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Akduran F, Karaca A, Eroglu SA. Effects of the supportive care needs of patients with cancer on their comfort levels. Int J Palliat Nurs 2024; 30:295-306. [PMID: 38913641 DOI: 10.12968/ijpn.2024.30.6.295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
BACKGROUND Providing supportive care to patients with cancer and improving their comfort levels can promote their adjustment to the disease, compliance with treatment and improve their quality of life. AIM The aim of this cross-sectional, descriptive study was to identify the effects of the supportive care needs of cancer patients on their comfort levels. METHODS The study was performed in the oncology department of a university hospital. A total of 153 cancer patients undergoing chemotherapy constituted the sample. The data collection procedure included the Supportive Care Needs Survey (SCNS) and the General Comfort Questionnaire (GCQ). RESULTS The SCNS scores of the patients were low (Mean±SD: 75.13±27.93). The socio-cultural dimension of the GCQ was the most adversely influenced area of comfort. There was a negative relationship between needs and comfort levels (rs=-0.69, p<0.01). Lower scores of comfort were associated with higher scores of SCNS (ß=-0.487; ß=-0.316; ß=-0.958, respectively). CONCLUSIONS Cancer patients undergoing chemotherapy were supported in meeting their physical and psychological needs and performing their activities of daily living and care during their hospital stay. Patients with higher support needs had lower comfort levels.
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Affiliation(s)
- Funda Akduran
- Assistant Professor, Sakarya University Faculty of Health Sciences Nursing Department, Turkey
| | - Anita Karaca
- Assistant Professor, Biruni University Faculty of Health Sciences Nursing Department, Turkey
| | - Semiha Akin Eroglu
- Professor, University of Health Sciences, Hamidiye Faculty of Nursing, Turkey
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Bozzetti F. The role of the nutrition in malnourished cancer patients: Revisiting an old dilemma. Clin Nutr 2024; 43:1320-1328. [PMID: 38669764 DOI: 10.1016/j.clnu.2024.03.018] [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: 01/28/2024] [Revised: 03/10/2024] [Accepted: 03/20/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND & AIMS GLIM definition of malnutrition is recognised all over the world and, when is referring to cancer, it specifies that weight or muscle loss are associated with an inflammatory status. However, the real-world practice shows that GLIM definition cannot encompass all the wide and heterogenous clinical presentations of cancer patients with malnutrition, which involves many other drivers beyond inflammation. Moreover, placing an excessive emphasis on the inflammation can overshadow, in the clinical practice, the role of the nutritional support in malnourished cancer patients. The aim of this paper is not to criticize the rationale of the GLIM definition of cancer cachexia, but to show the complexity and heterogeneity of malnutrition of cancer patients and reasons why nutritional support should deserve such a better consideration among the oncologists. METHODS Literature pertinent to pathophysiology of malnutrition of cancer patients is scrutinised and reasons for the frequent underuse of nutritional support are critically analysed. RESULTS The appraisal of the literature shows that there are various pathophysiological patterns of malnutrition among cancer patients and inflammatory markers are not universally present in weight-losing cancer patients. Inflammation alone does not account for weight loss in all cancer patients and factors other than inflammation can drive hypophagia and weight loss, and hypophagia appears to be a primary catalyst for weight loss. Furthermore, malnutrition may be the consequence of the presence of several Nutrition Impact Symptoms or of the oncologic therapy. The nutritional support may fail to show benefits in malnourished cancer patients because the golden standard to validate a therapy relies on RCT, but it is ethically impossible to have an unfed control group of malnourished patients. Furthermore, nutritional interventions often fell short of the optimal standards, adherence to treatment plans was often poor, nutritional support was mainly reserved for very advanced patients and the primary endpoints of the studies on nutritional support were sometimes unrealistic. CONCLUSION There is a gap between the suggestion of the guidelines which advocate the use of nutritional support to improve the compliance of patients facing intensive oncologic treatments or to prevent an early demise when patients enter a chronic phase of slow nutritional deterioration, and the poor use of nutrition in the real-world practice. This requires a higher level of awareness of the oncologists concerning the reasons for the lacking evidence of efficacy of the nutritional support and an understanding of its potential contribute to improve the outcome of the patients. Finally, this paper calls for a change of the oncologist's approach to the cancer patient, from only focusing on the cure of the tumour to taking care of the patient as a whole.
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Kahraman-Erkus O, Ar-Karci Y, Gençöz T. "My body is a cage": A qualitative investigation into the self-discrepancy experiences of young women with metastatic cancer. Chronic Illn 2024; 20:117-134. [PMID: 37036432 PMCID: PMC10865759 DOI: 10.1177/17423953231168014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 03/20/2023] [Indexed: 04/11/2023]
Abstract
OBJECTIVES The current study investigated self-discrepancy experiences of young women with metastatic cancer. METHODS Semistructured interviews were conducted. Data were analyzed through interpretative phenomenological analysis. FINDINGS Eight female patients with metastatic cancer aged between 27 and 38 years formed the sample. Three superordinate themes emerged: (1) compulsory changes in self-concept with ambivalent evaluations; (2) new ideals not on the agenda of a healthy young woman; and (3) so-called 'minimalist' expectations from others. DISCUSSION Findings indicated that diagnosis and treatment of metastatic cancer impose unique developmental challenges for young adult women. Advanced cancer disrupted the tasks and responsibilities of young adulthood, resulting in frustration, grief, isolation, and overcompensation. These findings suggest that a developmental perspective is crucial when working with self-discrepancy experiences of young women with metastatic cancer.
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Affiliation(s)
| | | | - Tülin Gençöz
- Department of Psychology, Middle East Technical University, Ankara, Turkey
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Freitas MJ, Remondes-Costa S, Veiga E, Macedo G, Teixeira RJ, Leite M. Life beyond Loss: A Retrospective Analysis of the Impact of Meaning of Life Therapy on the Grieving Process of Cancer Patients' Family Caregivers. Healthcare (Basel) 2024; 12:471. [PMID: 38391846 PMCID: PMC10887668 DOI: 10.3390/healthcare12040471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 01/18/2024] [Accepted: 02/10/2024] [Indexed: 02/24/2024] Open
Abstract
Oncological disease in the palliative stage is a huge challenge for patients and their family caregivers (FCs) due to the fact that it confronts them with death, as well as physical, psychological, and existential suffering. Meaning of Life Therapy (MLT) is a brief structured psycho-existential intervention aiming to help patients in a meaning-making life review process, promoting end-of-life adaptation. The Life Letter (LL) resulting from MLT is an element that facilitates communication between the patient and their caregivers. The goal of this study was to understand the impact of MLT on the grieving processes of eight FCs and to study their perceptions of the role of the LL on grief through semi-structured interviews. The results of our qualitative analysis indicate that MLT was perceived by the FCs as a positive experience despite the conspiracy of silence being identified as a drawback. The LL was interpreted as a communicational element, promoting emotional closeness with the cancer patients and serving as a valuable tool in the FCs' adaptation to loss. Our research findings show that the needs of FCs, especially after experiencing the loss of their relative, are dynamic and specific. This is why it is urgent to develop interventions that consider the idiosyncrasies of end-of-life cancer patients and their FCs in order to avoid frustrated farewells, lonely deaths, and maladaptive grieving processes. This is the direction in which MLT should evolve.
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Affiliation(s)
- Maria João Freitas
- Department of Social and Behavioural Sciences, University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal
| | - Sónia Remondes-Costa
- Department of Education and Psychology, University of Trás-os-Montes e Alto Douro, 5000-622 Vila Real, Portugal
| | - Elisa Veiga
- Research Centre for Human Development, Faculty of Education and Psychology, Universidade Católica Portuguesa, 4169-005 Porto, Portugal
| | - Gerly Macedo
- Clinical and Health Psychology Unit, Psychiatry and Mental Health Service, Hospital da Senhora da Oliveira, 4835-044 Guimarães, Portugal
| | - Ricardo João Teixeira
- REACH-Mental Health Clinic, 4000-138 Porto, Portugal
- CINEICC (Center for Research in Neuropsychology and Cognitive and Behavioral Intervention), Faculty of Psychology and Education Sciences, University of Coimbra, 3004-531 Coimbra, Portugal
| | - Manuela Leite
- Department of Social and Behavioural Sciences, University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal
- iHealth4Well-Being-Innovation in Health and Well-Being-Research Unit, Instituto Politécnico de Saúde do Norte, CESPU, 4560-462 Penafiel, Portugal
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Wang L, Li Y, Zhao R, Li J, Gong X, Li H. Development and Validation of the Home Hospice Care Needs Questionnaire for the Dying Old Adult (HHCNQ-DE) in Mainland China. Am J Hosp Palliat Care 2023:10499091231223486. [PMID: 38114232 DOI: 10.1177/10499091231223486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023] Open
Abstract
Context: Home hospice needs assessment is the key to the development of home hospice services. Therefore, there is a need to develop assessment tools in mainland China to meet the comprehensive needs of the old adult at the end of life. Objective: To develop and validate a tool to assess Chinese mainland palliative care needs of the dying old adult at home. Methods: Using the Harmony Nursing Theory as a theoretical framework, through reference to the China home hospice care needs scale, literature research, in-depth conversations with the dying old adult, and group discussions among members of the research team, 43 original questionnaire items were preliminarily drafted. A 31-item predictive questionnaire was formed through 2 rounds of expert review and small sample testing. From April to September 2023, 199 old adult at the end of life at home in Jinzhou, Liaoning Province were investigated to determine the reliability and validity of the questionnaire. Results: The final questionnaire included 31 items. Exploratory factor analysis extracted 5 common factors, and the cumulative variance contribution rate was 68.811%; the Cronbach's alpha coefficient of the total questionnaire was 0.832, and the re-test reliability was .806; the content validity index of the questionnaire was 0.982, and the content validity index of the items was 0.83-1.00. Conclusion: The construction method of the HHCNQ-DE is scientific and reliable, with good reliability and validity, and it can be used as a tool to measure the needs of home hospice care in mainland China in the future.
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Affiliation(s)
- Lei Wang
- College of Nursing, Jinzhou Medical University, Jinzhou, China
| | - Yaru Li
- College of Nursing, Jinzhou Medical University, Jinzhou, China
| | - Rui Zhao
- College of Nursing, Jinzhou Medical University, Jinzhou, China
| | - Jiangxu Li
- College of Nursing, Jinzhou Medical University, Jinzhou, China
| | - Xiangru Gong
- College of Nursing, Jinzhou Medical University, Jinzhou, China
| | - Hongyu Li
- College of Nursing, Jinzhou Medical University, Jinzhou, China
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Kane K, Kennedy F, Absolom KL, Harley C, Velikova G. Quality of life support in advanced cancer-web and technological interventions: systematic review and narrative synthesis. BMJ Support Palliat Care 2023; 13:e221-e234. [PMID: 33903259 DOI: 10.1136/bmjspcare-2020-002820] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 04/01/2021] [Accepted: 04/04/2021] [Indexed: 01/27/2023]
Abstract
BACKGROUND As treatments continue to progress, patients with advanced cancer are living longer. However, ongoing physical side-effects and psychosocial concerns can compromise quality of life (QoL). Patients and physicians increasingly look to the internet and other technologies to address diverse supportive needs encountered across this evolving cancer trajectory. OBJECTIVES 1. To examine the features and delivery of web and technological interventions supporting patients with advanced cancer. 2. To explore their efficacy relating to QoL and psychosocial well-being. METHODS Relevant studies were identified through electronic database searches (MEDLINE, PsychINFO, Embase, CINAHL, CENTRAL, Web of Science and ProQuest) and handsearching. Findings were collated and explored through narrative synthesis. RESULTS Of 5274 identified records, 37 articles were included. Interventions were evaluated within studies targeting advanced cancer (13) or encompassing all stages (24). Five subtypes emerged: Interactive Health Communication Applications (n=12), virtual programmes of support (n=11), symptom monitoring tools (n=8), communication conduits (n=3) and information websites (n=3). Modes of delivery ranged from self-management to clinically integrated. Support largely targeted psychosocial well-being, alongside symptom management and healthy living. Most studies (78%) evidenced varying degrees of efficacy through QoL and psychosocial measures. Intervention complexity made it challenging to distinguish the most effective components. Incomplete reporting limited risk of bias assessment. CONCLUSION While complex and varied in their content, features and delivery, most interventions led to improvements in QoL or psychosocial well-being across the cancer trajectory. Ongoing development and evaluation of such innovations should specifically target patients requiring longer-term support for later-stage cancer. PROSPERO REGISTRATION NUMBER CRD42018089153.
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Affiliation(s)
- Kathleen Kane
- Patient Centred Outcomes Research Group, Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
| | - Fiona Kennedy
- Patient Centred Outcomes Research Group, Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
| | - Kate L Absolom
- Patient Centred Outcomes Research Group, Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Clare Harley
- School of Healthcare, University of Leeds, Leeds, UK
| | - Galina Velikova
- Patient Centred Outcomes Research Group, Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
- Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, St James's University Hospital, Leeds, UK
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Cardoso AR, Remondes-Costa S, Veiga E, Almeida V, Rocha J, Teixeira RJ, Macedo G, Leite M. Meaning of Life Therapy: A Pilot Study of a Novel Psycho-Existential Intervention for Palliative Care in Cancer. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231209654. [PMID: 37884277 DOI: 10.1177/00302228231209654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
Intervention in Palliative Care aims to provide physical, psychosocial, and spiritual relief for patients and family members. Brief interventions with a psycho-existential approach have shown positive responses; however, cultural adaptations are needed. This pilot study aimed to develop the Meaning of Life Therapy (MLT), a novel psycho-existential intervention, rooted in the Dignity Therapy, Life Review, and Meaning-Centered Psychotherapy. MLT was culturally adapted to the Portuguese context to include questions about forgiveness, apology, reconciliation, farewell, and a legacy document, i.e., the Life Letter. Nine PC cancer patients answered a 14-question MLT protocol, intended to help patients find purpose and meaning in life. Eight themes emerged: Family, Preservation of Identity, Life Retrospective, Clinical Situation, Achievements, Socio-Professional Valorization, Forgiveness/Apology/Reconciliation, and Saying Goodbye. MLT has proved its ability to respond to the psycho-existential needs of PC patients. Further studies should be conducted to gain extensive knowledge of the effectiveness of culturally responsive interventions.
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Affiliation(s)
- Ana Rita Cardoso
- Casa de Saúde do Telhal, Instituto São João de Deus, Lisboa, Portugal
| | - Sónia Remondes-Costa
- Department of Education and Psychology, School of Human and Social Sciences, University of Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Elisa Veiga
- Faculty of Education and Psychology, Universidade Católica Portuguesa, Research Centre for Human Development, Porto, Portugal
| | - Vera Almeida
- Department of Social and Behavioural Sciences, University Institute of Health Sciences(IUCS), CESPU, Gandra, Portugal
- UNIPRO, Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences(IUCS), CESPU, Gandra, Portugal
| | - José Rocha
- Department of Social and Behavioural Sciences, University Institute of Health Sciences(IUCS), CESPU, Gandra, Portugal
| | - Ricardo João Teixeira
- CINEICC- Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal
- REACH - Mental Health Clinic, Porto, Portugal
| | - Gerly Macedo
- Clinical and Health Psychology Unit, Psychiatry and Mental Health Service, Hospital da Senhora de Oliveira de Guimarães, Guimarães, Portugal
| | - Manuela Leite
- Department of Social and Behavioural Sciences, University Institute of Health Sciences(IUCS), CESPU, Gandra, Portugal
- iHealth4Well-being - Innovation in Health and Well-Being, Research Unit, Instituto Politécnico de Saúde do Norte, CESPU, Penafiel, Portugal
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Dhakal K, Wang P, Mboineki JF, Getu MA, Chen C. Assessment of supportive care needs among cervical cancer patients under treatment in Nepal: a cross-sectional study. BMC Womens Health 2023; 23:407. [PMID: 37537619 PMCID: PMC10401776 DOI: 10.1186/s12905-023-02484-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 06/14/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUNDS The perceived supportive care needs (SCNs) of cancer patients are essential components of a care program. The first step in planning and intervening for supportive care is the proper identification of the SCNs of cancer patients. Cervical cancer (CC) is the most prevalent cancer among Nepali women. The authors assess SCNs and their predictors among CC patients under treatment by using a validated Nepali version supportive care need survey short form (SCNS- SF 34 N). METHODS This descriptive cross-sectional study was conducted in 5 cancer treatment hospitals in Nepal. A culturally adapted and psychometrically validated Nepali version SCNS -SF- 34 N was completed by a convenience sample of 218 CC patients. Data were analyzed by using descriptive (frequency, percentage, mean, median) and inferential (Chi-square P-value and binary logistic regression analysis) statistics. RESULTS The study showed that 99% of the respondents were in need of some level (low, moderate, high) of supportive care. The psychological domain, physical daily living, health system information, patient care support and sexuality domain ranked from first to fifth for SCNs with mean and standard deviations 70.29 ± 18.84, 63.25 ± 23.15, 57.90 ± 21.11, 56.46 ± 21.92 and 46.06 ± 34.16, respectively. Binary logistic regression found causal association between SCNs and variables "occupation (p-value = 0.007), and type of hospital (p-value = 0.000)" at a 95% confidence level. CONCLUSION Nepali CC patients perceive and experience many unmet SCNs, with psychological SCNs being the first priority. It is essential that the SCNs of patients may need to be known by their close family members, care providers, CC related program. so that they can offer intervention as per patients' needs.
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Affiliation(s)
- Kamala Dhakal
- Nursing Department, The first affiliated hospital of Zhengzhou University, Jianshe Dong Lu, Henan Province, Zhengzhou, Henan, 450000, China
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
- Maharjgunj Nursing Campus, Maharajgunj, Kathmandu, Nepal
- Institute for Hospital Management of Henan, Jianshe Dong Lu, Henan Province, Zhengzhou, Henan, 450000, China
| | - Panpan Wang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | | | - Mikiyas Amare Getu
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Changying Chen
- Nursing Department, The first affiliated hospital of Zhengzhou University, Jianshe Dong Lu, Henan Province, Zhengzhou, Henan, 450000, China.
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China.
- Institute for Hospital Management of Henan, Jianshe Dong Lu, Henan Province, Zhengzhou, Henan, 450000, China.
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Schnabel A, Lordick F, Oberth P, Neuschulz M, Lehmann-Laue A, Mehnert-Theuerkauf A, Hinz A. Supportive care needs and health-related quality of life in cancer patients receiving palliative care. Front Psychol 2023; 14:1166801. [PMID: 37303901 PMCID: PMC10250608 DOI: 10.3389/fpsyg.2023.1166801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 05/09/2023] [Indexed: 06/13/2023] Open
Abstract
Objective Cancer patients receiving palliative care experience a variety of impairments in their quality of life (QoL), and have corresponding supportive care needs (SCNs). The aim of this study was to analyze the relationship between SCNs, satisfaction with QoL dimensions, and the perceived importance of these dimensions. Method A sample of 152 cancer patients receiving palliative care were included in this cross-sectional study. Eight dimensions of QoL were defined and assessed concerning SCNs, satisfaction, and subjective importance using a new assessment instrument with five-point scales (range 1-5) for each dimension. Results Among the eight specific domains examined, the greatest SCNs were observed for absence of pain (M = 3.18; SD = 1.29). The patients were least satisfied with their physical functioning (M = 2.60; SD = 0.84), and the dimension social relationships (M = 4.14; SD = 0.72) received the highest perceived importance ratings. The eight dimensions' SCNs scores were significantly correlated with each other (r between 0.29 and 0.79); the lowest correlations were found for social relationships. The correlations between the satisfaction scores and the SCNs differed from dimension to dimension, with coefficients between -0.32 (absence of pain) and - 0.57 (sleep quality). Conclusion The results show that detriments in QoL do not automatically indicate high levels of SCNs in those dimensions. Health care providers should consider both factors, QoL (as measured with QoL questionnaires) and subjectively expressed SCNs, to optimize their patients' care regimens.
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Affiliation(s)
- Astrid Schnabel
- Department of Medicine (Oncology, Gastroenterology, Hepatology, Pulmonology), University of Leipzig Medical Center, Comprehensive Cancer Center Central Germany (CCCG), Leipzig, Germany
| | - Florian Lordick
- Department of Medicine (Oncology, Gastroenterology, Hepatology, Pulmonology), University of Leipzig Medical Center, Comprehensive Cancer Center Central Germany (CCCG), Leipzig, Germany
| | - Paula Oberth
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Markus Neuschulz
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Antje Lehmann-Laue
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Andreas Hinz
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
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Elsous A, Radwan M, Najjar S, Masad A, Abu Rayya M. Unmet needs and health-related quality of life of breast cancer survivors: survey from Gaza Strip, Palestine. Acta Oncol 2023; 62:194-209. [PMID: 36802358 DOI: 10.1080/0284186x.2023.2180326] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
BACKGROUND Cancer, especially breast cancer, remains a public health problem because of its negative consequences, which require long-term programs to alleviate its devastating effects. This study aimed to examine unmet supportive care needs and health-related quality of life of females with breast cancer. METHODS A cross-sectional study with a mixed-method design was employed. A simple, randomly selected sample of 352 females attending Al-Rantisi and Al-Amal hospitals was included in this study. A validated Arabic version of the Supportive Care Needs Survey (34 items) and The European Organization for Research and Treatment of Cancer Quality of Life (EORTC QLQ-C15-PAL) were used. Moreover, twenty-five semi-structured interviews were performed (13 females, eight husbands, and four healthcare workers). Quantitative data were analysed using descriptive and inferential analysis, whereas thematic analysis was used for qualitative data to highlight main themes. RESULTS The highest unmet need reported by females with breast cancer was psychological needs (63%), followed by health-related systems and information (62%) and physical and daily life (61%). Pain and fatigue were the most reported symptoms (65.8% and 62.5%, respectively), followed by emotional distress, physical function, and physical symptoms; 55.8%, 54.3%, and 51.5%, respectively. These unmet needs and health-related quality of life-related dimensions were highlighted and elicited by qualitative data analysis. Unmet needs are high among married females, on conservative treatments, young females (< 40 years old), and females in the first year of diagnosis. The presence of chronic diseases did not increase needs. However, health-related quality of life was affected. Six themes are subtracted: availability of anticancer therapy, affordability of healthcare, family and social support, psychological support, health education, and self-image & intimate relationship. CONCLUSION Many needs are unmet. Caring for females with breast cancer should be comprehensive to fill gaps, including psychological care, health information and education, physical care and support, and medical care.
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Affiliation(s)
- Aymen Elsous
- Faculty of Medical Sciences, Israa University -Gaza, Gaza strip, Palestine.,Department of Planning, Unit of Planning and Institutional Development Performance, Ministry of Health, Gaza strip, Palestine
| | - Mahmoud Radwan
- Department of Foreign Relations, General Directorate of International Cooperation, Ministry of Health, Gaza strip, Palestine
| | - Shahenaz Najjar
- Health Policy and Health Informatics, Arab American University of Palestine, Palestine.,Leuven Institute for Healthcare Policy, Pillar Quality and Safety, Department of Public Health and Primary Care, KU Leuven
| | - Atef Masad
- Department of Medical Laboratories, Faculty of Medical Sciences, Israa University -Gaza, Gaza strip, Palestine
| | - Mohammed Abu Rayya
- Public Health Consultant, Aid and Hope Program for Cancer Patients Care, Gaza strip, Palestine
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Blichfeldt M, Gregersen Oestergaard L, Sampedro Pilegaard M, la Cour K, Lindahl-Jacobsen L. Occupational performance and prioritized problematic everyday occupations among people with advanced cancer living alone versus living with someone. Scand J Occup Ther 2022:1-11. [DOI: 10.1080/11038128.2022.2141314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Melanie Blichfeldt
- European Master of Science in Occupational Therapy, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands
| | - Lisa Gregersen Oestergaard
- The Research Unit for User Perspectives and Community-based Interventions, Occupational Science, Department of Public Health, University of Southern Denmark, Odense, Denmark
- DEFACTUM, Central Denmark Region, Aarhus, Denmark
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - Marc Sampedro Pilegaard
- The Research Unit for User Perspectives and Community-based Interventions, Occupational Science, Department of Public Health, University of Southern Denmark, Odense, Denmark
- REHPA, the Danish Knowledge Centre for Rehabilitation and Palliative Care, Nyborg, Denmark
| | - Karen la Cour
- Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Line Lindahl-Jacobsen
- Department of Nutrition, Rehabilitation and Midwifery, University College Absalon, Naestved, Denmark
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12
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Verhoef M, Sweep B, de Nijs EJ, Valkenburg AC, Horeweg N, Pieterse AH, van der Steen JT, van der Linden YM. Assessment of patient symptom burden and information needs helps tailoring palliative care consultations: An observational study. Eur J Cancer Care (Engl) 2022; 31:e13708. [PMID: 36151895 PMCID: PMC9788071 DOI: 10.1111/ecc.13708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 05/25/2022] [Accepted: 08/31/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The objective of this study is to study (1) the relationship between patient-reported symptom burden and information needs in hospital-based palliative care and (2) differences in patient-reported needs during the disease trajectory. METHODS Observational study: patient-reported symptom burden and information needs were collected via a conversation guide comprising assessment scales for 12 symptoms (0-10), the question which symptom has priority to be solved and a question prompt list on 75 palliative care-related items (35 topics, 40 questions). Non-parametric tests assessed associations. RESULTS Conversation guides were used by 266 patients. Median age was 65 years (IQ-range, 57-72), 49% were male and 96% had cancer. Patients reported highest burden for Fatigue (median = 7) and Loss of appetite (median = 6) and prioritised Pain (26%), Fatigue (9%) and Shortness of breath (9%). Patients wanted information about 1-38 (median = 14) items, mostly Fatigue (68%), Possibilities to manage future symptoms (68%) and Possible future symptoms (67%). Patients also wanted information about symptoms for which they reported low burden. Patients in the symptom-directed phase needed more information about hospice care. CONCLUSION Symptom burden and information needs are related. Patients often also want information about non-prioritised symptoms and other palliative care domains. Tailored information-provision includes inviting patients to also discuss topics they did not consider themselves.
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Affiliation(s)
- Mary‐Joanne Verhoef
- Center of Expertise in Palliative CareLeiden University Medical CenterLeidenNetherlands
| | - Boudewijn Sweep
- Center of Expertise in Palliative CareLeiden University Medical CenterLeidenNetherlands
| | - Ellen J.M. de Nijs
- Center of Expertise in Palliative CareLeiden University Medical CenterLeidenNetherlands
| | - Anne C. Valkenburg
- Center of Expertise in Palliative CareLeiden University Medical CenterLeidenNetherlands
| | - Nanda Horeweg
- Department of Radiation OncologyLeiden University Medical CenterLeidenNetherlands
| | - Arwen H. Pieterse
- Department of Biomedical Data SciencesLeiden University Medical CenterLeidenNetherlands
| | - Jenny T. van der Steen
- Department of Public Health and Primary CareLeiden University Medical CenterLeidenNetherlands,Department of Primary and Community CareRadboud University Medical CenterNijmegenNetherlands
| | - Yvette M. van der Linden
- Center of Expertise in Palliative CareLeiden University Medical CenterLeidenNetherlands,Department of Radiation OncologyLeiden University Medical CenterLeidenNetherlands
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13
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Jensen W, Schmidt T. Bewegungstherapie bei nicht-heilbaren, fortgeschrittenen
Krebserkrankungen. B&G BEWEGUNGSTHERAPIE UND GESUNDHEITSSPORT 2022. [DOI: 10.1055/a-1901-4262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
ZusammenfassungDank der Entwicklung neuer Chemotherapie-Protokolle und verbesserter
zielgerichteter Therapiestrategien hat sich das Überleben von Patienten
mit nicht-heilbaren, fortgeschrittenen Krebserkrankungen deutlich
verlängert. Durch die krankheitsbedingten Symptome und die
zusätzlichen therapiebedingten Nebenwirkungen wird die
Lebensqualität dieser Patienten aber deutlich eingeschränkt.
Übersichtsarbeiten zeigen, dass auch Patienten mit nicht-heilbaren,
fortgeschrittenen Krebserkrankungen von angepasster Bewegungstherapie
profitieren können. Es wurde eine Literaturrecherche mithilfe
elektronischer Datenbanken (PubMed, MEDLINE, EMBASE, Cochrane Library)
durchgeführt und eine Übersicht der randomisierten
kontrollierten Studien (RCTs) zur Bewegungstherapie bei nicht-heilbaren,
fortgeschrittenen Krebserkrankungen gegeben. Die dargestellten Studien zeigen,
dass eine gezielte Bewegungstherapie bei Patienten mit nicht-heilbaren,
fortgeschrittenen Krebserkrankungen sicher und durchführbar ist und
positive Effekte auf die Lebensqualität, auf krankheits- und
therapiebedingte Symptome wie Fatigue, Dyspnoe und auf den körperlichen
Funktionsstatus erzielen kann. Der Artikel beinhaltet außerdem einen
Diskurs mit einem Praxisbezug zum Thema Knochenmetastasen.
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Affiliation(s)
- Wiebke Jensen
- Universitätsklinikum Hamburg-Eppendorf, Hubertus Wald
Tumorzentrum, Universitäres Cancer Center Hamburg (UCCH)
| | - Thorsten Schmidt
- UCCSH, Universitäres Cancer Center Schleswig-Holstein, Campus
Kiel
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14
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Rakhshani T, Najafi S, Javady F, Taghian Dasht Bozorg A, Mohammadkhah F, Khani Jeihooni A. The effect of Orem-based self-care education on improving self-care ability of patients undergoing chemotherapy: a randomized clinical trial. BMC Cancer 2022; 22:770. [PMID: 35840918 PMCID: PMC9284903 DOI: 10.1186/s12885-022-09881-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 07/11/2022] [Indexed: 11/10/2022] Open
Abstract
Background Cancer is a frightening disease. Therefore, the care of cancer patients is very complex. This study aimed to investigate the effect of the education based on Orem’s self-care model on self-care abilities of the patients undergoing chemotherapy in Shafa Hospital in Ahvaz city, Iran. Methods This randomized clinical trial was carried out in 2018 on 100 cancer patients undergoing chemotherapy, who referred to Shafa Hospital in Ahvaz city, Iran. The sampling method was simple and the subjects were randomly divided into two experimental and control groups (50 in the experimental and 50 in the control group). The study outcome was the self-care ability of the patients measured before and 2 months after the intervention by the control and experimental groups. The educational intervention consisted of five 60-minute sessions (one session per week) held as educational and counseling ones through group, face-to-face and individual training based on the identified needs of the patients in the experimental group at Shafa Hospital Chemotherapy Department. To collect data, two questionnaires [the assess and identify the conceptual pattern of Orem questionnaire and the Self-care capacity assessment (ESCI)]were used. Statistical data were entered into SPSS software version 20 and analyzed by chi-square, independent t-test and paired t-test. Results The mean and standard deviation of age was 35.06 ± 14.51 in the control group and 31.72 ± 15.01 in the experimental group. The results of the independent t-test showed that before the educational intervention, there was no significant difference between the two groups in terms of the mean self-care (P = 0.38). But after the intervention, a significant difference was found between the mean self-care scores of the experimental and control groups (P = 0.001). Conclusion Application of Orem’s self-care model led to increased self-care ability of the cancer patients undergoing chemotherapy. Therefore, it is recommended that this model be included in the routine programs of chemotherapy departments. Trial registration IRCT registration number: IRCT20160418027449N6. Registration date: 01/05/2019.
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Affiliation(s)
- Tayebeh Rakhshani
- Nutrition Research Center, Department of Public Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Siamak Najafi
- Department of Internal Medicine, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran
| | - Fakhry Javady
- Nutrition Research Center, Department of Public Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Fatemeh Mohammadkhah
- Department of Community health, child nursing and aging, Ramsar School of Nursing, Babol University of Medical Sciences, Babol, Iran
| | - Ali Khani Jeihooni
- Nutrition Research Center, Department of Public Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
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15
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Luu KL, Witkamp FE, Nieboer D, Bakker EM, Kranenburg LW, van der Rijt CCD, Lorig K, van der Heide A, Rietjens JAC. Effectiveness of the "Living with Cancer" peer self-management support program for persons with advanced cancer and their relatives: study protocol of a non-randomized stepped wedge study. Palliat Care 2022; 21:107. [PMID: 35692043 PMCID: PMC9188837 DOI: 10.1186/s12904-022-00994-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022] Open
Abstract
Background Persons with advanced cancer and their relatives experience physical, emotional, and psychosocial consequences of the illness. Most of the time, they must deal with these themselves. While peer self-management support programs may be helpful, there is little evidence on their value for this population. We present the research protocol of our SMART study that will evaluate the effectiveness of the “Living with Cancer” peer self-management support program, aimed at improving self-management behaviors, self-efficacy, and health-related quality of life of persons with advanced cancer and their relatives. Methods We will conduct a non-randomized stepped wedge study in the Netherlands. We will include 130 persons with advanced cancer and 32 relatives. Participants can choose to either start the program within 4 weeks after inclusion or after eight to 10 weeks. The “Living with Cancer” is a peer self-management support program, based on the Chronic Disease Self-Management Program. It consists of six 1,5 hours video-conferencing group meetings with eight to 12 participants, preceded by two or three preparatory audio clips with supportive text per session. The program has the following core components: the learning of self-management skills (action-planning, problem-solving, effective communication, and decision-making), discussing relevant themes (e.g. dealing with pain and fatigue, living with uncertainty, and future planning), and sharing experiences, knowledge, and best practices. The primary outcome for both persons with advanced cancer and relatives is self-management behavior assessed by the subscale “constructive attitudes and approaches” of the Health Education Impact Questionnaire. Secondary outcomes are other self-management behaviors, self-efficacy, health-related quality of life, symptoms, depression and anxiety, and loneliness. Participants complete an online questionnaire at baseline, and after eight and 16 weeks. After each session, they complete a logbook about their experiences. Group meetings will be video recorded. Discussion SMART aims to evaluate an innovative program building on an evidence-based self-management program. New features are its use for persons with advanced cancer, the inclusion of relatives, and the video-conferencing format for this population. The use of both quantitative and qualitative analyses will provide valuable insight into the effectiveness and value of this program. Trial registration This study was registered in the Dutch Trial Register on October 2021, identifier NL9806. Supplementary Information The online version contains supplementary material available at 10.1186/s12904-022-00994-5.
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Affiliation(s)
- K L Luu
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
| | - F E Witkamp
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.,Center of Expertise Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands
| | - D Nieboer
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - E M Bakker
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - L W Kranenburg
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - C C D van der Rijt
- Department of Medical Oncology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - K Lorig
- Stanford School of Medicine, CA, Stanford, USA
| | - A van der Heide
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - J A C Rietjens
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
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16
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Hart NH, Crawford-Williams F, Crichton M, Yee J, Smith TJ, Koczwara B, Fitch MI, Crawford GB, Mukhopadhyay S, Mahony J, Cheah C, Townsend J, Cook O, Agar MR, Chan RJ. Unmet supportive care needs of people with advanced cancer and their caregivers: a systematic scoping review. Crit Rev Oncol Hematol 2022; 176:103728. [PMID: 35662585 DOI: 10.1016/j.critrevonc.2022.103728] [Citation(s) in RCA: 67] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 05/24/2022] [Accepted: 05/26/2022] [Indexed: 01/11/2023] Open
Abstract
Examining and addressing unmet care needs is integral to improving the provision and quality of cancer services. This review explored the prevalence of unmet supportive care needs, and factors associated with unmet need, in adults with advanced cancers (solid and hematological malignancies) and their caregivers. Electronic databases (PubMed, CINAHL, EMBASE) were searched, producing 85 papers representing 81 included studies. People with advanced cancer reported the highest unmet needs in financial, health system and information, psychological, and physical and daily living domains, whereas caregivers reported the highest unmet needs in psychological, and patient care and support domains. Distress, depression, and anxiety were associated with higher unmet needs across all unmet need domains for people with advanced cancer and their caregivers. Substantial heterogeneity in study populations and methods was observed. Findings from this review can inform targeted strategies and interventions to address these unmet needs in people with advanced cancer.
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Affiliation(s)
- Nicolas H Hart
- Caring Futures Institute, College of Nursing and Health Science, Flinders University, SA, Australia; Exercise Medicine Research Institute, School of Medical and Health Sciences, Edith Cowan University, WA, Australia; Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, QLD, Australia; Institute for Health Research, University of Notre Dame Australia, WA, Australia.
| | - Fiona Crawford-Williams
- Caring Futures Institute, College of Nursing and Health Science, Flinders University, SA, Australia; Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, QLD, Australia
| | - Megan Crichton
- Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, QLD, Australia; Nutrition and Dietetics Research Group, Bond University, QLD, Australia
| | - Jasmine Yee
- Centre for Medical Psychology and Evidence-Based Decision-Making, Faculty of Medicine and Health, University of Sydney, NSW, Australia
| | - Thomas J Smith
- Division of General Internal Medicine, John Hopkins Medical Institutions, Baltimore, MD, USA
| | - Bogda Koczwara
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, SA, Australia; Flinders Cancer and Innovation Centre, Flinders Medical Centre, SA, Australia
| | - Margaret I Fitch
- School of Graduate Studies, Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Gregory B Crawford
- Discipline of Medicine, University of Adelaide, SA, Australia; Northern Adelaide Local Health Network, SA, Australia
| | - Sandip Mukhopadhyay
- Burdwan Medical College, West Bengal, Kolkata, India; Indian Council of Medical Research, National Institute of Cholera and Enteric Diseases, Kolkata, India
| | | | - Chan Cheah
- Internal Medicine, UWA Medical School, University of Western Australia, WA, Australia; Department of Haematology, Sir Charles Gairdner Hospital, WA, Australia; Department of Haematology, Hollywood Private Hospital, WA, Australia
| | | | - Olivia Cook
- McGrath Foundation, NSW, Australia; School of Nursing and Midwifery, Monash University, VIC, Australia
| | - Meera R Agar
- IMPACCT Centre, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Raymond J Chan
- Caring Futures Institute, College of Nursing and Health Science, Flinders University, SA, Australia; Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, QLD, Australia
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17
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Abu-Odah H, Molassiotis A, Yat Wa Liu J. Analysis of the unmet needs of Palestinian advanced cancer patients and their relationship to emotional distress: results from a cross-sectional study. BMC Palliat Care 2022; 21:72. [PMID: 35562732 PMCID: PMC9106510 DOI: 10.1186/s12904-022-00959-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 04/28/2022] [Indexed: 11/22/2022] Open
Abstract
Background Although several studies assessing the needs of advanced cancer patients have been conducted globally, most have focused on a specific type of cancer such as lung or breast cancer. The variation across studies has also created difficulties in generalizing the results and applying the findings in other countries. The aim of this study was to provide comprehensive information on the needs of Palestinian advanced cancer patients. The quality of life (QOL), distress levels, depression, anxiety, and spiritual well-being of the patients were also assessed. Methods A hospital-based study with a cross-sectional design was conducted on a convenience sample of patients aged 18 or above who had been diagnosed with advanced-stage cancer. The unmet needs of the patients were assessed using the Short form of the Supportive Care Needs Survey (SCNS-SF34). Four instruments were utilized to examine their distress, anxiety, depression, QOL, and spirituality. A modified Supportive Care Framework was adopted to guide the design of this study. Descriptive statistics and hierarchical linear regression were utilized to analyse the data. Results Of the 404 cancer patients invited to the study, 379 patients consented to participate and complete the questionnaire. Of them 96.8% stated that they had at least one ‘moderate to high’ level unmet need. The most frequent unmet needs were those in the physical aspects of daily living (Mean 58.94; SD ± 20.93) and psychological (Mean 58.84; SD ± 19.49) domains. Most of the patients (91%) were physically ill and reported experiencing physical symptoms. About 78.1% had a high level of distress. Almost 90% reported signs of depression and anxiety. Although they felt that their spiritual well-being was good, their QOL was poor. Hierarchical linear regression analyses confirmed that educational level, age, gender, marital status, cancer stage, cancer type, physical symptoms, depression, anxiety, distress, QOL, and spirituality were independently associated with unmet supportive care needs. Conclusion Palestinian advanced cancer patients exhibit a significantly higher prevalence of unmet needs than those in other countries, indicating a need to develop a palliative care programme within the healthcare system. They have a great need for physical, emotional/psychosocial, self-management and other services, which should be made available to them, particularly in the routine delivery of cancer care. Supplementary Information The online version contains supplementary material available at 10.1186/s12904-022-00959-8.
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Affiliation(s)
- Hammoda Abu-Odah
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong. .,Nursing and Health Sciences Department, University College of Applied Sciences (UCAS), Gaza, Palestine.
| | - Alex Molassiotis
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Justina Yat Wa Liu
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
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18
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The Needs of Parents of Children Suffering from Cancer—Continuation of Research. CHILDREN 2022; 9:children9020144. [PMID: 35204865 PMCID: PMC8870376 DOI: 10.3390/children9020144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/17/2022] [Accepted: 01/19/2022] [Indexed: 02/02/2023]
Abstract
Background: Parents experience many healthcare needs when caring for their sick children. Research shows that parents of oncological children have a high level of unmet needs, including psychosocial, emotional, physical, informational, financial, educational, and spiritual needs. To date, little quantitative research has been carried out on the specific needs of parents of children with cancer, which creates uncertainty about what areas should be addressed in care. This study investigated the prevalence of unmet needs among parents of children with cancer. Methods: A population survey was conducted between 2015 and 2020. Caregivers of children diagnosed with cancer were invited to participate in the study to assess their problems and needs. Results: The analysis found that 97% of the participants experienced some level of need for one or more items, and 73% of the respondents reported a moderate or high need for one or more items. In the field of medical information, 70% of respondents had moderate or high needs, 55% of parents reported a moderate or high level of need for help in the psychological or emotional field, and 30% in the financial domain. The prevalence of moderate or high need in the remaining domains ranged from 10% to 15%. Conclusions: Parents of children with cancer experience a high level of needs, especially psychological, emotional, and information. These data suggest that the existing healthcare system does not meet the needs of parents of sick children. The results show the need to investigate the mechanisms by which healthcare providers can use the healthcare system to identify and meet needs.
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19
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van Dongen SI, Stoevelaar R, Kranenburg LW, Noorlandt HW, Witkamp FE, van der Rijt CCD, van der Heide A, Rietjens JAC. The views of healthcare professionals on self-management of patients with advanced cancer: An interview study. PATIENT EDUCATION AND COUNSELING 2022; 105:136-144. [PMID: 34034936 DOI: 10.1016/j.pec.2021.05.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 04/13/2021] [Accepted: 05/12/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Self-management of patients with advanced cancer is challenging. Although healthcare professionals may play a crucial role in supporting these patients, scant scientific attention has been paid to their perspectives. Therefore, we examined healthcare professionals' views on self-management and self-management support in this population. METHODS We conducted qualitative interviews with 27 purposively sampled medical specialists (n = 6), nurse specialists (n = 6), general practitioners (n = 8) and homecare/ hospice nurses (n = 7) in the Netherlands. Transcripts were analysed using thematic analysis. RESULTS Healthcare professionals experienced self-management of patients with advanced cancer to be diverse, dynamic and challenging. They adopted instructive, collaborative and advisory roles in self-management support for this population. Whereas some professionals preferred or inclined towards one role, others indicated to switch roles, depending on the situation. CONCLUSIONS Just like patients with advanced cancer, healthcare professionals differ in their views and approaches regarding self-management and self-management support in this population. Therefore, instructive, collaborative and advisory self-management support roles will all be useful under certain circumstances. PRACTICE IMPLICATIONS Healthcare professionals can support self-management by being aware of their own views and communicating these clearly to their patients and colleagues. Education in self-management support should include self-reflection skills and discuss the relation between self-management and professional care.
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Affiliation(s)
- S I van Dongen
- Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands.
| | - R Stoevelaar
- Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands.
| | - L W Kranenburg
- Department of Psychiatry, Erasmus University Medical Centre, Rotterdam, The Netherlands.
| | - H W Noorlandt
- Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands.
| | - F E Witkamp
- Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands; Faculty of Nursing and Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands.
| | - C C D van der Rijt
- Department of Medical Oncology, Erasmus MC, Erasmus University Medical Centre, Rotterdam, The Netherlands.
| | - A van der Heide
- Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands.
| | - J A C Rietjens
- Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands.
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20
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Johnson MJ, Huang C, Chen H, Jones L, Twiddy M. Prostate cancer: unmet supportive and palliative care needs: national survey of patients and family carers. BMJ Support Palliat Care 2021:bmjspcare-2021-003438. [PMID: 34969695 DOI: 10.1136/bmjspcare-2021-003438] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 12/10/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Men living with prostate cancer have supportive and palliative needs. However, few studies detail unmet needs (vs quality of life measurement) or include data from those with advanced disease. We aimed to identify unmet needs of people living with prostate cancer (men, family carers), including those with advanced disease. METHODS Mixed-methods national survey (patient Supportive Care Needs Survey; Carer Support Needs Assessment Tool) and health status (EuroQol Visual Analogue Scale). Quantitative data were explored using regression analysis. Free text data were subjected to thematic analysis. RESULTS 216 men (mean age 65±8.5 years; active cancer 136 [63%]) and 97 carers (68 (70%) spouse/partner) provided data. 133 men (62%) reported moderate-to-high need which was more likely in advanced disease. Men's health status was worse with active vs remitted disease (mean difference -11; 95% CI -17 to -5; p<0.001). 85 (88%) carers reported at least one unmet need relating to 'enabling them to care' and 83 (86%) relating to 'their own well-being'. Carers with chronic illnesses had more unmet needs (p=0.01 to p=0.04) and patient receipt of palliative care independently predicted higher unmet carer needs (p=0.02).Free text data demonstrated widespread burden with: (1) poor communication/information, including about palliative care; (2) poorly managed symptoms/concerns and (3) poor care co-ordination. Incontinence, sexual dysfunction and hormone side-effects were serious problems, often left unaddressed. CONCLUSIONS Many living with prostate cancer continue with wide-ranging concerns. Lack of systematic, ongoing needs assessment and poor communication compound inadequate clinical pathways. Person-centred care, interdisciplinary working and integrated palliative care should be resourced.
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Affiliation(s)
- Miriam J Johnson
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK
| | - Chao Huang
- Institute of Clinical and Applied Health Research, Hull York Medical School, University of Hull, Hull, UK
| | - Hong Chen
- Institute of Clinical and Applied Health Research, Hull York Medical School, University of Hull, Hull, UK
| | - Lesley Jones
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK
| | - Maureen Twiddy
- Institute of Clinical and Applied Health Research, Hull York Medical School, University of Hull, Hull, UK
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21
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Evans Webb M, Murray E, Younger ZW, Goodfellow H, Ross J. The Supportive Care Needs of Cancer Patients: a Systematic Review. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:899-908. [PMID: 33492650 PMCID: PMC8523012 DOI: 10.1007/s13187-020-01941-9] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/06/2020] [Indexed: 06/12/2023]
Abstract
Cancer, and the complex nature of treatment, has a profound impact on lives of patients and their families. Subsequently, cancer patients have a wide range of needs. This study aims to identify and synthesise cancer patients' views about areas where they need support throughout their care. A systematic search of the literature from PsycInfo, Embase and Medline databases was conducted, and a narrative. Synthesis of results was carried out using the Corbin & Strauss "3 lines of work" framework. For each line of work, a group of key common needs were identified. For illness-work, the key needs idenitified were; understanding their illness and treatment options, knowing what to expect, communication with healthcare professionals, and staying well. In regards to everyday work, patients wanted to maintain a sense of normalcy and look after their loved ones. For biographical work, patients commonly struggled with the emotion impact of illness and a lack of control over their lives. Spiritual, sexual and financial problems were less universal. For some types of support, demographic factors influenced the level of need reported. While all patients are unique, there are a clear set of issues that are common to a majority of cancer journeys. To improve care, these needs should be prioritised by healthcare practitioners.
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Affiliation(s)
- Madeleine Evans Webb
- UCL Research Department of Epidemiology & Public Health, 1-19 Torrington Place, London, WC1E 6BT UK
| | - Elizabeth Murray
- Department of Primary Care and Population Health, Upper 3rd Floor, Royal Free Hospital, Rowland Hill Street, London, NW3 2PF UK
| | - Zane William Younger
- Department of Primary Care and Population Health, Upper 3rd Floor, Royal Free Hospital, Rowland Hill Street, London, NW3 2PF UK
| | - Henry Goodfellow
- Department of Primary Care and Population Health, Upper 3rd Floor, Royal Free Hospital, Rowland Hill Street, London, NW3 2PF UK
| | - Jamie Ross
- Department of Primary Care and Population Health, Upper 3rd Floor, Royal Free Hospital, Rowland Hill Street, London, NW3 2PF UK
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Guiteras AF, Abelló HV, Domingo JP, Danés CF, Ripoll AR, Berger R. Palliative Oncological Patients with Insomnia: Concerns of the Patients and Their Relatives' Perception. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168509. [PMID: 34444258 PMCID: PMC8392089 DOI: 10.3390/ijerph18168509] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 08/08/2021] [Accepted: 08/10/2021] [Indexed: 11/16/2022]
Abstract
Insomnia is one of the most frequent symptoms and usually generates significant stress in 60% of patients with advanced cancer. Worries from the patients' and relatives' perspective are crucial to improve the patients' quality of life but have received limited attention. The aims were to identify the concerns of patients with insomnia in the terminal illness stage in a palliative care unit and the relatives' perception, and to compare both. Here, 63 patients and 53 relatives answered a questionnaire about worries in the personal, spiritual, family-related and economic area, as well as a quality-of-life uniscale. The results showed that the relatives' most frequent concern was "Having lived life to the fullest" (100%), and the most intense was "The possible suffering during the process" (9.2/10). The patients' most expressed concern was: "Having unfinished business" (100%), and the most intense was "Suffering during the process" (9.3/10). Quality of life showed an average value of 6.95 out of 10. Relatives only coincided significantly in: "Not knowing what happens after death" (r = 0.600; p = 0.000). These results bring visibility to concerns during the final stage of oncological palliative patients with insomnia from the patients' and relatives' perspective. Knowing both is useful for professionals to foster the well-being for a short, yet very important, period for patients, relatives and the caregiving team.
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Affiliation(s)
- Antoni Font Guiteras
- Department de Psicologia Bàsica, Evolutiva i de la Educació, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain; (A.F.G.); (H.V.A.)
| | - Helena Villar Abelló
- Department de Psicologia Bàsica, Evolutiva i de la Educació, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain; (A.F.G.); (H.V.A.)
| | - José Planas Domingo
- Palliative Care Unit, Geriatric Department, Centre Fòrum, Hospital del Mar, 08003 Barcelona, Spain; (J.P.D.); (C.F.D.); (A.R.R.)
| | - Cristina Farriols Danés
- Palliative Care Unit, Geriatric Department, Centre Fòrum, Hospital del Mar, 08003 Barcelona, Spain; (J.P.D.); (C.F.D.); (A.R.R.)
| | - Ada Ruiz Ripoll
- Palliative Care Unit, Geriatric Department, Centre Fòrum, Hospital del Mar, 08003 Barcelona, Spain; (J.P.D.); (C.F.D.); (A.R.R.)
| | - Rita Berger
- Departamento de Psicología Social y Cuantitativa, Universitat de Barcelona, 08035 Barcelona, Spain
- Correspondence:
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23
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Lormans T, de Graaf E, van de Geer J, van der Baan F, Leget C, Teunissen S. Toward a socio-spiritual approach? A mixed-methods systematic review on the social and spiritual needs of patients in the palliative phase of their illness. Palliat Med 2021; 35:1071-1098. [PMID: 33876676 PMCID: PMC8189005 DOI: 10.1177/02692163211010384] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Patients express a variety of needs, some of which are labeled social and spiritual. Without an in-depth exploration of patients' expressions of these needs, it is difficult to differentiate between them and allocate appropriate healthcare interventions. AIM To gain insight into the social and spiritual needs of patients with a life-limiting illness and the distinction between these needs, as found in the research literature. DESIGN A mixed-methods systematic review and meta-aggregation were conducted following the Joanna Briggs Institute (JBI) approach to qualitative synthesis and the PALETTE framework and were reported according to the PRISMA statement. This review was registered in PROSPERO (CRD42019133571). DATA SOURCES The search was conducted in PubMed, EMBASE, CINAHL, Scopus, and PsycInfo. Eligible studies reported social and spiritual needs from the patients' perspective and were published between January 1st 2008 and October 2020. The quality of evidence was assessed using JBI Critical Appraisal Tools. RESULTS Thirty-four studies (19 qualitative, 1 mixed-methods, and 14 quantitative) were included. The five synthesized findings encompassing social and spiritual needs were: being autonomous, being connected, finding and having meaning, having a positive outlook, and dealing with dying and death. CONCLUSION What literature labels as social and spiritual needs shows great similarities and overlap. Instead of distinguishing social from spiritual needs based on patients' linguistic expressions, needs should always be explored in-depth. We propose a socio-spiritual approach that honors and preserves the multidimensionality of patients' needs and enables interdisciplinary teamwork to allocate patient-tailored care.
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Affiliation(s)
- Tom Lormans
- Center of Expertise Palliative Care Utrecht, UMC Utrecht, Utrecht, the Netherlands
| | - Everlien de Graaf
- Center of Expertise Palliative Care Utrecht, UMC Utrecht, Utrecht, the Netherlands
| | | | | | - Carlo Leget
- University of Humanistic Studies, Utrecht, the Netherlands
| | - Saskia Teunissen
- Center of Expertise Palliative Care Utrecht, UMC Utrecht, Utrecht, the Netherlands
- Academic Hospice Demeter, De Bilt, the Netherlands
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24
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Leroi I, Wolski L, Charalambous AP, Constantinidou F, Renaud D, Dawes P, Hann M, Himmelsbach I, Miah J, Payne M, Simkin Z, Thodi C, Yeung WK, Yohannes AM. Support care needs of people with hearing and vision impairment in dementia: a European cross-national perspective. Disabil Rehabil 2021; 44:5069-5081. [PMID: 34027751 DOI: 10.1080/09638288.2021.1923071] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
PURPOSE Aging-related sensory impairments are among the most common and disabling comorbidities in people with dementia (PwD). This study explored the unmet support care needs (SCNs) from the perspectives of people with hearing and/or vision impairment in dementia (PwD), and their care partners in Europe. METHODS This was a two-phase mixed methods study. We administered standardized questionnaires of SCNs and quality of life (QoL) to PwD with hearing and/or vision impairment (n = 97), and their care partners (n = 97) in the UK, France, and Cyprus. Next, a purposive sub-sample of 34 participants (PwD and care partners) participated as focus groups (FGs) or semi-structured interviews to explore their SCNs in depth. RESULTS Over 94% of the participants reported unmet SCNs (median, 13 (range 5-23)). Nearly three-quarters reported SCNs in the moderate to high range, with the most prevalent unmet SCNs for PwD being in the psychological (>60%) and physical domains (>56%), followed by the need for health information (>46%). Emergent qualitative themes were: (1) the need for tailored support care interventions; (2) care burden, social isolation, and loneliness arising from the combined problems; (3) the need for adequate support from professionals from the different fields, including education around the use of sensory aids. Both study phases revealed that SCNs were highly individualized. CONCLUSIONS This cross-national study revealed that PwD with sensory impairment and their care partners experience a wide range of unmet SCNs, the interactions between sensory impairments, SCNs and QoL are also complex. A tailored intervention could address these unmet SCNs, including additional support with sensory aids, psychological support, more information about concurrent impairments, and joined up health systems providing care.Implications for rehabilitationA majority of participants with combined age-related hearing, vision, and cognitive impairment had unmet SCNs.The needs of care partners including the risk of loneliness and social isolation, need to be considered.Individually tailored, specific interventions for hearing, vision, and cognitive impairment should incorporate physical and psychological support, as well as education.
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Affiliation(s)
- Iracema Leroi
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland.,Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - Lucas Wolski
- Catholic University of Applied Sciences Freiburg, Freiburg, Germany
| | | | - Fofi Constantinidou
- Centre for Applied Neurosciences & Department of Psychology, University of Cyprus, Nicosia, Cyprus
| | - David Renaud
- CMRR Memory Center, Claude Pompidou Institute, University of Nice Sophia Antipolis, Nice, France
| | - Piers Dawes
- Manchester Centre for Audiology and Deafness, University of Manchester, Manchester, UK
| | - Mark Hann
- Centre for Biostatistics, University of Manchester, Manchester, UK
| | - Ines Himmelsbach
- Catholic University of Applied Sciences Freiburg, Freiburg, Germany
| | - Jahanarah Miah
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - Magali Payne
- CMRR Memory Center, Claude Pompidou Institute, University of Nice Sophia Antipolis, Nice, France
| | - Zoe Simkin
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - Chryssoula Thodi
- Department of Health Sciences, European University Cyprus, Engomi, Cyprus
| | - Wai Kent Yeung
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
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25
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Goni-Fuste B, Crespo I, Monforte-Royo C, Porta-Sales J, Balaguer A, Pergolizzi D. What defines the comprehensive assessment of needs in palliative care? An integrative systematic review. Palliat Med 2021; 35:651-669. [PMID: 33648403 DOI: 10.1177/0269216321996985] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND The comprehensive assessment of needs in palliative care identifies where patients most want attention to guide clinical decisions that tailor care provision from their first encounters. AIM To define how and what needs are identified by the comprehensive assessment of needs in the original peer-reviewed articles in the field of palliative care. DESIGN An integrative systematic review as outlined by Whittemore and Knafl. Quality appraisal performed using the Mixed Methods Appraisal Tool. DATA SOURCES PubMed, CINAHL, PsycINFO, Web of Science databases searched through May 2019 and updated in July 2020. RESULTS Forty-nine articles met inclusion criteria for original articles in English or Spanish reporting comprehensive assessment of needs of adult patients receiving palliative care. The majority (41/49) of studies were moderate to high quality. Two themes were identified: (1) How a comprehensive assessment of needs should be carried out in palliative care, which reflected a preference to develop structured tools for assessment; (2) What needs of patients should be assessed in the comprehensive assessment of needs in palliative care, which conveyed a trend to assess beyond core domains - physical, psychological, social, spiritual - with information and practical most prevalent, but with substantial variation in specifying and classifying needs into domains. CONCLUSIONS The assessment of needs in palliative care is comprehensive but lacks consensus on the needs and domains that should be assessed by the palliative care team. Future studies should better define what needs can be standardized into the assessment to improve process of care and patient satisfaction.
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Affiliation(s)
- Blanca Goni-Fuste
- Nursing Department, School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallés, Barcelona, Spain
| | - Iris Crespo
- Department of Basic Sciences, School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Cristina Monforte-Royo
- Nursing Department, School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallés, Barcelona, Spain
| | - Josep Porta-Sales
- School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallés, Barcelona, Spain.,Institut Català d'Oncologia Girona, Girona, Spain
| | - Albert Balaguer
- School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallés, Barcelona, Spain.,Universitat Internacional de Catalunya, Hospital Universitari General de Catalunya, Barcelona, Spain
| | - Denise Pergolizzi
- School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallés, Barcelona, Spain
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26
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Mohd Shariff N, Azman N, Hami R, Mohd Mujar NM, Leong Bin Abdullah MFI. Multicentre prospective cohort study of unmet supportive care needs among patients with breast cancer throughout their cancer treatment trajectory in Penang: a PenBCNeeds Study protocol. BMJ Open 2021; 11:e044746. [PMID: 33722872 PMCID: PMC7959240 DOI: 10.1136/bmjopen-2020-044746] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 01/14/2021] [Accepted: 02/23/2021] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Proper assessment of unmet supportive care needs of patients with breast cancer and its influencing factors at different treatment intervals will improve the rehabilitation of patients with breast cancer. Therefore, this study aims to determine the prevalence of unmet supportive care needs, changes of needs over time and associated factors during the treatment period. METHODS AND ANALYSIS This multicentre, prospective cohort study will be conducted in three governmental hospitals and one tertiary cancer institute in Penang, Malaysia. Adult women diagnosed with primary or recurrent tumour, node, metastases stage I-IV breast cancer based on pathological biopsy will be eligible for this study. At least 281 samples are required for this study. Participants will undergo follow-up at three time intervals: T1 at breast cancer diagnosis; T2 at 3 months after diagnosis and T3 at 6 months after diagnosis. Patients will complete a set of questionnaires at each time. The primary outcome of this study includes the changes in supportive care needs over three time points, followed by the secondary outcome examining patients' characteristics, coping behaviours and positive psychological components as they affect changes in unmet supportive care needs over time. ETHICS AND DISSEMINATION The study has received ethics approval from the Medical Research and Ethics Committee, Ministry of Health Malaysia (NMRR-19-268-45809 IIR) and the Human Research Ethics Committee of Universiti Sains Malaysia (USM/JEPeM/17100443). The results of the prospective study will be submitted for publication in a peer-reviewed journal.
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Affiliation(s)
- Noorsuzana Mohd Shariff
- Advanced Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Penang, Malaysia
| | - Nizuwan Azman
- Biostatistics and Bioinformatics Unit, Research and Networking Department, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Minden, Penang, Malaysia
| | - Rohayu Hami
- Advanced Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Penang, Malaysia
| | - Noor Mastura Mohd Mujar
- Advanced Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Penang, Malaysia
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27
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Lee TY, Susanti HD, Hung KC, Yang SY, Fang HF, Tsai JR, Chiou JF, Chung MH. Health care needs of elderly patients with lung, liver, or colon cancer in Taiwan. BMC Palliat Care 2021; 20:21. [PMID: 33485348 PMCID: PMC7827987 DOI: 10.1186/s12904-021-00708-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 01/03/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Globally, different age groups in the elderly population have experienced major shifts over time. Human life expectancy doubled from the 19th to the twentieth century and has increased to 80 years in the twenty-first century. These conditions imply economic challenges and the increasing prevalence of certain health conditions. Old age is associated with increased care needs in various aspects of daily life. This study assessed the health care needs of elderly patients with lung, liver, and colorectal cancer in Taiwan and analyzed the factors underlying their needs. METHODS This cross-sectional descriptive survey assessed 234 elderly patients with diagnosis of lung, liver, and colorectal cancer in Taiwan. We investigated their health care needs and daily living functions by using the Supportive Care Needs Survey and Karnofsky Performance Status, respectively. RESULTS Patients required the most assistance in physical functioning and daily living. Patients aged ≥85 years required more care than those aged 65-74 years in terms of information access and sexuality needs. Patients with poor functional status required more care than those capable of undertaking normal activities. Patients diagnosed as having liver cancer required more care than those with lung or colorectal cancer. Patients with advanced cancer required more physical and daily care than those with early-stage cancer. CONCLUSIONS Patients' health care needs differed with age, primary cancer site, and functional status. Patients aged ≥85 years and those with poor function, primary liver cancer, and advanced cancer had higher care needs.
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Affiliation(s)
- Tzu-Yin Lee
- School of Nursing, College of Nursing, Taipei Medical University, No. 250, Wu-Xing Street, Taipei, Taiwan
| | - Henny Dwi Susanti
- School of Nursing, College of Nursing, Taipei Medical University, No. 250, Wu-Xing Street, Taipei, Taiwan.,Department of Nursing, Faculty of Health Science, University of Muhammadiyah Malang, Malang, East Java, Indonesia
| | - Kuo-Chen Hung
- Department of Computer Science and Information Management, Hungkuang University, Taichung City, Taiwan
| | - Su-Yueh Yang
- Department of Nursing, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Hui-Fen Fang
- Department of Nursing, Taipei Cancer Center, Taipei Medical University, Taipei, Taiwan.,Cancer Center, Taipei Medical University Hospital, Taipei, Taiwan.,Nursing Services, Taipei Medical University Hospital, Taipei, Taiwan
| | - Jia-Ruey Tsai
- Division of Hematology and Oncology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan
| | - Jeng-Fong Chiou
- Taipei Cancer Center, Taipei Medical University, Taipei, Taiwan.,School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Min-Huey Chung
- School of Nursing, College of Nursing, Taipei Medical University, No. 250, Wu-Xing Street, Taipei, Taiwan. .,Department of Nursing, Shuang-Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
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28
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Sampedro Pilegaard M, Knold Rossau H, Lejsgaard E, Kjer Møller JJ, Jarlbaek L, Dalton SO, la Cour K. Rehabilitation and palliative care for socioeconomically disadvantaged patients with advanced cancer: a scoping review. Acta Oncol 2021; 60:112-123. [PMID: 33021852 DOI: 10.1080/0284186x.2020.1827156] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Rehabilitation and palliative care may play an important role in addressing the problems and needs perceived by socioeconomically disadvantaged patients with advanced cancer. However, no study has synthesized existing research on rehabilitation and palliative care for socioeconomically disadvantaged patients with advanced cancer. The study aimed to map existing research of rehabilitation and palliative care for patients with advanced cancer who are socioeconomically disadvantaged. MATERIAL AND METHODS A scoping review was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). A systematic literature search was performed in CINAHL, PubMed and EMBASE. Two reviewers independently assessed abstracts and full-text articles for eligibility and performed data extraction. Both qualitative and quantitative studies published between 2010 and 2019 were included if they addressed rehabilitation or palliative care for socioeconomically disadvantaged (adults ≥18 years) patients with advanced cancer. Socioeconomic disadvantage is defined by socioeconomic position (income, educational level and occupational status). RESULTS In total, 11 studies were included in this scoping review (138,152 patients and 45 healthcare providers) of which 10 were quantitative studies and 1 was a qualitative study. All included studies investigated the use of and preferences for palliative care, and none focused on rehabilitation. Two studies explored health professionals' perspectives on the delivery of palliative care. CONCLUSION Existing research within this research field is sparse. Future research should focus more on how best to reach and support socioeconomically disadvantaged people with advanced cancer in community-based rehabilitation and palliative care.
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Affiliation(s)
- Marc Sampedro Pilegaard
- REHPA, the Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Odense, Denmark
- Department of Public Health, Research Unit of General Practice, The Research Initiative of Activity Studies and Occupational Therapy, University of Southern Denmark, Odense, Denmark
| | - Henriette Knold Rossau
- REHPA, the Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Odense, Denmark
| | - Esben Lejsgaard
- Department of Sociology and Social Work, Aalborg University, Denmark, Aalborg, Denmark
| | - Jens-Jakob Kjer Møller
- REHPA, the Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Odense, Denmark
| | - Lene Jarlbaek
- REHPA, the Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Odense, Denmark
| | - Susanne Oksbjerg Dalton
- Survivorship & Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
- Department for Clinical Oncology & Palliative Care, Danish Research Center for Equality in Cancer (COMPAS), Zealand University Hospital, Næstved, Denmark
| | - Karen la Cour
- REHPA, the Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Odense, Denmark
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29
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Lewandowska A, Rudzki G, Lewandowski T, Rudzki S. The Problems and Needs of Patients Diagnosed with Cancer and Their Caregivers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010087. [PMID: 33374440 PMCID: PMC7795845 DOI: 10.3390/ijerph18010087] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 12/20/2020] [Accepted: 12/22/2020] [Indexed: 12/12/2022]
Abstract
(1) Background: As the literature analysis shows, cancer patients experience a variety of different needs. Each patient reacts differently to the hardships of the illness. Assessment of needs allows providing more effective support, relevant to every person’s individual experience, and is necessary for setting priorities for resource allocation, for planning and conducting holistic care, i.e., care designed to improve a patient’s quality of life in a significant way. (2) Patients and Methods: A population survey was conducted between 2018 and 2020. Cancer patients, as well as their caregivers, received an invitation to take part in the research, so their problems and needs could be assessed. (3) Results: The study involved 800 patients, 78% women and 22% men. 66% of the subjects were village residents, while 34%—city residents. The mean age of patients was 62 years, SD = 11.8. The patients received proper treatment within the public healthcare. The surveyed group of caregivers was 88% women and 12% men, 36% village residents and 64% city residents. Subjects were averagely 57 years old, SD 7.8. At the time of diagnosis, the subjects most often felt anxiety, despair, depression, feelings of helplessness (46%, 95% CI: 40–48). During illness and treatment, the subjects most often felt fatigued (79%, 95% CI: 70–80). Analysis of needs showed that 93% (95% CI: 89–97) of patients experienced a certain level of need for help in one or more aspects. (4) Conclusions: Patients diagnosed with cancer have a high level of unmet needs, especially in terms of psychological support and medical information. Their caregivers also experience needs and concerns regarding the disease. Caregivers should be made aware of the health consequences of cancer and consider appropriate supportive care for their loved ones.
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Affiliation(s)
- Anna Lewandowska
- Institute of Healthcare, State School of Technology and Economics in Jaroslaw, 37-500 Jaroslaw, Poland
- Correspondence: ; Tel.: +48-698757926
| | - Grzegorz Rudzki
- Chair and Department of Endocrinology, Medical University of Lublin, 20-090 Lublin, Poland;
| | - Tomasz Lewandowski
- Institute of Technical Engineering, State School of Technology and Economics in Jaroslaw, 37-500 Jaroslaw, Poland;
| | - Sławomir Rudzki
- Chair and Department of General and Transplant Surgery and Nutritional, Medical University of Lublin, 20-090 Lublin, Poland;
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30
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la Cour K, Gregersen Oestergaard L, Brandt Å, Offersen SMH, Lindahl-Jacobsen L, Cutchin M, Pilegaard MS. Process evaluation of the Cancer Home-Life Intervention: What can we learn from it for future intervention studies? Palliat Med 2020; 34:1425-1435. [PMID: 32611224 DOI: 10.1177/0269216320939227] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND The Cancer Home-Life Intervention showed no significant effects, and examination of the processes affecting or inhibiting outcomes is relevant. AIM To evaluate the Cancer Home-Life Intervention for its processes of implementation, mechanisms of impact and contextual factors. DESIGN Process evaluation conducted alongside the randomised controlled trial, using quantitative and qualitative methods (ClinicalTrials.gov NCT02356627). The Cancer Home-Life Intervention is a tailored, occupational therapy-based programme. SETTING/PARTICIPANTS This study took place in participants' homes and at hospital. A total of 113 home-dwelling adults (⩾18 years) with advanced cancer who had received the Cancer Home-Life Intervention were included, together with five intervention-therapists. RESULTS All 113 participants (100%) received a first home visit; 32 participants (26%) received a second visit; and 4 participants (3%) received a third visit. Median number of delivered intervention components were 3 (interquartile range: 2; 4). Identified barriers for effect included unclear decision process for intervention dosage; participants' low expectations; participants' lack of energy; and insufficient time to adopt new strategies. The trial design constituted a barrier as the intervention could only be provided within a specific short period of time and not when relevant. Intervention components working to solve practical everyday problems, enhance enjoyment and increase a sense of safety were perceived as useful. CONCLUSION Future interventions can benefit from inclusion criteria closely related to the intervention focus and clear procedures for when to continue, follow-up and terminate intervention. Decisions about dose and timing may benefit from learning theory by taking into account the time and practice needed to acquire new skills.
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Affiliation(s)
- Karen la Cour
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital and University of Southern Denmark, Nyborg, Denmark
| | - Lisa Gregersen Oestergaard
- DEFACTUM, Central Denmark Region, Aarhus, Denmark.,Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus, Denmark.,Department of Public Health, Aarhus University, Aarhus, Denmark.,The Research Initiative of Activity Studies and Occupational Therapy, Research Unit of General Practice, University of Southern Denmark, Odense, Denmark
| | - Åse Brandt
- The Research Initiative of Activity Studies and Occupational Therapy, Research Unit of General Practice, University of Southern Denmark, Odense, Denmark
| | - Sara Marie Hebsgaard Offersen
- Research Unit for General Practice, Research Centre for Cancer Diagnosis in Primary Care, Aarhus University, Aarhus, Denmark
| | - Line Lindahl-Jacobsen
- The Research Initiative of Activity Studies and Occupational Therapy, Research Unit of General Practice, University of Southern Denmark, Odense, Denmark.,University College Absalon, Center for Nutrition and Rehabilitation, Sorø, Denmark
| | - Malcolm Cutchin
- Department of Health Care Sciences, Wayne State University, Detroit, MI, USA
| | - Marc Sampedro Pilegaard
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital and University of Southern Denmark, Nyborg, Denmark.,The Research Initiative of Activity Studies and Occupational Therapy, Research Unit of General Practice, University of Southern Denmark, Odense, Denmark
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31
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Wang T, Molassiotis A, Tan JY, Chung BPM, Huang HQ. Prevalence and correlates of unmet palliative care needs in dyads of Chinese patients with advanced cancer and their informal caregivers: a cross-sectional survey. Support Care Cancer 2020; 29:1683-1698. [PMID: 32776164 DOI: 10.1007/s00520-020-05657-w] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 07/24/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To examine palliative care needs of advanced cancer patients and their informal caregivers and correlates of their needs within Chinese context. METHODS This was a cross-sectional survey conducted in two study sites in Mainland China. Patients and caregivers were recruited in dyads. Patients completed the following questionnaires: Problems and Needs in Palliative Care-short version, Hospital Anxiety and Depression Scale (HADS), Edmonton Symptom Assessment Scale (ESAS), Medical Outcomes Study-Social Support Survey (MOS-SSS), Brief Coping Orientation to Problems Experienced Scale (Brief-COPE), and Quality-of-Life Questionnaire Core 15-Palliative Care Scale. Questionnaires for caregivers were as follows: Comprehensive Needs Assessment Tool in Cancer for Caregivers, HADS, ESAS, MOS-SSS, Brief-COPE, and Caregiver Quality of Life Index-Cancer. All of the outcome variables were selected based on a conceptual framework of palliative care needs assessment. RESULTS Four hundred nineteen patient-caregiver dyads completed this survey. Patients' unmet palliative care needs were mainly related to financial (85.2%), informational (82.3%), physical (pain) (69.7%), and psychological (64.9%) domains. Caregivers' commonly reported unmet needs mainly focused on the domains of healthcare staff (95.0%), information (92.1%), and hospital facilities and services (90.5%). Patients' greater severity of symptom distress, presence of anxiety and/or depression, use of coping strategies particularly the less use of problem-focused coping, and caregivers' poorer quality of life were identified as key negative predictors of the needs of both patients and caregivers (p < 0.05). CONCLUSIONS Both patients and caregivers had context-bounded palliative care needs. In addition to increasing the amount of external asistance, more emphasis should be placed on screening for physical and psychological distress, the use of coping strategies, and the well-being of caregivers to help identify those in need for more clinical attention and specific interventions.
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Affiliation(s)
- Tao Wang
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
- College of Nursing and Midwifery Brisbane Centre, Charles Darwin University, Brisbane, Australia
| | - Alex Molassiotis
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
| | - Jing-Yu Tan
- College of Nursing and Midwifery Brisbane Centre, Charles Darwin University, Brisbane, Australia
| | - Betty Pui Man Chung
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Hou-Qiang Huang
- Department of Nursing, The Affiliated Hospital of Southwest Medical University, Luzhou, China
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Temiz G, Durna Z. Evaluation of Quality of Life and Health Care Needs in Cancer Patients Receiving Chemotherapy. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2020; 35:796-807. [PMID: 31054110 DOI: 10.1007/s13187-019-01533-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Symptoms are decisive in the quality of life of patients. Progression of the underlying disease leads to many physical and psychological symptoms in patients. Increases in these symptoms often prevent patients from complying with treatment. Therefore, the symptoms must be recognized, evaluated, and controlled for the treatment to be effective. This study determined the unmet needs of patients undergoing chemotherapy treatment and the effects of these needs on the patients' quality of life. Four hundred fifty patients were studied. Data were collected using the Patient Information Form, the Nightingale Symptom Assessment Scale (N-HAQ), the Supportive Care Requirements Questionnaire (DBGÖ), and the FACT-G (v4) Quality of Life Scale. The areas in which patients needed the most support were pain, weakness/fatigue, bad feelings, sadness, mood swings, difficulty in doing home-related tasks, fear of the cancer spreading, inability to control the situation, worries about the future, fear of death, worries about upsetting relatives, and being in need of information regarding their sexual lives. The results showed that for patients who had higher support requirements, higher incidences of symptoms led to a reduced quality of life. Consequently, frequently evaluating these symptoms to meet the needs identified, frequently measuring the quality and efficiency of care and advising these patients on their needs is recommended.
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Affiliation(s)
- Gamze Temiz
- Faculty of Nursing, University of Health Sciences, Istanbul, Turkey.
| | - Zehra Durna
- Istanbul Bilim University Florence Nightingale Hospital School of Nursing, Istanbul, Turkey
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Jie Y, Wang Y, Chen J, Wang C, Lin Y, Hu R, Wu Y. Unmet supportive care needs and its relation to quality of life among adult acute leukaemia patients in China: a cross-sectional study. Health Qual Life Outcomes 2020; 18:199. [PMID: 32576289 PMCID: PMC7310469 DOI: 10.1186/s12955-020-01454-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 06/16/2020] [Indexed: 12/11/2022] Open
Abstract
Background Patients with acute leukaemia (AL) usually require prolonged periods of hospitalisation. The treatment and clinical symptoms may lead to patients’ supportive care needs (SCNs) not being met and impairs their quality of life (QoL). Studies on QoL and SCNs among AL patients are limited. This study aimed to identify the unmet SCNs and its relation to QoL of adult AL patients in China. Methods This multicentre cross-sectional study recruited 346 participants to complete a self-developed questionnaire, detailing demographic information and disease-related variables. A 34-item Supportive Care Needs Survey (SCNS-SF34) was used to identify unmet SCNs, and the Functional Assessment of Cancer Therapy-Leukaemia (FACT-Leu) questionnaire measured patients’ QoL. Results Unmet SCN rates for the 34 items ranged from17.6 to 81.7%. Patients’ needs were high for health systems and information, but low in the sexual domain. The results reveal nine factors associated with the unmet SCNs of adult AL patients, including marital status, original residence, age, education, occupation, other diseases, chemotherapy course, disease course, and treatment stage (p < 0.05). The total score of the FACT-Leu negatively correlated with the SCNS-SF34 in the physical/daily living (r = − 0.527, p < 0.01), psychological (r = − 0.688, p < 0.01), sexual (r = − 0.170, p < 0.01), patient care and support (r = − 0.352, p < 0.01), and health systems and information (r = − 0.220, p < 0.01) domains. Conclusions Adult AL patients exhibit a high demand for unmet SCNs, especially in the domain of health systems and information. There was a significant association between patients’ unmet SCNs and QoL. Future research should develop tailored interventions to address the unmet SCNs of adult AL patients, to further improve their QoL.
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Affiliation(s)
- Yan Jie
- School of Nursing, Fujian Medical University, NO.1 Xueyuan Road, Shangjie Town, Minhou County, Fuzhou City, 350122, Fujian Province, China
| | - Ying Wang
- School of Nursing, Fujian Medical University, NO.1 Xueyuan Road, Shangjie Town, Minhou County, Fuzhou City, 350122, Fujian Province, China
| | - Jingyi Chen
- School of Nursing, Fujian Medical University, NO.1 Xueyuan Road, Shangjie Town, Minhou County, Fuzhou City, 350122, Fujian Province, China
| | - Chunfeng Wang
- School of Nursing, Fujian Medical University, NO.1 Xueyuan Road, Shangjie Town, Minhou County, Fuzhou City, 350122, Fujian Province, China
| | - Yingchun Lin
- Department of Hematology, the First Affiliated Hospital of Fujian University, No. 20 of Chazhong Road, Taijiang District, Fuzhou City, 350004, Fujian Province, China
| | - Rong Hu
- School of Nursing, Fujian Medical University, NO.1 Xueyuan Road, Shangjie Town, Minhou County, Fuzhou City, 350122, Fujian Province, China.
| | - Yong Wu
- Department of Hematology, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Gulou District, Fuzhou City, 350001, Fujian Province, China.
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Wæhrens EE, Brandt Å, Peoples H, Cour K. Everyday activities when living at home with advanced cancer: A cross‐sectional study. Eur J Cancer Care (Engl) 2020; 29:e13258. [DOI: 10.1111/ecc.13258] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 01/13/2020] [Accepted: 04/16/2020] [Indexed: 01/22/2023]
Affiliation(s)
- Eva Ejlersen Wæhrens
- The Research Initiative for Activity Studies and Occupational Therapy, Research Unit of General Practice Institute of Public Health University of Southern Denmark Odense Denmark
- Department of Rheumatology The ADL Unit The Parker Institute Copenhagen University Hospitals Bispebjerg – Frederiksberg Frederiksberg Denmark
| | - Åse Brandt
- The Research Initiative for Activity Studies and Occupational Therapy, Research Unit of General Practice Institute of Public Health University of Southern Denmark Odense Denmark
- The National Board of Social Services Center for Disability and Mental Vulnerability Odense Denmark
| | - Hanne Peoples
- The Research Initiative for Activity Studies and Occupational Therapy, Research Unit of General Practice Institute of Public Health University of Southern Denmark Odense Denmark
| | - Karen Cour
- The Research Initiative for Activity Studies and Occupational Therapy, Research Unit of General Practice Institute of Public Health University of Southern Denmark Odense Denmark
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Chen YJ, Li XX, Ma HK, Zhang X, Wang BW, Guo TT, Xiao Y, Bing ZT, Ge L, Yang KH, Han XM. Exercise Training for Improving Patient-Reported Outcomes in Patients With Advanced-Stage Cancer: A Systematic Review and Meta-Analysis. J Pain Symptom Manage 2020; 59:734-749.e10. [PMID: 31546002 DOI: 10.1016/j.jpainsymman.2019.09.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 09/12/2019] [Accepted: 09/12/2019] [Indexed: 12/16/2022]
Abstract
CONTEXT Patients with advanced-stage cancer often suffer many physical and psychological symptoms. Exercise has been shown to improve quality of life (QoL), decrease cancer-related symptoms, and maintain or improve functional status in cancer survivors or patients with early stage cancer. However, the effect of exercise on these outcomes in patients with advanced-stage cancer is unclear. OBJECTIVES This meta-analysis aimed to assess the effectiveness of exercise interventions for patients with advanced-stage cancer in improving cancer-related symptoms and functional status outcomes. METHODS We conducted a comprehensive literature search in PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and Web of Science from their inception to February 3, 2019, to include randomized controlled trials (RCTs) comparing exercise and usual care for improving outcomes in patients with advanced-stage cancer. Two reviewers independently screened the studies, extracted data of interest, and assessed the risk of bias of individual RCTs using the Cochrane Handbook, Version 5.1.0. RESULTS About 15 RCTs enrolling 1208 patients were included. Compared with usual care, exercise showed a significant improvement in QoL (standardized mean difference [SMD] 0.22; 95% CI 0.06-0.38; P = 0.009), fatigue (SMD -0.25; 95% CI -0.45 to -0.04; P = 0.02), insomnia (SMD -0.36; 95% CI -0.56 to -0.17; P = 0.0002), physical function (SMD 0.22; 95% CI 0.05-0.38; P = 0.009), social function (SMD 0.18; 95% CI 0.02-0.34; P = 0.03), and dyspnea reduction (SMD -0.18; 95% CI -0.34 to -0.01; P = 0.03). CONCLUSION Exercise serves as an effective intervention to improve QoL and alleviate fatigue, insomnia, dyspnea, and physical and social functions for patients with advanced-stage cancer.
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Affiliation(s)
- Ya-Jing Chen
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, Gansu, China; Evidence-Based Social Science Center, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Xiu-Xia Li
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, Gansu, China; Evidence-Based Social Science Center, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Hai-Kun Ma
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Xu Zhang
- General Department 2, Second Hospital, Lanzhou University, Lanzhou, Gansu, China
| | - Bang-Wei Wang
- The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China
| | - Tao-Tao Guo
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Ya Xiao
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Zhi-Tong Bing
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China; Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, Gansu, China
| | - Long Ge
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, Gansu, China; Evidence-Based Social Science Center, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Ke-Hu Yang
- Evidence-Based Social Science Center, School of Public Health, Lanzhou University, Lanzhou, Gansu, China; Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China; Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, Gansu, China
| | - Xue-Mei Han
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, Gansu, China; Evidence-Based Social Science Center, School of Public Health, Lanzhou University, Lanzhou, Gansu, China.
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36
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van Dongen SI, de Nooijer K, Cramm JM, Francke AL, Oldenmenger WH, Korfage IJ, Witkamp FE, Stoevelaar R, van der Heide A, Rietjens JA. Self-management of patients with advanced cancer: A systematic review of experiences and attitudes. Palliat Med 2020; 34:160-178. [PMID: 32009565 PMCID: PMC7433395 DOI: 10.1177/0269216319883976] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Patients with advanced cancer are increasingly expected to self-manage. Thus far, this topic has received little systematic attention. AIM To summarise studies describing self-management strategies of patients with advanced cancer and associated experiences and personal characteristics. Also, to summarise attitudes of relatives and healthcare professionals towards patient self-management. DESIGN A systematic review including non-experimental quantitative and qualitative studies. Data were analysed using critical interpretive synthesis. Included studies were appraised on methodological quality and quality of reporting. DATA SOURCES MEDLINE, Embase, Cochrane Central, PsycINFO, CINAHL, Web of Science and Google Scholar (until 11 June 2019). RESULTS Of 1742 identified articles, 31 moderate-quality articles describing 8 quantitative and 23 qualitative studies were included. Patients with advanced cancer used self-management strategies in seven domains: medicine and pharmacology, lifestyle, mental health, social support, knowledge and information, navigation and coordination and medical decision-making (29 articles). Strategies were highly individual, sometimes ambivalent and dependent on social interactions. Older patients and patients with more depressive symptoms and lower levels of physical functioning, education and self-efficacy might have more difficulties with certain self-management strategies (six articles). Healthcare professionals perceived self-management as desirable and achievable if based on sufficient skills and knowledge and solid patient-professional partnerships (three articles). CONCLUSION Self-management of patients with advanced cancer is highly personal and multifaceted. Strategies may be substitutional, additional or even conflicting compared to care provided by healthcare professionals. Self-management support can benefit from an individualised approach embedded in solid partnerships with relatives and healthcare professionals.
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Affiliation(s)
- Sophie I van Dongen
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Kim de Nooijer
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Jane M Cramm
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Anneke L Francke
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands.,Amsterdam Public Health (APH) Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Wendy H Oldenmenger
- Faculty of Nursing and Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
| | - Ida J Korfage
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Frederika E Witkamp
- Faculty of Nursing and Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
| | - Rik Stoevelaar
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Agnes van der Heide
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Judith Ac Rietjens
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
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37
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Calman L, Radcliffe E, Berman R, Demain S, Restorick-Banks S, Richardson A, Wagland R, Foster C. The ENABLE study protocol: Understanding and characterising the value and role of self-management support for people living with cancer that is treatable but not curable. Eur J Cancer Care (Engl) 2020; 29:e13217. [PMID: 31958343 DOI: 10.1111/ecc.13217] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 11/07/2019] [Accepted: 12/10/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Attention is turning to the needs of people living with treatable but incurable cancer, a group with complex needs, living with uncertainty over time. More research is needed to understand how this group self-manage the impact of cancer to strengthen the evidence base for interventions. This study aims to understand the value and outcomes of self-management support for people living with treatable but incurable cancer. METHODS Qualitative longitudinal methods will examine how support needs change over time in relation to self-management and unpredictable disease trajectories. Thirty patients and 30 carers will be recruited from two hospitals, each participating in three interviews over 1 year. Patients will be purposively sampled according to age, gender, cancer type and anticipated survival. Carers will be recruited via nomination by patients but interviewed separately. One-off interviews will be conducted with 20 healthcare professionals, providing data from multiple perspectives. Based on interview findings, a modified Delphi process will map areas of consensus and disparity regarding conceptualisations and outcomes of self-management support. CONCLUSION The key output will be practice recommendations in relation to self-management support, producing evidence to inform service innovation for those living with treatable but incurable cancer.
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Affiliation(s)
- Lynn Calman
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Eloise Radcliffe
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, UK
| | | | - Sara Demain
- Faculty of Health and Human Sciences, University of Plymouth, Plymouth, UK
| | | | - Alison Richardson
- University of Southampton and University Hospital Southampton, Southampton, UK
| | - Richard Wagland
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Claire Foster
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, UK
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Shunmugasundaram C, Rutherford C, Butow PN, Sundaresan P, Dhillon HM. Content comparison of unmet needs self-report measures used in patients with head and neck cancer: A systematic review. Psychooncology 2019; 28:2295-2306. [PMID: 31654540 DOI: 10.1002/pon.5257] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 09/18/2019] [Accepted: 09/24/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Morbidity from head and neck cancers (HNCs) and their treatment are significant, given their proximity to anatomical sites impacting facial appearance and function. Assessing the needs of HNC patients throughout their cancer journey is critical to informing quality care and improving quality of life. We aimed to identify available unmet needs measures in the HNC setting and appraise their content and psychometric properties. METHODS We conducted a systematic search of five electronic databases (July 2007-July 2019) to identify studies of unmet needs in patients with HNC. In addition, three web-based patient-reported outcome measures (PROMs) databases were searched for unmet needs measures. Citations were screened for eligibility and identified measures reviewed for content coverage and psychometric properties. From identified measures and literature, a conceptual framework with 12 clinically relevant aspects of unmet needs was developed and used to assess the conceptual coverage of available unmet needs measures. RESULTS Literature search identified 273 records of which 28 studies assessing unmet needs in HNC cancer met eligibility criteria. Seven unmet needs measures were identified from retrieved studies and seven additional measures from PROM databases. Thus, 14 measures in total were reviewed. Content mapping revealed that three measures demonstrated excellent content validity (greater than 80% conceptual coverage): Patient Concerns Inventory (PCI), Needs Assessment for Advanced Cancer Patients (NA-ACP), and James Supportive Care Screening (JSCS). CONCLUSION We recommend PCI be used to measure unmet needs in the HNC setting considering the importance of content validity over quantitative psychometric properties.
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Affiliation(s)
- Chindhu Shunmugasundaram
- Centre for Medical Psychology and Evidence-based Decision-making, School of Psychology, Faculty of Science, University of Sydney, Camperdown, New South Wales, Australia.,Psycho-Oncology Cooperative Research Group, University of Sydney, Camperdown, New South Wales, Australia
| | - Claudia Rutherford
- Quality of Life Office, School of Psychology, Faculty of Science, University of Sydney, Camperdown, New South Wales, Australia.,Sydney Nursing School, Cancer Nursing Research Unit (CNRU), University of Sydney, Camperdown, New South Wales, Australia
| | - Phyllis N Butow
- Centre for Medical Psychology and Evidence-based Decision-making, School of Psychology, Faculty of Science, University of Sydney, Camperdown, New South Wales, Australia.,Psycho-Oncology Cooperative Research Group, University of Sydney, Camperdown, New South Wales, Australia
| | - Puma Sundaresan
- Radiation Oncology Network, Western Sydney Local Health District, North Parramatta, New South Wales, Australia.,Sydney Medical School, University of Sydney, Camperdown, New South Wales, Australia
| | - Haryana M Dhillon
- Centre for Medical Psychology and Evidence-based Decision-making, School of Psychology, Faculty of Science, University of Sydney, Camperdown, New South Wales, Australia.,Psycho-Oncology Cooperative Research Group, University of Sydney, Camperdown, New South Wales, Australia
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Nadler MB, Desnoyers A, Langelier DM, Amir E. The Effect of Exercise on Quality of Life, Fatigue, Physical Function, and Safety in Advanced Solid Tumor Cancers: A Meta-analysis of Randomized Control Trials. J Pain Symptom Manage 2019; 58:899-908.e7. [PMID: 31319105 DOI: 10.1016/j.jpainsymman.2019.07.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 07/03/2019] [Accepted: 07/05/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND People with metastatic cancers experience poor quality of life (QoL), fatigue, and decreased physical function. Exercise improves these symptoms in the curative setting, but the efficacy and safety of exercise in the metastatic setting is uncertain. METHODS Prospective, randomized trials of moderate/high-intensity aerobic exercise or resistance training vs. control in patients with advanced/metastatic solid cancers were identified from prior reviews and updated using a search of PubMed. The mean and SD for validated outcome measures (QoL, physical function, and fatigue) were extracted for intervention and control groups at baseline and postintervention. The Mann-Whitney test was used to evaluate the effect of exercise on the pooled change between baseline and postintervention. Safety was evaluated qualitatively. RESULTS Sixteen trials were analyzed. Among patients with scores at the mean or 2SD above, exercise was not associated with significant or clinical difference in QoL or fatigue. In patients with baseline scores 2SD below mean, exercise was associated with nonsignificant difference meeting minimal clinical important difference in QoL (-2.8 vs. 4.6, P = 0.28). For function, patients at the mean had nonstatistically significant, but clinically meaningful difference in the six-minute walk test (6-MWT) (14.7 vs. 29.0 m, P = 0.44). In patients 2 SD below the mean, there was a clinically meaningful difference in two patient-reported functional subscales (0.1 vs. 5.3, P = 0.076 and 0.44 vs. 8.5, P = 0.465) and a clinically meaningful improvement in the 6-MWT (-7.5 vs. 27.0 m, P = 0.34), although none of these associations met statistical significance. There were no differences in falls, fractures, or pain. DISCUSSION Exercise is associated with clinically meaningful improvements in QoL, function, and 6-MWT in some patients with metastatic cancer. Despite poor reporting of safety, there was no signal of increased harm from exercise in this setting.
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Affiliation(s)
- Michelle B Nadler
- Division of Medical Oncology & Hematology, Department of Medicine, Princess Margaret Cancer Centre and the University of Toronto, Toronto, Ontario, Canada.
| | - Alexandra Desnoyers
- Department of Medicine, Centre Hospitalier Universitaire de Sherbrooke and the University of Sherbrooke, Sherbrooke, Quebec, Canada
| | - David M Langelier
- Division of Physical Medicine and Rehabilitation, Department of Medicine, Toronto Rehabilitation Institute and the University of Toronto, Toronto, Ontario, Canada
| | - Eitan Amir
- Division of Medical Oncology & Hematology, Department of Medicine, Princess Margaret Cancer Centre and the University of Toronto, Toronto, Ontario, Canada
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40
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Brassil ME, Cheville A, Zheng JY, Smith SR, Tolchin DW, Wittry SA, Jones CA, Chernack B. Top Ten Tips Palliative Care Clinicians Should Know About Physical Medicine and Rehabilitation. J Palliat Med 2019; 23:129-135. [PMID: 31556786 DOI: 10.1089/jpm.2019.0440] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Physical medicine and rehabilitation (PM&R) is a specialty of medicine focused on optimizing function and quality of life for individuals with physical impairments, injuries, or disabling illnesses. Given the sometimes acute nature of the loss of function and even loss of independence, there are significant palliative care (PC) needs within patients seen by PM&R. This article, written by a team of PM&R and PC specialists, aims to help the PC team better understand the world of postacute care, expand their toolkit for treating musculoskeletal and neurological symptoms, improve prognostication for patients with brain and spinal cord injuries, and decide when patients may benefit from PM&R consultation and support. There is significant overlap between the populations treated by PM&R and PC. Better integration between these specialties will help patients to maintain independence as well as advance excellent patient-centered care.
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Affiliation(s)
- Michelle E Brassil
- Department of Physical Medicine and Rehabilitation, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Palliative Care Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Andrea Cheville
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota
| | - Jasmine Y Zheng
- Department of Physical Medicine and Rehabilitation, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Sean R Smith
- Department of Physical Medicine and Rehabilitation, University of Michigan Medical School, Ann Arbor, Michigan
| | - Dorothy W Tolchin
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts
| | | | - Christopher A Jones
- Palliative and Advanced Illness Research Center, University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Betty Chernack
- Department of Physical Medicine and Rehabilitation, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Palliative Care Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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Ang SHM. Promoting Effective Nurse-Patient Communication in Palliative Care Using the SAGE and THYME Model: Can it be Implemented Cross-Culturally? Open Nurs J 2019. [DOI: 10.2174/1874434601913010153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Effective communication in palliative care is essential in making optimal health care decisions that align with the interests of the patients and empowering them to be involved in their care planning. However, many Asian nurses lacked the prerequisite communication skills required to assess and address the informational needs of advanced cancer patients. These nurses often adopt a routinized approach of giving information to patients to overcome their inadequacies in eliciting patients’ concerns. Thus, this opinion paper seeks to understand whether the SAGE and THYME model can be utilised widely by nurses across different cultural contexts to facilitate more effective communication and to develop therapeutic relationships with advanced cancer patients who are receiving palliative care.
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Brekke MF, la Cour K, Brandt Å, Peoples H, Wæhrens EE. The Association between ADL Ability and Quality of Life among People with Advanced Cancer. Occup Ther Int 2019; 2019:2629673. [PMID: 31531007 PMCID: PMC6745094 DOI: 10.1155/2019/2629673] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 06/09/2019] [Accepted: 08/06/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Occupational therapy and occupational science are founded on the theoretical core assumption that occupation and quality of life (QoL) are closely related. However, such theoretical core assumptions must be supported through empirically based research. OBJECTIVE To investigate the association between QoL and occupation, here self-reported and observed ADL abilities as a part of occupation, among people with advanced cancer, including determining whether self-reported or observed ADL ability had the stronger association with QoL. METHODS The study was nested in a cross-sectional study. The association between ADL ability and QoL among 108 people with advanced cancer was investigated using the ADL Interview (ADL-I), the Assessment of Motor and Process Skills (AMPS), and the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC-QLQ-C30). RESULTS AND CONCLUSIONS Results showed that high observed ADL motor ability was associated with high QoL. In contrast, observed ADL process ability and self-reported ADL ability were not significantly associated with QoL. Oppositely expected, observed ADL ability had a stronger association with QoL than self-reported ADL ability. Thereby, the study to some extent contributes knowledge confirming the theoretical core assumptions about the relation between occupation, here performance of ADL, and QoL.
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Affiliation(s)
- Mette Falk Brekke
- Department of Occupational Therapy, University College Absalon, Næstved, Denmark
| | - Karen la Cour
- Department of Public Health, Research Unit for General Practice, University of Southern Denmark, Odense, Denmark
- The Danish Knowledge Center for Rehabilitation and Palliative Care, REHPA, Vestergade 17, 5800 Nyborg, Denmark
- Department of Public Health, Research Unit for General Practice, The Research Initiative for Activity Studies and Occupational Therapy, University of Southern Denmark, Odense, Denmark
| | - Åse Brandt
- Department of Public Health, Research Unit for General Practice, The Research Initiative for Activity Studies and Occupational Therapy, University of Southern Denmark, Odense, Denmark
- Centre for Disability and Mental Vulnerability, The National Board of Social Services, Odense, Denmark
| | - Hanne Peoples
- Department of Public Health, Research Unit for General Practice, The Research Initiative for Activity Studies and Occupational Therapy, University of Southern Denmark, Odense, Denmark
- Faculty of Health Sciences, Health Sciences Research Center, University College Lillebaelt, Odense, Denmark
| | - Eva Ejlersen Wæhrens
- Department of Public Health, Research Unit for General Practice, The Research Initiative for Activity Studies and Occupational Therapy, University of Southern Denmark, Odense, Denmark
- The Parker Institute, Copenhagen University Hospital Bispebjerg & Frederiksberg, Copenhagen, Denmark
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Afiyanti Y, Gayatri D, Besral, Dan Haryani. Unmet supportive care needs of Indonesian gynecological cancer survivors. ENFERMERIA CLINICA 2019. [PMID: 31326298 DOI: 10.1016/j.enfcli.2019.04.131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE This study aimed to assess the unmet supportive care needs of gynecological cancer patients in Indonesia. METHOD A quantitative descriptive cross-sectional study using survey was used. We recruited 298 gynecological cancer survivors from three hospitals in different provinces in Indonesia, i.e., Soetomo Hospital in East Java; Sardjito Hospital in Yogyakarta; and Dharmais Cancer Hospital in Jakarta. Demographic and clinical characteristic and the Cancer Survivor Unmet Needs (CaSUN) questionnaires were given to measure supportive care needs (i.e. comprehensive care need, existential need, quality of life need, relationship need, and informational need). Descriptive statistics including frequency, percentage, and mean were used to analyze the demographic and clinical characteristics and unmet supportive care needs of participants. RESULTS 98% of the survivors reported at least one supportive care need. The highest percentage of unmet supportive care need was an informational need (37.8%) followed by comprehensive care need (37.3%), quality of life need (36.1%), existential need (31.5%), and relationship need (23.9%). However, the highest mean of unmet needs was existential survivorship need 6.4 (5.7). CONCLUSIONS Gynecological cancer survivors in Indonesia marked various unmet needs. Nurses should identify the supportive care needs of the women diagnosed with gynecological cancer early in cancer trajectory and also at the critical points of cancer care such as after including primary treatment.
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Affiliation(s)
- Yati Afiyanti
- Faculty of Nursing, Universitas Indonesia, Depok, West Java, Indonesia.
| | - Dewi Gayatri
- Faculty of Nursing, Universitas Indonesia, Depok, West Java, Indonesia
| | - Besral
- Faculty of Public Health, Universitas Indonesia, Depok, West Java, Indonesia
| | - Dan Haryani
- Nursing Study Program, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
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Warth M, Kessler J, Koehler F, Aguilar-Raab C, Bardenheuer HJ, Ditzen B. Brief psychosocial interventions improve quality of life of patients receiving palliative care: A systematic review and meta-analysis. Palliat Med 2019; 33:332-345. [PMID: 30648926 DOI: 10.1177/0269216318818011] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Patients with a terminal disease report a high need for psychosocial and spiritual support. Previous literature reviews on psychosocial interventions in palliative care were restricted to certain subtypes of techniques, included a wide range of patients, conditions, and settings, or required a number of sessions unrealistic to be achieved in patients nearing the end of their lives. Aim: The aim of this study was to review and synthesize the evidence on brief psychosocial interventions (i.e. four sessions or less and less than 21 days) for patients receiving palliative treatment. Design: We performed a systematic review and meta-analysis in accordance with standard guidelines and a pre-registered protocol (PROSPERO: CRD42018082713). Data sources: Electronic databases, journals, and references were searched for controlled clinical trials. We used the Cochrane criteria to assess the risk of bias within studies. Results: In total, 15 studies met the eligibility criteria and reported the effects of 17 interventions and a total of 1248 patients. The most frequently used techniques were life review techniques and music therapy. After exclusion of outliers, psychosocial interventions showed to be superior with regard to the improvement of quality of life (effect size = 0.36, confidence interval = 0.08 to 0.64), and the reduction of emotional (effect size = −0.51, confidence interval = −0.77 to −0.26) and existential distress (effect size = −0.40, confidence interval = −0.71 to −0.07) compared to the control groups. Conclusion: Brief psychosocial interventions can improve clinically relevant health outcomes and should therefore be made available for patients receiving palliative care.
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Affiliation(s)
- Marco Warth
- 1 Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Jens Kessler
- 2 Center of Pain Therapy and Palliative Care Medicine, Department of Anesthesiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Friederike Koehler
- 1 Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Corina Aguilar-Raab
- 1 Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Hubert J Bardenheuer
- 2 Center of Pain Therapy and Palliative Care Medicine, Department of Anesthesiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Beate Ditzen
- 1 Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
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Seow H, Barbera L, Howell D, Dy SM. How End-Of-Life Home Care Services Are Used from Admission to Death: A Population-Based Cohort Study. J Palliat Care 2018. [DOI: 10.1177/082585971002600403] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aim: Our goal was to describe the trajectories of end-of-life nursing and personal support worker (PSW) use from home care admission until death. Methods: We studied a historical prospective cohort of end-of-life home care patients in Ontario, Canada, linking administrative databases. We calculated the odds of using any nursing or PSW hours and the incidence rate ratio of services used for each week approaching death, controlling for confounders. Results: Among all patients (n=11,867), the odds of using any nursing and PSW hours increased by 4 percent and 10 percent, respectively, each week closer to death. Among patients using services, the ratio of nursing and PSW hours increased 20 percent and 11 percent, respectively, in the last 4 weeks of life compared to use at 24 weeks before death. Conclusion: Use of nursing and PSW hours increases slightly each week before death and sharply in the last month of life. Understanding the trajectory of home care services use can help decision makers design better end-of-life care.
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Affiliation(s)
- Hsien Seow
- H Seow (corresponding author): Department of Oncology, McMaster University, Hamilton, Ontario, Canada, and Juravinski Cancer Centre, 699 Concession St, 4th Floor, Room 4–229, Hamilton, Ontario, Canada L8V 5C2
| | - Lisa Barbera
- L Barbera: Departments of Radiation Oncology and Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Doris Howell
- D Howell: Oncology Nursing Research, Princess Margaret Hospital, Toronto, Ontario, Canada
| | - Sydney M. Dy
- SM Dy: Health Policy and Management, Johns Hopkins School of Public Health, Baltimore, Maryland, United States
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Wang T, Molassiotis A, Chung BPM, Tan JY. Unmet care needs of advanced cancer patients and their informal caregivers: a systematic review. BMC Palliat Care 2018; 17:96. [PMID: 30037346 PMCID: PMC6057056 DOI: 10.1186/s12904-018-0346-9] [Citation(s) in RCA: 335] [Impact Index Per Article: 55.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 06/25/2018] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND This systematic review aimed to identify the unmet care needs and their associated variables in patients with advanced cancer and informal caregivers, alongside summarizing the tools used for needs assessment. METHODS Ten electronic databases were searched systematically from inception of each database to December 2016 to determine eligible studies. Studies that considered the unmet care needs of either adult patients with advanced cancer or informal caregivers, regardless of the study design, were included. The Mixed Methods Appraisal Tool was utilized for quality appraisal of the included studies. Content analysis was used to identify unmet needs, and descriptive analysis was adopted to synthesize other outcomes. RESULTS Fifty studies were included, and their methodological quality was generally robust. The prevalence of unmet needs varied across studies. Twelve unmet need domains were identified in patients with advanced cancer, and seven among informal caregivers. The three most commonly reported domains for patients were psychological, physical, and healthcare service and information. The most prominent unmet items of these domains were emotional support (10.1-84.4%), fatigue (18-76.3%), and "being informed about benefits and side-effects of treatment" (4-66.7%). The most commonly identified unmet needs for informal caregivers were information needs, including illness and treatment information (26-100%) and care-related information (21-100%). Unmet needs of patients with advanced cancer were associated with their physical symptoms, anxiety, and quality of life. The most commonly used instruments for needs assessment among patients with advanced cancer were the Supportive Care Needs Survey (N = 8) and Problems and Needs in Palliative Care questionnaire (N = 5). The majority of the included studies investigated unmet needs from the perspectives of either patients or caregivers with a cross-sectional study design using single time-point assessments. Moreover, significant heterogeneity, including differences in study contexts, assessment methods, instruments for measurement, need classifications, and reporting methods, were identified across studies. CONCLUSION Both advanced cancer patients and informal caregivers reported a wide range of context-bound unmet needs. Examining their unmet needs on the basis of viewing patients and their informal caregivers as a whole unit will be highly optimal. Unmet care needs should be comprehensively evaluated from the perspectives of all stakeholders and interpreted by using rigorously designed mixed methods research and longitudinal studies within a given context.
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Affiliation(s)
- Tao Wang
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Alex Molassiotis
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Betty Pui Man Chung
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Jing-Yu Tan
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
- College of Nursing and Midwifery, Charles Darwin University, Darwin, Australia
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Ammari ABH, Hendriksen C, Rydahl-Hansen S. Results from the family and coping oriented palliative homecare intervention study (FamCope)-A randomized controlled trial. J Psychosoc Oncol 2018; 36:557-581. [PMID: 29995589 DOI: 10.1080/07347332.2018.1460003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
We tested if a family-and-coping-oriented basic palliative homecare intervention (six visits within 15 weeks) could improve quality-of-life and reduce anxiety and depression of advanced cancer patients and their closest relative, and reduce acute hospital admissions of patients. Fifty-seven families were randomized, but patient enrollment was terminated before reaching target sample due to a low recruitment rate. We found no evidence of effect of the FamCope-intervention, but further investigation of effective methods to support how families cope with advanced cancer at home is needed as levels of distress is as high in relatives as it is in patients. However, duration of interventions to support family-coping may need a considerable time-span to show effect on quality-of-life. We recommend that recruitment is undertaken in close collaboration with the hospital clinics, and that complexity of problems is used as inclusion criterion to decide when a family-coping intervention is needed based on the level of problems and distress in the family.
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Affiliation(s)
- Anne Birgitte Hjuler Ammari
- a Research Unit of Clinical Nursing, Palliative Medical Department , Bispebjerg and Frederiksberg University Hospital , Copenhagen , Denmark
| | - Carsten Hendriksen
- b Institute of Public Health, University of Copenhagen , Copenhagen , Denmark.,c Department of Integrated Health Care , Bispebjerg and Frederiksberg University Hospital , Copenhagen , Denmark
| | - Susan Rydahl-Hansen
- d Research Unit of Clinical Nursing, Bispebjerg and Frederiksberg University Hospital , Copenhagen , Denmark.,e Department of Nursing Science , University of Aarhus , Aarhus , Denmark
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Johansson E, Steineck G, Holmberg L, Johansson JE, Nyberg T, Bill-Axelson A. Quality of Life after Radical Prostatectomy or Watchful Waiting With or Without Androgen Deprivation Therapy: The SPCG-4 Randomized Trial. Eur Urol Oncol 2018; 1:134-142. [DOI: 10.1016/j.euo.2018.03.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 03/15/2018] [Accepted: 03/23/2018] [Indexed: 11/17/2022]
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White J, Park J, Russell KB, Reynolds K, Madani A, Carlson LE, Giese-Davis J. Falling through the cracks. A thematic evaluation of unmet needs of adult survivors of childhood cancers. Psychooncology 2018; 27:1979-1986. [DOI: 10.1002/pon.4754] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Revised: 04/17/2018] [Accepted: 04/24/2018] [Indexed: 12/16/2022]
Affiliation(s)
- Jennifer White
- Department of Physiotherapy; Monash University; Melbourne Victoria Australia
| | - Joanne Park
- Department of Psychology; University of British Columbia; Vancouver British Columbia Canada
- Department of Oncology; University of Calgary; Calgary Alberta Canada
- Tom Baker Cancer Centre, Psychosocial Resources; Calgary Alberta Canada
| | - K. Brooke Russell
- Department of Oncology; University of Calgary; Calgary Alberta Canada
- Tom Baker Cancer Centre, Psychosocial Resources; Calgary Alberta Canada
| | | | - A. Madani
- Provincial Health Services Authority; Vancouver British Columbia Canada
| | - Linda E. Carlson
- Department of Oncology; University of Calgary; Calgary Alberta Canada
- Tom Baker Cancer Centre, Psychosocial Resources; Calgary Alberta Canada
| | - Janine Giese-Davis
- Department of Oncology; University of Calgary; Calgary Alberta Canada
- Tom Baker Cancer Centre, Psychosocial Resources; Calgary Alberta Canada
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50
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Pilegaard MS, la Cour K, Gregersen Oestergaard L, Johnsen AT, Lindahl-Jacobsen L, Højris I, Brandt Å. The 'Cancer Home-Life Intervention': A randomised controlled trial evaluating the efficacy of an occupational therapy-based intervention in people with advanced cancer. Palliat Med 2018; 32:744-756. [PMID: 29299957 PMCID: PMC5881790 DOI: 10.1177/0269216317747199] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND People with advanced cancer face difficulties with their everyday activities at home that may reduce their health-related quality of life. To address these difficulties, we developed the 'Cancer Home-Life Intervention'. AIM To evaluate the efficacy of the 'Cancer Home Life-Intervention' compared with usual care with regard to patients' performance of, and participation in, everyday activities, and their health-related quality of life. DESIGN AND INTERVENTION A randomised controlled trial ( ClinicalTrials.gov NCT02356627). The 'Cancer Home-Life Intervention' is a brief, tailored, occupational therapy-based and adaptive programme for people with advanced cancer targeting the performance of their prioritised everyday activities. SETTING/PARTICIPANTS Home-living adults diagnosed with advanced cancer experiencing functional limitations were recruited from two Danish hospitals. They were assessed at baseline, and at 6 and 12 weeks of follow-up. The primary outcome was activities of daily living motor ability. Secondary outcomes were activities of daily living process ability, difficulty performing prioritised everyday activities, participation restrictions and health-related quality of life. RESULTS A total of 242 participants were randomised either to the intervention group ( n = 121) or the control group ( n = 121). No effect was found on the primary outcome (between-group mean change: -0.04 logits (95% confidence interval: -0.23 to 0.15); p = 0.69). Nor was any effect on the secondary outcomes observed. CONCLUSION In most cases, the 'Cancer Home-Life Intervention' was delivered through only one home visit and one follow-up telephone contact, which not was effective in maintaining or improving participants' everyday activities and health-related quality of life. Future research should pay even more attention to intervention development and feasibility testing.
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Affiliation(s)
- Marc Sampedro Pilegaard
- 1 The Research Initiative of Activity Studies and Occupational Therapy, Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark.,2 OPEN - Odense Patient Data Explorative Network, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Karen la Cour
- 1 The Research Initiative of Activity Studies and Occupational Therapy, Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark.,2 OPEN - Odense Patient Data Explorative Network, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Lisa Gregersen Oestergaard
- 3 Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus, Denmark.,4 Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Anna Thit Johnsen
- 5 Department of Psychology, University of Southern Denmark, Odense, Denmark.,6 Department of Palliative Medicine, Bispebjerg Hospital, Copenhagen, Denmark
| | | | - Inger Højris
- 8 Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Åse Brandt
- 1 The Research Initiative of Activity Studies and Occupational Therapy, Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark.,2 OPEN - Odense Patient Data Explorative Network, Odense University Hospital, University of Southern Denmark, Odense, Denmark.,9 Centre for Disability and Mental Vulnerability, The National Board of Social Services, Odense, Denmark
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