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Hollen PJ, Gralla RJ, Gentzler RD, Hall RD, Coyne B, Cheng H, Halmos B, Gildersleeve J, Calderon C, Hinton I, Weiss G, Crawford J, Cerise J, Lesser M. Do Patients Regret Having Received Systemic Treatment for Advanced Non-Small Cell Lung Cancer: A Prospective Evaluation. Oncologist 2020; 26:224-230. [PMID: 33098189 DOI: 10.1002/onco.13571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 10/05/2020] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Thousands of patients annually receive treatment for advanced non-small cell lung cancer (NSCLC), but little is known about their views on the decision to receive that treatment, or regret. This trial prospectively evaluated the incidence of regret and whether baseline characteristics, patient decision-making parameters, or clinical progress early in the treatment course predicts regret. MATERIALS AND METHODS Patients receiving systemic treatment for advanced NSCLC completed every 3-week patient reported outcome (PRO) assessment using the electronic Lung Cancer Symptom Scale (eLCSS-QL), including the 3-Item Global Index (3-IGI; assessing overall distress, activities, and quality of life [QL]). A prespecified secondary aim was to determine the frequency of regret evaluated at 3 months after starting treatment. Patients were randomized to usual care or enhanced care (which included use of the DecisionKEYS decision aid). RESULTS Of 164 patients entered, 160 received treatment and 142 were evaluable for regret. In total, 11.5% of patients and 9% of their supporters expressed regret. Baseline characteristics did not predict regret; regret was rarely expressed by those who had a less than 20% decline or improvement in the 3-IGI PRO score after two treatment cycles. In contrast, when asked if they would make the same decision again, only 1% not having a 20% 3-IGI decline expressed regret, versus 14% with a 3-IGI decline (p = .01). CONCLUSION The majority of patients having regret were identified early using the PRO 3-IGI of the eLCSS-QL measure. Identifying patients at risk for regret allows for interventions, including frank discussions of progress and goals early in the treatment course, which could address regret in patients and their supporters. IMPLICATIONS FOR PRACTICE This report documents prospectively, for the first time, the incidence of treatment-related regret in patients with advanced lung cancer and outlines that risk of regret is associated with patient-determined worsening health status early in the course of treatment. Identifying patients at risk for regret early in treatment (before the third cycle of treatment) appears to be crucial. Counseling at that time should include a discussion of consideration of treatment change and the reason for this change.
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Affiliation(s)
| | | | | | | | - Bethany Coyne
- University of Virginia, Charlottesville, Virginia, USA
| | - Haiying Cheng
- Albert Einstein College of Medicine, Bronx, New York, USA
| | - Balazs Halmos
- Albert Einstein College of Medicine, Bronx, New York, USA
| | | | | | - Ivora Hinton
- University of Virginia, Charlottesville, Virginia, USA
| | | | | | - Jane Cerise
- Feinstein Institute for Medical Research, Manhasset, New York, USA
| | - Martin Lesser
- Feinstein Institute for Medical Research, Manhasset, New York, USA
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Titler MG, Shuman C, Dockham B, Harris M, Northouse L. Acceptability of a Dyadic Psychoeducational Intervention for Patients and Caregivers. Oncol Nurs Forum 2020; 47:342-351. [PMID: 32301936 DOI: 10.1188/20.onf.342-351] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To assess participants' acceptability of the FOCUS program, a psychoeducational intervention, delivered to multiple patient-caregiver dyads in a small-group format. PARTICIPANTS & SETTING A total of 72 adults diagnosed with cancer and their caregivers (36 dyads) who participated in 1 of 11 FOCUS programs delivered at two Cancer Support Community affiliates. METHODOLOGIC APPROACH A pre-/postintervention design was used to implement the FOCUS program. The FOCUS Satisfaction Instrument measured participants' satisfaction with the program, usefulness of the materials, helpfulness in coping with cancer, duplication of services, willingness to recommend the program to others, and the most and least beneficial aspects. Descriptive statistics, t tests, and content analysis were used. FINDINGS Most participants reported that the program did not duplicate services, that it helped them cope with cancer, and that they would recommend the program to others. The most beneficial aspects of the program were the group format and the dyadic approach. IMPLICATIONS FOR NURSING A group format and dyadic approach to address the psychosocial impact of cancer is highly valued by individuals with cancer and their caregivers. Nurses are well positioned to lead implementation of programs like the FOCUS program that complement other cancer support services.
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Washington KT, Oliver DP, Benson JJ, Rolbiecki AJ, Jorgensen LA, Cruz-Oliver DM, Demiris G. Factors influencing engagement in an online support group for family caregivers of individuals with advanced cancer. J Psychosoc Oncol 2019; 38:235-250. [PMID: 31690247 DOI: 10.1080/07347332.2019.1680592] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: To explore factors that influenced engagement in an online support group (OSG) for family caregivers of hospice patients with cancer.Design: Secondary qualitative data analysis.Sample: 58 family caregivers of hospice patients with advanced cancer.Methods: Template analysis of individual family caregiver interviews.Findings: Emotional isolation and caregiving downtime positively influenced engagement, while reluctance to share personal information, a short timeframe of participation in the OSG, and caregiving commitments were negatively influential. While the group facilitation and secure privacy settings of the OSG were viewed positively, reactions to the OSG platform and group tone were mixed. Information on pain and the dying process was found to be particularly engaging.Practice implications: Providers offering OSGs for family caregivers should maximize factors that promote meaningful member engagement, responding to changes in activity and tone over time.
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Affiliation(s)
- Karla T Washington
- Department of Family and Community Medicine, University of Missouri, Columbia, Missouri, USA
| | - Debra Parker Oliver
- Department of Family and Community Medicine, University of Missouri, Columbia, Missouri, USA
| | - Jacquelyn J Benson
- Development of Human Development and Family Science, University of Missouri, Columbia, Missouri, USA
| | - Abigail J Rolbiecki
- Department of Family and Community Medicine, University of Missouri, Columbia, Missouri, USA
| | - Lucas A Jorgensen
- Department of Family and Community Medicine, University of Missouri, Columbia, Missouri, USA
| | - Dulce M Cruz-Oliver
- Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - George Demiris
- Department of Biobehavioral and Health Sciences, School of Nursing, University of Pennsylvania, Philadelphia, USA.,Department of Biostatistics, Epidemiology, and Informatics, School of Medicine, University of Pennsylvania, Philadelphia, USA
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Litzelman K, Reblin M, McDowell HE, DuBenske LL. Trajectories of social resource use among informal lung cancer caregivers. Cancer 2019; 126:425-431. [PMID: 31626343 DOI: 10.1002/cncr.32545] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 08/20/2019] [Accepted: 08/31/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Social support is a key component in maintaining cancer caregiver well-being, and many resources exist to facilitate caregivers' use of social support (eg, cancer support groups). This study sought to determine how informal cancer caregivers use social resources over the course of caregiving. METHODS The data are from the Comprehensive Health Enhancement Support System study of informal caregivers (n = 202) of patients with recently diagnosed lung cancer. Caregivers self-reported their sociodemographic and caregiving characteristics and social resource use over 6 months. Generalized additive models were used to assess social resource use over time, and generalized estimating equation logistic regression models were used to assess the correlates of social resource use. RESULTS Nearly two-thirds of caregivers reported any social resource use. The most prevalent social resources were faith-based groups (38%) and social clubs (30%). Only 1 in 4 caregivers participated in a formal resource such as counseling (11%) or a cancer support group (6%). Social resource use was lowest immediately after the diagnosis and increased over time. Formal resource use exhibited a nonlinear association with time such that formal resource use peaked approximately 9 to 10 months after the cancer diagnosis. Caregivers were more likely to report social resource use if the patient also reported social engagement. CONCLUSIONS This study has found that many cancer caregivers do not use social resources, although social resource use increases over time after the cancer diagnosis. Because of the association between social engagement and well-being, this information may inform future research and interventions to improve outcomes for cancer caregivers and their families.
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Affiliation(s)
- Kristin Litzelman
- Department of Human Development and Family Studies, University of Wisconsin-Madison, Madison, Wisconsin.,Department of Psychiatry, University of Wisconsin Carbone Cancer Center, Madison, Wisconsin
| | | | | | - Lori L DuBenske
- Department of Human Development and Family Studies, University of Wisconsin-Madison, Madison, Wisconsin.,Department of Psychiatry, University of Wisconsin Carbone Cancer Center, Madison, Wisconsin
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Staccini P, Fernandez-Luque L. Health Social Media and Patient-Centered Care: Buzz or Evidence? Findings from the Section "Education and Consumer Health Informatics" of the 2015 Edition of the IMIA Yearbook. Yearb Med Inform 2017; 10:160-3. [PMID: 26293862 DOI: 10.15265/iy-2015-032] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To summarize the 2014 state of the art in the areas related to consumer health informatics and social media. METHODS We conducted a systematic review of articles published in 2014 in PubMed with a predefined set of queries. We identified 439 articles relevant for the review. The two section editors independently screened those papers taking into account their relevance to the topics covered by the section. In a second step, they jointly selected the 20 most representative papers as candidate best papers. Candidate best papers were then submitted for full review and scoring by external reviewers. Based on the scoring, section editors together with the IMIA Yearbook editorial board selected the four best papers published in 2014 in consumer health informatics. RESULTS Helping patients acquire a healthier lifestyle is a crucial part of patient empowerment. In this line of work, new studies are exploring the efficacy of online health interventions for patient behavioral change. The special case of smoking cessation for consumers with low socio-economic status is particularly noticeable. Another study has explored how an online intervention can reduce the anxiety of women who experience an abnormal mammography. The team of PatientsLikeMe has studied how online support groups could play a role in the quality of life of organ transplant recipients. The patient perspective of online forums' users is also analyzed in the domain of anticoagulation therapy. CONCLUSIONS Online health interventions, many of them using social media, have confirmed their potential to impact consumer behavioral change. However, there are still many methodological issues that need to be addressed in order to prove cost-effectiveness.
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Affiliation(s)
- P Staccini
- Pr Pascal Staccini, 1INSERM UMR 912 SESSTIM, IRIS Dept, UFR Médecine,, Université Nice-Sophia Antipolis, 28 avenue de Valombrose, 06107 Nice cedex 2, France, E-mail:
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Dambi JM, Tapera L, Chiwaridzo M, Tadyanemhandu C, Nhunzvi C. Psychometric evaluation of the Shona version of the Multidimensional Scale of Perceived Social Support Scale (MSPSS-Shona) in adult informal caregivers of patients with cancer in Harare, Zimbabwe. Malawi Med J 2017; 29:89-96. [PMID: 28955413 PMCID: PMC5610276 DOI: 10.4314/mmj.v29i2.3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Providing care for a patient with cancer can negatively affect the health and psychosocial well-being of informal caregivers. However, social support has been enlisted as an essential buffer to stressful life events. There is now a greater call to routinely measure and provide support for caregivers and this is only feasible through use of validated outcome measures. The multidimensional scale of perceived social support (MSPSS) is one of the most commonly used social support outcome measure. Consequently, the MSPSS has been translated into several languages and validated across several populations. The aim of the present study was to translate the MPSS to Shona (Zimbabwean native language) and validate it in caregivers of patients with cancer. METHODS The MSPSS was translated to Shona using a backward-forward translation method, pretested on a group of caregivers (n = 10) before being administered to large sample (N = 126) at Parirenyatwa Group of Hospitals. Both exploratory and confirmatory factor analysis were performed to assess the structural validity of the MSPSS-Shona version. Reliability was assessed using the Cronbach's alpha. RESULTS Data for 120 caregivers were analysed. Most were females (69.2%), had attained at least secondary education (81.7%) and married (75%). There was moderate evidence for structural validity for the 2-factor model and excellent evidence for internal consistency as the scale yielded α = 0.905. CONCLUSIONS Despite moderate evidence for structural validity, the translation of MSPSS into native languages (e.g. MSPSS-Shona) in low resource settings can be deemed as "steps in the right direction" for evidence based practise in management of cancer. There is also need for further psychometric evaluation of the MSPSS-Shona.
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Affiliation(s)
- Jermaine M Dambi
- College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Lyster Tapera
- College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | | | | | - Clement Nhunzvi
- College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
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Pailler ME, Johnson TM, Zevon MA, Kuszczak S, Griffiths E, Thompson J, Wang ES, Wetzler M. Acceptability, Feasibility, and Efficacy of a Supportive Group Intervention for Caregivers of Newly Diagnosed Leukemia Patients. J Psychosoc Oncol 2015; 33:163-77. [DOI: 10.1080/07347332.2014.992086] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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