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Shamloo MBB, Elahi N, Shamsi A. Iranian Muslim women's adaptation after mastectomy. Int J Palliat Nurs 2024; 30:451-463. [PMID: 39276136 DOI: 10.12968/ijpn.2024.30.8.451] [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: 09/16/2024]
Abstract
BACKGROUND Breast cancer is the most common malignancy among women. Women with breast cancer need to adapt all aspects of their life following their diagnosis. AIM To investigate how women with breast cancer make adaptations in their lives to cope with the condition. METHODS A directed content analysis was used for this study and 23 participants were interviewed. The participants included women undergoing a mastectomy and their husbands, oncologists, oncology ward nurses and psychologists. Questions were asked regarding the participants' experiences of their adaptation to a mastectomy and cancer. RESULTS Data analysis led to the emergence of four dimensions; the physical dimension, self-concept, role-playing and interdependence. These four dimensions consisted of 21 main categories, 59 subcategories and 111 codes. CONCLUSION The present study showed that despite the emergence of different coping approaches, women undergoing mastectomy have had various physical and mental problems that lead to role disruption. It is recommended that solutions be adopted to increase the adaptation of these patients.
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Affiliation(s)
| | - Nasrin Elahi
- Associate Professor of Nursing, Department of Nursing, School of Nursing and Midwifery, Nursing Care Research Center in Chronic Diseases, Ahvaz Jundishapur University of Medical Sciences, Iran
| | - Aziz Shamsi
- Assistant Professor of Nursing, Mehabad Faculty of Medical Sciences, University of Medical Sciences, Iran
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Jamshidi F, Farzad M, MacDermid JC, Hosseini SA, Habibi Asgarabad M, Alizadehasl A. Characterization of functioning in breast cancer survivors: an interpretive descriptive analysis study based on the International Classification of Functioning, Disability, and Health (ICF) and the Item-Perspective Classification Framework. Disabil Rehabil 2024; 46:2023-2041. [PMID: 37237439 DOI: 10.1080/09638288.2023.2212915] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 05/07/2023] [Indexed: 05/28/2023]
Abstract
PURPOSE Breast cancer survivors may experience a variety of disabilities that could potentially compromise their independent functioning. This study aimed to examine their perspectives and experts on their functioning and interpret concepts with the International Classification of Functioning, Disability, and Health (ICF) and the Item-Perspective Classification Framework (IPF). METHODS Interpretive descriptive methods were used with in-depth interviewing with 16 breast cancer survivors and 22 experts using a semi-structured interview guide. The interviews were recorded, transcribed, and qualitatively analyzed using thematic analysis. The extracted data were linked to the ICF Core Set for Breast cancer and were interpreted by the IPF. RESULTS Four main themes emerged to define the functioning of breast cancer survivors: body functioning, physical functioning, social functioning, and mental functioning. Three other factors were also categorized as modifiers of functioning personal, emotional, and environmental. The 592 extracted meaningful concepts were linked to 38 (47%) categories from the ICF: 16 Body Functions, 14 Activities and Participation, and 8 Environmental Factors. The IPF classified all the extracted concepts, and most rational appraisals fell in the biological (B) domain. The concepts that required emotional appraisal were classified in Psychology (P). CONCLUSION Psychological and emotional factors were pivotal in defining functioning in patients with BC.
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Affiliation(s)
- Farkhondeh Jamshidi
- Department of Occupational Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- Department of Occupational Therapy, School of Allied Medical Sciences, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Maryam Farzad
- Department of Occupational Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- Department of Health and Rehabilitation Sciences, School of Physical Therapy, University of Western Ontario, London, Canada
- Roth McFarlane Hand and Upper Limb Centre, St. Joseph's Hospital, London, Canada
| | - Joy C MacDermid
- Physical Therapy and Surgery, Western University, London, Canada
- Clinical Research Lab, Hand and Upper Limb Centre, St. Joseph's Health Centre, London, Canada
- Rehabilitation Science, McMaster University, Hamilton, Canada
| | - Seyed Ali Hosseini
- Department of Occupational Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mojtaba Habibi Asgarabad
- Health Promotion Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Health Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
- Positive Youth Development Lab, Human Development and Family Sciences, TX Tech University, Lubbock, TX, USA
- Center of Excellence in Cognitive Neuropsychology, Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran
| | - Azin Alizadehasl
- Cardio-Oncology Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
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Tuckey N, Agteren JV, Chur-Hansen A, Ali K, Fassnacht DB, Beatty L, Bareham M, Wardill H, Iasiello M. Implementing a group-based online mental well-being program for women living with and beyond breast cancer - A mixed methods study. Asia Pac J Clin Oncol 2024. [PMID: 38558488 DOI: 10.1111/ajco.14060] [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: 12/10/2023] [Revised: 02/21/2024] [Accepted: 03/11/2024] [Indexed: 04/04/2024]
Abstract
PURPOSE There is a gap in available mental well-being services in Australia for women diagnosed with breast cancer. This pilot mixed-methods uncontrolled study aimed to assess the feasibility of an online mental health and well-being intervention, the Be Well Plan (BWP), which enables participants to create a personalized, flexible well-being strategy. METHODS Women diagnosed with stages I-IV breast cancer were recruited into 4 asynchronous groups to participate in the BWP, a 5-week facilitator-led group-based mental health and well-being program. Psychological measures used at baseline and post-intervention included: the Warwick Edinburgh Mental Well-Being Scale, Brief Resilience Scale, Self-compassion Scale, 9-item Patient Health Questionnaire, 7-item General Anxiety Disorder scale, and EORC QLQ-C30. Multivariate analysis of variance and effect sizes were calculated on pre- and post-psychological measures, followed by qualitative content analysis on post-completion interviews with participants. RESULTS Nineteen women (mean age 45.7, standard deviation = 7.74) were included in the study. Large effect sizes were reported for mental well-being, depressive symptoms, and anxiety (partial ω2 = 0.28, 0.21, and 0.20, respectively). Self-compassion, resilience, and quality of life results were not statistically significant. Qualitative content analysis provided insight into experiences with Program Delivery Experience, Application of the BWP, Mental Health Improvements, Supporter Involvement, Adopted Interventions, and Recruitment. Participants reported benefits in mindfulness, grounding techniques, and physical activities. CONCLUSION The BWP has the potential to be an effective intervention to support the mental health and well-being of breast cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS This study highlights flexible interventions that accommodate the diverse needs of breast cancer survivors to improve mental well-being and alleviate psychological distress.
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Affiliation(s)
- Natalie Tuckey
- Mental Health and Well-being Program, Lifelong Health Theme, South Australian Health and Medical Research Institute, Adelaide, Australia
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Joep van Agteren
- Mental Health and Well-being Program, Lifelong Health Theme, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Anna Chur-Hansen
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Kathina Ali
- School of Health, University of the Sunshine Coast, Queensland, Australia
| | - Daniel B Fassnacht
- School of Health, University of the Sunshine Coast, Queensland, Australia
| | - Lisa Beatty
- Flinders University Institute of Mental Health & Well-being, College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia
| | - Monique Bareham
- Patient Advocate and Cancer Survivor - SA 2022 Local Hero, Adelaide, Australia
| | - Hannah Wardill
- Supportive Oncology Research Group, Precision Medicine Theme (Cancer Program), The South Australian Health and Medical Research Institute, Adelaide, Australia
- School of Biomedicine, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - Matthew Iasiello
- Mental Health and Well-being Program, Lifelong Health Theme, South Australian Health and Medical Research Institute, Adelaide, Australia
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Myers L, Johnston EA, Zajdlewicz L, Viljoen B, Kelly S, Perry N, Stiller A, Crawford-Williams F, Chan RJ, Emery JD, Bergin RJ, Aitken JF, Goodwin BC. What are the mechanisms underlying the delivery of survivorship care information in Australia? A realist review. Psychooncology 2024; 33:e6321. [PMID: 38488825 DOI: 10.1002/pon.6321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 01/15/2024] [Accepted: 02/28/2024] [Indexed: 03/19/2024]
Abstract
OBJECTIVE Quality survivorship information is an essential component of cancer care. However, survivors often report not receiving this information and healthcare professionals report limited practical guidance on how to effectively deliver survivorship information. Therefore, this study used realist review methods to identify mechanisms reported within the published literature for communicating survivorship information and to understand the contextual factors that make these mechanisms effective. METHODS Full-text papers published in CINAHL, PubMed, Web of Science, Scopus, Cochrane Library, and Academic Search Ultimate were included. Studies included in this review were conducted in Australia between January 2006 and December 2023, and reported on how information regarding survivorship care was communicated to adult cancer survivors living in the community. This review utilized realist methodologies: text extracts were converted to if-then statements used to generate context-mechanism-outcome theories. RESULTS Fifty-one studies were included and six theories for mechanisms that underpin the effective delivery of survivorship information were formed. These include: (1) tailoring information based on the survivors' background, (2) enhancing communication among providers, (3) employing dedicated survivorship staff, (4) providing survivorship training, (5) reducing the burden on survivors to navigate their care, and (6) using multiple modalities to provide information. CONCLUSIONS Findings can inform practical guidance for how survivorship care information is best delivered in practice. Clinicians can apply this guidance to improve their individual interactions with cancer survivors, as can policymakers to develop healthcare systems and procedures that support effective communication of cancer survivorship information.
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Affiliation(s)
- Larry Myers
- Cancer Council Queensland, Fortitude Valley, Queensland, Australia
- School of Psychology and Wellbeing, University of Southern Queensland, Springfield, Queensland, Australia
| | - Elizabeth A Johnston
- Cancer Council Queensland, Fortitude Valley, Queensland, Australia
- Population Health Program, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Leah Zajdlewicz
- Cancer Council Queensland, Fortitude Valley, Queensland, Australia
| | - Bianca Viljoen
- Cancer Council Queensland, Fortitude Valley, Queensland, Australia
- School of Nursing and Midwifery, University of Southern Queensland, Toowoomba, Queensland, Australia
- Centre for Health Research, University of Southern Queensland, Springfield, Queensland, Australia
| | - Sarah Kelly
- Cancer Council Queensland, Fortitude Valley, Queensland, Australia
| | - Nicole Perry
- Cancer Council Queensland, Fortitude Valley, Queensland, Australia
| | - Anna Stiller
- Cancer Council Queensland, Fortitude Valley, Queensland, Australia
| | - Fiona Crawford-Williams
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia
| | - Raymond J Chan
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia
| | - Jon D Emery
- Department of General Practice and Primary Care, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia
- Centre for Cancer Research, University of Melbourne, Melbourne, Victoria, Australia
| | - Rebecca J Bergin
- Department of General Practice and Primary Care, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Joanne F Aitken
- Cancer Council Queensland, Fortitude Valley, Queensland, Australia
- School of Public Health, The University of Queensland, Herston, Queensland, Australia
- School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Belinda C Goodwin
- Cancer Council Queensland, Fortitude Valley, Queensland, Australia
- Centre for Health Research, University of Southern Queensland, Springfield, Queensland, Australia
- School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
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R K, L S, P B, S G, R LP. Psychosocial experiences of breast cancer survivors: a meta-review. J Cancer Surviv 2024; 18:84-123. [PMID: 36854799 PMCID: PMC10866753 DOI: 10.1007/s11764-023-01336-x] [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: 10/12/2022] [Accepted: 01/15/2023] [Indexed: 03/02/2023]
Abstract
PURPOSE Advances in breast cancer care have led to a high rate of survivorship. This meta-review (systematic review of reviews) assesses and synthesises the voluminous qualitative survivorship evidence-base, providing a comprehensive overview of the main themes regarding breast cancer survivorship experiences, and areas requiring further investigation. METHODS Sixteen breast cancer reviews identified by a previous mixed cancer survivorship meta-review were included, with additional reviews published between 1998 and 2020, and primary papers published after the last comprehensive systematic review between 2018 and 2020, identified via database searches (MEDLINE, Embase, CINAHL, PsycINFO). Quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Systematic Reviews and the CASP (Critical Appraisal Skills Programme Qualitative) checklist for primary studies. A meta-ethnographic approach was used to synthesise data. RESULTS Of 1673 review titles retrieved, 9 additional reviews were eligible (25 reviews included in total). Additionally, 76 individual papers were eligible from 2273 unique papers. Reviews and studies commonly focused on specific survivorship groups (including those from ethnic minorities, younger/older, or with metastatic/advanced disease), and topics (including return to work). Eight themes emerged: (1) Ongoing impact and search for normalcy, (2) Uncertainty, (3) Identity: Loss and change, (4) Isolation and being misunderstood, (5) Posttraumatic growth, (6) Return to work, (7) Quality of care, and (8) Support needs and coping strategies. CONCLUSIONS Breast cancer survivors continue to face challenges and require interventions to address these. IMPLICATIONS FOR CANCER SURVIVORS Breast cancer survivors may need to prepare for ongoing psychosocial challenges in survivorship and proactively seek support to overcome these.
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Affiliation(s)
- King R
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | - Stafford L
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | - Butow P
- Centre for Medical Psychology and Evidence-Based Decision-Making, School of Psychology, The University of Sydney, Sydney, Australia
| | - Giunta S
- Centre for Medical Psychology and Evidence-Based Decision-Making, School of Psychology, The University of Sydney, Sydney, Australia
| | - Laidsaar-Powell R
- Centre for Medical Psychology and Evidence-Based Decision-Making, School of Psychology, The University of Sydney, Sydney, Australia.
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Webb K, Sharpe L, Butow P, Dhillon H, Zachariae R, Tauber NM, O'Toole MS, Shaw J. Caregiver fear of cancer recurrence: A systematic review and meta-analysis of quantitative studies. Psychooncology 2023; 32:1173-1191. [PMID: 37303263 DOI: 10.1002/pon.6176] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/10/2023] [Accepted: 05/25/2023] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Fear of cancer recurrence (FCR) is reported by both cancer survivors and caregivers however less is known about caregiver FCR. This study aimed to (a) conduct a meta-analysis to compare survivor and caregiver FCR levels; (b) examine the relationship between caregiver FCR and depression, and anxiety; (c) evaluate psychometric properties of caregiver FCR measures. METHODS CINAHL, Embase, PsychINFO and PubMed were searched for quantitative research examining caregiver FCR. Eligibility criteria included caregivers caring for a survivor with any type of cancer, reporting on caregiver FCR and/or measurement, published in English-language, peer-review journals between 1997 and November 2022. The COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) taxonomy was used to evaluate content and psychometric properties. The review was pre-registered (PROSPERO ID: CRD42020201906). RESULTS Of 4297 records screened, 45 met criteria for inclusion. Meta-analysis revealed that caregivers reported FCR levels as high as FCR amongst survivors, with around 48% of caregivers reporting clinically significant FCR levels. There was a strong correlation between anxiety and depression and medium correlation with survivor FCR. Twelve different instruments were used to measure caregiver FCR. Assessments using the COSMIN taxonomy revealed few instruments had undergone appropriate development and psychometric testing. Only one instrument met 50% or more of the criteria, indicating substantial development or validation components were missing in most. CONCLUSIONS Results suggest FCR is as often a problem for caregivers as it is for survivors. As in survivors, caregiver FCR is associated with more severe depression and anxiety. Caregiver FCR measurement has predominately relied on survivor conceptualisations and unvalidated measures. More caregiver-specific research is urgently needed.
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Affiliation(s)
- Kyra Webb
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
- The Psycho-oncology Co-operative Group (PoCoG), School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
| | - Louise Sharpe
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
| | - Phyllis Butow
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
- The Psycho-oncology Co-operative Group (PoCoG), School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
| | - Haryana Dhillon
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
- The Psycho-oncology Co-operative Group (PoCoG), School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
- Centre for Medical Psychology & Evidence-Based Decision Making (CeMPED), School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
| | - Robert Zachariae
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
- Department of Oncology, Unit for Psychooncology and Health Psychology (EPoS), Aarhus University Hospital, Aarhus, Denmark
| | - Nina Møller Tauber
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Mia Skytte O'Toole
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Joanne Shaw
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
- The Psycho-oncology Co-operative Group (PoCoG), School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
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Fan R, Wang L, Bu X, Wang W, Zhu J. Unmet supportive care needs of breast cancer survivors: a systematic scoping review. BMC Cancer 2023; 23:587. [PMID: 37365504 PMCID: PMC10294377 DOI: 10.1186/s12885-023-11087-8] [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: 02/21/2023] [Accepted: 06/19/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Breast cancer is the most common type of cancer in women worldwide. Though improved treatments and prolonged overall survival, breast cancer survivors (BCSs) persistently suffer from various unmet supportive care needs (USCNs) throughout the disease. This scoping review aims to synthesize current literature regarding USCNs among BCSs. METHODS This study followed a scoping review framework. Articles were retrieved from Cochrane Library, PubMed, Embase, Web of Science, and Medline from inception through June 2023, as well as reference lists of relevant literature. Peer-reviewed journal articles were included if USCNs among BCSs were reported. Inclusion/exclusion criteria were adopted to screen articles' titles and abstracts as well as to entirely assess any potentially pertinent records by two independent researchers. Methodological quality was independently appraised following Joanna Briggs Institute (JBI) critical appraisal tools. Content analytic approach and meta-analysis were performed for qualitative and quantitative studies respectively. Results were reported according to the PRISMA extension for scoping reviews. RESULTS A total of 10,574 records were retrieved and 77 studies were included finally. The overall risk of bias was low to moderate. The self-made questionnaire was the most used instrument, followed by The Short-form Supportive Care Needs Survey questionnaire (SCNS-SF34). A total of 16 domains of USCNs were finally identified. Social support (74%), daily activity (54%), sexual/intimacy (52%), fear of cancer recurrence/ spreading (50%), and information support (45%) were the top unmet supportive care needs. Information needs and psychological/emotional needs appeared most frequently. The USCNs was found to be significantly associated with demographic factors, disease factors, and psychological factors. CONCLUSION BCSs are experiencing a large number of USCNs in fearing of cancer recurrence, daily activity, sexual/intimacy, psychology and information, with proportions ranging from 45% to 74%. Substantial heterogeneity in study populations and assessment tools was observed. There is a need for further research to identify a standard evaluation tool targeted to USCNs on BCSs. Effective interventions based on guidelines should be formulated and conducted to decrease USCNs among BCSs in the future.
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Affiliation(s)
- Rongrong Fan
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, No.37, Guoxue Lane, Wuhou District, Chengdu, Sichuan China
| | - Lili Wang
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, No.37, Guoxue Lane, Wuhou District, Chengdu, Sichuan China
| | - Xiaofan Bu
- The School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Wenxiu Wang
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, No.37, Guoxue Lane, Wuhou District, Chengdu, Sichuan China
| | - Jing Zhu
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, No.37, Guoxue Lane, Wuhou District, Chengdu, Sichuan China
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A systematic mixed studies review of fear of cancer recurrence in families and caregivers of adults diagnosed with cancer. J Cancer Surviv 2021; 16:1184-1219. [PMID: 34762248 DOI: 10.1007/s11764-021-01109-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 09/06/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Fear of cancer recurrence (FCR) may be equally prevalent, persistent and burdensome in cancer caregivers as in survivors. This systematic review evaluated FCR prevalence, severity, correlates, course, impact and interventions in cancer caregivers. METHODS Electronic databases were searched from 1997 to May 2021. Two reviewers identified eligible peer-reviewed qualitative or quantitative studies on FCR in adult caregivers or family members of adult cancer survivors. The risk of bias was assessed using the Cochrane Risk of Bias tools for randomised and non-randomised studies and the Mixed-Methods Appraisal Tool. A narrative synthesis and thematic synthesis occurred on quantitative and qualitative studies, respectively. RESULTS Of 2418 papers identified, 70 reports (59 peer-reviewed articles, 11 postgraduate theses) from 63 studies were included. Approximately 50% of caregivers experienced FCR. Younger caregivers and those caring for survivors with worse FCR or overall health reported higher FCR. Most studies found caregivers' FCR levels were equal to or greater than survivors'. Caregivers' FCR was persistently elevated but peaked approaching survivor follow-up appointments. Caregivers' FCR was associated with poorer quality of life in caregivers and survivors. Three studies found couple-based FCR interventions were acceptable, but had limited efficacy. CONCLUSIONS FCR in caregivers is prevalent, persistent and burdensome. Younger caregivers of survivors with worse overall health or FCR are at the greatest risk. Further research on identifying and treating caregivers' FCR is required. IMPLICATIONS FOR CANCER SURVIVORS Caregiver and survivor FCR are similarly impactful and appear interrelated. Addressing FCR may improve outcomes for both cancer caregivers and survivors.
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Risk Reduction Recommendations for Upper Quadrant Side Effects After Breast Cancer Surgery and Treatments: A Delphi Survey to Evaluate Consensus Among Expert Physical Therapists and Alignment With Current Evidence. REHABILITATION ONCOLOGY 2021. [DOI: 10.1097/01.reo.0000000000000274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Kano M, Chen L, Boyce T, Gomez R, Gundelach AC, Jaffe SA, Sussman AL, Dayao ZR, Lobo J, Pestak CR, Rutledge TL. Characterizing Low-Risk Breast and Gynecological Cancer Patients for Transition into an Oncology/Primary Care Coordinated Care Model: Findings from a Survey of Diverse Survivors in a Rural U.S. State. Cancers (Basel) 2021; 13:cancers13174428. [PMID: 34503237 PMCID: PMC8431122 DOI: 10.3390/cancers13174428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/27/2021] [Accepted: 08/31/2021] [Indexed: 02/01/2023] Open
Abstract
We conducted a survey to characterize the key attributes of racial/ethnic and geographically diverse low-risk breast and gynecologic cancer patients. We collected data regarding patients' access to primary care (PC); compliance with screening recommendations; treatment for comorbidities; logistical barriers to clinic visits; and receipt of survivorship care documentation (SCD). Survey findings informed the development of an oncology/Primary Care Provider (PCP) care coordination intervention to improve care. We distributed a cross-sectional survey among a convenience sample of 150 cancer survivors. Responses were calculated using descriptive statistics and compared based on the distance participants traveled to their appointments at the cancer center (≤30 vs. >30 miles). Of the 150 respondents, 35% traveled >30 miles for follow-up care and 78% reported having one or more comorbid condition(s). PC utilization was high: 88% reported having a PCP, and 91% indicated ≤1 yearly follow-up visit. Participants traveling >30 miles reported higher rates of logistical challenges associated with cancer center visits compared to those traveling ≤30 miles. Nearly half of respondents (46%) had not received SCD. In conclusion, survey studies such as these allow for the systematic assessment of survivor behaviors and care utilization patterns to inform the development of care coordination interventions for diverse, low-risk cancer patients.
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Affiliation(s)
- Miria Kano
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM 87131, USA; (Z.R.D.); (C.R.P.)
- The University of New Mexico Comprehensive Cancer Center, Albuquerque, NM 87131, USA; (T.B.); (R.G.); (A.C.G.); (S.A.J.); (A.L.S.); (T.L.R.)
- Correspondence: ; Tel.: +1-(505)-925-1115
| | - Lu Chen
- Department of Preventive Medicine and Population Health, The University of Texas Medical Branch; Albuquerque, NM 77555, USA;
| | - Tawny Boyce
- The University of New Mexico Comprehensive Cancer Center, Albuquerque, NM 87131, USA; (T.B.); (R.G.); (A.C.G.); (S.A.J.); (A.L.S.); (T.L.R.)
| | - Ricardo Gomez
- The University of New Mexico Comprehensive Cancer Center, Albuquerque, NM 87131, USA; (T.B.); (R.G.); (A.C.G.); (S.A.J.); (A.L.S.); (T.L.R.)
| | - Amy C. Gundelach
- The University of New Mexico Comprehensive Cancer Center, Albuquerque, NM 87131, USA; (T.B.); (R.G.); (A.C.G.); (S.A.J.); (A.L.S.); (T.L.R.)
| | - Shoshana Adler Jaffe
- The University of New Mexico Comprehensive Cancer Center, Albuquerque, NM 87131, USA; (T.B.); (R.G.); (A.C.G.); (S.A.J.); (A.L.S.); (T.L.R.)
| | - Andrew L. Sussman
- The University of New Mexico Comprehensive Cancer Center, Albuquerque, NM 87131, USA; (T.B.); (R.G.); (A.C.G.); (S.A.J.); (A.L.S.); (T.L.R.)
- Department of Family and Community Medicine, University of New Mexico, Albuquerque, NM 87131, USA;
| | - Zoneddy R. Dayao
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM 87131, USA; (Z.R.D.); (C.R.P.)
- Department of Obstetrics and Gynecology, University of New Mexico, Albuquerque, NM 87131, USA
| | - Jolene Lobo
- Department of Family and Community Medicine, University of New Mexico, Albuquerque, NM 87131, USA;
| | - Claire R. Pestak
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM 87131, USA; (Z.R.D.); (C.R.P.)
- Department of Family and Community Medicine, University of New Mexico, Albuquerque, NM 87131, USA;
| | - Teresa L. Rutledge
- The University of New Mexico Comprehensive Cancer Center, Albuquerque, NM 87131, USA; (T.B.); (R.G.); (A.C.G.); (S.A.J.); (A.L.S.); (T.L.R.)
- Department of Obstetrics and Gynecology, University of New Mexico, Albuquerque, NM 87131, USA
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Culbertson MG, Bennett K, Kelly CM, Sharp L, Cahir C. The psychosocial determinants of quality of life in breast cancer survivors: a scoping review. BMC Cancer 2020; 20:948. [PMID: 33008323 PMCID: PMC7531081 DOI: 10.1186/s12885-020-07389-w] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 09/08/2020] [Indexed: 01/08/2023] Open
Abstract
Background Breast cancer care today involves state-of-the-art biomedical treatment but can fail to address the broader psychosocial and quality-of-life (QoL) issues associated with the transition to breast cancer survivorship. This scoping review examines the evidence on the influence of psychosocial determinants on QoL in breast cancer survivors. Methods Scoping review methodology was used to: (1) identify the research question(s); (2) identify relevant studies; (3) undertake study selection; (4) extract data; (5) collate, summarise and report the results. Results A total of 33 studies met the inclusion criteria. The majority of studies were conducted in the US (n = 22, 67%) and were mainly cross-sectional (n = 26, 79%). Sixteen psychosocial determinants of QoL were identified. Social support (n = 14, 42%), depression (n = 7, 21%) and future appraisal and perspective (n = 7, 21%) were the most frequently investigated determinants. Twelve different QoL measures were used. A range of different measurement tools were also used per psychosocial determinant (weighted average = 6). The 14 studies that measured the influence of social support on QoL employed 10 different measures of social support and 7 different measures of QoL. In general, across all 33 studies, a higher level of a positive influence and a lower level of a negative influence of a psychosocial determinant was associated with a better QoL e.g. higher social support and lower levels of depression were associated with a higher/better QoL. For some determinants such as spirituality and coping skills the influence on QoL varied, but these determinants were less commonly investigated. Conclusion Consensus around measures of QoL and psychological determinants would be valuable and would enable research to determine the influence of psychosocial determinants on QoL adequately. Research in other healthcare settings beyond the US is required, in order to understand the influence of organisation and follow-up clinical and supportive care on psychosocial determinants and QoL and to improve the quality of care in breast cancer survivors.
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Affiliation(s)
- Michael G Culbertson
- Division of Population Health Sciences, Royal College of Surgeons in Ireland, Beaux Lane House, Mercer Street, Dublin, 2, Ireland
| | - Kathleen Bennett
- Division of Population Health Sciences, Royal College of Surgeons in Ireland, Beaux Lane House, Mercer Street, Dublin, 2, Ireland
| | | | - Linda Sharp
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle, UK
| | - Caitriona Cahir
- Division of Population Health Sciences, Royal College of Surgeons in Ireland, Beaux Lane House, Mercer Street, Dublin, 2, Ireland.
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