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Sandell T, Schütze H, Miller A. Acceptability of a shared cancer follow-up model of care between general practitioners and radiation oncologists: A qualitative evaluation. Health Expect 2023; 26:2441-2452. [PMID: 37583292 PMCID: PMC10632636 DOI: 10.1111/hex.13846] [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: 03/21/2023] [Revised: 07/30/2023] [Accepted: 08/01/2023] [Indexed: 08/17/2023] Open
Abstract
INTRODUCTION Facilitators to implement shared cancer follow-up care into clinical practice include mechanisms to allow the oncologist to continue overseeing the care of their patient, two-way information sharing and clear follow-up protocols for general practitioners (GPs). This paper aimed to evaluate patients, GPs and radiation oncologists (ROs) acceptance of a shared care intervention. METHODS Semi-structured interviews were conducted pre- and post intervention with patients that were 3 years post radiotherapy treatment for breast, colorectal or prostate cancer, their RO, and their GP. Inductive and deductive thematical analysis was employed. RESULTS Thirty-two participants were interviewed (19 patients, 9 GPs, and 4 ROs). Pre intervention, there was support for GPs to play a greater role in cancer follow-up care, however, patients were concerned about the GPs cancer-specific skills. Patients, GPs and ROs were concerned about increasing the GPs workload. Post intervention, participants were satisfied that the GPs had specific skills and that the impact on GP workload was comparable to writing a referral. However, GPs expressed concern about remuneration. GPs and ROs felt the model provided patient choice and were suitable for low-risk, stable patients around 2-3 years post treatment. Patients emphasised that they trusted their RO to advise them on the most appropriate follow-up model suited to their individual situation. The overall acceptance of shared care depended on successful health technology to connect the GP and RO. There were no differences in patient acceptance between rural, regional, and cancer types. ROs presented differences in acceptance for the different cancer types, with breast cancer strongly supported. CONCLUSION Patients, GPs and ROs felt this shared cancer follow-up model of care was acceptable, but only if the RO remained directly involved and the health technology worked. There is a need to review funding and advocate for health technology advances to support integration. PATIENT OR PUBLIC CONTRIBUTION Patients treated with curative radiotherapy for breast, colorectal and prostate cancer, their RO and their GPs were actively involved in this study by giving their consent to be interviewed.
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Affiliation(s)
- Tiffany Sandell
- School of Graduate MedicineFaculty of Science, Medicine and Health, University of WollongongWollongongNew South WalesAustralia
- Illawarra Shoalhaven Local Health District, Cancer ServicesNowraNew South WalesAustralia
| | - Heike Schütze
- School of Graduate MedicineFaculty of Science, Medicine and Health, University of WollongongWollongongNew South WalesAustralia
- Office of Medical EducationFaculty of Medicine and Health, University of New South WalesSydneyNew South WalesAustralia
| | - Andrew Miller
- Illawarra Shoalhaven Local Health District, Cancer ServicesNowraNew South WalesAustralia
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Magnani C, Smith AB, Rey D, Sarradon-Eck A, Préau M, Bendiane MK, Bouhnik AD, Mancini J. Fear of cancer recurrence in young women 5 years after diagnosis with a good-prognosis cancer: the VICAN-5 national survey. J Cancer Surviv 2023; 17:1359-1370. [PMID: 35318569 DOI: 10.1007/s11764-022-01193-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 02/18/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Fear of cancer recurrence (FCR) is frequent in survivors, but less is known about FCR in long-term survivors with very low risk of relapse. Our aim was to estimate the prevalence and clinical and socio-behavioural factors associated with FCR in young women 5 years after diagnosis of a good-prognosis cancer. METHODS Using data from the VICAN-5 survey, conducted in 2015-2016 amongst a national representative French sample of cancer survivors, we included women with non-metastatic melanoma, breast, or thyroid cancer, aged 55 years or under at diagnosis, who experienced no disease progression in the 5 years post-diagnosis. Multinomial logistic regression was used to identify factors associated with FCR, characterised using a three-level indicator: no, mild, and moderate/severe FCR. RESULTS Amongst the 1153 women included, mean age was 44 years at diagnosis, and 81.8% had breast cancer, 12.5% thyroid cancer, and 5.8% melanoma. Five years after diagnosis, 35.4% reported no FCR, 46.0% mild FCR, and 18.6% moderate/severe FCR. Women with thyroid cancer were less likely to suffer from mild or moderate/severe FCR, while cancer-related treatment sequelae, fatigue, and anxiety were more likely. Limited health literacy was associated with mild FCR. Women who reported only occasionally consulting a general practitioner (GP) for the management of their cancer had a higher probability of FCR. CONCLUSION Moderate/severe FCR affected nearly 20% of young female long-term survivors diagnosed with a good-prognosis cancer, particularly those reporting cancer-related sequelae, suffering from fatigue or anxiety, with breast cancer or melanoma (versus thyroid cancer), and consulting a GP only occasionally for cancer management. IMPLICATIONS FOR CANCER SURVIVORS Given the recognised impact of FCR on quality of life, it is essential to detect it as early as possible, and to implement targeted interventions in routine care.
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Affiliation(s)
| | - Allan Ben Smith
- Ingham Institute for Applied Medical Research, New South Wales, Sydney, Australia
- South Western Sydney Clinical School, University of New South Wales, New South Wales, Liverpool, Australia
| | - Dominique Rey
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L'Information Médicale, ISSPAM, Equipe CANBIOS Labellisée Ligue 2019, Marseille, France
| | - Aline Sarradon-Eck
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L'Information Médicale, ISSPAM, Equipe CANBIOS Labellisée Ligue 2019, Marseille, France
- Institut Paoli-Calmettes, SESSTIM, Marseille, France
| | - Marie Préau
- Unité UMR 1296 «Radiations: Défense, Santé, Environnement», Lyon, France
- Institut de Psychologie, Université Lumière Lyon 2, Bron, France
| | - Marc-Karim Bendiane
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L'Information Médicale, ISSPAM, Equipe CANBIOS Labellisée Ligue 2019, Marseille, France
| | - Anne-Déborah Bouhnik
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L'Information Médicale, ISSPAM, Equipe CANBIOS Labellisée Ligue 2019, Marseille, France.
| | - Julien Mancini
- Aix Marseille Univ, APHM, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L'Information Médicale, ISSPAM, Equipe CANBIOS Labellisée Ligue 2019, Hop Timone, BioSTIC, Biostatistique et Technologies de l'Information et de la Communication, Marseille, France
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Goyal N, Day A, Epstein J, Goodman J, Graboyes E, Jalisi S, Kiess AP, Ku JA, Miller MC, Panwar A, Patel VA, Sacco A, Sandulache V, Williams AM, Deschler D, Farwell DG, Nathan C, Fakhry C, Agrawal N. Head and neck cancer survivorship consensus statement from the American Head and Neck Society. Laryngoscope Investig Otolaryngol 2022; 7:70-92. [PMID: 35155786 PMCID: PMC8823162 DOI: 10.1002/lio2.702] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/15/2021] [Accepted: 11/10/2021] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVES To provide a consensus statement describing best practices and evidence regarding head and neck cancer survivorship. METHODS Key topics regarding head and neck cancer survivorship were identified by the multidisciplinary membership of the American Head and Neck Society Survivorship, Supportive Care & Rehabilitation Service. Guidelines were generated by combining expert opinion and a review of the literature and categorized by level of evidence. RESULTS Several areas regarding survivorship including dysphonia, dysphagia, fatigue, chronic pain, intimacy, the ability to return to work, financial toxicity, lymphedema, psycho-oncology, physical activity, and substance abuse were identified and discussed. Additionally, the group identified and described the role of key clinicians in survivorship including surgical, medical and radiation oncologists; dentists; primary care physicians; psychotherapists; as well as physical, occupational, speech, and respiratory therapists. CONCLUSION Head and neck cancer survivorship is complex and requires a multidisciplinary approach centered around patients and their caregivers. As survival related to head and neck cancer treatment improves, addressing post-treatment concerns appropriately is critically important to our patient's quality of life. There continues to be a need to define effective and efficient programs that can coordinate this multidisciplinary effort toward survivorship.
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Affiliation(s)
- Neerav Goyal
- Department of Otolaryngology—Head and Neck SurgeryThe Pennsylvania State University, College of MedicineHersheyPennsylvaniaUSA
| | - Andrew Day
- Department of Otolaryngology—Head and Neck SurgeryUniversity of Texas Southwestern Medical CenterDallasTexasUSA
| | - Joel Epstein
- Department of SurgeryCedars SinaiLos AngelesCaliforniaUSA
- City of HopeCaliforniaDuarteUSA
| | - Joseph Goodman
- Ear, Nose and Throat CenterGeorge Washington UniversityWashingtonDistrict of ColumbiaUSA
| | - Evan Graboyes
- Department of Otolaryngology—Head and Neck SurgeryMedical University of South CarolinaCharlestonSouth CarolinaUSA
| | - Scharukh Jalisi
- Department of OtolaryngologyBeth Israel DeaconessBostonMassachusettsUSA
| | - Ana P. Kiess
- Department of Radiation Oncology and Molecular Radiation SciencesJohns Hopkins MedicineBaltimoreMarylandUSA
| | - Jamie A. Ku
- Head and Neck InstituteCleveland ClinicClevelandOhioUSA
| | - Matthew C. Miller
- Department of OtolaryngologyUniversity of Rochester Medical CenterRochesterNew YorkUSA
| | - Aru Panwar
- Department of Head and Neck Surgical Oncology, Methodist Estabrook Cancer CenterNebraska Methodist HospitalOmahaNebraskaUSA
| | - Vijay A. Patel
- Department of OtolaryngologyUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Assuntina Sacco
- Department of Medical OncologyUniversity of California San DiegoLa JollaCaliforniaUSA
| | - Vlad Sandulache
- Department of Otolaryngology—Head and Neck SurgeryBaylor College of MedicineHoustonTexasUSA
| | - Amy M. Williams
- Department of Otolaryngology—Head and Neck SurgeryHenry Ford Health SystemDetroitMichiganUSA
| | - Daniel Deschler
- Department of Otolaryngology–Head and Neck SurgeryMassachusetts Eye and EarBostonMassachusettsUSA
| | - D. Gregory Farwell
- Department of Otolaryngology—Head and Neck SurgeryUniversity of California DavisDavisCaliforniaUSA
| | - Cherie‐Ann Nathan
- Department of Otolaryngology—Head and Neck SurgeryLouisiana State UniversityShreveportLouisianaUSA
| | - Carole Fakhry
- Department of Otolaryngology—Head and Neck SurgeryJohns Hopkins School of MedicineBaltimoreMarylandUSA
| | - Nishant Agrawal
- Department of Surgery, Section of Otolaryngology—Head and Neck SurgeryUniversity of Chicago Pritzker School of MedicineChicagoIllinoisUSA
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Poirée M, Duplan M, Letort-Bertrand M, Thouvenin S, Deparis M, Galland F, Aladenise C, Lervat C. Soins de support en oncologie pédiatrique ou le respect des besoins fondamentaux des enfants et adolescents. Bull Cancer 2022; 109:557-567. [DOI: 10.1016/j.bulcan.2021.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 10/11/2021] [Accepted: 10/24/2021] [Indexed: 11/29/2022]
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5
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Survivors' preferences for the organization and delivery of supportive care after treatment: An integrative review. Eur J Oncol Nurs 2021; 54:102040. [PMID: 34571444 DOI: 10.1016/j.ejon.2021.102040] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/08/2021] [Accepted: 09/11/2021] [Indexed: 01/18/2023]
Abstract
PURPOSE Quality supportive care during cancer survivorship contributes to positive physical and psychosocial health. However, the potential positive impacts are influenced by survivors' perceptions of and ability to access the supportive care services that they deem important to their well-being. The purpose of this integrative review was to examine cancer survivors' preferences for the organization and delivery of supportive care services in the post-treatment period. METHODS We conducted a systematic search for relevant quantitative, qualitative and mixed methods studies. Included studies were analyzed using directed content analysis, focused on models of care and type of provider, site of care, specialized services, structural supports through transitions, and sources of information. RESULTS Sixty-nine studies were included. Overall, survivors' preferences are not static and fluctuate over time based on their perceived health needs, concerns and points of transition in care. While specialist supportive care led by consultant oncologists is often identified as the preferred model of care, survivors' also express preferences for integrated and shared models of care, involving oncology nurses, primary care and multidisciplinary professionals to optimise coordination and impact of supportive care. Flexibility in care delivery, leveraging technology and expertise, was preferred to ensure convenient and timely access to supportive care. CONCLUSIONS Cancer survivors express preferences for the organization and delivery of supportive care in the post-treatment phase that fluctuate based on their perceived health needs. The development of novel survivorship health services must consider survivors' preferences and allow flexibility in care delivery to facilitate engagement, uptake, and effectiveness.
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Lopes-Conceição L, Brandão M, Araújo N, Severo M, Dias T, Peleteiro B, Fontes F, Pereira S, Lunet N. Quality of life trajectories in breast cancer patients: an updated analysis 5 years after diagnosis. J Public Health (Oxf) 2021; 43:e133-e134. [PMID: 32756914 DOI: 10.1093/pubmed/fdaa118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 06/17/2020] [Accepted: 06/27/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Luisa Lopes-Conceição
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Mariana Brandão
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal.,Academic Trials Promoting Team, Institut Jules Bordet, Brussels, Belgium
| | - Natália Araújo
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Milton Severo
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Teresa Dias
- Instituto Português de Oncologia do PortoFG, EPE (IPO-Porto), Porto, Portugal
| | - Bárbara Peleteiro
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Filipa Fontes
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Instituto Português de Oncologia do PortoFG, EPE (IPO-Porto), Porto, Portugal
| | - Susana Pereira
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Instituto Português de Oncologia do PortoFG, EPE (IPO-Porto), Porto, Portugal
| | - Nuno Lunet
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
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"There Should Have Been a More Holistic Approach"-A Qualitative Study of Young Adult Cancer Survivors' Experiences of Follow-up After Cancer Treatment. Cancer Nurs 2021; 45:E299-E308. [PMID: 33481409 DOI: 10.1097/ncc.0000000000000924] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Young adult cancer survivors (YACSs) are in a vulnerable period of life with increased risk of severe physical and psychosocial late effects. However, limited research exists on follow-up of YACSs after cancer treatment. OBJECTIVE The aim of this study was to explore how YACSs experience follow-up from the healthcare system after finishing cancer treatment. METHODS Using a qualitative method with an interpretive descriptive design, 20 YACSs were interviewed 4 times over a period of 6 months. The transcribed interviews were analyzed using Systematic Text Condensation. RESULTS Four main themes were identified: "They should have prepared me better," "The GP (general practitioner) does not understand my challenges," "My check-ups are all about cancer relapse," and "I do not know who's in charge." CONCLUSION The findings indicate deficiency in the healthcare system's follow-up of YACSs in terms of preparation for the survival phase, interdisciplinary cooperation, and acknowledgement of late effects, as well as organization of follow-up care within the healthcare system. IMPLICATIONS FOR PRACTICE A more holistic perspective on follow-up care that addresses YACSs' multidimensional challenges is suggested, including a multidisciplinary approach where cancer nurses should play an active role.
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8
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Johnston EA, van der Pols JC, Ekberg S. Needs, preferences, and experiences of adult cancer survivors in accessing dietary information post-treatment: A scoping review. Eur J Cancer Care (Engl) 2020; 30:e13381. [PMID: 33377564 DOI: 10.1111/ecc.13381] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 10/13/2020] [Accepted: 11/18/2020] [Indexed: 01/08/2023]
Abstract
INTRODUCTION To support provision of healthy lifestyle information tailored to patients' needs and preferences, this review maps adult cancer survivors' self-reported needs, preferences, and experiences accessing dietary information post-treatment. METHODS A scoping review of research published within the past decade conducted using PRISMA-ScR guidelines. Seven databases were searched in June 2020. RESULTS Of 15,973 articles identified, 57 met eligibility criteria. Studies most frequently included survivors of breast cancer (49%), persons aged 40+ years (95%), ≤5 years post-diagnosis (54%), and residing in North America (44%). Cancer survivors commonly identified needing information regarding healthy eating, particularly practical skills, and support in changing dietary behaviours. Preferences included specific recommendations, direct communication with healthcare professionals, and peer support from other cancer survivors. In practice, survivors frequently reported receiving generic advice from healthcare professionals, limited dietary follow-up, and lack of referral to support. Unmet needs in healthcare settings led to dietary information-seeking elsewhere; however, survivors indicated difficulty identifying credible sources. Personal beliefs and desire for involvement in care motivated dietary information-seeking post-treatment. CONCLUSION Cancer survivors' experiences accessing dietary information post-treatment do not align with needs and preferences. Less is known about survivors who are young adults, >5 years post-diagnosis, and living in rural areas.
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Affiliation(s)
- Elizabeth A Johnston
- School of Exercise and Nutrition Sciences, Queensland University of Technology (QUT), Kelvin Grove, QLD, Australia
| | - Jolieke C van der Pols
- School of Exercise and Nutrition Sciences, Queensland University of Technology (QUT), Kelvin Grove, QLD, Australia
| | - Stuart Ekberg
- School of Psychology and Counselling, Queensland University of Technology (QUT), Kelvin Grove, QLD, Australia
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Schulte FSM, Chalifour K, Eaton G, Garland SN. Quality of life among survivors of adolescent and young adult cancer in Canada: A Young Adults With Cancer in Their Prime (YACPRIME) study. Cancer 2020; 127:1325-1333. [PMID: 33332603 DOI: 10.1002/cncr.33372] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 11/13/2020] [Accepted: 11/16/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND The quality of life (QoL) among survivors of adolescent and young adult (AYA) cancer may be compromised compared with that in the general population. In this study, the authors: 1) assessed for differences in QoL among a national study of AYA cancer survivors compared with the Canadian population and 2) explored the factors associated with poorer QoL in AYA cancer survivors. METHODS For the current research, data from the Young Adults With Cancer in Their Prime study were used. QoL was measured using physical and mental component scores from a 12-item short-form health status measure. A comparison group was derived from the Canadian Community Health Survey. RESULTS AYAs (n = 195; 17.8% male; mean ± SD: 35.62 ± 6.89 years on study, 6.48 ± 5.73 years from treatment) were compared with a comparison sample (n = 665; 21.2% male). Among survivors, 31.8% reported poor physical health, and 49.7% reported poor mental health. Compared with the general population, AYAs had significantly lower physical health (F[1,818] = 52.80; P = .00) and mental health (F[1,818] = 83.54; P = .00), controlling for sex and age. Multivariable logistic regression analyses revealed that an annual income level <$40,000 (adjusted odds ratio [AOR], 8.32; 95% CI, 2.85-24.30), poor sleep quality (AOR, 1.19; 95% CI, 1.06-1.33), worse body image (AOR, 1.08; 95% CI, 1.02-1.14), and higher social support (AOR, 1.02; 95% CI, 1.00-1.05) were significantly associated with poor physical health. Poor sleep quality (AOR, 1.22; 95% CI, 1.08-1.38), body image (AOR, 1.06; 95% CI, 1.01-1.12), fear of cancer recurrence (AOR, 1.13; 95% CI, 1.06-1.21) were associated with poor mental health. CONCLUSIONS The QoL of AYAs requires urgent attention. Sleep, body image, and social support may be important modifiable targets for intervention to improve their QoL.
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Affiliation(s)
- Fiona S M Schulte
- Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Hematology, Oncology, and Transplant program, Alberta Children's Hospital, Calgary, Alberta, Canada
| | | | - Geoff Eaton
- Young Adult Cancer Canada, St John's, Newfoundland, Canada
| | - Sheila N Garland
- Department of Psychology, Faculty of Science, Memorial University of Newfoundland, St John's, Newfoundland, Canada
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Gorman JR, Drizin JH, Malcarne VL, Hsieh TC. Measuring the Multidimensional Reproductive Concerns of Young Adult Male Cancer Survivors. J Adolesc Young Adult Oncol 2020; 9:613-620. [PMID: 32298593 DOI: 10.1089/jayao.2019.0146] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Purpose: The aims of this study were to adapt the multidimensional Reproductive Concerns After Cancer (RCAC) scale for use with young adult (YA) male cancer survivors, defined as current age 18-35 years and at least 1 year postdiagnosis, and to examine the factor structure, reliability, and validity of the newly adapted RCAC-Male (RCAC-M) scale. Methods: We conducted cognitive interviews with 10 YA male cancer survivors to inform modifications to RCAC item wording. Online surveys were then completed by 170 YA male cancer survivors. We used confirmatory factor analysis to examine structural models of the RCAC-M scale, and assessed reliability and construct validity. Results: The oblique six-factor model of the RCAC-M scale provided the best model fit. Omega total and Revelle's omega total estimates for all six three-item subscales were in the nearly satisfactory to good range (0.69-0.88). As hypothesized, men who wanted to have a baby and men who believed that having a biological child was very important scored higher on at least one RCAC-M subscale. We observed correlations in the expected directions between the RCAC-M and measures of depression and health-related quality of life. Conclusion: The RCAC-M scale is a multidimensional scale that is best represented as a profile of subscale scores. This scale demonstrated good reliability and construct validity and can be used to inform tailored interventions to more effectively address men's reproductive concerns.
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Affiliation(s)
- Jessica R Gorman
- College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA
| | - Julia H Drizin
- College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA
| | - Vanessa L Malcarne
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, California, USA.,Department of Psychology, San Diego State University, San Diego, California, USA
| | - Tung-Chin Hsieh
- Department of Urology, UC San Diego Health System, San Diego, California, USA
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11
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Brown SA. Preventive Cardio-Oncology: The Time Has Come. Front Cardiovasc Med 2020; 6:187. [PMID: 31998754 PMCID: PMC6965025 DOI: 10.3389/fcvm.2019.00187] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 12/10/2019] [Indexed: 12/17/2022] Open
Affiliation(s)
- Sherry-Ann Brown
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, United States
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12
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van Egmond S, Wakkee M, van Rengen A, Bastiaens M, Nijsten T, Lugtenberg M. Factors influencing current low-value follow-up care after basal cell carcinoma and suggested strategies for de-adoption: a qualitative study. Br J Dermatol 2019; 180:1420-1429. [PMID: 30597525 PMCID: PMC6850416 DOI: 10.1111/bjd.17594] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Providing follow-up to patients with low-risk basal cell carcinoma (BCC) can be considered as low-value care. However, dermatologists still provide substantial follow-up care to this patient group, for reasons not well understood. OBJECTIVES To identify factors influencing current BCC follow-up practices among dermatologists and suggested strategies to de-adopt this low-value care. In addition, views of patients regarding follow-up care were explored. METHODS A qualitative study was conducted consisting of 18 semistructured interviews with dermatologists and three focus groups with a total of 17 patients with low-risk BCC who had received dermatological care. The interviews focused on current follow-up practices, influencing factors and suggested strategies to de-adopt the follow-up care. The focus groups discussed preferred follow-up schedules and providers, as well as the content of follow-up. All (group) interviews were transcribed verbatim and analysed by two researchers using ATLAS.ti software. RESULTS Factors influencing current follow-up care practices among dermatologists included complying with patients' preferences, lack of trust in general practitioners (GPs), financial incentives and force of habit. Patients reported varying needs regarding periodic follow-up visits, preferred to be seen by a dermatologist and indicated a need for improved information provision. Suggested strategies by dermatologists to de-adopt the low-value care encompassed educating patients with improved information, educating GPs to increase trust of dermatologists, realizing appropriate financial reimbursement and informing dermatologists about the low value of care. CONCLUSIONS A mixture of factors appear to contribute to current follow-up practices after low-risk BCC. In order to de-adopt this low-value care, strategies should be aimed at dermatologists and GPs, and also patients.
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Affiliation(s)
- S. van Egmond
- Department of DermatologyErasmus MC Cancer InstituteRotterdamthe Netherlands
- Department of Public HealthErasmus MC University Medical CenterRotterdamthe Netherlands
| | - M. Wakkee
- Department of DermatologyErasmus MC Cancer InstituteRotterdamthe Netherlands
| | - A. van Rengen
- Department of DermatologyMohs KliniekenDordrechtthe Netherlands
| | - M.T. Bastiaens
- Department of DermatologyElisabeth‐TweeSteden HospitalTilburgthe Netherlands
| | - T. Nijsten
- Department of DermatologyErasmus MC Cancer InstituteRotterdamthe Netherlands
| | - M. Lugtenberg
- Department of DermatologyErasmus MC Cancer InstituteRotterdamthe Netherlands
- Department of Public HealthErasmus MC University Medical CenterRotterdamthe Netherlands
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Roser K, Baenziger J, Mader L, Christen S, Dehler S, Michel G. Attendance to Follow-Up Care in Survivors of Adolescent and Young Adult Cancer: Application of the Theory of Planned Behavior. J Adolesc Young Adult Oncol 2018; 7:584-591. [PMID: 29924664 DOI: 10.1089/jayao.2018.0010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
PURPOSE The aim was to study follow-up care attendance in adolescent and young adult (AYA) cancer survivors to investigate: (1) correlates of the intention to attend follow-up care and (2) whether the intention is associated with the actual attendance, applying the theory of planned behavior (TPB). METHODS We conducted a questionnaire survey in AYA cancer survivors diagnosed 1990-2005 at age 16-25 years, registered in the Cancer Registry Zurich and Zug, Switzerland, who had survived at least 5 years. Structural equation modeling was applied to investigate TPB-related correlates (attitudes, subjective norms, and perceived behavioral control) of intention to attend follow-up care. Logistic regression analysis was used to study the association between intention and actual attendance. RESULTS We included 160 AYA cancer survivors in the study (mean age at study: 34.0 years, mean age at diagnosis: 21.6 years, 98 [61.3%] male). Positive attitudes toward follow-up care (coefficient = 0.32, 95% confidence interval [CI]: 0.05 to 0.60) and supportive subjective norms (coefficient = 0.59, 95% CI: 0.41 to 0.78) were associated with higher intention to attend follow-up care. Perceived behavioral control was not associated with intention to attend (coefficient = -0.13, 95% CI: -0.36 to 0.10), but with actual attendance (odds ratio [OR] = 4.55, 95% CI: 1.83 to 11.31). Higher intention was associated with actual follow-up care attendance (OR = 14.29, 95% CI: 5.80 to 35.21). CONCLUSION Positive attitudes and supportive social norms were associated with higher intention to attend follow-up care, and higher intention was associated with actual follow-up care attendance. Increasing awareness of the importance and benefits of follow-up care not only among survivors but also family, friends and healthcare professionals may help increase follow-up care attendance among AYA cancer survivors.
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Affiliation(s)
- Katharina Roser
- 1 Department of Health Sciences and Health Policy, University of Lucerne , Lucerne, Switzerland
| | - Julia Baenziger
- 1 Department of Health Sciences and Health Policy, University of Lucerne , Lucerne, Switzerland
| | - Luzius Mader
- 1 Department of Health Sciences and Health Policy, University of Lucerne , Lucerne, Switzerland
| | - Salome Christen
- 1 Department of Health Sciences and Health Policy, University of Lucerne , Lucerne, Switzerland
| | - Silvia Dehler
- 2 Cancer Registry Zurich and Zug, Institute of Surgical Pathology, University Hospital Zurich and Epidemiology, Biostatistics and Prevention Institute, University Zurich , Zurich, Switzerland .,3 Department of Health and Social Affairs, Division of Health, Canton Argovia , Arau, Switzerland
| | - Gisela Michel
- 1 Department of Health Sciences and Health Policy, University of Lucerne , Lucerne, Switzerland .,4 Institute of Social and Preventive Medicine, University of Bern , Bern, Switzerland
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Affiliation(s)
- Stacey Marjerrison
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Hematology/Oncology, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Ronald D Barr
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Hematology/Oncology, McMaster Children's Hospital, Hamilton, Ontario, Canada
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Howard AF, Kazanjian A, Pritchard S, Olson R, Hasan H, Newton K, Goddard K. Healthcare system barriers to long-term follow-up for adult survivors of childhood cancer in British Columbia, Canada: a qualitative study. J Cancer Surviv 2018; 12:277-290. [PMID: 29222704 PMCID: PMC5956053 DOI: 10.1007/s11764-017-0667-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 11/29/2017] [Indexed: 12/21/2022]
Abstract
PURPOSE Risk-stratified life-long follow-up care is recommended for adult childhood cancer survivors (CCS) to ensure appropriate prevention, screening, and management of late effects. The identification of barriers to long-term follow-up (LTFU), particularly in varying healthcare service contexts, is essential to develop and refine services that are responsive to survivor needs. We aimed to explore CCS and healthcare professionals (HCP) perspectives of healthcare system factors that function as barriers to LTFU in British Columbia, Canada. METHODS We analyzed data from 43 in-depth interviews, 30 with CCS and 13 with HCP, using qualitative thematic analysis and constant comparative methods. RESULTS Barriers to accessible, comprehensive, quality LTFU were associated with the following: (1) the difficult and abrupt transition from pediatric to adult health services, (2) inconvenient and under-resourced health services, (3) shifting patient-HCP relationships, (4) family doctor inadequate experience with late effects management, and (5) overdue and insufficient late effects communication with CCS. CONCLUSIONS Structural, informational, and interpersonal/relational healthcare system factors often prevent CCS from initially accessing LTFU after discharge from pediatric oncology programs as well as adversely affecting engagement in ongoing screening, surveillance, and management of late effects. IMPLICATIONS FOR CANCER SURVIVORS Understanding the issues faced by adult CCS will provide insight necessary to developing patient-centered healthcare solutions that are key to accessible, acceptable, appropriate, and effective healthcare.
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Affiliation(s)
- A Fuchsia Howard
- School of Nursing, The University of British Columbia, T201 - 2211 Wesbrook Mall, Vancouver, Canada.
| | - Arminee Kazanjian
- School of Population and Public Health, The University of British Columbia, Vancouver, Canada
| | - Sheila Pritchard
- Division of Hematology/Oncology, BC Children's Hospital, Vancouver, Canada
| | - Rob Olson
- Department of Surgery, The University of British Columbia, Vancouver, Canada
- Radiation Oncology, BC Cancer Agency - Centre for the North, Prince George, Canada
| | - Haroon Hasan
- Department of Radiation Oncology, BC Cancer Agency, Vancouver, Canada
| | - Kelly Newton
- School of Nursing, The University of British Columbia, T201 - 2211 Wesbrook Mall, Vancouver, Canada
| | - Karen Goddard
- Department of Radiation Oncology, BC Cancer Agency, Vancouver, Canada
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16
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Harju E, Roser K, Dehler S, Michel G. Health-related quality of life in adolescent and young adult cancer survivors. Support Care Cancer 2018; 26:3099-3110. [DOI: 10.1007/s00520-018-4151-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 03/05/2018] [Indexed: 01/18/2023]
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17
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Gorman JR, Standridge DC, Lyons KS, Elliot DL, Winters-Stone K, Julian AK, Weprin J, Storksdieck M, Hayes-Lattin B. Patient-centered communication between adolescent and young adult cancer survivors and their healthcare providers: Identifying research gaps with a scoping review. PATIENT EDUCATION AND COUNSELING 2018; 101:185-194. [PMID: 28882546 DOI: 10.1016/j.pec.2017.08.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 08/23/2017] [Accepted: 08/30/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To conduct a scoping literature review to identify practices or programs that promote AYA patient-centered communication. METHODS Between January and May of 2016, we applied standard scoping review methodology to systematically review articles. We considered peer-reviewed, English language articles written at any phase of intervention research. Both qualitative and quantitative studies were eligible, and no additional search restrictions were applied. We retained articles that included explicit or implicit outcomes for one of the six functions of patient-centered communication in cancer care. At least two independent reviewers assessed the articles. RESULTS We screened a total of 4072 titles and abstracts, retaining 27 for full-text review. Ultimately, eight titles met the review's inclusion criteria. We categorized each publication by the action or setting used to improve patient-centered communication, resulting in five categories. Most studies were not included because they did not include a patient-centered communication outcome. CONCLUSION This area of research is still emerging, as indicated by the small number of eligible studies and predominance of qualitative, descriptive, pilot, and feasibility studies with small sample sizes. PRACTICE IMPLICATIONS Our results suggest a clear need to develop and evaluate interventions focused on improving patient-centered communication between AYA survivors and their healthcare providers.
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Affiliation(s)
- Jessica R Gorman
- School of Social and Behavioral Health Sciences, Oregon State University, Corvallis, USA.
| | - Danielle C Standridge
- School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR, USA.
| | - Karen S Lyons
- School of Nursing, Oregon Health & Science University, Portland, USA.
| | - Diane L Elliot
- Department of Medicine, Oregon Health & Science University, Portland, USA.
| | | | - Anne K Julian
- School of Social and Behavioral Health Sciences, Oregon State University, Corvallis, USA.
| | - Jennifer Weprin
- School of Nursing, Oregon Health & Science University, Portland, USA.
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Abstract
Care coordination and effective transitions of care are essential for high-quality care in cancer survivors. Aspects of care that require coordination include cancer surveillance, managing the effects of cancer and its treatment, and preventive care, including screening for new cancers, with the clinician responsible for each aspect of care clearly defined. There are many barriers to transitioning and coordinating care across cancer specialists and primary care physicians; possible solutions include survivorship care plans and certain care models. Improving these areas, along with survivorship care training and education, may lead to more effective care coordination and transitions in the future.
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Affiliation(s)
- Youngjee Choi
- Department of Medicine, Division of General Internal Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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19
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de Oliveira RAA, da Conceição VM, Araujo JS, Zago MMF. Concept analysis of cancer survivorship and contributions to oncological nursing. Int J Nurs Pract 2017; 24. [DOI: 10.1111/ijn.12608] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 09/05/2017] [Accepted: 09/13/2017] [Indexed: 01/02/2023]
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Logan S, Perz J, Ussher J, Peate M, Anazodo A. A systematic review of patient oncofertility support needs in reproductive cancer patients aged 14 to 45 years of age. Psychooncology 2017; 27:401-409. [DOI: 10.1002/pon.4502] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 06/28/2017] [Accepted: 07/17/2017] [Indexed: 12/22/2022]
Affiliation(s)
- S. Logan
- School of Women and Children's Health; Faculty of Medicine, UNSW; Sydney New South Wales Australia
| | - J. Perz
- Centre for Health Research, School of Medicine; Western Sydney University; Sydney New South Wales Australia
| | - J.M. Ussher
- Centre for Health Research, School of Medicine; Western Sydney University; Sydney New South Wales Australia
| | - M. Peate
- Psychosocial Health and Wellbeing (emPoWeR) Unit, Department of Obstetrics and Gynaecology, Royal Women's Hospital; University of Melbourne; Melbourne Victoria Australia
| | - A. Anazodo
- School of Women and Children's Health; Faculty of Medicine, UNSW; Sydney New South Wales Australia
- Sydney Children's Hospital; Sydney New South Wales Australia
- Prince of Wales Hospital; Sydney New South Wales Australia
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Brandenbarg D, Berendsen AJ, de Bock GH. Patients' expectations and preferences regarding cancer follow-up care. Maturitas 2017; 105:58-63. [PMID: 28705438 DOI: 10.1016/j.maturitas.2017.07.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 07/04/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Most survivors of cancer enter a follow-up routine after their treatment, the aim of which is to detect recurrence, provide psychological support, monitor treatment-related side-effects, and to evaluate care. Due to rising numbers of people with cancer and better survival of these patients, current follow-up routines are under pressure. We reviewed the literature on patients' expectations and preferences regarding this care. METHODS We systematically searched the databases of Pubmed, CINAHL, and PsychInfo. Studies were screened and data extraction was double performed by three authors. Data were collected from quantitative and qualitative studies and described thematically. RESULTS After screening, 12 full-text articles were included, comprising 849 patients aged from 28 to 90 years. Patients expect follow-up visits to detect recurrence of cancer. They want to undergo extensive testing to get reassurance. Furthermore, patients expect relevant information to be provided and to get advice about different aspects of their illness. Psychosocial support is also expected. Patients express a desire for consistency of care as well as continuity of care, and prefer long and intensive follow-up. DISCUSSION AND CONCLUSION After cancer, patients appear to lose confidence in their bodies and fear cancer recurrence after the end of treatment, which may lead to intensive screening wishes. This is not desirable, since care for cancer is already under pressure due to rising numbers of survivors. We have to ensure that follow-up routines are sustainable and effective. Patients should receive good information about the need for follow-up tests. Doctors should be trained to give this information.
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Affiliation(s)
- D Brandenbarg
- University of Groningen, University Medical Center Groningen, Department of General Practice, P.O. Box 196, 9700 AD Groningen, The Netherlands
| | - A J Berendsen
- University of Groningen, University Medical Center Groningen, Department of General Practice, P.O. Box 196, 9700 AD Groningen, The Netherlands
| | - G H de Bock
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, P.O. Box 30001, 9700 RB Groningen, The Netherlands.
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22
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Hamblin A, Greenfield DM, Gilleece M, Salooja N, Kenyon M, Morris E, Glover N, Miller P, Braund H, Peniket A, Shaw BE, Snowden JA. Provision of long-term monitoring and late effects services following adult allogeneic haematopoietic stem cell transplant: a survey of UK NHS-based programmes. Bone Marrow Transplant 2017; 52:889-894. [DOI: 10.1038/bmt.2017.67] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 01/15/2017] [Accepted: 01/23/2017] [Indexed: 12/28/2022]
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23
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Lie HC, Mellblom AV, Brekke M, Finset A, Fosså SD, Kiserud CE, Ruud E, Loge JH. Experiences with late effects-related care and preferences for long-term follow-up care among adult survivors of childhood lymphoma. Support Care Cancer 2017; 25:2445-2454. [PMID: 28236146 DOI: 10.1007/s00520-017-3651-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 02/17/2017] [Indexed: 10/20/2022]
Abstract
PURPOSE Given childhood cancer survivors' risk of treatment-induced late effects, long-term follow-up care is recommended. We explored experiences with late effects-related care and preferences for long-term follow-up care among adult survivors of childhood malignant lymphoma in Norway. METHODS We conducted five focus group interviews with 34 survivors (19 females; 21 Hodgkin/13 non-Hodgkin lymphoma survivors; mean age 39 years; mean time from diagnosis 26 years). Data was analyzed using principles of thematic analysis. RESULTS Two main themes were identified: (1) the survivors' experiences with late effects-related care and (2) their preferences for long-term follow-up care. Most of the survivors were dissatisfied with their late effects-related care due to perceptions of poor coordination of healthcare needs in a fragmented system, combined with a perceived lack of knowledge of late effects among themselves and general practitioners (GPs). All survivors valued long-term follow-up care. Oncologists were the preferred care providers, but GPs were considered acceptable providers if they had sufficient knowledge of late effects and routine examinations, short waiting times, and improved GP-oncologist collaboration. CONCLUSIONS Our results suggest that a shared care model of long-term follow-up care involving specialists, GPs, and the survivors themselves is likely to fulfill several of the currently unmet needs among adult survivors of childhood cancers. Improved patient education about late effects and follow-up care would aid self-management. The survivors' concerns regarding lack of sufficient knowledge of late effects among GPs suggest a need for improving access to, and dissemination of, information of late effects.
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Affiliation(s)
- Hanne C Lie
- Department of Behavioural Sciences in Medicine, Institute for Basic Medical Sciences, Faculty of Medicine, University of Oslo, P.B. 1111 Blindern, 0317, Oslo, Norway. .,Department of Paediatric Medicine, Faculty of Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway. .,National Advisory Unit on Late Effects after Cancer Treatment, Oslo University Hospital, Oslo, Norway.
| | - Anneli V Mellblom
- Department of Behavioural Sciences in Medicine, Institute for Basic Medical Sciences, Faculty of Medicine, University of Oslo, P.B. 1111 Blindern, 0317, Oslo, Norway
| | - Mette Brekke
- Department of General Practice, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Arnstein Finset
- Department of Behavioural Sciences in Medicine, Institute for Basic Medical Sciences, Faculty of Medicine, University of Oslo, P.B. 1111 Blindern, 0317, Oslo, Norway
| | - Sophie D Fosså
- National Advisory Unit on Late Effects after Cancer Treatment, Oslo University Hospital, Oslo, Norway
| | - Cecilie E Kiserud
- National Advisory Unit on Late Effects after Cancer Treatment, Oslo University Hospital, Oslo, Norway
| | - Ellen Ruud
- Department of Paediatric Medicine, Faculty of Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Jon H Loge
- Department of Behavioural Sciences in Medicine, Institute for Basic Medical Sciences, Faculty of Medicine, University of Oslo, P.B. 1111 Blindern, 0317, Oslo, Norway.,Regional Advisory Unit in Palliative Care, Department of Oncology, Oslo University Hospital, Oslo, Norway
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Huibertse LJ, van Eenbergen M, de Rooij BH, Bastiaens MT, Fossion LMCL, de la Fuente RB, Kil PJM, Koldewijn EL, Meier AHP, Mommers RJM, Niemer AQ, Oddens JR, Oomens EHGM, Prins M, de Roos KP, Thissen MRTM, Timmermans MWH, Wijsman BP, van de Poll-Franse LV, Ezendam NPM. Cancer survivors' preference for follow-up care providers: a cross-sectional study from the population-based PROFILES-registry. Acta Oncol 2017; 56:278-287. [PMID: 28068157 DOI: 10.1080/0284186x.2016.1267398] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND The best practice for the organization of follow-up care in oncology is under debate, due to growing numbers of cancer survivors. Understanding survivors' preferences for follow-up care is elementary for designing patient-centred care. Based on data from prostate cancer and melanoma survivors, this study aims to identify: 1) preferences for follow-up care providers, for instance the medical specialist, the oncology nurse or the general practitioner; 2) characteristics associated with these preferences and 3) the preferred care provider to discuss cancer-related problems. MATERIAL AND METHODS Survivors diagnosed with prostate cancer (N = 535) and melanoma (N = 232) between 2007 and 2013 as registered in The Netherlands Cancer Registry returned a questionnaire (response rate was 71% and 69%, respectively). A latent class cluster model analysis was used to define preferences and a multinomial logistic regression analysis was used to identify survivor-related characteristics associated with these preferences. RESULTS Of all survivors, 29% reported no preference, 40% reported a preference for the medical specialist, 20% reported a preference for both the medical specialist and the general practitioner and 11% reported a preference for both the medical specialist and the oncology nurse. Survivors who were older, lower/intermediate educated and women were more likely to have a preference for the medical specialist. Lower educated survivors were less likely to have a preference for both the medical specialist and the general practitioner. Overall, survivors prefer to discuss diet, physical fitness and fatigue with the general practitioner, and hereditary and recurrence with the medical specialist. Only a small minority favored to discuss cancer-related problems with the oncology nurse. CONCLUSION Survivors reported different preferences for follow-up care providers based on age, education level, gender and satisfaction with the general practitioner, showing a need for tailored follow-up care in oncology. The results indicate an urgency to educate patients about transitions in follow-up care.
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Affiliation(s)
- Lotte J. Huibertse
- Department of Research, Netherlands Comprehensive Cancer Organization, Utrecht, The Netherlands
| | - Mies van Eenbergen
- Department of Research, Netherlands Comprehensive Cancer Organization, Utrecht, The Netherlands
| | - Belle H. de Rooij
- Department of Research, Netherlands Comprehensive Cancer Organization, Utrecht, The Netherlands
- CoRPS – Center of Research on Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Maarten T. Bastiaens
- Department of Dermatology, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | | | | | - Paul J. M. Kil
- Department of Urology, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | | | - A. H. P. Meier
- Department of Urology, VieCuri Hospital, Venlo, The Netherlands
| | | | - A. Q. Niemer
- Department of Urology, Bernhoven Hospital, Uden, The Netherlands
| | - Jorg R. Oddens
- Department of Urology, Jeroen Bosch Hospital, Den Bosch, The Netherlands
| | | | - Mandy Prins
- Department of Dermatology, Maxima Medical Center, Eindhoven, The Netherlands
| | | | - Monique R. T. M. Thissen
- Department of Dermatology, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Dermatology, Catharina Hospital, Eindhoven, The Netherlands
| | | | - Bart P. Wijsman
- Department of Urology, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - Lonneke V. van de Poll-Franse
- Department of Research, Netherlands Comprehensive Cancer Organization, Utrecht, The Netherlands
- CoRPS – Center of Research on Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Nicole P. M. Ezendam
- Department of Research, Netherlands Comprehensive Cancer Organization, Utrecht, The Netherlands
- CoRPS – Center of Research on Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
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Sexual Consequences of Cancer and Its Treatment in Adolescents and Young Adults. CANCER IN ADOLESCENTS AND YOUNG ADULTS 2017. [DOI: 10.1007/978-3-319-33679-4_24] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Mayes J, Brown MC, Davies N, Skinner R. Health promotion and information provision during long-term follow-up for childhood cancer survivors: A service evaluation. Pediatr Hematol Oncol 2016; 33:359-370. [PMID: 27689786 DOI: 10.1080/08880018.2016.1225325] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Health promotion is an important component of long-term follow-up (LTFU) care for childhood cancer survivors (CCS). However, little information exists about how survivors perceive their own health promotion needs. As part of a service evaluation, 51 CCS who had previously attended the LTFU clinic took part in a single semistructured interview to seek their views on information they had received regarding late adverse effects (LAEs) of treatment, the purpose of LTFU, and the provision of health promotion information. Although most (93%) CCS were satisfied with the information received about LAEs, 37% desired further details. Over half (59%) believed that the purpose of LTFU was to screen for LAEs, whereas 31% felt that it was to check for relapse. No survivor reported health promotion to be an aim of LTFU; only 14% of CCS expected to receive healthy lifestyle advice, and fewer than 10% wanted dietary and physical activity advice. Most (88%) CCS felt that their hospital-based health care professional was best placed to give healthy lifestyle advice, but there was no consensus about the optimum timing for health promotion. CCS varied in their knowledge, needs, and wishes regarding LTFU care. The results of this evaluation strongly indicate that the profile of health promotion needs to be raised within our service and identifies issues that may be pertinent to similar services. Further research is needed to understand the views of CCS regarding health promotion and lifestyle behaviors, with the aim of tailoring and improving the delivery of effective health education to CCS.
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Affiliation(s)
- Jonathan Mayes
- a Northern Institute of Cancer Research and Institute of Health and Society, Newcastle University , Newcastle upon Tyne , UK
| | - Morven C Brown
- a Northern Institute of Cancer Research and Institute of Health and Society, Newcastle University , Newcastle upon Tyne , UK
| | - Nicola Davies
- b Department of Paediatric and Adolescent Haematology/Oncology , Great North Children's Hospital , Newcastle upon Tyne , UK
| | - Roderick Skinner
- a Northern Institute of Cancer Research and Institute of Health and Society, Newcastle University , Newcastle upon Tyne , UK.,b Department of Paediatric and Adolescent Haematology/Oncology , Great North Children's Hospital , Newcastle upon Tyne , UK
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Matheson L, Boulton M, Lavender V, Collins G, Mitchell-Floyd T, Watson E. The Experiences of Young Adults With Hodgkin Lymphoma Transitioning to Survivorship: A Grounded Theory Study. Oncol Nurs Forum 2016; 43:E195-E2014. [DOI: 10.1188/16.onf.e195-e2014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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"It's just going to a new hospital … that's it." Or is it? An experiential perspective on moving from pediatric to adult cancer services. Cancer Nurs 2016; 37:E23-31. [PMID: 24145251 DOI: 10.1097/ncc.0b013e3182a40f99] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Survivors of childhood cancer will, at some stage, move from pediatric to adult care and/or to a different model of care to continue to receive long-term follow-up. Literature relating to transitional care for childhood onset conditions exists, but little research has been undertaken into transition in a cancer context, specifically from an experiences perspective. OBJECTIVE The aim of this study was to report how the process of transition should be considered within the context of young people's entire illness experience and how that experience can impact their transition readiness. INTERVENTION/METHODS A qualitative, collective case study approach was adopted. Semistructured interviews were conducted with young people, parents, and healthcare professionals. Young people's oncology case notes were also reviewed. RESULTS Data analysis generated a multidimensional and multiple-perspective understanding of the experience of the process of transition. A central orienting theme was identified: the experience of readiness in the context of transition. CONCLUSIONS Understanding the multifaceted components of readiness is crucial; readiness should embody people's illness experiences, the numerous and associated losses intertwined with a move from pediatric to adult care, and the simultaneous developmental changes occurring in people's lives. IMPLICATIONS FOR PRACTICE The findings provide a meaningful framework to understand the experience of transition from the perspective of young people, parents, and healthcare professionals. These findings could help with the planning and preparation of individualized transitional care pathways for survivors of childhood cancer.
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Preferences for the organization of long-term follow-up in adolescent and young adult cancer survivors. Support Care Cancer 2016; 24:3425-36. [PMID: 26988228 DOI: 10.1007/s00520-016-3157-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 03/07/2016] [Indexed: 10/22/2022]
Abstract
PURPOSE As survival rates of adolescent and young adult (AYA) cancer patients increase, a growing number of AYA cancer survivors need follow-up care. However, there is little research on their preferences for follow-up care. We aimed to (1) describe AYA cancer survivors' preferences for the organization and content of follow-up care, (2) describe their preferences for different models of follow-up, and (3) investigate clinical and sociodemographic characteristics associated with preferences for the different models. METHODS AYA cancer survivors (diagnosed with cancer at age 16-25 years; ≥5 years after diagnosis) were identified through the Cancer Registry Zurich and Zug. Survivors completed a questionnaire on follow-up attendance, preferences for organizational aspects of follow-up care (what is important during follow-up, what should be included during appointments, what specialists should be involved, location), models of follow-up (telephone/questionnaire, general practitioner (GP), pediatric oncologist, medical oncologist, multidisciplinary team), and sociodemographic characteristics. Information on tumor and treatment was available through the Cancer Registry Zurich and Zug. RESULTS Of 389 contacted survivors, 160 (41.1 %) participated and 92 (57.5 %) reported still attending follow-up. Medical aspects of follow-up care were more important than general aspects (p < 0.001). Among different organizational models, follow-up by a medical oncologist was rated higher than all other models (p = 0.002). Non-attenders of follow-up rated GP-led follow-up significantly higher than attenders (p = 0.001). CONCLUSION Swiss AYA cancer survivors valued medical content of follow-up and showed a preference for medical oncologist-led follow-up. Implementation of different models of follow-up care might improve accessibility and attendance among AYA cancer survivors.
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Poloméni A, Lapusan S, Bompoint C, Rubio MT, Mohty M. The impact of allogeneic-hematopoietic stem cell transplantation on patients' and close relatives' quality of life and relationships. Eur J Oncol Nurs 2015; 21:248-56. [PMID: 26602410 DOI: 10.1016/j.ejon.2015.10.011] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Revised: 10/24/2015] [Accepted: 10/27/2015] [Indexed: 11/15/2022]
Abstract
PURPOSE Although evidence suggests considerable disruption to families, the impact of allo-Hematopoietic Stem Cell Transplantation (HSCT) on patients' partners and close relatives has not been sufficiently explored. The present mixed-methods study aimed to enlighten allo-HSCT effects on patients' and close relatives' quality of life (QOL) and their relationships. METHODS Patients who received allo-HSCT between 2007 and 2010 (N = 58) and their close relatives (parents, partners and/or adult children) were asked to respond to an anonymous questionnaire including socio-demographic data, Likert-scale of the impact of HSCT on sexual, couple, family, professional and social life, as well as on perceived support. QOL of patients and close relatives was evaluated (by the FACT-BMT and by WHO-QOL-bref) as were the adjustments of the couples (patients/partners by the DAS). In-depth interviews were performed with patients and partners who consented to this proposition. RESULTS Patients (N = 28) and close relatives (N = 48) reported fatigue, sleep and sexual problems, emotional distress and relationship difficulties. Patients were mainly concerned with « being a burden » to their close relatives. Close relatives' main concerns were changes in marital and family dynamics, disruptions in daily routine tasks and the responsibility for being the main provider of physical and emotional care. These difficulties increased after HSCT - notably when patients have to face the long-term consequences of the procedure. CONCLUSION HSCT has a negative impact on patients' partners and other close relatives' QOL. Data on this topic is still scarce and this study might pave the way for future research in this field and notably guide psychosocial interventions.
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Affiliation(s)
- A Poloméni
- Département d'Hématologie clinique et thérapie cellulaire, Hôpital Saint Antoine, Assistance Publique-Hôpitaux de Paris, 184 rue du Fbg Saint Antoine, 75012 Paris, France.
| | - S Lapusan
- Département d'Hématologie clinique et thérapie cellulaire, Hôpital Saint Antoine, Assistance Publique-Hôpitaux de Paris, 184 rue du Fbg Saint Antoine, 75012 Paris, France.
| | - C Bompoint
- Département d'Hématologie clinique et thérapie cellulaire, Hôpital Saint Antoine, Assistance Publique-Hôpitaux de Paris, 184 rue du Fbg Saint Antoine, 75012 Paris, France.
| | - M T Rubio
- Département d'Hématologie clinique et thérapie cellulaire, Hôpital Saint Antoine, Assistance Publique-Hôpitaux de Paris, 184 rue du Fbg Saint Antoine, 75012 Paris, France.
| | - M Mohty
- Département d'Hématologie clinique et thérapie cellulaire, Hôpital Saint Antoine, Assistance Publique-Hôpitaux de Paris, 184 rue du Fbg Saint Antoine, 75012 Paris, France.
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Brown S, Greenfield D, Thompson J. Knowledge and awareness of long-term and late treatment consequences amongst colorectal cancer survivors: A qualitative study. Eur J Oncol Nurs 2015; 20:191-8. [PMID: 26412577 DOI: 10.1016/j.ejon.2015.08.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 08/23/2015] [Indexed: 11/29/2022]
Abstract
PURPOSE To describe patient knowledge and awareness of long-term and late onset treatment consequences amongst colorectal cancer survivors. METHODS Semi-structured qualitative interviews were conducted with 19 colorectal cancer survivors at least 12 months post-treatment. Interviews were audio-recorded, transcribed into NVivo 10 software and analysed using the framework method. RESULTS Participants were aware of disease recurrence but not many other treatment consequences; change in bowel habit and impact on diet were common and had significant impact, yet many felt they had not received 'warning', considering it a gap in both information and support. Participants expressed preference to know about possible consequences early on and were willing to engage in education and support if offered. Information overload, timing of information provision and unequipped health care professionals were considered barriers to awareness. CONCLUSION Improvement in information provision, management of expectations and support around bowel function would facilitate patient self-empowerment and could improve holistic management of health and well-being after cancer.
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Affiliation(s)
- Sarah Brown
- Academic Unit of Primary Medical Care, University of Sheffield, Samuel Fox House (Room 212), Northern General Hospital, Herries Road, Sheffield, S5 7AU, UK
| | - Diana Greenfield
- Specialised Cancer Services, Sheffield Teaching Hospitals NHS FT, Weston Park Hospital, Whitham Road, Sheffield, S10 2SJ, UK
| | - Joanne Thompson
- Academic Unit of Primary Medical Care, University of Sheffield, Samuel Fox House (Room 212), Northern General Hospital, Herries Road, Sheffield, S5 7AU, UK.
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Vetsch J, Rueegg CS, Gianinazzi ME, Bergsträsser E, von der Weid NX, Michel G. Information needs in parents of long-term childhood cancer survivors. Pediatr Blood Cancer 2015; 62:859-66. [PMID: 25663499 DOI: 10.1002/pbc.25418] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Accepted: 12/06/2014] [Indexed: 11/08/2022]
Abstract
BACKGROUND Parents' knowledge about cancer, treatment, potential late effects and necessary follow-up is important to reassure themselves and motivate their child to participate in regular follow-up. We aimed to describe (i) parents' perception of information received during and after treatment; (ii) parents' current needs for information today, and to investigate; and (iii) associations between information needs and socio-demographic and clinical characteristics. METHODS As part of the Swiss Childhood Cancer Survivor Study, a follow-up questionnaire was sent to parents of survivors, diagnosed < 16 years and after 1990, and aged 11-17 years at study. We assessed parents' perception of information received and information needs, concerns about consequences of the cancer and socio-demographic information. Information on clinical data was available from the Swiss Childhood Cancer Registry. RESULTS Of 309 eligible parents, 189 responded (67%; mean time since diagnosis: 11.3 years, SD = 2.5). Parents perceived to have received verbal information (on illness: verbal 91%, written 40%; treatment: verbal 88%, written 46%; follow-up: verbal 85% written 27%; late effects: verbal 75%, written 19%). Many parents reported current information needs, especially on late effects (71%). The preferred source was written general (28%) or verbal information (25%), less favored was online information (12%). Information needs were associated with migration background (P = 0.039), greater concerns about consequences of cancer (P = 0.024) and no information received (P = 0.035). CONCLUSION Parents reported that they received mainly verbal information. However, they still needed further information especially about possible late effects. Individual long-term follow-up plans, including a treatment summary, should be provided to each survivor, preferably in written format.
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Affiliation(s)
- Janine Vetsch
- Department of Health Sciences & Health Policy, University of Lucerne, Switzerland
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Poplack DG, Fordis M, Landier W, Bhatia S, Hudson MM, Horowitz ME. Childhood cancer survivor care: development of the Passport for Care. Nat Rev Clin Oncol 2014; 11:740-50. [PMID: 25348788 DOI: 10.1038/nrclinonc.2014.175] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Survivors of childhood cancer are at risk of long-term adverse effects and late effects of the disease and/or its treatment. In response to national recommendations to improve evidence-based follow-up care, a web-based support system for clinical decision making, the Passport for Care (PFC), was developed for use at the point of care to produce screening recommendations individualized to the survivor. To date, the PFC has been implemented in over half of the nearly 200 clinics affiliated with the Children's Oncology Group across the USA. Most clinician users report that the PFC has been integrated into clinic workflows, and that it fosters improved conversations with survivors about the potential late effects a survivor might experience and about the screening and/or behavioural interventions recommended to improve health status. Furthermore, clinicians using the PFC have indicated that they adhered more closely to follow-up care guidelines. Perspectives on the challenges encountered and lessons learned during the development and deployment of the PFC are reviewed and contrasted with other nationwide approaches to the provision of guidance on survivor follow-up care; furthermore, the implications for the care of childhood cancer survivors are discussed.
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Affiliation(s)
- David G Poplack
- Hematology-Oncology Section, Department of Paediatrics, Texas Children's Cancer Center, Baylor College, One Baylor Plaza, Houston, TX 77030, USA
| | - Michael Fordis
- Center for Collaborative and Interactive Technologies, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA
| | - Wendy Landier
- Department of Population Sciences, City of Hope, 1500 East Duarte Road, Duarte, CA 91010, USA
| | - Smita Bhatia
- Department of Population Sciences, City of Hope, 1500 East Duarte Road, Duarte, CA 91010, USA
| | - Melissa M Hudson
- Cancer Survivorship Division, Departments of Oncology and Epidemiology, and Cancer Control, St Jude's Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA
| | - Marc E Horowitz
- Hematology-Oncology Section, Department of Paediatrics, Texas Children's Cancer Center, Baylor College, One Baylor Plaza, Houston, TX 77030, USA
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Foster RH, Stern M. Peer and romantic relationships among adolescent and young adult survivors of childhood hematological cancer: a review of challenges and positive outcomes. Acta Haematol 2014; 132:375-82. [PMID: 25228563 DOI: 10.1159/000360239] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
This review focuses on peer and romantic relationship experiences of adolescent and young adult (AYA) survivors of childhood cancer, highlighting those surviving leukemia or lymphoma. While most AYA survivors adjust well to life following a hematological cancer diagnosis and treatment, many unique experiences, both positive and challenging, have been documented with respect to successfully navigating developmentally normative social goals. Therefore, the social implications of surviving childhood leukemia or lymphoma are explored. Specifically, the development of peer and romantic relationships, perceptions of social acceptance, parental influences and attachment, perceived vulnerabilities and body image, and risks to fertility are discussed.
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Affiliation(s)
- Rebecca H Foster
- Department of Psychology, Winona State University, Winona, Minn., USA
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Halpern MT, Viswanathan M, Evans TS, Birken SA, Basch E, Mayer DK. Models of Cancer Survivorship Care: Overview and Summary of Current Evidence. J Oncol Pract 2014; 11:e19-27. [PMID: 25205779 DOI: 10.1200/jop.2014.001403] [Citation(s) in RCA: 121] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION This article, derived from a Technical Brief prepared for the Agency for Healthcare Research and Quality, presents an overview on current models of care for survivors of adult-onset cancer who have completed active treatment. METHODS This article integrates reviewed literature on background, context, research gaps, and future research directions for survivorship care models. We also conducted a systematic literature review of current evidence from studies of survivorship care models. RESULTS Our systematic review identified nine empirical studies of survivorship care models, covering multiple models types and illustrating the heterogeneity in this field. The literature review indicated considerable heterogeneity in models of survivorship care, components of models, survivor populations, and target outcomes. Models of survivorship care are highly individualized to the institution or setting where they are provided. "Usual care" is often uncoordinated and highly varied across cancer survivors and within cancer programs. Anticipated shortages in the oncology workforce may require the expanded use of nurse practitioners and physician assistants and shared care with primary care providers to deliver survivorship care to the growing number of survivors. Concerns associated with survivorship care models include payment considerations, adequacy of training, and the potential for lack of coordination and fragmented care. CONCLUSION There is substantial variation in survivorship care models. The optimal nature, timing, intensity, format, and outcomes of survivorship care models are uncertain and require further research. Specific research questions need to be addressed by the survivorship community to better understand the advantages and limitations of survivorship models.
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Affiliation(s)
- Michael T Halpern
- RTI International, Washington, DC, and Research Triangle Park, NC; and University of North Carolina-Chapel Hill, Chapel Hill, NC
| | - Meera Viswanathan
- RTI International, Washington, DC, and Research Triangle Park, NC; and University of North Carolina-Chapel Hill, Chapel Hill, NC
| | - Tammeka S Evans
- RTI International, Washington, DC, and Research Triangle Park, NC; and University of North Carolina-Chapel Hill, Chapel Hill, NC
| | - Sarah A Birken
- RTI International, Washington, DC, and Research Triangle Park, NC; and University of North Carolina-Chapel Hill, Chapel Hill, NC
| | - Ethan Basch
- RTI International, Washington, DC, and Research Triangle Park, NC; and University of North Carolina-Chapel Hill, Chapel Hill, NC
| | - Deborah K Mayer
- RTI International, Washington, DC, and Research Triangle Park, NC; and University of North Carolina-Chapel Hill, Chapel Hill, NC
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Transitional care of a childhood cancer survivor to adult services: facilitating the process of individual access to different models. Curr Opin Support Palliat Care 2014; 7:309-13. [PMID: 23912390 DOI: 10.1097/spc.0b013e32836484bb] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW In the past 20 years, several papers have been published concerning healthcare transition from pediatric after-care to long-term follow-up in adult health service for childhood cancer survivors. Initially, the papers were optimistic and included guidelines and models of care. However, after this optimistic beginning, more recent research has found that transitional care is not a successful process. RECENT FINDINGS Although the number of papers regarding transition in the past 2 years is few, they include revealing results about barriers and facilitators of the transition process. SUMMARY There is some evidence that joint pediatric/adult transition clinics are more successful in providing transitional care. The use of tools to assess individual psychological factors is important for the transition process and could lead to more individualized models of transition.
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Thompson J, Coleman R, Colwell B, Freeman J, Greenfield D, Holmes K, Mathers N, Reed M. Preparing breast cancer patients for survivorship (PREP) – A pilot study of a patient-centred supportive group visit intervention. Eur J Oncol Nurs 2014; 18:10-6. [DOI: 10.1016/j.ejon.2013.10.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Revised: 09/25/2013] [Accepted: 10/10/2013] [Indexed: 11/29/2022]
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Abstract
BACKGROUND Hematologic malignancies occur frequently in young adults. With treatment, many patients are able to survive. Issues of dependency and peer group membership present unique challenges to this subset of cancer survivors. Interest in cancer survivorship has grown, but little is known about the quality of life (QOL) of young adult survivors. OBJECTIVE The objectives of this study were to examine QOL among young adult survivors in relation to middle-aged and older adults, identify common areas of concern, and explore the association of individual characteristics with levels of QOL. METHODS This was a descriptive correlational study using a convenience sample of 48 patients, aged 18 to 35 years at time of diagnosis. Data collection consisted of a 1-time telephone interview utilizing the City of Hope Quality of Life of Cancer Survivors questionnaire and 3 open-ended questions. RESULTS No significant correlations were found between QOL dimensions and current age, age at treatment completion, or time since treatment completion. Social well-being was related to age and spiritual well-being to race. A substantial proportion of the sample identified the need for additional education and peer group support. CONCLUSIONS Results support the importance of developing survivorship programs tailored to the needs of the young adult patient. This may include ongoing opportunities to meet with other survivors and referrals to appropriate support resources. Data suggest that the need for survivorship services exists beyond the first few years after treatment completion. IMPLICATIONS FOR PRACTICE Young adult patients who may be at higher risk for decreased QOL can be targeted for earlier intervention.
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Forsythe LP, Arora NK, Alfano CM, Weaver KE, Hamilton AS, Aziz N, Rowland JH. Role of oncologists and primary care physicians in providing follow-up care to non-Hodgkin lymphoma survivors within 5 years of diagnosis: a population-based study. Support Care Cancer 2014; 22:1509-17. [PMID: 24414999 DOI: 10.1007/s00520-013-2113-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Accepted: 12/25/2013] [Indexed: 10/25/2022]
Abstract
PURPOSE The growing population of non-Hodgkin lymphoma (NHL) survivors living longer with high physical and psychological treatment burden, in combination with the projected shortage of medical professionals, necessitates redesigning cancer follow-up care. This study examined follow-up care patterns, factors associated with follow-up care, and attitudes towards follow-up care among NHL survivors. METHODS We surveyed survivors of aggressive NHL 2 to 5 years post-diagnosis (N = 363) using a population-based sample from the Los Angeles County Surveillance Epidemiology and End Results registry. RESULTS Most survivors (82 %) received cancer-related follow-up care in the past year from an oncologist. History of recurrence, more comorbidities, more symptoms, and a shorter survivor-oncologist relationship were associated with high-frequency care with the oncologist [(≥5 visits in the past year), p < 0.05]. Many survivors followed up by oncologists (71 %) also saw a primary care provider (PCP) and 47 % also saw both a PCP and other specialists. Factors associated with seeing a PCP in addition to an oncologist included more symptoms, more health information needs, no history of recurrence, perceived excellent quality of cancer follow-up care, and fewer visits with the oncologist (p < 0.05). Survivors generally reported high reassurance from, and low negative anticipation towards, follow-up care. CONCLUSIONS The high proportion of NHL survivors receiving care from multiple physicians, and the sizable proportion (∼30 %) who have not recently seen a PCP, suggests that coordinating care across specialties is critical to ensure comprehensive, non-duplicative care. Understanding factors associated with cancer-related follow-up is a first step towards more effective, efficient, patient-centered care.
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Affiliation(s)
- Laura P Forsythe
- Patient-Centered Outcomes Research Institute (PCORI), 1828 L Street, NW, Suite 900, Washington, DC, 20036, USA,
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Andreyev J. Late Effects of Cancer Treatment in Adult Patients. Nutr Cancer 2013. [DOI: 10.1002/9781118788707.ch9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Eccles SA, Aboagye EO, Ali S, Anderson AS, Armes J, Berditchevski F, Blaydes JP, Brennan K, Brown NJ, Bryant HE, Bundred NJ, Burchell JM, Campbell AM, Carroll JS, Clarke RB, Coles CE, Cook GJR, Cox A, Curtin NJ, Dekker LV, dos Santos Silva I, Duffy SW, Easton DF, Eccles DM, Edwards DR, Edwards J, Evans DG, Fenlon DF, Flanagan JM, Foster C, Gallagher WM, Garcia-Closas M, Gee JMW, Gescher AJ, Goh V, Groves AM, Harvey AJ, Harvie M, Hennessy BT, Hiscox S, Holen I, Howell SJ, Howell A, Hubbard G, Hulbert-Williams N, Hunter MS, Jasani B, Jones LJ, Key TJ, Kirwan CC, Kong A, Kunkler IH, Langdon SP, Leach MO, Mann DJ, Marshall JF, Martin LA, Martin SG, Macdougall JE, Miles DW, Miller WR, Morris JR, Moss SM, Mullan P, Natrajan R, O’Connor JPB, O’Connor R, Palmieri C, Pharoah PDP, Rakha EA, Reed E, Robinson SP, Sahai E, Saxton JM, Schmid P, Smalley MJ, Speirs V, Stein R, Stingl J, Streuli CH, Tutt ANJ, Velikova G, Walker RA, Watson CJ, Williams KJ, Young LS, Thompson AM. Critical research gaps and translational priorities for the successful prevention and treatment of breast cancer. Breast Cancer Res 2013; 15:R92. [PMID: 24286369 PMCID: PMC3907091 DOI: 10.1186/bcr3493] [Citation(s) in RCA: 275] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Accepted: 09/12/2013] [Indexed: 02/08/2023] Open
Abstract
INTRODUCTION Breast cancer remains a significant scientific, clinical and societal challenge. This gap analysis has reviewed and critically assessed enduring issues and new challenges emerging from recent research, and proposes strategies for translating solutions into practice. METHODS More than 100 internationally recognised specialist breast cancer scientists, clinicians and healthcare professionals collaborated to address nine thematic areas: genetics, epigenetics and epidemiology; molecular pathology and cell biology; hormonal influences and endocrine therapy; imaging, detection and screening; current/novel therapies and biomarkers; drug resistance; metastasis, angiogenesis, circulating tumour cells, cancer 'stem' cells; risk and prevention; living with and managing breast cancer and its treatment. The groups developed summary papers through an iterative process which, following further appraisal from experts and patients, were melded into this summary account. RESULTS The 10 major gaps identified were: (1) understanding the functions and contextual interactions of genetic and epigenetic changes in normal breast development and during malignant transformation; (2) how to implement sustainable lifestyle changes (diet, exercise and weight) and chemopreventive strategies; (3) the need for tailored screening approaches including clinically actionable tests; (4) enhancing knowledge of molecular drivers behind breast cancer subtypes, progression and metastasis; (5) understanding the molecular mechanisms of tumour heterogeneity, dormancy, de novo or acquired resistance and how to target key nodes in these dynamic processes; (6) developing validated markers for chemosensitivity and radiosensitivity; (7) understanding the optimal duration, sequencing and rational combinations of treatment for improved personalised therapy; (8) validating multimodality imaging biomarkers for minimally invasive diagnosis and monitoring of responses in primary and metastatic disease; (9) developing interventions and support to improve the survivorship experience; (10) a continuing need for clinical material for translational research derived from normal breast, blood, primary, relapsed, metastatic and drug-resistant cancers with expert bioinformatics support to maximise its utility. The proposed infrastructural enablers include enhanced resources to support clinically relevant in vitro and in vivo tumour models; improved access to appropriate, fully annotated clinical samples; extended biomarker discovery, validation and standardisation; and facilitated cross-discipline working. CONCLUSIONS With resources to conduct further high-quality targeted research focusing on the gaps identified, increased knowledge translating into improved clinical care should be achievable within five years.
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Affiliation(s)
- Suzanne A Eccles
- The Institute of Cancer Research, 15 Cotswold Road, London SM2 5MG, UK
| | - Eric O Aboagye
- Imperial College London, Exhibition Rd, London SW7 2AZ, UK
| | - Simak Ali
- Imperial College London, Exhibition Rd, London SW7 2AZ, UK
| | | | - Jo Armes
- Kings College London, Strand, London WC2R 2LS, UK
| | | | - Jeremy P Blaydes
- University of Southampton, University Road, Southampton SO17 1BJ, UK
| | - Keith Brennan
- University of Manchester, Oxford Road, Manchester M13 9PL, UK
| | - Nicola J Brown
- University of Sheffield, Western Bank, Sheffield S10 2TN, UK
| | - Helen E Bryant
- University of Sheffield, Western Bank, Sheffield S10 2TN, UK
| | - Nigel J Bundred
- University of Manchester, Oxford Road, Manchester M13 9PL, UK
| | | | | | - Jason S Carroll
- Cancer Research UK, Cambridge Research Institute/University of Cambridge, Trinity Lane, Cambridge CB2 1TN, UK
| | - Robert B Clarke
- University of Manchester, Oxford Road, Manchester M13 9PL, UK
| | - Charlotte E Coles
- Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge CB2 0QQ, UK
| | - Gary JR Cook
- Kings College London, Strand, London WC2R 2LS, UK
| | - Angela Cox
- University of Sheffield, Western Bank, Sheffield S10 2TN, UK
| | - Nicola J Curtin
- Newcastle University, Claremont Road, Newcastle upon Tyne NE1 7RU, UK
| | | | | | - Stephen W Duffy
- Queen Mary University of London, Mile End Road, London E1 4NS, UK
| | - Douglas F Easton
- Cancer Research UK, Cambridge Research Institute/University of Cambridge, Trinity Lane, Cambridge CB2 1TN, UK
| | - Diana M Eccles
- University of Southampton, University Road, Southampton SO17 1BJ, UK
| | - Dylan R Edwards
- University of East Anglia, Earlham Road, Norwich NR4 7TJ, UK
| | - Joanne Edwards
- University of Glasgow, University Avenue, Glasgow G12 8QQ, UK
| | - D Gareth Evans
- University of Manchester, Oxford Road, Manchester M13 9PL, UK
| | - Deborah F Fenlon
- University of Southampton, University Road, Southampton SO17 1BJ, UK
| | | | - Claire Foster
- University of Southampton, University Road, Southampton SO17 1BJ, UK
| | | | | | - Julia M W Gee
- University of Cardiff, Park Place, Cardiff CF10 3AT, UK
| | - Andy J Gescher
- University of Leicester, University Road, Leicester LE1 4RH, UK
| | - Vicky Goh
- Kings College London, Strand, London WC2R 2LS, UK
| | - Ashley M Groves
- University College London, Gower Street, London WC1E 6BT, UK
| | | | - Michelle Harvie
- University of Manchester, Oxford Road, Manchester M13 9PL, UK
| | - Bryan T Hennessy
- Royal College of Surgeons Ireland, 123, St Stephen’s Green, Dublin 2, Ireland
| | | | - Ingunn Holen
- University of Sheffield, Western Bank, Sheffield S10 2TN, UK
| | - Sacha J Howell
- University of Manchester, Oxford Road, Manchester M13 9PL, UK
| | - Anthony Howell
- University of Manchester, Oxford Road, Manchester M13 9PL, UK
| | | | | | | | - Bharat Jasani
- University of Cardiff, Park Place, Cardiff CF10 3AT, UK
| | - Louise J Jones
- Queen Mary University of London, Mile End Road, London E1 4NS, UK
| | - Timothy J Key
- University of Oxford, Wellington Square, Oxford OX1 2JD, UK
| | - Cliona C Kirwan
- University of Manchester, Oxford Road, Manchester M13 9PL, UK
| | - Anthony Kong
- University of Oxford, Wellington Square, Oxford OX1 2JD, UK
| | - Ian H Kunkler
- University of Edinburgh, South Bridge, Edinburgh EH8 9YL, UK
| | - Simon P Langdon
- University of Edinburgh, South Bridge, Edinburgh EH8 9YL, UK
| | - Martin O Leach
- The Institute of Cancer Research, 15 Cotswold Road, London SM2 5MG, UK
| | - David J Mann
- Imperial College London, Exhibition Rd, London SW7 2AZ, UK
| | - John F Marshall
- Queen Mary University of London, Mile End Road, London E1 4NS, UK
| | - Lesley Ann Martin
- The Institute of Cancer Research, 15 Cotswold Road, London SM2 5MG, UK
| | - Stewart G Martin
- University of Nottingham, University Park, Nottingham NG7 2RD, UK
| | | | | | | | | | - Sue M Moss
- Queen Mary University of London, Mile End Road, London E1 4NS, UK
| | - Paul Mullan
- Queen’s University Belfast, University Road, Belfast BT7 1NN, UK
| | - Rachel Natrajan
- The Institute of Cancer Research, 15 Cotswold Road, London SM2 5MG, UK
| | | | | | - Carlo Palmieri
- The University of Liverpool, Brownlow Hill, Liverpool L69 7ZX, UK
| | - Paul D P Pharoah
- Cancer Research UK, Cambridge Research Institute/University of Cambridge, Trinity Lane, Cambridge CB2 1TN, UK
| | - Emad A Rakha
- University of Nottingham, University Park, Nottingham NG7 2RD, UK
| | - Elizabeth Reed
- Princess Alice Hospice, West End Lane, Esher KT10 8NA, UK
| | - Simon P Robinson
- The Institute of Cancer Research, 15 Cotswold Road, London SM2 5MG, UK
| | - Erik Sahai
- London Research Institute, 44 Lincoln’s Inn Fields, London WC2A 3LY, UK
| | - John M Saxton
- University of East Anglia, Earlham Road, Norwich NR4 7TJ, UK
| | - Peter Schmid
- Brighton and Sussex Medical School, University of Sussex, Brighton, East Sussex BN1 9PX, UK
| | | | | | - Robert Stein
- University College London, Gower Street, London WC1E 6BT, UK
| | - John Stingl
- Cancer Research UK, Cambridge Research Institute/University of Cambridge, Trinity Lane, Cambridge CB2 1TN, UK
| | | | | | | | | | - Christine J Watson
- Cancer Research UK, Cambridge Research Institute/University of Cambridge, Trinity Lane, Cambridge CB2 1TN, UK
| | - Kaye J Williams
- University of Manchester, Oxford Road, Manchester M13 9PL, UK
| | - Leonie S Young
- Royal College of Surgeons Ireland, 123, St Stephen’s Green, Dublin 2, Ireland
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Abstract
BACKGROUND Over recent years, several initiatives have impacted on the referral of patients to secondary care, most notably targets for urgent referral in suspected cancer and the patient choice agenda. At the same time, improved long-term survival in cancer has increased numbers attending follow-up, doubts about the effectiveness of specialist follow-up have emerged, and alternative models of follow-up have been tested. AIM The aim of the study was to explore patient and carer perspectives on the flexibility and responsiveness of cancer services. This article focuses on findings relating to referral, subsequent outpatient appointments and cessation of outpatient follow-up. METHODS Issues were explored in a qualitative study using face-to-face interviews with a purposive sample of 54 people affected by cancer. Data were analysed concurrently with data collection, using qualitative analysis software. FINDINGS The study gave rise to a number of salient themes. Links were identified between three of these: choice and responsiveness during referral; the flexibility and responsiveness of outpatient appointment systems; and negotiating cessation of follow-up. It appeared that policy on urgent referrals might be adversely affecting practice relating to appointment systems and the continuance of follow-up. DISCUSSION AND CONCLUSIONS Hospital-based cancer follow-up is being given decreasing priority because of doubts about effectiveness and a target-driven focus on referral. This is impacting on patients, who may value outpatient follow-up as a 'safety net' but have difficulties in obtaining appointments, and may be discharged without negotiation or adequate support. For these reasons, new forms of flexible/responsive aftercare are urgently needed.
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Affiliation(s)
- Kate Wilson
- School of Nursing Midwifery and Social Work, University of Manchester, Manchester, UK.
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Follow-up programs for childhood cancer survivors in Europe: a questionnaire survey. PLoS One 2012; 7:e53201. [PMID: 23300889 PMCID: PMC3534070 DOI: 10.1371/journal.pone.0053201] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2012] [Accepted: 11/26/2012] [Indexed: 11/19/2022] Open
Abstract
Background For many childhood cancer survivors follow-up care is important long after treatment completion. We aimed to describe the availability and characteristics of long-term follow-up programs (LTFU) across Europe, their content and aims, their problems, and to assess opinions on different models of LTFU. Methodology/Principal Findings We asked 179 pediatric oncology institutions in 20 European countries to complete an online survey on LTFU available at their institution. Of 110 respondents (62% response), 66% reported having LTFU for pediatric survivors, 38% for adult survivors of childhood cancer. Availability varied widely across European regions, from 9% of institutions in Northern Europe reporting LTFU for adult survivors to 83% of institution on the British Isles reporting LTFU for pediatric survivors. Pediatric and adult LTFU were usually located in pediatric hospitals and run by pediatric oncologists. Content of follow-up included screening for adverse outcomes and health education. Important problems included lack of time, personnel and funding. Most institutions without LTFU reported that they would like to offer a program (86%). Conclusion/Significance Despite general agreement on the need of follow-up care, there is still a lack of well-organized LTFU for survivors of childhood cancer across Europe.
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Pirie ES, Sinclair C. Implementation of nurse authorisation of blood components. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2012; 21:1328-1332. [PMID: 23249800 DOI: 10.12968/bjon.2012.21.22.1328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
A collaborative project between the Better Blood Transfusion teams in the Scottish National Blood Transfusion Service (SNBTS) and NHS Blood and Transplant (NHSBT) explored the feasibility of nurses prescribing blood components, and clarified that blood components are not considered medicinal products, so the term prescription does not apply. No legal barriers to trained, competent nurses and midwives undertaking this role were identified and nurse authorisation of blood components was seen as having the potential to improve patients' experiences. A number of NHS Scotland boards showed interest in implementing this but there are challenges to ensuring that a robust governance structure is in place to support role development . Progress has been made with support from the Scottish Government Health Department and using a governance framework that was developed to support nurses who wish to undertake this role.
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Kumar AR, Schapira L. The impact of intrapersonal, interpersonal, and community factors on the identity formation of young adults with cancer: a qualitative study. Psychooncology 2012; 22:1753-8. [DOI: 10.1002/pon.3207] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2012] [Revised: 08/31/2012] [Accepted: 09/13/2012] [Indexed: 11/11/2022]
Affiliation(s)
| | - Lidia Schapira
- Gillette Center for Breast Cancer; Massachusetts General Hospital; Boston; MA; USA
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46
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Kent EE, Parry C, Montoya MJ, Sender LS, Morris RA, Anton-Culver H. "You're too young for this": adolescent and young adults' perspectives on cancer survivorship. J Psychosoc Oncol 2012; 30:260-79. [PMID: 22416959 DOI: 10.1080/07347332.2011.644396] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Adolescent and young adult cancer survivors face unique challenges not systematically addressed by cancer clinicians. Four focus groups and two individual interviews were conducted with 19 survivors to profile experiences and identify key concerns for future interventions. The resultant themes reflect cancer care continuum challenges (such as delays in diagnosis, problems with adherence), psychosocial concerns (such as infertility and reproductive concerns, changing social relationships, financial burden), and the paradox of being diagnosed with cancer as a young adult. Future intervention development for adolescent and young adult survivors should involve patient voices at each stage of the research process.
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Affiliation(s)
- Erin E Kent
- Cancer Prevention Fellowship Program and Office of Cancer Survivorship, National Cancer Institute, National Institutes of Health, Rockville, MD 20852, USA.
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Mosavel M, Sanders K. Needs of low-income african american cancer survivors: multifaceted and practical. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2011; 26:717-723. [PMID: 21706193 DOI: 10.1007/s13187-011-0253-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This study aimed to identify the needs of low-income, African American cancer survivors in an urban setting. Data were collected from semi-structured interviews conducted with cancer survivors (n = 12), caregivers (n = 10), professionals (n = 10), and surveys from town hall meetings (n = 80). The major needs identified, across all groups, included a diverse array of practical needs including transportation, financial and job assistance, childcare, self-care assistance, more education and lifestyle information when diagnosed as well as after diagnosis, better post treatment plan, and more need for social support. They identified the ideal resource center as being located within the survivor's neighborhood and would provide a range of medically specific support as well as recreational services. Being of limited economic means has a host of implications for those diagnosed with cancer and for their family members. Participants suggested that needs for cancer survivors have to take into account a complexity of factors including culture, family, and especially economic implications.
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Affiliation(s)
- Maghboeba Mosavel
- Department of Social and Behavioral Health, School of Medicine, Virginia Commonwealth University, Richmond, VA 23298-0149, USA.
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Kuehni CE, Rueegg CS, Michel G, Rebholz CE, Strippoli MPF, Niggli FK, Egger M, von der Weid NX. Cohort profile: the Swiss childhood cancer survivor study. Int J Epidemiol 2011; 41:1553-64. [PMID: 22736394 DOI: 10.1093/ije/dyr142] [Citation(s) in RCA: 96] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Affiliation(s)
- Claudia E Kuehni
- Institute of Social and Preventive Medicine (ISPM), Swiss Childhood Cancer Registry, University of Bern, Bern, Switzerland.
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49
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[The experience of disease and treatments among teenagers and young adults with hematological malignancies]. Bull Cancer 2011; 98:1193-200. [PMID: 22008215 DOI: 10.1684/bdc.2011.1455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We conducted an exploratory study of young patients (< 25 years) in remission from hematologic malignancies to better understand their experiences of care, the impact of disease and therapeutics on their quality of life (assessed by the FACT-BMT) and on their mental state (assessed by the HADS). On the plan of research, the findings of this study confirm the relevance of the qualitative approach; on the plan of care, the need of interdisciplinary support for these patients in remission.
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50
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Knobf MT, Ferrucci LM, Cartmel B, Jones BA, Stevens D, Smith M, Salner A, Mowad L. Needs assessment of cancer survivors in Connecticut. J Cancer Surviv 2011; 6:1-10. [PMID: 21984194 DOI: 10.1007/s11764-011-0198-2] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2011] [Accepted: 08/30/2011] [Indexed: 12/28/2022]
Abstract
INTRODUCTION There are knowledge gaps regarding the needs of cancer survivors in Connecticut and their utilization of supportive services. METHODS A convenience sample of cancer survivors residing in Connecticut were invited to complete a self-administered (print or online) needs assessment (English or Spanish). Participants identified commonly occurring problems and completed a modified version of the Supportive Care Needs Survey Short Form (SNCS-SF34) assessing needs across five domains (psychosocial, health systems/information, physical/daily living, patient care /support, and sexuality). RESULTS The majority of the 1,516 cancer survivors (76.4%) were women, 47.5% had completed high school or some college, 66.1% were diagnosed ≤5 years ago, and 87.7% were non-Hispanic white. The breast was the most common site (47.6%), followed by the prostate, colorectal, lung, and melanoma. With multivariate adjustment, need on the SCNS-SF34 was greatest among women, younger survivors, those diagnosed within the past year, those not free of cancer, and Hispanics/Latinos. We also observed some differences by insurance and education status. In addition, we assessed the prevalence of individual problems, with the most common being weight gain/loss, memory changes, paying for care, communication, and not being told about services. CONCLUSIONS Overall and domain specific needs in this population of cancer survivors were relatively low, although participants reported a wide range of problems. Greater need was identified among cancer survivors who were female, younger, Hispanic/Latino, and recently diagnosed. IMPLICATIONS FOR CANCER SURVIVORS These findings can be utilized to target interventions and promote access to available resources for Connecticut cancer survivors.
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Affiliation(s)
- M Tish Knobf
- Yale University School of Nursing, New Haven, CT 06536, USA.
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