 2.30–12.18, P < 0.001). Factors inversely associated with higher patient preference were male gender (OR 0.5; 95%CI 0.271-0.935, P = 0.030), UC (OR 0.444; 95%CI 0.241–0.819, P = 0.009), and above average income level (OR 0.267; 95%CI: 0.124–0.577, P = 0.001).
CONCLUSION The highest priority for treatment outcomes was symptom relief. Patients preferences were impacted by ethnicity, gender, and socio-economic disparity. Understanding patients' priorities may improve communication and enable a personalized approach.
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Affiliation(s)
- Timna Naftali
- Institute of Gastroenterology, Meir Medical Center, Kfar-saba 4428164, Israel
| | - Vered Richter
- Department of Gastroenterology, Shamir Medical Center, Zerifin 70300, Israel
| | - Amir Mari
- Department of Gastroenterology, Nazareth Hospital, Nazareth 16100, Israel
| | - Tawfik Khoury
- Department of Gastroenterology, Nazareth Hospital, Nazareth 16100, Israel
| | - Haim Shirin
- Shamir (Assaf Harofeh) Medical Center, Affiliated to Sackler School of Medicine, The Gonczarowski Family Institute of Gastroenterology and Liver Diseases, Tel Aviv University, Zerifin 70300, Israel
| | - Efrat Broide
- Pediatric Gastroenterology Unit, Asaf Harofeh Medical Center, Zrifin 70300, Israel
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Rhodes MG, Fletcher KE, Blumenfeld-Kouchner F, Jacobs EA. Spanish Medical Interpreters' Management of Challenges in End of Life Discussions. PATIENT EDUCATION AND COUNSELING 2021; 104:1978-1984. [PMID: 33563501 PMCID: PMC8217083 DOI: 10.1016/j.pec.2021.01.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 01/14/2021] [Accepted: 01/16/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Professional medical interpreters facilitate patient understanding of illness, prognosis, and treatment options. Facilitating end of life discussions can be challenging. Our objective was to better understand the challenges professional medical interpreters face and how they affect the accuracy of provider-patient communication during discussions of end of life. METHODS We conducted semi-structured interviews with professional Spanish medical interpreters. We asked about their experiences interpreting end of life discussions, including questions about values, professional and emotional challenges interpreting these conversations, and how those challenges might impact accuracy. We used a grounded theory, constant comparative method to analyze the data. Participants completed a short demographic questionnaire. RESULTS Seventeen Spanish language interpreters participated. Participants described intensive attention to communication accuracy during end of life discussions, even when discussions caused emotional or professional distress. Professional strains such as rapid discussion tempo contributed to unintentional alterations in discussion content. Perceived non-empathic behaviors of providers contributed to rare, intentional alterations in discussion flow and content. CONCLUSION We found that despite challenges, Spanish language interpreters focus intensively on accurate interpretation in discussions of end of life. PRACTICE IMPLICATIONS Provider training on how to best work with interpreters in these important conversations could support accurate and empathetic interpretation.
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Affiliation(s)
- Mary G Rhodes
- Department of Medicine, Medical College of Wisconsin, Milwaukee, USA.
| | - Kathlyn E Fletcher
- Department of Medicine, Medical College of Wisconsin, Milwaukee, USA; Department of Medicine, Clement J. Zablocki VA Medical Center, Milwaukee, USA.
| | - Francois Blumenfeld-Kouchner
- Department of Medicine, Medical College of Wisconsin, Milwaukee, USA; Department of Palliative Care, Aurora Medical Group, Grafton Medical Center, Grafton, USA(1).
| | - Elizabeth A Jacobs
- Departments of Internal Medicine and Population Health, The University of Texas at Austin Dell Medical School, Austin, USA; Maine Medical Center Research Institute, MaineHealth, Portland, ME, USA(1).
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The Effect of Prognostic Communication on Patient Outcomes in Palliative Cancer Care: a Systematic Review. Curr Treat Options Oncol 2020; 21:40. [PMID: 32328821 PMCID: PMC7181418 DOI: 10.1007/s11864-020-00742-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND While prognostic information is considered important for treatment decision-making, physicians struggle to communicate prognosis to advanced cancer patients. This systematic review aimed to offer up-to-date, evidence-based guidance on prognostic communication in palliative oncology. METHODS PubMed and PsycInfo were searched until September 2019 for literature on the association between prognostic disclosure (strategies) and patient outcomes in palliative cancer care, and its moderators. Methodological quality was reported. RESULTS Eighteen studies were included. Concerning prognostic disclosure, results revealed a positive association with patients' prognostic awareness. Findings showed no or positive associations between prognostic disclosure and the physician-patient relationship or the discussion of care preferences. Evidence for an association with the documentation of care preferences or physical outcomes was lacking. Findings on the emotional consequences of prognostic disclosure were multifaceted. Concerning disclosure strategies, affective communication seemingly reduced patients' physiological arousal and improved perceived physician's support. Affective and explicit communication showed no or beneficial effects on patients' psychological well-being and satisfaction. Communicating multiple survival scenarios improved prognostic understanding. Physicians displaying expertise, positivity and collaboration fostered hope. Evidence on demographic, clinical and personality factors moderating the effect of prognostic communication was weak. CONCLUSION If preferred by patients, physicians could disclose prognosis using sensible strategies. The combination of explicit and affective communication, multiple survival scenarios and expert, positive, collaborative behaviour likely benefits most patients. Still, more evidence is needed, and tailoring communication to individual patients is warranted. IMPLICATIONS Future research should examine the effect of prognostic communication on psychological well-being over time and treatment decision-making, and focus on individualising care.
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Chan KY, Chan ML, Yau TCC, Li CW, Cheng HW, Sham MK. Quality of Life for Hong Kong Chinese Patients with Advanced Gynecological Cancers in the Palliative phase of Care: A Cross-Sectional Study. J Palliat Care 2018. [DOI: 10.1177/082585971202800404] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study investigated the quality of life (QOL) of Hong Kong Chinese patients with advanced gynecological cancers (AGC). A cross-sectional study was conducted with 53 consecutive patients with AGC who were admitted to a university-based palliative care unit. The assessment tools utilized were: the McGill Quality of Life Questionnaire for Hong Kong Chinese (MQOL-HK); the Hospital Anxiety and Depression Scale (HADS); the Palliative Performance Scale (PPS); and the Psychosocial Adjustment to Illness Scale (PAIS), sexual relationships subscale. The mean total score of the MQOL-HK was 4.63 ± 1.94, within which the physical domain scored the worst (mean=3.99, SD=2.15, range: 0–7). Depression symptoms were common (62 percent). The median PPS was 40 percent. Younger age, higher HADS depression scores, and higher HADS anxiety scores were significantly correlated with poorer QOL. Furthermore, younger age and depression were significant predictors for a worse MQOL-HK score. In conclusion, Chinese patients with AGC have a relatively poor QOL, especially in the physical domain and in terms of depression symptoms. Age and depression symptoms are the most important factors affecting QOL. Proper identification of physical symptoms and depression symptoms, along with appropriate treatments, are important for improving QOL for patients.
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Affiliation(s)
- Kwok Ying Chan
- KY Chan (corresponding author): Palliative Medical Unit, Grantham Hospital, 125 Wong Chuk Hang, Hong Kong, China
| | - Man Lui Chan
- ML Chan: Department of Psychiatry, Kowloon Hospital, Hong Kong, China
| | - Thomas Chung Cheung Yau
- TCC Yau: Departments of Medicine and Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong, China
| | - Cho Wing Li
- TCC Yau: Departments of Medicine and Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong, China
| | - Hon Wai Cheng
- CW Li, HW Cheng, MK Sham: Palliative Medical Unit, Grantham Hospital, Hong Kong, China
| | - Mau Kwong Sham
- CW Li, HW Cheng, MK Sham: Palliative Medical Unit, Grantham Hospital, Hong Kong, China
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Finlayson CS, Fu MR, Squires A, Applebaum A, Van Cleave J, O'Cearbhaill R, DeRosa AP. The Experience of Being Aware of Disease Status in Women with Recurrent Ovarian Cancer: A Phenomenological Study. J Palliat Med 2018; 22:377-384. [PMID: 30407108 DOI: 10.1089/jpm.2018.0127] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Awareness of disease status has been identified as a factor in the treatment decision-making process. Women with recurrent ovarian cancer are facing the challenge of making treatment decisions throughout the disease trajectory. It is not understood how women with ovarian cancer perceive their disease and subsequently make treatment decisions. PURPOSE The purpose of this phenomenological study was to understand the lived experience of women with recurrent ovarian cancer, how they understood their disease and made their treatment decisions. METHODS A qualitative design with a descriptive phenomenological method was used to conduct 2 in-depth interviews with 12 women (n = 24 interviews). Each interview was ∼60 minutes and was digitally recorded and professionally transcribed. Data collection focused on patients' understanding of their disease and how patients participated in treatment decisions. A modified version of Colaizzi's method of phenomenological reduction guided data analysis. RESULTS Three themes emerged to describe the phenomenon of being aware of disease status: (1) perceiving recurrent ovarian cancer as a chronic illness, (2) perceived inability to make treatment decisions, and (3) enduring emotional distress. CONCLUSIONS AND IMPLICATIONS This study revealed how 12 women conceptualized recurrent ovarian cancer as a chronic disease and their perceived inability to make treatment decisions because of lack of information and professional qualifications, resulting in enduring emotional distress. Future research should replicate the study to confirm the persistence of the themes for racially, ethnically, and religiously diverse patient samples and to improve understanding of awareness of disease status and decision-making processes of patients.
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Affiliation(s)
| | - Mei R Fu
- 1 New York University Rory Meyers College of Nursing , New York, New York
| | - Allison Squires
- 1 New York University Rory Meyers College of Nursing , New York, New York
| | | | - Janet Van Cleave
- 1 New York University Rory Meyers College of Nursing , New York, New York
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Tang ST, Chang WC, Chen JS, Chou WC, Hsieh CH, Chen CH. Associations of prognostic awareness/acceptance with psychological distress, existential suffering, and quality of life in terminally ill cancer patients' last year of life. Psychooncology 2015; 25:455-62. [DOI: 10.1002/pon.3943] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 06/01/2015] [Accepted: 07/29/2015] [Indexed: 11/09/2022]
Affiliation(s)
- Siew Tzuh Tang
- School of Nursing; Chang Gung University; Tao-Yuan Taiwan
| | - Wen-Cheng Chang
- Division of Hematology-Oncology, Chang Gung Memorial Hospital at Linkou; College of Medicine, Chang Gung University; Tao-Yuan Taiwan
| | - Jen-Shi Chen
- Division of Hematology-Oncology, Chang Gung Memorial Hospital at Linkou; College of Medicine, Chang Gung University; Tao-Yuan Taiwan
| | - Wen-Chi Chou
- Division of Hematology-Oncology, Chang Gung Memorial Hospital at Linkou; College of Medicine, Chang Gung University; Tao-Yuan Taiwan
| | - Chia-Hsun Hsieh
- Division of Hematology-Oncology, Chang Gung Memorial Hospital at Linkou; College of Medicine, Chang Gung University; Tao-Yuan Taiwan
| | - Chen H. Chen
- School of Nursing; Chang Gung University; Tao-Yuan Taiwan
- Department of Nursing; Kang-Ning Junior College of Medical Care and Management; Taipei Taiwan
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Cerimagic S, Ahmadi N, Gurney H, Patel MI. Doctor-patient communication: a study of Australian ethnic urological cancer patients. INTERNATIONAL JOURNAL OF HUMAN RIGHTS IN HEALTHCARE 2015. [DOI: 10.1108/ijhrh-09-2014-0022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose– The purpose of this paper is to examine doctor-patient communication, focusing on ethnic Australian urological cancer patients.Design/methodology/approach– Samples of 50 Australian urological cancer patients of ethnic origin were chosen to participate in this study. The patients completed a 31-question survey, followed by a one-on-one semi-structured 30-40-minute interview with the patient.Findings– Most (90 per cent,n=45) of the patients indicated that they can communicate with their doctor without feeling stereotyped or judged. However, despite these responses 48 per cent (n=24) of the patients reported they did not ask for the doctor to explain the medical terms or meanings they did not understand. This resulted in 46 per cent (n=23) of the patients not knowing the stage of their cancer.Research limitations/implications– This is only a pilot study and the sample was limited to 50 patients. The limitations of this study make the results of the findings more suggestive rather than definitive. Further research would benefit by repeating this study with a larger sample size, to address the shortcomings of the study and to venture further into the realm of doctor and overseas patients communication in Australia.Practical implications– This research found that patients from lower socioeconomic backgrounds for whom English is not their first language have low levels of medical literacy and therefore require additional written information about their illness and treatment such as informative brochures, educational booklets and educational videos on their illness.Originality/value– To the knowledge, this is the first study that focuses on ethnic Australian urological cancer patients and their doctor-patient communication.
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Tang ST, Lin KC, Chen JS, Chang WC, Hsieh CH, Chou WC. Threatened with death but growing: changes in and determinants of posttraumatic growth over the dying process for Taiwanese terminally ill cancer patients. Psychooncology 2014; 24:147-54. [DOI: 10.1002/pon.3616] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Revised: 06/09/2014] [Accepted: 06/09/2014] [Indexed: 11/06/2022]
Affiliation(s)
- Siew Tzuh Tang
- School of Nursing; Chang Gung University; Tao-Yuan Taiwan
| | - Kuan-Chia Lin
- Department of Health Care and Management; National Taipei University of Nursing and Health Science; Taipei Taiwan
| | - Jen-Shi Chen
- Division of Hematology-Oncology; Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine; Tao-Yuan Taiwan
| | - Wen-Cheng Chang
- Division of Hematology-Oncology; Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine; Tao-Yuan Taiwan
| | - Chia-Hsun Hsieh
- Division of Hematology-Oncology; Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine; Tao-Yuan Taiwan
| | - Wen-Chi Chou
- Division of Hematology-Oncology; Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine; Tao-Yuan Taiwan
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Tang ST, Liu TW, Chow JM, Chiu CF, Hsieh RK, Chen CH, Liu LN, Feng WL. Associations between accurate prognostic understanding and end-of-life care preferences and its correlates among Taiwanese terminally ill cancer patients surveyed in 2011-2012. Psychooncology 2014; 23:780-7. [DOI: 10.1002/pon.3482] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Revised: 12/15/2013] [Accepted: 12/17/2013] [Indexed: 01/03/2023]
Affiliation(s)
- Siew Tzuh Tang
- School of Nursing; Chang Gung University; Tao-Yuan Taiwan
| | - Tsang-Wu Liu
- National Health Research Institutes; National Institute of Cancer Research; Taipei Taiwan
| | - Jyh-Ming Chow
- Section of Hematology and Medical Oncology; Wan-Fang Hospital; Taipei Taiwan
| | - Chang-Fang Chiu
- Division of Hematology-Oncology and Comprehensive Cancer Center; China Medical University Hospital; Taichung Taiwan
| | - Ruey-Kuen Hsieh
- Division of Hematology and Oncology, Department of Internal Medicine; Mackay Memorial Hospital; Taipei Taiwan
| | - Chen H. Chen
- School of Nursing; Kang-Ning Junior College of Medical Care and Management; Taipei Taiwan
| | - Li Ni Liu
- Department of Nursing; Fu Jen Catholic University; Taipei Taiwan
| | - Wei-Lien Feng
- National Health Research Institutes; National Institute of Cancer Research; Taipei Taiwan
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Kim JH, Yoon S, Won WY, Lee C, Lee CU, Song KY, Min JA, Lyoo IK, Kim TS. Age-specific influences of emotional distress on performance status in cancer patients. Psychooncology 2013; 22:2220-6. [DOI: 10.1002/pon.3276] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Revised: 02/06/2013] [Accepted: 02/09/2013] [Indexed: 01/22/2023]
Affiliation(s)
- Ji-Hyun Kim
- Department of Psychiatry; Catholic University of Daegu School of Medicine; Daegu South Korea
| | - Sujung Yoon
- Department of Psychiatry; Catholic University of Korea College of Medicine; Seoul South Korea
- The Brain Institute and Department of Psychiatry; University of Utah School of Medicine; Salt Lake City UT USA
| | - Wang-Youn Won
- Department of Psychiatry; Catholic University of Korea College of Medicine; Seoul South Korea
| | - Chul Lee
- Department of Psychiatry; Catholic University of Korea College of Medicine; Seoul South Korea
| | - Chang-Uk Lee
- Department of Psychiatry; Catholic University of Korea College of Medicine; Seoul South Korea
| | - Kyo Young Song
- Division of Gastrointestinal Surgery, Department of Surgery; Catholic University of Korea College of Medicine; Seoul South Korea
| | - Jung-Ah Min
- Department of Psychiatry; Catholic University of Korea College of Medicine; Seoul South Korea
| | - In Kyoon Lyoo
- Division of Life and Pharmaceutical Sciences and Ewha Brain Institute; Ewha University; Seoul South Korea
| | - Tae-Suk Kim
- Department of Psychiatry; Catholic University of Korea College of Medicine; Seoul South Korea
- The Brain Institute and Department of Psychiatry; University of Utah School of Medicine; Salt Lake City UT USA
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Gany F, Yogendran L, Massie D, Ramirez J, Lee T, Winkel G, Diamond L, Leng J. "Doctor, what do i have?" Knowledge of cancer diagnosis among immigrant/migrant minorities. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2013; 28:165-70. [PMID: 23093484 PMCID: PMC5469292 DOI: 10.1007/s13187-012-0429-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
This study explores patient knowledge of cancer diagnosis among underserved immigrant/migrant minorities. Patients were recruited at a hospital-based cancer clinic in New York City. Demographic and self-reported diagnosis and treatment information were collected; charts were reviewed to ascertain cancer diagnosis. Four hundred thirty-four patients were included. Eighty-seven percent preferred to speak a language other than English in the health care setting. Sixteen percent had incorrect knowledge of their cancer diagnosis. Multivariate analysis indicated that both preference for a non-English language and diagnosis of a "below the belt" cancer were jointly predictive of incorrect knowledge (LR = 17.01; p = 0.0002). "Below the belt" cancers included bladder, colorectal, gynecological, penile, prostate, and testicular cancers. Among this cohort of immigrant/migrant cancer patients, a considerable proportion was unaware of their correct cancer diagnoses. This may have a significant impact on subsequent cancer education, treatment, and care. Limited-English-proficiency patients may be at particular risk.
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Affiliation(s)
- Francesca Gany
- Memorial Sloan-Kettering Cancer Center, Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Department of Medicine, 300 E. 66 St, 15 floor, New York, NY 10065
| | - Lalanthica Yogendran
- Memorial Sloan-Kettering Cancer Center, Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, 300 E. 66 Street, 15 floor, New York, NY 10065
| | - Dana Massie
- Memorial Sloan-Kettering Cancer Center, Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, 300 E. 66 Street, 15 floor, New York, NY 10065
| | - Julia Ramirez
- Memorial Sloan-Kettering Cancer Center, Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, 300 E. 66 Street, 15 floor, New York, NY 10065
| | - Trevor Lee
- Memorial Sloan-Kettering Cancer Center, Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, 300 E. 66 Street, 15 floor, New York, NY 10065
| | - Gary Winkel
- Mount Sinai School of Medicine, Department of Oncological Sciences, Icahn Medical Institute, Room 15-70, One Gustave L. Levy Place, Box 1130, New York, NY 10029
| | - Lisa Diamond
- Memorial Sloan-Kettering Cancer Center, Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Department of Medicine, 300 E. 66 St, 15 floor, New York, NY 10065
| | - Jennifer Leng
- Memorial Sloan-Kettering Cancer Center, Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Department of Medicine, 300 E. 66 St, 15 floor, New York, NY 10065
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Pachler J, Wille-Jørgensen P. Quality of life after rectal resection for cancer, with or without permanent colostomy. Cochrane Database Syst Rev 2012; 12:CD004323. [PMID: 23235607 PMCID: PMC7197443 DOI: 10.1002/14651858.cd004323.pub4] [Citation(s) in RCA: 89] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND For almost one hundred years abdominoperineal excision has been the standard treatment of choice for rectal cancer. With advances in the techniques for rectal resection and anastomosis, anterior resection with preservation of the sphincter function has become the preferred treatment for rectal cancers, except for those cancers very close to the anal sphincter. The main reason for this has been the conviction that the quality of life for patients with a colostomy after abdominoperineal excision was poorer than for patients undergoing an operation with a sphincter-preserving technique. However, patients having sphincter-preserving operations may experience symptoms affecting their quality of life that are different from stoma-patients. OBJECTIVES To compare the quality of life in rectal cancer patients with or without permanent colostomy. SEARCH METHODS We searched PUBMED, EMBASE, LILACS, the Cochrane Central Register of Controlled Trials (CENTRAL), the Cochrane Colorectal Cancer Group's specialised register. Abstract books from major gastroenterological and colorectal congresses were searched. Reference lists of the selected articles were scrutinized. SELECTION CRITERIA All controlled clinical trials and observational studies in which quality of life was measured in patients with rectal cancer having either abdominoperineal excision/Hartmann's operation or low anterior resection, using a validated quality of life instrument, were considered. DATA COLLECTION AND ANALYSIS One reviewer (JP) checked the titles and abstracts identified from the databases and hand search. Full text copies of all studies of possible relevance were obtained. The reviewer decided which studies met the inclusion criteria. Both reviewers independently extracted data. If information was insufficient the original author was contacted to obtain missing data. Extracted data were cross-checked and discrepancies resolved by consensus. MAIN RESULTS Sixty-nine potential studies were identified. Thirty-five of these, all non-randomised and representing 5127 participants met the inclusion criteria. Fourteen trials found that people undergoing abdominoperineal excision/Hartmann's operation did not have poorer quality of life measures than patients undergoing anterior resection. The rest of the studies found some difference, but not always in favour of non-stoma patients. Due to clinical heterogeneity and the fact that all studies were observational trials, meta-analysis of the included studies was not possible. AUTHORS' CONCLUSIONS The studies included in this review do not allow firm conclusions as to the question of whether the quality of life of people after anterior resection is superior to that of people after abdominoperineal excision/Hartmann's operation. The included studies challenges the assumption that anterior resection patients fare better. Larger, better designed and executed prospective studies are needed to answer this question.
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Affiliation(s)
- Jørn Pachler
- Gastroenterology Unit, Hvidovre Hospital, Hvidovre, Denmark.
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Logan HL, Tomar SL, Chang M, Turner GE, Mendenhall WM, Riggs CE. Selecting a comparison group for 5-year oral and pharyngeal cancer survivors: two methods. BMC Med Res Methodol 2012; 12:63. [PMID: 22551236 PMCID: PMC3466141 DOI: 10.1186/1471-2288-12-63] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2011] [Accepted: 04/16/2012] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND To assess potential long-term consequences of cancer treatment, studies that include comparison groups are needed. These comparison groups should be selected in a way that allows the subtle long-range effects of cancer therapy to be detected and distinguishes them from the effects of aging and other risk factors. The purpose of this investigation was to test two methods of recruiting a comparison group for 5-year oral and pharyngeal cancer survivors (peer-nominated and listed sample) with emphasis on feasibility and the quality of the match. METHODS Participants were drawn from a pool of 5-year survivors treated at a large Southeastern hospital. A peer-nominated sample was solicited from the survivors. A listed sample matched on sex, age, and zip code was purchased. Telephone interviews were conducted by a professional call center. RESULTS The following represent our key findings: The quality of matching between survivors and listed sample was better than that between survivors and peer-nominated group in age and sex. The quality of matching between the two methods on other key variables did not differ except for education, with the peer method providing a better match for the survivors than the listed sample. The yield for the listed sample method was greater than for the peer-nominated method. The cost per completed interview was greater for the peer-nominated method than the listed sample. CONCLUSION This study not only documents the methodological challenges in selecting a comparison group for studies examining the late effects of cancer treatment among older individuals but also documents challenges in matching groups that potentially have disproportionate levels of comorbidities and at-risk health behaviors.
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Affiliation(s)
- Henrietta L Logan
- Department of Community Dentistry and Behavioral Science, University of Florida, 1329 SW 16th Street Room 5174, Gainesville, FL 32610-3628, USA.
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Poirier P. The Impact of Fatigue on Role Functioning During Radiation Therapy. Oncol Nurs Forum 2011; 38:457-65. [DOI: 10.1188/11.onf.457-465] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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André S, Taboulet P, Elie C, Milpied N, Nahon M, Kierzek G, Billemont M, Perruche F, Charpentier S, Clément H, Pourriat JL, Claessens YE. Febrile neutropenia in French emergency departments: results of a prospective multicentre survey. Crit Care 2010; 14:R68. [PMID: 20403164 PMCID: PMC2887190 DOI: 10.1186/cc8972] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2009] [Revised: 01/12/2010] [Accepted: 04/19/2010] [Indexed: 02/03/2023] Open
Abstract
INTRODUCTION Febrile neutropenia (FN) is common in cancer patients receiving myelotoxic therapy. The procedures to treat FN are well established in oncology, but it is unclear whether management is adequate in the emergency department (ED). METHODS This prospective, multicentre, observational study was carried out in 47 French EDs for 6 months. Patients were adults presenting at the ED with FN after myelotoxic treatment for cancer. Severity of infection was defined according to Bone criteria for severe sepsis and septic shock (SS/SSh) and risk was determined according to Multinational Association of Supportive Care in Cancer (MASCC) criteria. The end point was the implementation of guidelines. Management of patients with SS/SSh required: (i) adequate intravenous (IV) antimicrobial therapy for the first 90 min (broad-spectrum beta-lactam with or without an aminoglycoside); (ii) fluid challenge (500 mL); (iii) lactate measurement; (iv) at least one blood culture; and (v) hospitalization. Management of patients without SS/SSh required: (1) no initiation of granulocyte - cell stimulating factor (G-CSF); (2) adequate IV antimicrobial therapy (broad-spectrum beta-lactam) and hospitalization if the patient was high-risk according to MASCC criteria; (3) adequate oral antimicrobial therapy (quinolone or amoxicillin/clavulanate or cephalosporin) and hospital discharge if the patient was low-risk. RESULTS 198 patients were enrolled; 89 patients had SS/SSh, of whom 19 received adequate antimicrobial therapy within 90 min and 42 received appropriate fluid challenge. Blood cultures were obtained from 87 and lactate concentration was measured in 29. Overall, only 6 (7%) patients with SS/SSh received adequate management. Among 108 patients without SS/SSh, 38 (35%) were high-risk and 70 (65%) low-risk. In the high-risk group, adequate antimicrobial therapy was given to 31 patients, G-CSF was initiated in 4 and 35 were hospitalized. In the low-risk group, 4 patients received adequate oral antimicrobial therapy, IV antimicrobial therapy was prescribed in 59, G-CSF was initiated in 12 and six patients were discharged. Adequate management was given to 26/38 (68%) high-risk and 1/70 low-risk patients. Factors associated with adequate management were absence of SS/SSh (P = 0.0009) and high-risk according to MASCC criteria (P < 0.0001). CONCLUSIONS In this French sample of cancer patients presenting to the ED with FN, management was often inadequate and severity was under-evaluated in the critically ill.
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Affiliation(s)
- Stéphanie André
- Department of Emergency Medicine, Hôpital Cochin, APHP, 27, rue du Faubourg Saint-Jacques, F-75679 Paris Cedex 14, France
- Université Paris Descartes, 12, rue de l'Ecole de Médecine, 75006 Paris, France
| | - Pierre Taboulet
- Department of Emergency Medicine, Hôpital Saint-Louis, APHP, 1 avenue Claude-Vellefaux, 75010 Paris, France
| | - Caroline Elie
- Université Paris Descartes, 12, rue de l'Ecole de Médecine, 75006 Paris, France
- Department of Biostatistics, Hôpital Necker, APHP, 149 rue de Sèvres, 75015 Paris, France
| | - Noël Milpied
- Department of Haematology, Hôpital Haut-Lévêque, Groupe Hospitalier Sud, CHU de Bordeaux, Avenue de Magellan, 33604 Pessac Cedex, France
| | - Michel Nahon
- Université Paris Descartes, 12, rue de l'Ecole de Médecine, 75006 Paris, France
- Department of Emergency Medicine, Hôpital Necker, APHP, 149 rue de Sèvres, 75015 Paris, France
| | - Gérald Kierzek
- Université Paris Descartes, 12, rue de l'Ecole de Médecine, 75006 Paris, France
- Department of Emergency Medicine, Hôtel-Dieu, APHP, 1 place du Parvis Notre-Dame, 75004 Paris, France
| | - Mariève Billemont
- Department of Emergency Medicine, Hôpital Cochin, APHP, 27, rue du Faubourg Saint-Jacques, F-75679 Paris Cedex 14, France
| | - Franck Perruche
- Department of Emergency Medicine, Hôpital Cochin, APHP, 27, rue du Faubourg Saint-Jacques, F-75679 Paris Cedex 14, France
| | - Sandrine Charpentier
- Department of Emergency Medicine, Hôpital Purpan, CHU de Toulouse, Place du Docteur Baylac, 31059 Toulouse Cedex 9, France
| | - Hélène Clément
- Department of Emergency Medicine, Hôpital Cochin, APHP, 27, rue du Faubourg Saint-Jacques, F-75679 Paris Cedex 14, France
| | - Jean-Louis Pourriat
- Department of Emergency Medicine, Hôpital Cochin, APHP, 27, rue du Faubourg Saint-Jacques, F-75679 Paris Cedex 14, France
- Université Paris Descartes, 12, rue de l'Ecole de Médecine, 75006 Paris, France
- Department of Emergency Medicine, Hôtel-Dieu, APHP, 1 place du Parvis Notre-Dame, 75004 Paris, France
| | - Yann-Erick Claessens
- Department of Emergency Medicine, Hôpital Cochin, APHP, 27, rue du Faubourg Saint-Jacques, F-75679 Paris Cedex 14, France
- Université Paris Descartes, 12, rue de l'Ecole de Médecine, 75006 Paris, France
- Department of Emergency Medicine, Hôtel-Dieu, APHP, 1 place du Parvis Notre-Dame, 75004 Paris, France
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Cheung YB, Goh C, Wee J, Khoo KS, Thumboo J. Measurement Properties of the Chinese Language Version of the Functional Assessment of Cancer Therapy-General in a Singaporean Population. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2009. [DOI: 10.47102/annals-acadmedsg.v38n3p225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Introduction: Health-related quality of life is an important aspect of health outcome. The assessment of it must be done by validated instruments. There is no published data on the validity, reliability and sensitiveness to change of the official Chinese translation of the Functional Assessment of Cancer Therapy-General (version 4; FACT-G).
Materials and Methods: A Chinese questionnaire package comprising the FACT-G and Functional Living Index-Cancer (FLIC, which was translated, modified and validated in Singapore) was filled in by 165 ethnic Chinese patients recruited from the National Cancer Centre, Singapore. Four weeks later, the patients were assessed again by a postal questionnaire survey.
Results: The FACT-G and FLIC total scores were strongly correlated (r = 0.85). The Physical, Social/Family, Emotional and Functional Well-being scales of the FACT-G converged to and diverged from FLIC components as conceptually expected. The FACT-G and its 4 scales also demonstrated known-groups validity in differentiating patients with different performance status (each P <0.001). Their internal consistency ranged from 0.81 to 0.93 and test-retest reliability ranged from 0.74 to 0.85. The FACT-G and its Physical, Emotional and Functional Well-being scales showed trends of change in relation to change in performance status. The Social/Family Well-being scale was sensitive to decline but not improvement in performance status.
Conclusions: The Chinese version of the FACT-G can be used to assess overall level and some specific aspects of health-related quality of life. However, researchers should be cautious in using this instrument to specifically investigate the social aspect of quality of life.
Key words: Quality of life, Reliability, Sensitivity, Validity
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Affiliation(s)
- Yin Bun Cheung
- Clinical Trials and Epidemiology Research Unit, Singapore
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Gao F, Ng GY, Cheung YB, Thumboo J, Pang G, Koo WH, Sethi VK, Wee J, Goh C. The Singaporean English and Chinese versions of the EQ-5D achieved measurement equivalence in cancer patients. J Clin Epidemiol 2008; 62:206-13. [PMID: 18619790 DOI: 10.1016/j.jclinepi.2008.03.007] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2007] [Revised: 02/06/2008] [Accepted: 03/12/2008] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To assess measurement equivalence of the Singaporean English and Chinese versions of the EuroQol Group's 5-domain questionnaire (EQ-5D) in cancer patients. STUDY DESIGN AND SETTING Seven hundred and seventy-one ethnic Chinese patients in Singapore were recruited, and they answered either an English or a Chinese version of the EQ-5D. Seven days later, a similar questionnaire in the same language was mailed to the patients. Regression analysis was used to assess equivalence of the mean values obtained by using the two language versions. The validity, responsiveness to change, and reliability of the two versions of the EQ-5D were assessed and compared. RESULTS Based on the prespecified equivalence margin of +/-10% for binary outcome, +/-0.05 for utility index, and +/-5 points in the visual analog scale, the two language versions of the EQ-5D gave equivalent mean values at item and scale levels. They also showed similar characteristics in validity, responsiveness, and reliability. For example, the test-retest reliability values for the EQ-5D utility index in the two language samples were identical in two significant digits: 0.79. CONCLUSION The Singaporean English and Chinese versions of the EQ-5D were validated in cancer patients and were shown to achieve measurement equivalence.
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Affiliation(s)
- Fei Gao
- Division of Clinical Trials and Epidemiological Sciences, National Cancer Centre, 11 Hospital Drive, Singapore 169610, Singapore.
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Lim JW, Yi J, Zebrack B. Acculturation, social support, and quality of life for Korean immigrant breast and gynecological cancer survivors. ETHNICITY & HEALTH 2008; 13:243-260. [PMID: 18568975 DOI: 10.1080/13557850802009488] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVES This study examines the direct and/or indirect pathways among acculturation, social support, depressive symptoms, and quality of life (QOL) for Korean immigrant breast and gynecological cancer survivors. DESIGN The QOL-Cancer Survivor measure was translated and then administered to 51 survivors. This tool measured acculturation by assessing westernization, language barriers, and length of stay. In addition, the Brief Symptom Inventory-18 was used to assess depressive symptoms. Social support components were conceptualized as comprising both functional social support and social network structures. RESULTS Structural equation modeling identified significant relationships among acculturation, social support, depressive symptoms, and QOL. Higher acculturation was associated with positive network structures (larger network size, diversity, and closer social ties) and lower depressive symptoms, which in turn contributed to better QOL. Simultaneously, positive social network structures strongly correlated with better emotional support and, thus, influenced lower depressive symptoms. CONCLUSIONS The evidence that acculturation influences QOL through social support for Korean immigrant cancer survivors should serve as a rationale for developing psychosocial interventions that enhance immigrant cancer survivors' social participation and adjustment in the unfamiliar US environment.
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Affiliation(s)
- Jung-won Lim
- Center of Community Alliance for Research and Education, City of Hope National Medical Center, Duarte, CA, USA.
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Abstract
PURPOSE/OBJECTIVES To examine factors that might affect patients' ability to perform their usual activities during radiation therapy. DESIGN Prospective, longitudinal design. SETTING A community hospital radiation oncology department. SAMPLE 77 patients receiving radiation therapy for curative or adjuvant intent. METHODS The role function mode of the Roy Adaptation Model guided the study. Participants rated the extent to which they were performing their usual activities on a scale of 0 (not at all) to 10 (all the time). Data were collected at baseline prior to starting radiation, weekly during treatment, and one month post-treatment. Cross-sectional and longitudinal regression analyses were used to capture changes in performance of usual activities over time. MAIN RESEARCH VARIABLES Performance of usual activities, Karnofsky Performance Status (KPS), fatigue, and side effects. FINDINGS Participants maintained relatively high performance status throughout the course of treatment. The ability to perform usual activities decreased significantly from baseline to the end of treatment. Ability to perform usual activities was highly negatively correlated with fatigue and side effects. Work, sick-leave benefits, living situation, fatigue, KPS, and comorbidities were associated with ability to perform usual activities along the trajectory of radiation therapy. CONCLUSIONS Fatigue and side effects of treatment negatively affected patients' ability to carry out their usual activities during radiation therapy. IMPLICATIONS FOR NURSING Management of side effects of treatment, including fatigue, and supporting patients' need to work or not work during treatment may help patients continue to perform activities that are important to them during radiation therapy.
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Dohan D, Levintova M. Barriers beyond words: cancer, culture, and translation in a community of Russian speakers. J Gen Intern Med 2007; 22 Suppl 2:300-5. [PMID: 17957415 PMCID: PMC2078549 DOI: 10.1007/s11606-007-0325-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND Language and culture relate in complex ways. Addressing this complexity in the context of language translation is a challenge when caring for patients with limited English proficiency (LEP). OBJECTIVE To examine processes of care related to language, culture and translation in an LEP population is the objective of this study. DESIGN We used community based participatory research to examine the experiences of Russian-speaking cancer patients in San Francisco, California. A Russian Cancer Information Taskforce (RCIT), including community-based organizations, local government, and clinics, participated in all phases of the study. PARTICIPANTS A purposeful sample of 74 individuals were the participants of the study. APPROACH The RCIT shaped research themes and facilitated access to participants. Methods were focus groups, individual interviews, and participant observation. RCIT reviewed data and provided guidance in interpreting results. RESULTS Four themes emerged. (1) Local Russian-language resources were seen as inadequate and relatively unavailable compared to other non-English languages; (2) a taboo about the word "cancer" led to language "games" surrounding disclosure; (3) this taboo, and other dynamics of care, reflected expectations that Russian speakers derived from experiences in their countries of origin; (4) using interpreters as cultural brokers or establishing support groups for Russian speakers could help address barriers. CONCLUSIONS The language barriers experienced by this LEP population reflect cultural and linguistic issues. Providers should consider partnering with trained interpreters to address the intertwining of language and culture.
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Affiliation(s)
- Daniel Dohan
- Institute for Health Policy Studies, University of California San Francisco, UCSF Box 0936, San Francisco, CA 94143, USA.
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Cheung YB, Daniel R, Ng GY. Response and non-response to a quality-of-life question on sexual life: a case study of the simple mean imputation method. Qual Life Res 2006; 15:1493-501. [PMID: 16732467 DOI: 10.1007/s11136-006-0004-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2006] [Indexed: 11/25/2022]
Abstract
We investigated the non-response rates to the question "I am satisfied with my sex life" in the Functional Assessment of Cancer Therapy-General questionnaire in Chinese (n = 769), Malay (n = 41) and Indian (n = 33) patients in Singapore, a multi-ethnic society whose residents are said to have a conservative sexual attitude. Non-response rates to the question were 44%, 22% and 24% in the three groups respectively. The rates were much higher than that reported previously in a US study (7%) and used in the associated simulation study of the simple mean imputation method. We further examined the Chinese respondents in detail. The odds of non-response and the scores among the responders were associated with several demographic and clinical characteristics. Using the checklist proposed by Fayers et al. [Stat Med 1998; 17: 679-696] to assess the data patterns, we found that the application of the simple mean imputation is questionable. We employed an alternative (multiple) imputation procedure that took into account covariates that predicted the odds of non-response and the observed response scores. We compared the analytic results based on different approaches to handling missing values, and found that analysis based on the simple mean imputation gave results similar to that based on multiply imputed data even in this quite extreme example.
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Affiliation(s)
- Yin Bun Cheung
- Division of Clinical Trials and Epidemiological Sciences, National Cancer Centre, Singapore, Singapore.
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Sideris L, Lasser P, Elias D, Pocard M. [Rectal cancer and quality of life: what is known and what it means to tailor the treatment to patients]. ACTA ACUST UNITED AC 2006; 29:1125-31. [PMID: 16505757 DOI: 10.1016/s0399-8320(05)82176-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Lucas Sideris
- Département de Chirurgie Carcinologique, Institut Gustave Roussy, Villejuif
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Sideris L, Zenasni F, Vernerey D, Dauchy S, Lasser P, Pignon JP, Elias D, Di Palma M, Pocard M. Quality of life of patients operated on for low rectal cancer: impact of the type of surgery and patients' characteristics. Dis Colon Rectum 2005; 48:2180-91. [PMID: 16228842 DOI: 10.1007/s10350-005-0155-0] [Citation(s) in RCA: 92] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE This study was designed to compare the impact of a permanent colostomy and sociodemographic characteristics on the quality of life of patients operated on for low rectal cancer. METHODS A cross-sectional study was performed by use of the European Organization for Research and Treatment of Cancer QLQ-C30 and CR-38 questionnaires. Patients came to the hospital to fill out the self-administered questionnaire or were sent the questionnaire by mail, followed by a live or telephone interview. All patients had undergone one of four operations: low anterior resection with colorectal or coloanal anastomosis (non-stoma group), or abdominoperineal resection with pseudocontinent perineal colostomy (nonstoma group) or left lower quadrant colostomy (stoma group). RESULTS A total of 132 patients were included for analysis and there were no missing data. For the majority of quality of life scores (26/29), there was no significant difference between stoma and nonstoma patients. However, stoma patients complained of diminished body image (P = 0.0022), and this was especially true for married (P = 0.0073) and less educated (P = 0.0014) patients at subgroup analysis. Stoma patients experienced greater financial worries (P = 0.0029), whereas nonstoma patients had greater gastrointestinal concerns (P = 0.0098). CONCLUSIONS Although most quality of life scores between stoma and nonstoma patients were similar, significant differences regarding body image, finance, and gastrointestinal symptoms, especially for married and less educated patients, were noticed. These factors should be taken into account, along with oncologic criteria, to better tailor treatments to patients.
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Affiliation(s)
- Lucas Sideris
- Department of Surgical Oncology, Institut Gustave Roussy, Villejuif, France
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Pachler J, Wille-Jørgensen P. Quality of life after rectal resection for cancer, with or without permanent colostomy. Cochrane Database Syst Rev 2005:CD004323. [PMID: 15846707 DOI: 10.1002/14651858.cd004323.pub3] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND For almost one hundred years abdominoperineal excision has been the standard treatment of choice for rectal cancer. With advances in the techniques for rectal resection and anastomosis, anterior resection with preservation of the sphincter function has become the preferred treatment for rectal cancers, except for those cancers very close to the anal sphincter. The main reason for this has been the conviction that the quality of life for patients with a colostomy after abdominoperineal excision was poorer than for patients undergoing a sphincter-preserving technique. However, patients having sphincter-preserving operations may experience symptoms affecting their quality of life that are different from those with stoma-patients. OBJECTIVES To compare the quality of life in rectal cancer patients with or without permanent colostomy. SEARCH STRATEGY We searched PUBMED, EMBASE, LILACS, the Cochrane Central Register of Controlled Trials (CENTRAL), the Cochrane Colorectal Cancer Group's specialised register. Abstract books from major gastroenterological and colorectal congresses were searched. Reference lists of the selected articles were scrutinized. SELECTION CRITERIA All controlled clinical trials and observational studies in which quality of life was measured in patients with rectal cancer having either abdominoperineal excision or low anterior resection, using a validated quality of life instrument, were considered. DATA COLLECTION AND ANALYSIS One reviewer (JP) checked the titles and abstracts identified from the databases and hand search. Full text copies of all studies of possible relevance were obtained. The reviewer decided which studies met the inclusion criteria. Both reviewers independently extracted data. If information was insufficient the original author was contacted to obtain missing data. Extracted data were crosschecked and discrepancies resolved by consensus. MAIN RESULTS Thirty potential studies were identified. Eleven of these, all non-randomised and representing 1412 participants met the inclusion criteria. Six trials found that people undergoing abdominoperineal excision did not have poorer quality of life measures than patients undergoing anterior resection. One study found that a stoma only slightly affected the person's quality of life. Four studies found that patients receiving abdominoperineal excision had significantly poorer quality of life than after anterior resection. Due to heterogeneity, meta-analysis of the included studies was not possible. AUTHORS' CONCLUSIONS The studies included in this review do not allow firm conclusions as to the question of whether the quality of life of people after anterior resection is superior to that of people after abdominoperineal excision. The included studies challenged the assumption that anterior resection patients fare better.Larger, better designed and executed prospective studies are needed to answer this question.
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Affiliation(s)
- J Pachler
- Department of Surgical Gastroenterology K, H/S Bispebjerg Hospital., Bispebjerg Bakke 23, Copenhagen NV, Denmark, DK 2400.
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Cheung YB, Khoo KS, Thumboo J, Ng GY, Wee J, Goh C. Validation of the English and Chinese versions of the Quick-FLIC quality of life questionnaire. Br J Cancer 2005; 92:668-72. [PMID: 15700037 PMCID: PMC2361884 DOI: 10.1038/sj.bjc.6602399] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
A useful measure of quality of life should be easy and quick to complete. Recently, we reported the development and validation of a shortened Chinese version of the Functional Living Index – Cancer (FLIC), which we called the Quick-FLIC. In the present study of 327 English-speaking and 221 Chinese-speaking cancer patients, we validated the English version of the Quick-FLIC and further assessed the Chinese version. The 11 Quick-FLIC items were administered alongside the 11 remaining items of the full FLIC, but there appeared to be little context effect. Validity of the English version of the Quick-FLIC was attested by its strong correlation with two other measures of quality of life, and its ability to detect differences between patients with different performance status and treatment status (each P<0.001). Its internal consistency (alpha=0.86) and test–retest reliability (intraclass correlation=0.76) were also satisfactory. The measure was responsive to changes in performance status (P<0.001). The Chinese version showed similar characteristics. The Quick-FLIC behaved in ways that are highly comparable with the FLIC, even though the Quick-FLIC comprised only 11 items whereas the FLIC comprised 22. Further research is required to see whether the use of shorter instruments can improve data quality and response rates, but the fact that shorter instruments place less burden on the patients is itself inherently important.
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Affiliation(s)
- Y-B Cheung
- Division of Clinical Trials and Epidemiological Sciences, National Cancer Centre, Singapore
| | - K-S Khoo
- Department of Medical Oncology, National Cancer Centre, Singapore
| | - J Thumboo
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore
| | - G-Y Ng
- Division of Clinical Trials and Epidemiological Sciences, National Cancer Centre, Singapore
| | - J Wee
- Division of Clinical Trials and Epidemiological Sciences, National Cancer Centre, Singapore
| | - C Goh
- Department of Palliative Medicine, National Cancer Centre, 11 Hospital Drive, Singapore 169610
- Department of Palliative Medicine, National Cancer Centre, 11 Hospital Drive, Singapore 169610. E-mail:
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Cheung YB, Thumboo J, Goh C, Khoo KS, Che W, Wee J. The equivalence and difference between the English and Chinese versions of two major, cancer-specific, health-related quality-of-life questionnaires. Cancer 2004; 101:2874-80. [PMID: 15529310 DOI: 10.1002/cncr.20681] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND English and Chinese are two of the most widely used primary languages in the world. Patients in many cancer centers have a variety of ethnic backgrounds and primary languages. The comparability of version 4 of the English and Chinese versions of the Functional Assessment of Cancer Therapy-General (FACT-G) and version 3 of the European Organization for the Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30) have not been established. METHODS In total, 1136 ethnic Chinese patients with cancer were recruited from the National Cancer Centre of Singapore. Patients chose to answer an English or Chinese questionnaire, according to their own preference. Multiple regression analysis was used to adjust for differences in demographic and health characteristics. Equivalence was confirmed if the 90% confidence intervals of the adjusted mean difference fell completely within an equivalence zone of +/- 0.25 standard deviations (SD). RESULTS The English and Chinese versions of the Total, Emotional, and Functional Well Being Scales of the FACT-G and the Physical and Emotional Functioning Scales of the EORTC QLQ-C30 were equivalent. Scores for the other scales on the two questionnaires, at most, had a small differences that did not exceed 0.5 SD. Nevertheless, the Chinese translation of the question "I have a lack of energy" in the Physical Well Being Scale of the FACT-G produced results that differed from the results produced by the original English version. CONCLUSIONS Data collected from English-speaking and Chinese-speaking respondents were capable of being pooled, and either version could be used for bilingual respondents. Nevertheless, the authors recommend modification of the Physical Well Being question that produced different results ("I have a lack of energy").
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Affiliation(s)
- Yin-Bun Cheung
- Division of Clinical Trials and Epidemiological Sciences, National Cancer Centre, Singapore.
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Boyle DA. Cultural Diversity Issues in Cancer Nursing. Oncol Nurs Forum 2004. [DOI: 10.1188/04.onf.686-688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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