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Ndungu A, Nellums L, Bramley L. Exploring Health Information Seeking Among Participants from a Black Ethnic Group in the UK: a Qualitative Study. J Racial Ethn Health Disparities 2024; 11:2475-2487. [PMID: 37450252 DOI: 10.1007/s40615-023-01713-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 06/15/2023] [Accepted: 07/06/2023] [Indexed: 07/18/2023]
Abstract
Empirical evidence has shown that individuals from minority ethnic communities have been at an increased risk of COVID-19 infections and adverse clinical outcomes including hospitalization, intensive care unit admission, and mortality. The COVID-19 vaccine has been heralded as key in ending the global pandemic. However, evidence suggests that although minority ethnic communities have been disproportionately affected by COVID-19, vaccine delivery to these communities has been poor. A barrier to the vaccine uptake has been health information. Health information is an important variable in the health decision-making process. Lack of or wrong health information has serious implications. Health information leads to better understanding of personal health and appropriate utilization of health services and consequently improves an individual's health outcomes. This study sought to explore the health information seeking practices among participants from a Black ethnic minority community in the UK. This study interviewed six Black Africans from the UK. The study explored and highlighted the thoughts, perceptions, and experiences of the participants while health information seeking. This study found challenges in health information access, assumptions about health information and feelings of being dismissed, and an information void. Participants acknowledge that there is a lot that could be done to improve their health information experiences. Targeted health information and measures such as cultural sensitivity and competency could be important in improving health information seeking, not just for Black Africans but all ethnic minorities in the UK.
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Affiliation(s)
- Antony Ndungu
- Department of Research and Education for Emergency Department, Acute Medicine and Major Trauma, Nottingham University Hospitals NHS Trust, Nottingham, UK.
| | - Laura Nellums
- Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, UK
| | - Louise Bramley
- Nottingham University Hospitals NHS Trust, Nottingham, UK
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Schneider N, Altmann U, Brandt F, Hübner J, Strauss B, Keinki C. A web-based knowledge database to provide evidence-based information to cancer patients: Utilization within the PIKKO study. Support Care Cancer 2024; 32:521. [PMID: 39017937 PMCID: PMC11254981 DOI: 10.1007/s00520-024-08725-7] [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: 12/22/2023] [Accepted: 07/05/2024] [Indexed: 07/18/2024]
Abstract
PURPOSE Cancer is associated with an urgent need for understandable and reliable information, which is often not satisfied by information available online. Therefore, as part of the PIKKO project, a web-based knowledge database (WDB) was introduced to provide cancer patients with quality-assured, evidence-based information. This paper aims to provide insights into the usage (Who? How? What?) and the effects regarding health literacy of the WDB. METHODS A patient survey and automatically generated logfile data were evaluated. Two user groups, patients and patient navigators (PNs), were compared. RESULTS The 13 PNs were responsible for 1/3 of all accesses over the entire duration of the project. The 413 patients used WDB twice on average and spent an average of 12 min per session online (PNs: 9 min per session, more frequently). The top 3 topics of interest were 'therapy', 'nutrition' and 'carcinogenesis' for the patients, and 'therapy', 'naturopathy' and 'legal regulations/support' for the PNs. Of the patients surveyed, 69% said that WDB was helpful in making informed decisions, 76% found the information they wanted and 90% thought WDB was an appropriate way to provide information. CONCLUSION Our WDB provided important information about cancer and its treatment on a digital way both, to patients and PNs. In routine cancer care, the WDB can improve health literacy and informed decision-making. TRIAL REGISTRATION This study was retrospectively registered in the German Clinical Trial Register under DRKS00016703 (21 Feb 2019, retrospectively registered). https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00016703.
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Affiliation(s)
- Nico Schneider
- Institute of Psychosocial Medicine, Psychotherapy and Psychooncology (IPMPP), Jena University Hospital, Stoystrasse 3, 07740, Jena, Germany.
| | - Uwe Altmann
- Institute of Psychosocial Medicine, Psychotherapy and Psychooncology (IPMPP), Jena University Hospital, Stoystrasse 3, 07740, Jena, Germany
- Department of Psychology, MSB Medical School Berlin GmbH, Berlin, Germany
| | - Florian Brandt
- IKK Südwest, Europaallee 3-4, 66113, Saarbrücken, Germany
| | - Jutta Hübner
- Department of Haematology and Medical Oncology, Jena University Hospital, Jena, Germany
| | - Bernhard Strauss
- Institute of Psychosocial Medicine, Psychotherapy and Psychooncology (IPMPP), Jena University Hospital, Stoystrasse 3, 07740, Jena, Germany
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Topf C, Scholl I, Hahlweg P. Attitudes and experiences of cancer patients toward the provision of audio recordings of their own medical encounter: a cross-sectional online survey. Front Psychol 2024; 15:1378854. [PMID: 38962233 PMCID: PMC11220273 DOI: 10.3389/fpsyg.2024.1378854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 05/17/2024] [Indexed: 07/05/2024] Open
Abstract
Background The provision of audio recordings of their own medical encounters to patients, termed consultation recordings, has demonstrated promising benefits, particularly in addressing information needs of cancer patients. While this intervention has been explored globally, there is limited research specific to Germany. This study investigates the attitudes and experiences of cancer patients in Germany toward consultation recordings. Methods We conducted a nationwide cross-sectional quantitative online survey, informed by semi-structured interviews with cancer patients. The survey assessed participants' attitudes, experiences and desire for consultation recordings in the future. The data was analyzed using descriptive statistics and subgroup analyses. Results A total of 287 adult cancer patients participated. An overwhelming majority (92%) expressed a (very) positive attitude. Overall, participants strongly endorsed the anticipated benefits of the intervention, such as improved recall and enhanced understanding. Some participants expressed concerns that physicians might feel pressured and could become more reserved in their interactions with the use of such recordings. While a small proportion (5%) had prior experience with audio recording medical encounters, the majority (92%) expressed interest in having consultation recordings in the future. Discussion We observed positive attitudes of cancer patients in Germany toward consultation recordings, paralleling international research findings. Despite limited experiences, participants acknowledged the potential benefits of the intervention, particularly related to recalling and comprehending information from medical encounters. Our findings suggest that the potential of the intervention is currently underutilized in German cancer care. While acknowledging the possibility of a positive bias in our results, we conclude that this study represents an initial exploration of the intervention's potential within the German cancer care context, laying the groundwork for its further evaluation.
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Affiliation(s)
- Cheyenne Topf
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Frølund JC, Løkke A, Jensen HI, Farver-Vestergaard I. The Use of Podcasts as Patient Preparation for Hospital Visits-An Interview Study Exploring Patients' Experiences. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:746. [PMID: 38928992 PMCID: PMC11203501 DOI: 10.3390/ijerph21060746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 06/04/2024] [Accepted: 06/05/2024] [Indexed: 06/28/2024]
Abstract
INTRODUCTION Podcasts have emerged as a promising tool in patient preparation for hospital visits. However, the nuanced experiences of patients who engage with this medium remain underexplored. OBJECTIVES This study explored patients' experiences of receiving information by way of podcasts prior to their hospital visits. METHODS Semi-structured interviews were conducted with patients with suspected chronic obstructive pulmonary disease (COPD), lung cancer, or sleep apnea. The method of data analysis chosen was thematic analysis. RESULTS Based on data from 24 interviews, five key themes were identified: technical challenges in utilization of podcasts; individual preferences for information prior to hospital visits; building trust and reducing anxiety through podcasts; the role of podcasts as an accessible and convenient source of information; and enhancement of engagement and empowerment through podcasts. Additionally, the study highlighted the critical importance of tailoring podcasts' content to individual preferences to optimize the delivery of healthcare information. CONCLUSIONS Podcasts can serve as a meaningful supplement to traditional information sources for patients. However, it is important to recognize that not all patients may be able to engage with this medium effectively due to technical challenges or personal preferences.
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Affiliation(s)
- Jannie Christina Frølund
- Department of Medicine, Vejle Hospital, Lillebaelt Hospital, University Hospital of Southern Denmark, Beriderbakken 4, DK 7100 Vejle, Denmark; (A.L.); (I.F.-V.)
| | - Anders Løkke
- Department of Medicine, Vejle Hospital, Lillebaelt Hospital, University Hospital of Southern Denmark, Beriderbakken 4, DK 7100 Vejle, Denmark; (A.L.); (I.F.-V.)
- Department of Regional Reseacrh, University of Southern Denmark, J.B. Winsløvsvej 19, DK 5000 Odense, Denmark;
| | - Hanne Irene Jensen
- Department of Regional Reseacrh, University of Southern Denmark, J.B. Winsløvsvej 19, DK 5000 Odense, Denmark;
- Department of Anaesthesiology and Intensive Care, Vejle Hospital, Lillebaelt Hospital, University Hospital of Southern Denmark, Beriderbakken 4, DK 7100 Vejle, Denmark
- Department of Anaesthesiology and Intensive Care, Kolding Hospital, Lillebaelt Hospital, University Hospital of Southern Denmark, Sygehusvej 24, DK 6000 Kolding, Denmark
| | - Ingeborg Farver-Vestergaard
- Department of Medicine, Vejle Hospital, Lillebaelt Hospital, University Hospital of Southern Denmark, Beriderbakken 4, DK 7100 Vejle, Denmark; (A.L.); (I.F.-V.)
- Department of Regional Reseacrh, University of Southern Denmark, J.B. Winsløvsvej 19, DK 5000 Odense, Denmark;
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Lee JC, Hamill CS, Shnayder Y, Buczek E, Kakarala K, Bur AM. Exploring the Role of Artificial Intelligence Chatbots in Preoperative Counseling for Head and Neck Cancer Surgery. Laryngoscope 2024; 134:2757-2761. [PMID: 38126511 DOI: 10.1002/lary.31243] [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: 07/06/2023] [Revised: 10/25/2023] [Accepted: 11/30/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE To evaluate the potential use of artificial intelligence (AI) chatbots, such as ChatGPT, in preoperative counseling for patients undergoing head and neck cancer surgery. STUDY DESIGN Cross-Sectional Survey Study. SETTING Single institution tertiary care center. METHODS ChatGPT was used to generate presurgical educational information including indications, risks, and recovery time for five common head and neck surgeries. Chatbot-generated information was compared with information gathered from a simple browser search (first publicly available website excluding scholarly articles). The accuracy of the information, readability, thoroughness, and number of errors were compared by five experienced head and neck surgeons in a blinded fashion. Each surgeon then chose a preference between the two information sources for each surgery. RESULTS With the exception of total word count, ChatGPT-generated pre-surgical information has similar readability, content of knowledge, accuracy, thoroughness, and numbers of medical errors when compared to publicly available websites. Additionally, ChatGPT was preferred 48% of the time by experienced head and neck surgeons. CONCLUSION Head and neck surgeons rated ChatGPT-generated and readily available online educational materials similarly. Further refinement in AI technology may soon open more avenues for patient counseling. Future investigations into the medical safety of AI counseling and exploring patients' perspectives would be of strong interest. LEVEL OF EVIDENCE N/A. Laryngoscope, 134:2757-2761, 2024.
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Affiliation(s)
- Jason C Lee
- Department of Otolaryngology, University of Kansas Medical Center, Kansas City, Kansas, U.S.A
| | - Chelsea S Hamill
- Department of Otolaryngology, University of Kansas Medical Center, Kansas City, Kansas, U.S.A
| | - Yelizaveta Shnayder
- Department of Otolaryngology, University of Kansas Medical Center, Kansas City, Kansas, U.S.A
| | - Erin Buczek
- Department of Otolaryngology, University of Kansas Medical Center, Kansas City, Kansas, U.S.A
| | - Kiran Kakarala
- Department of Otolaryngology, University of Kansas Medical Center, Kansas City, Kansas, U.S.A
| | - Andrés M Bur
- Department of Otolaryngology, University of Kansas Medical Center, Kansas City, Kansas, U.S.A
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Sweileh WM. Analysis and mapping the research landscape on patient-centred care in the context of chronic disease management. J Eval Clin Pract 2024; 30:638-650. [PMID: 38567707 DOI: 10.1111/jep.13988] [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: 06/17/2023] [Revised: 02/07/2024] [Accepted: 03/18/2024] [Indexed: 05/25/2024]
Abstract
RATIONALE Patient-centred care has emerged as a transformative approach in managing chronic diseases, aiming to actively involve patients in their healthcare decisions. AIMS AND OBJECTIVES This study was conducted to analyse and map the research landscape on patient-centred care in the context of chronic disease management. METHODS This study used Scopus to retrieve the relevant articles. The analysis focused on the growth pattern, highly cited articles, randomised clinical trials, patients and providers perspectives, facilitators and barriers, frequent author keywords, emerging topics, and prolific countries and journals in the field. RESULTS In total, 926 research articles met the inclusion criteria. There was a notable increase in the number of publications over time. Cancer had the highest number of articles (n = 379, 40.9%), followed by diabetes mellitus, and mental health and psychiatric conditions. Studies on patient-centred care in diabetic patients received the highest number of citations. The results identified 52 randomised controlled trials that covered four major themes: patient-centred care for diabetes management, shared decision-making in mental health and primary care, shared decision-making in cancer care, and economic evaluation and cost-effectiveness. The study identified 51 studies that examined the impact of tools such as computer-based systems, decision aids, smartphone apps, and online tools to improve patient-centred outcomes. A map of author keywords showed that renal dialysis, HIV, and atrial fibrillation were the most recent topics in the field. Researchers from the United States contributed to more than half of the retrieved publications. The top active journals included "Patient Education and Counselling" and "Health Expectations". CONCLUSION This study provides valuable insights into the research landscape of patient-centred care within the context of chronic diseases. The current study provided a comprehensive overview of the research landscape on patient-centred care, which can empower patients by raising their awareness about clinical experiences and outcomes.
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Affiliation(s)
- Waleed M Sweileh
- Department of Physiology and Pharmacology/Toxicology, Division of Biomedical Sciences, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
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Hodkiewicz CG, White MJ, Ankeny JS, Jensen EH, Marmor S, Brauer DG. Evaluating the redundancy of patient-centered internet-based content for pancreas cancer and pancreaticoduodenectomy. HPB (Oxford) 2024; 26:851-853. [PMID: 38499454 DOI: 10.1016/j.hpb.2024.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 02/27/2024] [Accepted: 02/29/2024] [Indexed: 03/20/2024]
Affiliation(s)
- Chase G Hodkiewicz
- Division of Surgical Oncology, Department of Surgery, University of Minnesota, USA
| | - McKenzie J White
- Division of Surgical Oncology, Department of Surgery, University of Minnesota, USA
| | - Jake S Ankeny
- Division of Surgical Oncology, Department of Surgery, University of Minnesota, USA
| | - Eric H Jensen
- Division of Surgical Oncology, Department of Surgery, University of Minnesota, USA
| | - Schelomo Marmor
- Division of Surgical Oncology, Department of Surgery, University of Minnesota, USA
| | - David G Brauer
- Division of Surgical Oncology, Department of Surgery, University of Minnesota, USA.
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Low CE, Pillay RM, Teo FJJ, Loh CYL, Yau CE, Yan Bin Lee AR, Ho CSH, Chen MZ. Educational interventions to reduce depression and anxiety in older adults with cancer in the community: a systematic review, meta-analysis and meta-regression of randomised controlled trials. Age Ageing 2024; 53:afae111. [PMID: 38821857 DOI: 10.1093/ageing/afae111] [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: 04/06/2023] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND Older adults make up half of those with cancer and are prone to mood disorders, such as depression and severe anxiety, resulting in negative repercussions on their health-related quality-of-life (HRQOL). Educational interventions have been shown to reduce adverse psychological outcomes. We examined the effect of educational interventions on the severity of psychological outcomes in older adults with cancer (OAC) in the community. METHOD This PRISMA-adherent systematic review involved a search of PubMed, MedLine, Embase and PsycINFO for randomised controlled trials (RCTs) that evaluated educational interventions impacting the severity of depression, anxiety and HRQOL in OAC. Random effects meta-analyses and meta-regressions were used for the primary analysis. RESULTS Fifteen RCTs were included. Meta-analyses showed a statistically insignificant decrease in the severity of depression (SMD = -0.30, 95%CI: -0.69; 0.09), anxiety (SMD = -0.30, 95%CI: -0.73; 0.13) and improvement in overall HRQOL scores (SMD = 0.44, 95%CI: -0.16; 1.04). However, subgroup analyses revealed that these interventions were particularly effective in reducing the severity of depression and anxiety in specific groups, such as OAC aged 60-65, those with early-stage cancer, those with lung cancer and those treated with chemotherapy. A systematic review found that having attained a higher education and income level increased the efficacy of interventions in decreasing the severity of adverse psychological outcomes. CONCLUSION Although overall meta-analyses were statistically insignificant, subgroup meta-analyses highlighted a few specific subgroups that the educational interventions were effective for. Future interventions can be implemented to target these vulnerable groups.
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Affiliation(s)
- Chen Ee Low
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Renish M Pillay
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Finn Jing Jie Teo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Chun En Yau
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Cyrus Su Hui Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Psychological Medicine, National University Hospital, Singapore
| | - Matthew Zhixuan Chen
- Division of Geriatric Medicine, Department of Medicine, National University Hospital, Singapore
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Elkefi S, Matthews AK. Exploring Health Information-Seeking Behavior and Information Source Preferences Among a Diverse Sample of Cancer Survivors: Implications for Patient Education. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2024:10.1007/s13187-024-02448-3. [PMID: 38807002 DOI: 10.1007/s13187-024-02448-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/26/2024] [Indexed: 05/30/2024]
Abstract
This study examined health information-seeking behavior among cancer survivors, including informational sources used and the factors correlated with information-seeking across different racial/ethnic groups. We used data from the Health Information National Trends Survey (2017-2022). Adjusted logistic regression was conducted to identify the predictors of information-seeking by race/ethnicity. Predicting variables were organized into demographic (age, education, race, income, and comorbidity), enabling (having health insurance, having a regular provider, and frequency of care visits), predisposing (quality of care, self-efficacy, and confidence in one's ability to get information), and reinforcing (patient-centered communication, ease of getting information, and confusing information available) factors based on the PRECEDE-PROCEED Model. We included 4723 cancer survivors, of which 15.41% have breast cancer, 17.50% have skin cancer, and 11.11% have prostate cancer. A majority (75.08%) had sought health information. Healthcare providers were the most preferred sources of information across demographic groups, followed by the Internet. Health insurance, a regular provider, and frequent visits were enabling factors that positively influenced information-seeking behavior. Confidence in getting information when needed and self-efficacy were predisposing factors positively associated with the information-seeking behavior. Finally, reinforcing factors (ease of getting information and non-confusion of the information available) were also positively associated with information-seeking. Study findings suggest that one-fourth of cancer survivors had not sought cancer-related information. The results have implications for identifying patients at increased risk for unmet information needs. They also contribute to our understanding of critical racial differences and similarities. Further, findings can help guide interventions to assist in information seeking based on patient preferences.
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Affiliation(s)
- Safa Elkefi
- Department of Research and Scholarship, School of Nursing, Columbia University, New York City, NY, USA.
| | - Alicia K Matthews
- Department of Research and Scholarship, School of Nursing, Columbia University, New York City, NY, USA
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Ke Q, Timmins F, Furlong E, Stokes D. Unmet care needs of women who have undergone breast cancer surgery: A scoping review. J Adv Nurs 2024; 80:1732-1749. [PMID: 37950373 DOI: 10.1111/jan.15953] [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: 08/18/2023] [Revised: 10/26/2023] [Accepted: 10/28/2023] [Indexed: 11/12/2023]
Abstract
AIM To summarize the evidence regarding the unmet care needs of women who have undergone breast cancer surgery and identify research gaps. DESIGN A scoping review. DATA SOURCES This review entailed a systematic search in EMBASE, Medline via PubMed, CINAHL Complete, APA PsycINFO, Cochrane Library, Web of Science and Scopus (up until 30 July 2023). REVIEW METHODS This review was guided by Arksey and O'Malley's Framework (2005) and the Preferred Reporting Items for Systematic Reviews and Meta-analysis-Scoping Review extension (PRISMA-ScR). RESULTS Twenty-five studies that included 4914 participants were retrieved. Fourteen studies employed quantitative designs, eight used qualitative methods, two were mixed-methods studies and one used a qualitative meta-synthesis. Women who have undergone breast cancer surgery experience a wide range of complex and multifaceted unmet care needs. The informational/educational and psychological/emotional domains were the most frequently reported among the identified domains. Meanwhile, the sexual and spiritual/religious beliefs domains remained relatively underexplored. Furthermore, none of the assessment tools used in these studies captured the entirety of the possible domains of unmet care needs. CONCLUSION Needs assessment should be integrated into the routine care of women who have undergone breast cancer surgery. Interventions should be developed to address the unmet informational/educational and psychological/emotional needs of women. Future studies should employ high-quality mixed-methods approaches to explore women's sexual and spiritual/religious concerns. IMPACT This review provides a comprehensive overview of the unmet care needs of women who have undergone the breast cancer surgery. These findings will contribute to the development of tailored interventions. This review also informs future studies to explore distinct domains of unmet care needs. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Qiaohong Ke
- School of Nursing, Midwifery and Health Systems, UCD Health Sciences Centre, University College Dublin, Dublin, Ireland
| | - Fiona Timmins
- School of Nursing, Midwifery and Health Systems, UCD Health Sciences Centre, University College Dublin, Dublin, Ireland
| | - Eileen Furlong
- School of Nursing, Midwifery and Health Systems, UCD Health Sciences Centre, University College Dublin, Dublin, Ireland
| | - Diarmuid Stokes
- College of Health and Agricultural Sciences, University College Dublin, Dublin, Ireland
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Dower K, Halkett GKB, Dhillon H, Naehrig D, O'Connor M. Eliciting the views of left breast cancer patients' receiving deep inspiration breath hold radiation therapy to inform the design of multimedia education and improve patient-centred care for prospective patients. J Med Radiat Sci 2024. [PMID: 38623813 DOI: 10.1002/jmrs.790] [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: 12/19/2023] [Accepted: 03/31/2024] [Indexed: 04/17/2024] Open
Abstract
INTRODUCTION The currently accepted best practice radiation treatment for left breast cancer patients is Deep Inspiration Breath Hold (DIBH) where patients hold a deep breath to reduce late cardiac and pulmonary effects from treatment. DIBH can be challenging and induce or exacerbate anxiety in patients due to the perceived pressure to reduce radiation treatment side effects. This study explored the experiences of patients treated with Deep Inspiration Breath Hold Radiation Therapy (DIBH-RT) to improve patient-centred care and inform the design of multimedia educational tools for future patients undergoing DIBH. METHODS This descriptive qualitative study was underpinned by a social constructivist approach to create new educational and patient care approaches based on previous patients' experiences. Semi-structured interviews were conducted with patients who had completed DIBH-RT for breast cancer. Data was analysed with reflexive thematical analysis. RESULTS Twenty-two patients were interviewed with five key themes identified: (1) informational needs, (2) care needs, (3) autonomy, (4) DIBH performance influencers and (5) other centredness. Recommendations were derived from these themes to improve future treatments of DIBH patients. These recommendations revolved around improvements to education, patient-centred care and strategies to improve self-efficacy with breath holding. CONCLUSION Patients offer a wealth of knowledge regarding their lived experiences with treatment which can enhance future patients' experiences if incorporated into their education and care. Eliciting patients' views of their DIBH-RT treatment highlighted the need to improve patient self-efficacy with DIBH through familiarity with their planned treatment from new multimedia education, and foster patient care to enhance their experience.
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Affiliation(s)
- Kathleene Dower
- North Coast Cancer Institute, Lismore, New South Wales, Australia
- Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Georgia K B Halkett
- Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Haryana Dhillon
- School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
| | | | - Moira O'Connor
- Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
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Nyeko R, Okello N, Abeja CJ, Adyanga P, Apio B, Nabasirye CK, Mwa PA, Angom R, Geriga F, Buser J. Reproductive Concerns and Associated Factors Among Adolescent and Young Adult Cancer Survivors in Uganda: A Hospital-Based Cross-Sectional Study. J Adolesc Young Adult Oncol 2024. [PMID: 38578003 DOI: 10.1089/jayao.2023.0184] [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: 04/06/2024] Open
Abstract
Purpose: Reproductive health (RH) is a critical issue among cancer survivors worldwide. However, in developing countries where RH services for patients with cancer are often lacking, reproductive concerns among adolescent and young adult (AYA) survivors remain uncertain. In this study, we assessed the reproductive concerns of AYA cancer survivors in a resource-limited context of Uganda. Methods: We collected data from AYA cancer survivors at two facilities in Uganda using an interviewer-administered questionnaire. Descriptive statistics were calculated, one-way analysis of variance was used for intergroup comparisons, and multiple regressions were used to test for predictors of reproductive concerns. Results: A total of 110 AYA cancer survivors, with a median age of 20 years (interquartile range [IQR], 18-22), were interviewed. More than half (53.6%) of the respondents were males. The median time since cancer diagnosis was 19 months (IQR, 13.0-35.0). Almost all (91.8%) respondents had a future desire to have children, but only 15.5% received reproductive counseling. The mean total score for the reproductive concern subscales was highest for the fertility concern, followed by the information-seeking and health-related concerns. Reproductive counseling, desire to have children, and respondents' age were the factors influencing reproductive concern. Conclusions: The study shows a strong desire for biological parenthood with very low reproductive counseling among AYA cancer survivors, who remain concerned about their fertility, information needs, and health. This outcome underscores the need to integrate RH services into resource-limited cancer care settings.
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Affiliation(s)
- Richard Nyeko
- Department of Paediatric and Child Health, Faculty of Medicine, Lira University, Lira, Uganda
- Paediatric Oncology Service, Uganda Cancer Institute, Kampala, Uganda
| | - Nelson Okello
- Department of Paediatric and Child Health, Faculty of Medicine, Lira University, Lira, Uganda
| | | | - Proscovia Adyanga
- Department of Paediatric and Child Health, Faculty of Medicine, Lira University, Lira, Uganda
| | - Betty Apio
- Lira Regional Referral Hospital, Lira, Uganda
| | | | - Pamella Aol Mwa
- Department of Paediatrics and Child Health, St. Mary's Hospital Lacor, Gulu, Uganda
| | - Racheal Angom
- Paediatric Oncology Service, Uganda Cancer Institute, Kampala, Uganda
| | - Fadhil Geriga
- Paediatric Oncology Service, Uganda Cancer Institute, Kampala, Uganda
| | - Julie Buser
- University of Michigan, Ann Arbor, Michigan, USA
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Frølund JC, Løkke A, Jensen HI, Farver-Vestergaard I. Development of Podcasts in a Hospital Setting: A User-Centered Approach. JOURNAL OF HEALTH COMMUNICATION 2024; 29:244-255. [PMID: 38420940 DOI: 10.1080/10810730.2024.2321385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Patient information plays a pivotal role in preparing individuals for hospital visits and empowering them to actively participate in decision-making processes regarding their healthcare. However, many patients face challenges related to reading comprehension. In response, podcasts have become a popular, user-friendly medium for sharing essential and easily understandable information in an engaging format.The aim of the present project was to use a user-centered approach to develop podcasts providing patient information prior to hospital visits. We aimed to describe the steps of the development in detail with the purpose of inspiring podcast development in the future.In Phase 1 we conducted interviews with patients and focus groups with clinicians based on the "empathy map" method, with the purpose of exploring patients' needs on which to subsequently build the podcasts' content and format. In Phase 2 we produced and refined the podcasts on the basis of feedback from clinician- and patients representatives.Our results indicated the importance of clear and concise language, personalization of communication, and content alignment with patients' needs. Our project resulted in a description of each step of the development that can be used as inspiration for others who wish to take a user-centered approach to podcast development.
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Affiliation(s)
- J C Frølund
- Department of Medicine, Vejle Hospital, a part of Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark
| | - A Løkke
- Department of Medicine, Vejle Hospital, a part of Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - H I Jensen
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Department of Anaesthesiology and Intensive Care, Vejle Hospital, a part of Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark
- Department of Anaesthesiology and Intensive Care, Kolding Hospital, a part of Lillebaelt Hospital, University Hospital of Southern Denmark, Kolding, Denmark
| | - I Farver-Vestergaard
- Department of Medicine, Vejle Hospital, a part of Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
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14
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Paschke A, Grewal US. Lost in translation: evaluating the readability of online patient information for neuroendocrine tumors. Endocrine 2024; 84:97-99. [PMID: 38010471 DOI: 10.1007/s12020-023-03607-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 11/10/2023] [Indexed: 11/29/2023]
Abstract
INTRODUCTION Recent data show that many patients with NETs do not receive sufficient education regarding their diagnosis and therefore tend to search for information or literature independently. We sought to assess the readability of OPI for neuroendocrine tumors and to analyze compliance to NIH guidelines for OPI (readability level 8th grade or below). METHODS We performed a Google search to compile a list of the top ten OPI websites using the search term "neuroendocrine tumor". We calculated median readability scores for each website across the 9 scales as well as overall readability scores across all sites. RESULTS A total of 10 websites were included for analysis. 6/10 (60%) of the websites belonged to academic institutions, while 2/10 (20%) were from non-profit organizations, and 1 each were a government website (10%) and patient advocacy organization (10%). The median (with interquartile range or IQR) readability score for all websites across the nine readability tests was 9.6 (IQR 8.8-11.2). CONCLUSION Our findings underscore the need to develop online patient education material that is readable and therefore easily understandable for patients and caregivers dealing with this unique group of malignancies.
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Affiliation(s)
| | - Udhayvir Singh Grewal
- University of Iowa Carver College of Medicine, Iowa City, IA, USA.
- University of Iowa Holden Comprehensive Cancer Center, Iowa City, IA, USA.
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15
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Grenot M, Vandenbroucke T, Bucau M, Koskas M. Quality of information and decision regrets during fertility-sparing management for atypical hyperplasia and endometrial cancer in a prospective cohort study. J Gynecol Obstet Hum Reprod 2024; 53:102722. [PMID: 38185245 DOI: 10.1016/j.jogoh.2024.102722] [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: 09/07/2023] [Revised: 12/27/2023] [Accepted: 01/04/2024] [Indexed: 01/09/2024]
Abstract
OBJECTIVE To evaluate satisfaction with information, treatment, and decision regret during management to preserve fertility for atypical hyperplasia (AH) or endometrial cancer (EC). METHODS A cohort study with standardized management using chlormadinone acetate was established through a national referral centre between January 2013 and November 2019. During this period, a questionnaire was given to 136 patients aged 19 to 43 years who were followed for fertility preservation for AH or EC. The questionnaire included the validated EORTC-QLQ-INFO25, as well as questions from the validated EVAPIL questionnaire, the Treatment Satisfaction with Medicines Questionnaire, and the Decision Regret Scales concerning treatment tolerability and general satisfaction. The main outcomes measured were the quality and satisfaction with the information and treatment received and the decision regret. RESULTS 75 patients (55.1 %) responded to the questionnaire. Overall, patients were satisfied with the information received (median 75.0, range: 25-100) and thought it was helpful (median 100.0, range: 25-100). However, 54.7 % wished for more information. Most women (52.0 %) indicated that psychological support should be available. Patients who were less satisfied with the information received or wished to receive more information thought about stopping treatment more frequently. Decision regret was not related to treatment outcome (remission, hysterectomy, live birth), and 47 of the 56 patients who did not obtain a live birth did not regret fertility preservation. None of the nine patients who regretted fertility preservation obtained a live birth. Almost all the patients reported side effects. CONCLUSIONS Dedicated information tools that detail conservative treatment for AH and EC as well as its secondary effects should be provided to improve adherence to treatment and follow-up. Furthermore, psychological support should be systematically proposed.
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Affiliation(s)
- Marie Grenot
- Resident in Gynaecology-Obstetrics, Bichat University Hospital Paris University, 8 rue Georges Boisseau Clichy-La-Garenne, Paris 92110, France.
| | - Tineke Vandenbroucke
- Department of Obstetrics and Gynaecology, and Department of Oncology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Margot Bucau
- Pathology Department, Bichat-Claude Bernard Hospital, Paris, France
| | - Martin Koskas
- Resident in Gynaecology-Obstetrics, Bichat University Hospital Paris University, 8 rue Georges Boisseau Clichy-La-Garenne, Paris 92110, France
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16
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Akakura K, Uemura H, Kawakami S, Yokomizo A, Nakamura M, Nishimura K, Komori T, Ledesma DA. Metastatic castration resistant prostate cancer patients' experience with Radium-223 treatment in Japan. Future Oncol 2024; 20:781-798. [PMID: 38275149 DOI: 10.2217/fon-2023-0870] [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] [Indexed: 01/27/2024] Open
Abstract
Aim: We aimed to determine Japanese metastatic castration resistant prostate cancer (CRPC) patients' Ra-223 treatment experience. Patients & methods: Patients answered the Cancer Therapy Satisfaction Questionnaire (CTSQ domains: Satisfaction with Therapy [SWT], Expectations of Therapy [ET], Feelings about Side Effects [FSE]), the Memorial Anxiety Scale for Prostate Cancer (MAX-PC) and the FACT-Bone Pain (FACT-BP) Questionnaire at baseline, during (vists 3 and 5) and after treatment (end of observation; EOO). Results: Data from 72 patients were included. Baseline median CTSQ scores SWT: 66.1 (IQR19.7), ET: 75.0 (IQR45), and FSE 68.8 (IQR 34.4) were unchanged during vists 3 and 5, but the SWT (-3.57 [IQR17.9]) and ET (-5.0 [IQR30]) decreased while FSE was unchanged (0.0 [IQR31.25]) at EOO. The median MAX-PC (18.0 [IQR 49]) score was unchanged (0.0, IQR 6) while the median FACT BP (54.0 [IQR13]) score decreased by -1.0 (IQR 8) at EOO. Conclusion: Japanese metastatic castration resistant prostate cancer patients' experience is stable during Ra-223 treatment.
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Affiliation(s)
| | - Hiroji Uemura
- Yokohama City University Medical Center, Yokohama, Japan
| | - Satoru Kawakami
- Saitama Medical Center, Saitama Medical University, Saitama, Japan
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17
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Al Saffar H, Thomson A, Tan JS, Wang Q, Birch E, Koschel S, Medhurst E, Jobson D, Ong S, Moon DA, Murphy D, Lawrentschuk N. Patient-centred pathology reporting improves patient experience and understanding of disease in prostate cancer care. BJUI COMPASS 2024; 5:497-505. [PMID: 38633832 PMCID: PMC11019249 DOI: 10.1002/bco2.322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 12/16/2023] [Accepted: 12/23/2023] [Indexed: 04/19/2024] Open
Abstract
Introduction and Objectives Patient-centred (PC) and holistic care improves patient satisfaction and health outcomes. We sought to investigate the benefit of utilising a PC pathology report in patients undergoing radical prostatectomy (RP) for prostate cancer (PCa). Our study aimed to evaluate and compare patient understanding of their PCa diagnosis after RP, upon receiving either a standard histopathology report or a personalised and PC report (PCR). Moreover, we evaluated knowledge retention at 4 weeks after the initial consultation. Methods We invited patients undergoing RP at three metropolitan Urology clinics to participate in our randomised controlled study. Patients were randomised to receive either a PCR or standard pathology report. Patient satisfaction questionnaires (Perceived Efficacy in Patient-Physician Interactions [PEPPI], Consultation and Relational Empathy [CARE] and Communication Assessment Tool [CAT]) and a knowledge test were conducted within 72 h of the initial appointment and again at 4 weeks. Accurate recollection of Gleason grade group (GGG) and extracapsular extension (ECE) were classified as 'correct'. Baseline demographic data included age, education, marital and employment status, pre-op prostate specific antigen (PSA) and clinical stage. Baseline data were tested for differences between groups using the Student's t test, chi-squared test or Fisher's exact test depending on whether data were continuous, categorical or sparse. Comparison of correctly answered 'knowledge' questions was analysed using chi-squared test. A significance level of p ≤ 0.05 was used. Results Data from 62 patients were analysed (30 standard vs. 32 PCR). No significant differences in baseline demographics were found between groups. Both groups reported high levels of satisfaction with their healthcare experiences in all domains of patient-physician rapport, empathy and communication. There were no significant differences between groups in PEPPI (p = 0.68), CAT (p = 0.39) and CARE (p = 0.66) scores, at baseline and 4 weeks. Ninety-three per cent of patients who received the PCR understood the report while 90% felt the report added to their understanding of their PCa. Regarding patient knowledge, the PCR group had significantly more correct answers on GGG and ECE as compared with the standard report group at baseline and 4 weeks (p < 0.001 and 0.001, respectively). Conclusions Our findings demonstrate that PC pathology reports improve patient knowledge and understanding of their PCa that is retained for at least 4 weeks after initial receipt of results.
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Affiliation(s)
- Haidar Al Saffar
- Department of Genitourinary Cancer SurgeryPeter MacCallum Cancer CentreMelbourneVictoriaAustralia
| | - Alice Thomson
- Department of Genitourinary Cancer SurgeryPeter MacCallum Cancer CentreMelbourneVictoriaAustralia
| | - Jo‐Lynn S. Tan
- Department of Genitourinary Cancer SurgeryPeter MacCallum Cancer CentreMelbourneVictoriaAustralia
- St Vincent's Hospital, MelbourneFitzroyVictoriaAustralia
| | - Qiwei Wang
- St Vincent's Hospital, MelbourneFitzroyVictoriaAustralia
- Melbourne Medical School, St Vincent's Hospital, MelbourneUniversity of MelbourneFitzroyVictoriaAustralia
| | - Emma Birch
- Department of Genitourinary Cancer SurgeryPeter MacCallum Cancer CentreMelbourneVictoriaAustralia
| | - Samantha Koschel
- Department of Genitourinary Cancer SurgeryPeter MacCallum Cancer CentreMelbourneVictoriaAustralia
| | - Elizabeth Medhurst
- Department of Genitourinary Cancer SurgeryPeter MacCallum Cancer CentreMelbourneVictoriaAustralia
| | - Dale Jobson
- St Vincent's Hospital, MelbourneFitzroyVictoriaAustralia
- School of Public Health and Preventative MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Sean Ong
- Department of Genitourinary Cancer SurgeryPeter MacCallum Cancer CentreMelbourneVictoriaAustralia
- EJ Whitten Prostate Cancer Research CentreEpworth HospitalRichmondVictoriaAustralia
| | - Daniel A. Moon
- Department of Genitourinary Cancer SurgeryPeter MacCallum Cancer CentreMelbourneVictoriaAustralia
- Department of Surgery (Urology)Epworth Hospital RichmondRichmondVictoriaAustralia
| | - Declan Murphy
- Department of Genitourinary Cancer SurgeryPeter MacCallum Cancer CentreMelbourneVictoriaAustralia
- Department of Surgery (Urology)Epworth Hospital RichmondRichmondVictoriaAustralia
| | - Nathan Lawrentschuk
- Department of Genitourinary Cancer SurgeryPeter MacCallum Cancer CentreMelbourneVictoriaAustralia
- EJ Whitten Prostate Cancer Research CentreEpworth HospitalRichmondVictoriaAustralia
- Department of Surgery (Urology)Epworth Hospital RichmondRichmondVictoriaAustralia
- Department of Surgery (Urology)Royal Melbourne HospitalMelbourneVictoriaAustralia
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18
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Abdulbaki H, Ha PK, Knott PD, Park AM, Seth R, Heaton CM, Wai KC. Postoperative inpatient surgical complications following head and neck microvascular free tissue transfer. Head Neck 2024. [PMID: 38445792 DOI: 10.1002/hed.27728] [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: 10/08/2023] [Revised: 02/04/2024] [Accepted: 02/27/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Complications following head and neck microvascular free tissue transfer (MFTT) are common. Less is known about when they occur. METHOD Retrospective study of patients with primary or recurrent head and neck cancer undergoing MFTT reconstruction at a tertiary care institution. MFTT reconstructions with inpatient postoperative complications were included. The Kruskal-Wallis test was used to compare median postoperative day (POD) onset of complication by flap type. RESULTS Of 1090 patients undergoing MFTT reconstruction, 126 (11.6%) patients experienced inpatient complications including fibula (n = 35), anterolateral thigh (n = 60), or radial forearm (n = 31) MFTTs. POD onset was shortest for surgical site hematoma (median = 1 [IQR 1-5]), and longest for donor site infection (median = 11.5 [IQR 8-15]). There was no significant difference between flap types and POD onset of complications (p > 0.05). CONCLUSION Hematoma formation and flap failure occur earliest during hospitalization, while dehiscence, infection, and fistula occur later. There is no difference in complication timing between flap types.
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Affiliation(s)
- Hasan Abdulbaki
- San Francisco School of Medicine, University of California, San Francisco, California, USA
| | - Patrick K Ha
- Department of Otolaryngology - Head and Neck Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Philip D Knott
- Department of Otolaryngology - Head and Neck Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Andrea M Park
- Department of Otolaryngology - Head and Neck Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Rahul Seth
- Department of Otolaryngology - Head and Neck Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Chase M Heaton
- Department of Otolaryngology - Head and Neck Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Katherine C Wai
- Department of Otolaryngology - Head and Neck Surgery, University of California, San Francisco, San Francisco, California, USA
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19
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Williams N, Griffin G, Wall M, Watson S, Warland J, Bradfield Z. Patient evaluation of gynaecological information provision and preferences. J Adv Nurs 2024; 80:1188-1200. [PMID: 37731325 DOI: 10.1111/jan.15866] [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: 05/26/2023] [Revised: 08/03/2023] [Accepted: 08/30/2023] [Indexed: 09/22/2023]
Abstract
AIM To evaluate gynaecological patients' preferences and satisfaction regarding information provision, exploring enablers and barriers to information access. DESIGN A descriptive cross-sectional survey design was used. METHODS A total of 293 women accessing gynaecological services responded to the survey. Quantitative analysis included descriptive and inferential statistics. Content analysis was conducted on qualitative data. RESULTS Health professionals were the most common and preferred sources of gynaecological health information. Enablers to information provision included positive communication strategies by health professionals, participants having prior knowledge and doing their own research. Despite its widespread availability, only 24.2% of women preferred the internet as an information source. Poor communication and inadequate information provision were identified as barriers to information access. Statistically significant associations were identified between location of residence, education level, year of birth, diagnostic group and health information preferences. Recommendations from women included improved communication strategies, system changes and provision of individualized information. CONCLUSION Health professionals are central to women accessing information about gynaecological diagnoses. Areas for improvement include communication strategies, facilitating access to internet-based resources for information and consideration of women's preferences when providing health information. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE Consumer co-design of gynaecological health information and communication training for health professionals is recommended. Improved communication and facilitated use of internet-based resources may improve women's understanding of information. IMPACT This study explored gynaecological patients' preferences and satisfaction regarding information provision, exploring enablers and barriers to information access. It was found that gynaecological patients preferred individualized information provided to them directly by health professionals and despite its widespread availability, the internet is an underutilized health information resource. These findings are applicable to health professionals and patients utilizing tertiary gynaecological health services in Australia but may be generalized if demographic data aligns with other jurisdictions. REPORTING METHOD The STROBE reporting method was used in the preparation of the manuscript. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Natalie Williams
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Australia
| | - Georgia Griffin
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Australia
| | - Megan Wall
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Australia
| | - Stuart Watson
- Women's Health, Genetics & Mental Health, King Edward Memorial Hospital, Subiaco, Australia
| | - Jane Warland
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Australia
- School of Nursing, Curtin University, Bentley, Australia
| | - Zoe Bradfield
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Australia
- School of Nursing, Curtin University, Bentley, Australia
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20
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Gedik A, van Meerten E, Reuvers MJP, Husson O, van der Graaf WTA. The views of cancer patients of Turkish, Moroccan, Surinamese, and Dutch-Caribbean descent on diagnosis, treatment and prognosis: A systematic literature review. J Cancer Policy 2024; 39:100455. [PMID: 37984696 DOI: 10.1016/j.jcpo.2023.100455] [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: 07/18/2023] [Revised: 10/12/2023] [Accepted: 11/15/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND The number of international migrants is increasing worldwide. The four major non-western ethnic groups in the Netherlands are Turkish, Moroccan, Surinamese, and Dutch-Caribbean. This review examined the scientific literature on the views of cancer patients from these four ethnic groups on cancer diagnosis, treatment, and prognosis. METHODS A systematic literature review was conducted using the databases EMBASE, Medline Web of Science, and Cochrane Central Register. Studies with patients who were of Turkish, Moroccan, Surinamese, and Dutch-Caribbean descent were included. Both qualitative and quantitative studies were included, and thematic analysis was performed. The methodological quality was assessed using the Mixed Methods Appraisal Tool. RESULTS Thirteen studies were conducted in Turkey on Turkish cancer patients, while three were conducted in the Netherlands on Turkish and Moroccan cancer patients. Four themes emerged from the included studies: disclosure of diagnosis, communication, information provision, and decision-making. The majority of cancer patients in Turkey wanted information regarding their diagnosis and treatment. However, disclosure of a cancer diagnosis was rarely discussed with cancer patients in Turkey, whereas in the Netherlands it was provided directly. Family members in both the host and native countries had a strong influence on communication and decision-making. No literature on this topic for Surinamese or Dutch-Caribbean cancer patients was found. CONCLUSION Although major ethnic groups live in host countries, there is a lack of knowledge on optimal communication and information disclosure on cancer to patients and their families. POLICY SUMMARY Further research into the views of ethnic groups on how to communicate about cancer is essential to ensuring that every patient receives optimal care and treatment.
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Affiliation(s)
- Asiye Gedik
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, 3015 GD Rotterdam, the Netherlands
| | - Esther van Meerten
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, 3015 GD Rotterdam, the Netherlands
| | - Milou J P Reuvers
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, 1006 BE Amsterdam, the Netherlands
| | - Olga Husson
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, 1006 BE Amsterdam, the Netherlands; Department of Surgical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, 3015 GD Rotterdam, the Netherlands; Department of Medical Oncology, Netherlands Cancer Institute, 1006 BE Amsterdam, the Netherlands
| | - Winette T A van der Graaf
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, 3015 GD Rotterdam, the Netherlands; Department of Medical Oncology, Netherlands Cancer Institute, 1006 BE Amsterdam, the Netherlands.
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21
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Melhem SJ, Nabhani-Gebara S, Kayyali R. Evaluating online health information utilisation and its psychosocial implications among breast cancer survivors: Qualitative explorations. Health Promot Perspect 2024; 14:61-69. [PMID: 38623349 PMCID: PMC11016143 DOI: 10.34172/hpp.42682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 12/26/2023] [Indexed: 04/17/2024] Open
Abstract
Background This study investigated the online information-seeking behaviours of breast cancer patients at Jordan University Hospital, focusing on their dissatisfaction with available online health resources and its impact on their well-being and anxiety levels. Methods Employing descriptive phenomenology and convenience sampling, we conducted five Skype-based focus groups with 4-6 breast cancer survivors each, from March to July 2020. Data analysis was performed using NVivo, following Braun and Clark's inductive thematic analysis framework. Results The thematic analysis revealed critical insights into survivors' interactions with online cancer resources, identifying key subthemes such as the quality of online information, cyberchondriasis, health literacy and search strategies, the distress caused by counterproductive searches, and the tendency to avoid internet searches. Conclusion The study underscores the challenges breast cancer survivors face in accessing online health information, especially in Arabic. It highlights the need to improve the quality and accessibility of these resources. Enhancing the cultural relevance of online materials and educating patients on effective information evaluation are crucial. These measures can significantly boost health literacy, mitigate anxiety, and provide better support for breast cancer survivors.
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Affiliation(s)
- Samar J Melhem
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan. Amman-Jordan
- Department of Pharmacy, School of Life Sciences, Pharmacy and Chemistry, Kingston University London, Kingston upon Thames, Surrey KT1 1LQ, UK
| | - Shereen Nabhani-Gebara
- Department of Pharmacy, School of Life Sciences, Pharmacy and Chemistry, Kingston University London, Kingston upon Thames, Surrey KT1 1LQ, UK
| | - Reem Kayyali
- Department of Pharmacy, School of Life Sciences, Pharmacy and Chemistry, Kingston University London, Kingston upon Thames, Surrey KT1 1LQ, UK
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22
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O'Sullivan-Steben K, Galarneau L, Judd S, Laizner AM, Williams T, Kildea J. Design and implementation of a prototype radiotherapy menu in a patient portal. J Appl Clin Med Phys 2024; 25:e14201. [PMID: 37942985 DOI: 10.1002/acm2.14201] [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: 10/03/2023] [Revised: 10/10/2023] [Accepted: 10/31/2023] [Indexed: 11/10/2023] Open
Abstract
PURPOSE Radiotherapy patients often face undue anxiety due to misconceptions about radiation and their inability to visualize their upcoming treatments. Access to their personal treatment plans is one way in which pre-treatment anxiety may be reduced. But radiotherapy data are quite complex, requiring specialized software for display and necessitating personalized explanations for patients to understand them. Therefore, our goal was to design and implement a novel radiotherapy menu in a patient portal to improve patient access to and understanding of their radiotherapy treatment plans. METHODS A prototype radiotherapy menu was developed in our institution's patient portal following a participatory stakeholder co-design methodology. Customizable page templates were designed to render key radiotherapy data in the portal's patient-facing mobile phone app. DICOM-RT data were used to provide patients with relevant treatment parameters and generate pre-treatment 3D visualizations of planned treatment beams, while the mCODE data standard was used to provide post-treatment summaries of the delivered treatments. A focus group was conducted to gather initial patient feedback on the menu. RESULTS Pre-treatment: the radiotherapy menu provides patients with a personalized treatment plan overview, including a personalized explanation of their treatment, along with an interactive 3D rendering of their body, and treatment beams for visualization. Post-treatment: a summary of the delivered radiotherapy is provided, allowing patients to retain a concise personal record of their treatment that can easily be shared with future healthcare providers. Focus group feedback was overwhelmingly positive. Patients highlighted how the intuitive presentation of their complex radiotherapy data would better prepare them for their radiation treatments. CONCLUSIONS We successfully designed and implemented a prototype radiotherapy menu in our institution's patient portal that improves patient access to and understanding of their radiotherapy data. We used the mCODE data standard to generate post-treatment summaries in a way that is easily shareable and interoperable.
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Affiliation(s)
| | - Luc Galarneau
- Medical Physics Unit, McGill University, Montreal, Quebec, Canada
| | - Susie Judd
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Andrea M Laizner
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Ingram School of Nursing, McGill University, Montreal, Quebec, Canada
| | - Tristan Williams
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - John Kildea
- Medical Physics Unit, McGill University, Montreal, Quebec, Canada
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Gerald Bronfman Department of Oncology, McGill University, Montreal, Quebec, Canada
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23
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Voigt KR, de Bruijn EA, Wullaert L, Witteveen L, Verhoef C, Husson O, Grünhagen DJ. Assessing patients' needs in the follow-up after treatment for colorectal cancer-a mixed-method study. Support Care Cancer 2024; 32:192. [PMID: 38409637 PMCID: PMC10896820 DOI: 10.1007/s00520-024-08401-w] [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: 10/30/2023] [Accepted: 02/21/2024] [Indexed: 02/28/2024]
Abstract
PURPOSE The accessibility of cancer care faces challenges due to the rising prevalence of colorectal cancer (CRC) coupled with a shrinkage of healthcare professionals-known as the double aging phenomenon. To ensure sustainable and patient-centred care, innovative solutions are needed. This study aims to assess the needs of CRC patients regarding their follow-up care. METHODS This study uses a mixed-method approach divided in three phases. The initial phase involved focus group sessions, followed by semi-structured interviews to identify patients' needs during follow-up. Open analysis was done to define main themes and needs for patients. In the subsequent quantitative phase, a CRC follow-up needs questionnaire was distributed to patients in the follow-up. RESULTS After two focus groups (n = 14) and interviews (n = 5), this study identified six main themes. Findings underscore the importance of providing assistance in managing both physical and mental challenges associated with cancer. Participants emphasised the need of a designated contact person and an increased focus on addressing psychological distress. Furthermore, patients desire individualised feedback on quality of life questionnaires, and obtaining tailored information. The subsequent questionnaire (n = 96) revealed the priority of different needs, with the highest priority being the need for simplified radiology results. A possible approach to address a part of the diverse needs could be the implementation of a platform; nearly 70% of patients expressed interest in the proposed platform. CONCLUSIONS CRC patients perceive substantial room for improvement of their follow-up care. Findings can help to develop a platform fulfilling the distinct demands of CRC patients during follow-up.
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Affiliation(s)
- Kelly R Voigt
- Department of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC Cancer Institute, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Esmee A de Bruijn
- Department of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC Cancer Institute, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Lissa Wullaert
- Department of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC Cancer Institute, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Léon Witteveen
- On Behalf of Stichting Darmkanker, Utrecht, The Netherlands
| | - Cornelis Verhoef
- Department of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC Cancer Institute, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Olga Husson
- Department of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC Cancer Institute, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Dirk J Grünhagen
- Department of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC Cancer Institute, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.
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Katalan A, Drach-Zahavy A, Dagan E. Medical encounters with patients diagnosed with cancer: The association between physicians' behavior and perceived patient centered care and anxiety. Eur J Oncol Nurs 2024; 68:102484. [PMID: 38064803 DOI: 10.1016/j.ejon.2023.102484] [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: 08/13/2023] [Revised: 11/20/2023] [Accepted: 11/26/2023] [Indexed: 02/18/2024]
Abstract
PURPOSE To evaluate the association between physicians' behavior and cancer patients' perceived patient-centered care (PCC) and anxiety following medical encounters. METHODS A prospective study design with 100 encounters, including 100 cancer patients and 22 oncology/surgery physicians, was performed between November 2019 and July 2021. Before the medical encounters, patients were asked to complete the validated State-Trait Anxiety Inventory (STAI), and physicians and patients completed sociodemographic and clinical data. During the medical encounters, structured 'real-time' observations of the physicians' behaviors were performed using the Four Habits Coding Scheme (4HCS). Following the medical encounters, patients were asked to re-complete the STAI and to fill the validated Perceived PCC questionnaire. RESULTS Mean 4HCS was positively associated with perceived PCC (β = 0.351, p < 0.001) and contributed 10.5% to the total 25.3% explained variance beyond the sociodemographic and clinical variables. Of the 4HCS sub scales, 'Demonstrate Empathy' displayed the lowest correlation with perceived PCC as compared to informational behaviors. In contrast, mean 4HCS was not associated with post-meeting anxiety (p > 0.05). CONCLUSION Our 'in-vivo' observations of medical encounters expands on previous studies in educational settings in showing how physicians' behaviors impact real patients' experience. The findings may provide a more accurate picture of physicians' supportive and unsupportive behaviors that impact on perceived PCC and anxiety. Patients may prefer their physicians to focus on the informational content related to their disease trajectory rather than focusing on empathy with their emotions. Physicians should be trained in ways to support patients on how to regain emotional control in stressful medical situations.
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Affiliation(s)
- Anat Katalan
- Cancer Center, Emek Medical Center, Afula, Israel; The Cheryl Spencer Department of Nursing, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
| | - Anat Drach-Zahavy
- The Cheryl Spencer Department of Nursing, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Efrat Dagan
- The Cheryl Spencer Department of Nursing, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
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Tagliaferri L, Mancini S, Lancellotta V, Dinapoli L, Capocchiano N, Cornacchione P, Scalise S, Autorino R, Campitelli M, Colloca GF, Fionda B, Rovirosa A, Macchia G, Ferrandina G, Gambacorta MA. The Impact of HAPPY (Humanity Assurance Protocol in Interventional Radiotherapy) on the Psychological Well-being of Gynecological Cancer Patients. Curr Radiopharm 2024; 17:168-173. [PMID: 37807408 DOI: 10.2174/0118744710247426230925054848] [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: 02/24/2023] [Revised: 07/14/2023] [Accepted: 07/24/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND HAPPY (Humanity Assurance Protocol in Interventional Radiotherapy) reports the necessity for gynecological cancer patients to undergo interventional radiotherapy (IRT, also called brachytherapy). The present paper has evaluated how some precautions may improve the psychological well-being of the patients during IRT. METHODS Patients with gynecological cancer undergoing IRT-HDR were analyzed. Patients answered three questionnaires before the IRT procedure (T0) and at the end of IRT (T1): Distress Thermometer (DT), Numerical Rating Scale for IRT procedure distress (NRS), and Hospital Anxiety and Depression Scale (HADS). Correlations have been calculated pairwise through pandas. corrwith with a Pearson algorithm, and the p-values have been calculated through scipy.stats.pearsonr. Plots have been generated through seaborn and matplotlib. A Wilcoxon test was used. RESULTS 55 patients were selected for this study. The median age of the patients was 64 (range, 39-84) years. 52 patients were with stage I endometrial cancer, whereas 3/3 patients with cervical cancer had locally advanced stages (IIB-IVA). 26 patients had a high education level (47.3%), and 38 were married or with a partner (69.1%). Only 14/55 (25.45%) patients were working. The HADS, DT, and NRS averages before the IRT procedure (T0) were 10.2, 3.8, and 4.3, respectively. After applying the HAPPY protocol, the HADS, DT, and NRS averages after IRT (T1) were 9.4, 3.4, and 2.6, respectively. The Wilcoxon signed rank test analysis showed a significant improvement in NRS (p < 0.00001) and HADS (p = 0.034). Living with a partner, parents or relatives was the only parameter statistically significantly associated with better DT pre-IRT (p = 0.04), HADS pre-IRT (p = 0.01), DT post-IRT (p = 0.01), and HADS post-IRT (p = 0.04). CONCLUSION In our study, the HAPPY protocol was associated with a significant reduction in patients' distress, anxiety, and discomfort.
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Affiliation(s)
- Luca Tagliaferri
- Dipartimento di Diagnostica per Immagini, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, UOC Radioterapia Oncologica, Radioterapia Oncologica ed Ematologia, 00168, Rome, Italy
| | - Silvia Mancini
- Università Cattolica del Sacro Cuore Sede di Roma, 00168, Rome, Italy
| | - Valentina Lancellotta
- Dipartimento di Diagnostica per Immagini, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, UOC Radioterapia Oncologica, Radioterapia Oncologica ed Ematologia, 00168, Rome, Italy
| | - Loredana Dinapoli
- Dipartimento di Diagnostica per Immagini, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, UOC Radioterapia Oncologica, Radioterapia Oncologica ed Ematologia, 00168, Rome, Italy
- UOS Psicologia Clinica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Nikola Capocchiano
- Dipartimento di Diagnostica per Immagini, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, UOC Radioterapia Oncologica, Radioterapia Oncologica ed Ematologia, 00168, Rome, Italy
| | - Patrizia Cornacchione
- Dipartimento di Diagnostica per Immagini, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, UOC Radioterapia Oncologica, Radioterapia Oncologica ed Ematologia, 00168, Rome, Italy
| | - Sara Scalise
- Dipartimento di Diagnostica per Immagini, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, UOC Radioterapia Oncologica, Radioterapia Oncologica ed Ematologia, 00168, Rome, Italy
| | - Rosa Autorino
- Dipartimento di Diagnostica per Immagini, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, UOC Radioterapia Oncologica, Radioterapia Oncologica ed Ematologia, 00168, Rome, Italy
| | - Maura Campitelli
- Dipartimento di Diagnostica per Immagini, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, UOC Radioterapia Oncologica, Radioterapia Oncologica ed Ematologia, 00168, Rome, Italy
| | - Giuseppe Ferdinando Colloca
- Dipartimento di Diagnostica per Immagini, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, UOC Radioterapia Oncologica, Radioterapia Oncologica ed Ematologia, 00168, Rome, Italy
| | - Bruno Fionda
- Dipartimento di Diagnostica per Immagini, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, UOC Radioterapia Oncologica, Radioterapia Oncologica ed Ematologia, 00168, Rome, Italy
| | - Angeles Rovirosa
- Fonaments Clínics Department, University of Barcelona, 08036, Barcelona, Spain
- Radiation Oncology Department, Hospital Clínic Universitari, 08036, Barcelona, Spain
- Gynecologic Cancer Unit, Hospital Clínic Universitari, 08036, Barcelona, Spain
| | - Gabriella Macchia
- Gemelli Molise Hospital, Radiation Oncology Unit, Università Cattolica del Sacro Cuore, 86100, Campobasso, Italy
| | - Gabriella Ferrandina
- Università Cattolica del Sacro Cuore Sede di Roma, 00168, Rome, Italy
- Woman, Child and Public Health Department, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Maria Antonietta Gambacorta
- Dipartimento di Diagnostica per Immagini, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, UOC Radioterapia Oncologica, Radioterapia Oncologica ed Ematologia, 00168, Rome, Italy
- Università Cattolica del Sacro Cuore Sede di Roma, 00168, Rome, Italy
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Blickle P, Schmidt ME, Steindorf K. Post-traumatic growth in cancer survivors: What is its extent and what are important determinants? Int J Clin Health Psychol 2024; 24:100418. [PMID: 37867603 PMCID: PMC10585376 DOI: 10.1016/j.ijchp.2023.100418] [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: 04/06/2023] [Accepted: 10/08/2023] [Indexed: 10/24/2023] Open
Abstract
Background/Objective The aim was to investigate the extent and longitudinal determinants of post-traumatic growth (PTG) in cancer survivors. Methods A sample of 1316 cancer survivors with various cancer types was examined using the EORTC QLQ-FA12 to assess fatigue, the EORTC QLQ-C30 pain items to assess pain and the Patient Health Questionnaire (PHQ-4) to assess emotional distress two years after diagnosis (t0). Additionally, patients rated how well they felt informed about fatigue at t0. PTG was assessed with the 21-item PTG-Inventory four years after diagnosis (t1) comprising the five subdimensions appreciation of life, relation to others, personal strengths, new possibilities and spiritual change. Results Regarding the extent of PTG, most positive developments were experienced in the PTG subdimension appreciation of life whereas the subdimension spiritual change was the least pronounced domain. Fatigue, pain and emotional distress were longitudinal but non-linear predictors of long-term PTG. Additionally, poor informedness about fatigue was associated with less PTG. Conclusions PTG can be perceived even years after a traumatic cancer event and is longitudinally associated with common cancer side effects like fatigue, emotional distress and pain. Further research into the role of individuals' informedness contributing to PTG is needed.
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Affiliation(s)
- Patricia Blickle
- German Cancer Research Center (DKFZ) Heidelberg, Division Physical Activity, Prevention and Cancer, Germany
- Medical Faculty, University of Heidelberg, Heidelberg, Germany
| | - Martina E. Schmidt
- German Cancer Research Center (DKFZ) Heidelberg, Division Physical Activity, Prevention and Cancer, Germany
| | - Karen Steindorf
- German Cancer Research Center (DKFZ) Heidelberg, Division Physical Activity, Prevention and Cancer, Germany
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Brajković L, Milat-Panža K, Kopilaš V. Subjective Well-Being in Cancer Patients: The Roles of Social Support, Purpose in Life, Resilience, and Informativeness. Healthcare (Basel) 2023; 11:3181. [PMID: 38132071 PMCID: PMC10742701 DOI: 10.3390/healthcare11243181] [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: 11/04/2023] [Revised: 12/07/2023] [Accepted: 12/15/2023] [Indexed: 12/23/2023] Open
Abstract
The aim of this research was to determine the relationship between subjective well-being (life satisfaction, positive and negative experiences, and prosperity) and various psychosocial factors (social support received from family members and partners, purpose in life, resilience and information) in cancer patients and to examine the possibility of predicting components of subjective well-being based on these mentioned factors in cancer patients. A total of 338 adult cancer patients from Croatia participated in the study (41.1% male and 58.9% female). To measure the constructs, the Diener Subjective Well-Being Scale, the Social Support Scale at work and in the family, the Purpose in Life Scale, the Short Resilience Scale, and the EORTC-QLQ information questionnaire were used. Results showed a high level of life satisfaction and prosperity, as well as more frequent positive compared to negative experiences. A medium to high level of social support received from family members and from the partner was determined. High levels of purpose in life and medium levels of resilience and information were found. A high correlation was found among the components of the construct of subjective well-being, and a low to medium correlation among the predictors. Positive associations were found between the criteria of life satisfaction and prosperity with psychosocial factors. Negative associations were established between the positive/negative experience variables and the factors. Furthermore, the purpose in life was determined as an important predictor of all three components of subjective well-being, social support (both sources) as important for predicting life satisfaction, resilience for experiencing positive and negative experiences, and social family support for predicting the prosperity of cancer patients.
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Affiliation(s)
| | | | - Vanja Kopilaš
- Faculty of Croatian Studies, University of Zagreb, 10000 Zagreb, Croatia; (L.B.)
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Fortini C, Daeppen JB. How do hospital providers perceive and experience the information-delivery process? A qualitative exploratory study. PEC INNOVATION 2023; 3:100222. [PMID: 37842173 PMCID: PMC10570693 DOI: 10.1016/j.pecinn.2023.100222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 09/21/2023] [Accepted: 09/30/2023] [Indexed: 10/17/2023]
Abstract
Objective To explore how professionals deal with informing their patients and how they experience the process per se, in order to deepen understanding of the issues involved and to identify areas of focus for improvement. Methods Semi-structured qualitative interviews were conducted with 13 hospital professionals at Lausanne University Hospital, Switzerland. Results Information includes feedback, practical information, patient condition, treatment/process of care, and educational material. Information-delivery is a process that involves informing the patient then checking patient reception of the information. The main expected outcome is patient action. Providers can feel trapped, guilty, inadequate, powerless, disenchanted when the process fails to achieve its expected purpose. Conclusions Informing and checking strategies are not implemented optimally, and providers could benefit from guidance in order to decrease discomfort and become more proficient at delivering information. Innovation Addressing the information-delivery process per se provides us with a novel insight into the complexity of the process and contributes to identifying essential ingredients of future innovative training programs for providers at large.
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Affiliation(s)
- Cristiana Fortini
- Addiction Medicine, Lausanne University Hospital CHUV, 23A rue du Bugnon, Lausanne 1011, Switzerland
| | - Jean-Bernard Daeppen
- Addiction Medicine, Lausanne University Hospital CHUV, 23A rue du Bugnon, Lausanne 1011, Switzerland
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Tilahun SW, Kitaw LD, Yusuf NT. Predictors of information needs among women with breast cancer receiving adjuvant therapy at Tikur Anbessa specialized hospital, Addis Ababa Ethiopia: a cross-sectional study. BMC Womens Health 2023; 23:659. [PMID: 38066595 PMCID: PMC10704721 DOI: 10.1186/s12905-023-02805-2] [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: 07/31/2023] [Accepted: 11/25/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Women undergoing adjuvant therapy for breast cancer have diverse information needs that remain unfulfilled. Extensive research has shown that access to relevant information about their condition can significantly enhance the quality of life for these women, making it an essential part of cancer care. However, various clinical and socioeconomic factors influence the information needs of these women. Hence, the primary aim of this study is to identify predictors of the information needs of women undergoing adjuvant therapy for breast cancer. In addition, this study will also describe the preferred sources of information and the optimal timing for its acquisition. METHODS A facility-based cross-sectional study was undertaken at Tikur Anbessa Specialty Hospital, enlisting a cohort comprising 121 women undergoing adjuvant therapy for breast cancer. Trained interviewers administered an Amharic-translated Toronto information needs questionnaire specifically designed for breast cancer to assess the information needs of the study participants Statistical analysis was executed using the sophisticated software SPSS (version 25). Descriptive statistics were employed to summarize the variables of the study. A linear regression analyses was then carried out to identify notable predictors that significantly influenced the information needs of the women. RESULTS The total mean score for overall information needs in the current study was 194.30 (± 28.01), with a range scale of 142-260 and a standardized mean score of 3.74 (± 0.54). The disease and treatment domains had the highest information needs, with standardized mean scores (standard deviation) of 4.00 (± 0.54) and 3.77 (± 0.59), respectively. 95% of the participants sought information from healthcare professionals, and 67.7% of the women needed the information before beginning the treatments. Predictors of information needs were following a single treatment option (β = 12.68; 95% CI (0.68, 24.68); P = 0.039) and joining higher education and above (β = 17.1; 95% CI (1.47, 34.14); P = 0.033). CONCLUSION The women exhibited a substantial demand for information. Healthcare professionals need to consider the women's educational background and treatment status while delivering the needed information.
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Affiliation(s)
- Sosina W Tilahun
- Department of Nursing, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Leul D Kitaw
- Department of Nursing, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Nete T Yusuf
- Department of Nursing, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Mayo SJ, Panesar P, Edwards B, Howell D. Information needs across time after a hematological cancer diagnosis: A qualitative study of patient and clinician perspectives. PATIENT EDUCATION AND COUNSELING 2023; 117:107970. [PMID: 37716029 DOI: 10.1016/j.pec.2023.107970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/16/2023] [Accepted: 09/02/2023] [Indexed: 09/18/2023]
Abstract
OBJECTIVE The aim of this study was to characterize the information needs experienced by adult patients across the continuum of their hematological cancer. METHODS Individual semi-structured telephone interviews were conducted with 28 adults with hematological cancer and 18 clinicians recruited from across Canada and analyzed using interpretive description. RESULTS Distinct information needs were organized across seven points of the cancer continuum: prior to diagnosis, at diagnosis, prior to treatment, during treatment, after treatment, relapse/non-response, and end of life. Patients' information needs reflected a desire to better understand their current physical and psychosocial circumstances, as well as how to make decisions about their treatment, self-management, and health care. The need to receive information in a preparatory way was relevant across all phases of the cancer continuum. CONCLUSION Our work contributes an initial approach for providing patient education and counselling for people with hematological cancers, which can be tailored based on individuals' unique characteristics and treatment pathways. PRACTICE IMPLICATIONS Adults with hematological cancers require information to support decision making over the course of their diagnosis, treatment, and survivorship, but can experience information overwhelm. These findings provide an approach for organizing the delivery of information based on different points of need across the cancer continuum.
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Affiliation(s)
- Samantha J Mayo
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada; Princess Margaret Cancer Centre, Toronto, Canada.
| | - Prabdeep Panesar
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | | | - Doris Howell
- Princess Margaret Cancer Centre, Toronto, Canada
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Mishra A, Nair J, Sharan AM. Coping in Post-Mastectomy Breast Cancer Survivors and Need for Intervention: Systematic Review. Breast Cancer (Auckl) 2023; 17:11782234231209126. [PMID: 37954028 PMCID: PMC10638885 DOI: 10.1177/11782234231209126] [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: 10/27/2022] [Accepted: 10/04/2023] [Indexed: 11/14/2023] Open
Abstract
Background Breast cancer is the most prominent cancer type to affect women. Surgical treatment of invasive breast cancers involves mastectomy. Due to mastectomy, women are subjected to social, emotional, and cultural problems which need to be addressed. Objective The objective of the study is to understand how women cope with body image-related issues, trauma, anxiety, and depression post-mastectomy. Design A systematic literature review was conducted for understanding the coping in post-mastectomy patients. The methods for identifying the studies were based on Preferred Reporting Items for Systematic reviews and Meta-analysis (PRISMA) guidelines. Databases Medline/PubMed, PsycInfo, and Cochrane databases were used for searching relevant articles. A final of 19 studies were analyzed for the work. Methods Search strings such as "coping strategies and post mastectomy," "body image coping and post mastectomy" and "anxiety coping and post mastectomy" were used for identification of references from databases. Eligibility criteria were used for finalizing the references. Results Analysis of the 19 studies has clearly shown that women who undergo mastectomy suffer from anxiety, stress, and trauma. This study has observed that women have problems with their body image post-mastectomy along with bouts of depression. Self-coping has been observed in relatively few studies. Psychological interventions before surgery have been observed to be a better coping strategy. In most of the studies, women opted for breast reconstruction to overcome the trauma associated with mastectomy. Conclusion Mastectomy has a severe impact on women's appearance and psychology. Breast reconstruction and acceptance have played an important role in coping among these women. However, breast reconstruction is not accepted by many women due to a multitude of factors. Thus, it is essential to have proper intervention programs in place to ensure women can cope with this situation and can lead healthy lives. Registration Systematic literature review (SLR) is submitted to PROSPERO. The application confirmation number is 449135.Registration awaited from the database.
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Changrani K, Chima S, Sharma A, Han GG, Sharma A, McNamara M, Jefford M, Emery J, Druce P. A systematic review of smartphone applications for cancer survivors. J Cancer Surviv 2023:10.1007/s11764-023-01435-9. [PMID: 37700151 DOI: 10.1007/s11764-023-01435-9] [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: 11/30/2022] [Accepted: 07/21/2023] [Indexed: 09/14/2023]
Abstract
PURPOSE Mobile phone applications are positioned to support, educate, and empower cancer survivors during post-treatment care. We undertook a review to assess the utility of such smartphone applications; determine whether their use correlates with improved quality of life and other self-reported outcomes; and understand the feasibility of integrating mobile apps into routine follow-up care. METHODS MEDLINE, EMBASE, Emcare, and PsycINFO databases were searched for studies evaluating apps that addressed at least one of the five Cancer Survivorship Care Quality Framework (CSCQF) domains published up until December 2021. Studies were narratively synthesized. Implementation barriers and facilitators were mapped against the Technology Acceptance Model. RESULTS Twenty-three primary studies were included in this review. Only three randomized controlled trials (RCTs) were identified. Studies generally found mobile apps to be feasible, acceptable, and well-placed to support survivorship care. Health promotion was the most predominant CSCQF domain with apps primarily aiming to support exercise and dietary changes. The domains of monitoring for cancer recurrence (n=5) and management of co-morbidities (n=1) were underrepresented. Barriers to app use included greater time since active treatment, lack of familiarity with technology, and content not tailored to the user. CONCLUSIONS Mobile apps are both feasible and acceptable in supporting the transition between active treatment and follow-up care. However, understanding the utility of such apps is limited by the low number of RCTs. IMPLICATIONS FOR CANCER SURVIVORS Mobile apps have the potential to be useful support tools for patients post-treatment. However, given the number of apps developed, targeted, and available to cancer survivors, practical guidance to help cancer survivors choose appropriate apps is needed.
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Affiliation(s)
| | - Sophie Chima
- Centre for Cancer Research and Department of General Practice, Victorian Comprehensive Cancer Centre, University of Melbourne, Melbourne, Australia
| | - Arun Sharma
- The Royal Melbourne Hospital, Parkville, Melbourne, Australia
| | - Gil-Gyu Han
- The Royal Melbourne Hospital, Parkville, Melbourne, Australia
| | - Anushka Sharma
- The Royal Melbourne Hospital, Parkville, Melbourne, Australia
| | - Mairead McNamara
- Centre for Cancer Research and Department of General Practice, Victorian Comprehensive Cancer Centre, University of Melbourne, Melbourne, Australia
| | - Michael Jefford
- Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia
| | - Jon Emery
- Centre for Cancer Research and Department of General Practice, Victorian Comprehensive Cancer Centre, University of Melbourne, Melbourne, Australia
| | - Paige Druce
- Centre for Cancer Research and Department of General Practice, Victorian Comprehensive Cancer Centre, University of Melbourne, Melbourne, Australia
- Central Clinical School, Monash University, Melbourne, Australia
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Hautefeuille V, Walter T, Do Cao C, Coriat R, Dominguez S, Mineur L, Cadiot G, Terrebonne E, Sobhani I, Gueguen D, Houchard A, Mouawad C, Anota A, Hammel P. OPERA: perception of information in patients with gastroenteropancreatic neuroendocrine tumors on lanreotide autogel. Eur J Endocrinol 2023; 189:281-289. [PMID: 37542470 DOI: 10.1093/ejendo/lvad094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 06/02/2023] [Accepted: 06/12/2023] [Indexed: 08/07/2023]
Abstract
IMPORTANCE Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) can affect patient health-related quality of life (HRQoL). Appropriate information may improve their adherence to treatment and quality of life. OBJECTIVE To evaluate the change in patient's perceptions of the level of information at lanreotide (LAN) treatment initiation for GEP-NETs vs after 6 months. DESIGN OPERA (NCT03562091) was a prospective, longitudinal, noninterventional study. SETTING Thirty-one centers in France specialized in the management of patients with NETs. INTERVENTION Planned clinical visits at enrollment and end-of-study visits at month 6, with completion of the European Organisation for Research and Treatment of Cancer 25-item Quality of Life Questionnaire-Information Module (QLQ-INFO25) and 30-item Quality of Life Questionnaire-Core. MAIN OUTCOME Absolute change in the patient's perception of the information between baseline and month 6, using the relevant domains of the QLQ-INFO25. Endpoints measured at baseline and month 6 for at least 1 of the 3 targeted QLQ-INFO25 dimensions of the primary endpoint. RESULTS Ninety-three of the 115 patients enrolled completed ≥1 primary endpoint information dimension. Mean (SD) scores for the primary endpoint information dimensions were high at baseline (disease, 63.41 [20.71]; treatment, 58.85 [19.00]; supportive care, 26.53 [24.69]; maximum 100). There were no significant changes between baseline (98.34% CI) and 6 months (disease, -2.84 [-8.69, 3.01; P = .24]; treatment, -4.37 [-11.26, 2.52; P = .13]; supportive care, 0.46 [-6.78, 7.70; P = .88]), and in HRQoL between baseline and 6 months. CONCLUSIONS AND RELEVANCE The lack of change in patient's perceptions of the disease, treatment, and supportive care information provided over the first 6 months of LAN treatment may suggest that physicians provided adequate information at the treatment initiation.
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Affiliation(s)
| | | | | | - Romain Coriat
- Hôpital Cochin, GH AP-HP Centre-University Paris Cite, Paris, France
| | - Sophie Dominguez
- Hemato-Oncology Department, Lille Catholic Hospitals, Lille Catholic University, Lille, France
| | | | | | | | | | | | | | | | | | - Pascal Hammel
- Paul Brousse Hospital APHP, University Paris-Saclay, Villejuif, France
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Billman E, Smith SM, Jain SL. Perspectives of Childhood Cancer Survivors as Young Adults: a Qualitative Study of Illness Education Resources and Unmet Information Needs. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023; 38:1140-1148. [PMID: 36456891 DOI: 10.1007/s13187-022-02240-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/14/2022] [Indexed: 06/17/2023]
Abstract
This study investigates the resources used by childhood cancer survivors (CCS) to learn about their cancer histories and evaluates if CCS feel these resources prepare them to manage their health needs as young adults. Young adult participants (aged 18-30 years) were diagnosed with cancer at ≤ 10 years and recruited by word of mouth and from social media and/or non-profit organizations and completed semi-structured interviews. A descriptive thematic analysis guided by an essentialist/realist paradigm combined inductive and deductive approaches to identify key themes. Fourteen participants were interviewed, and six key themes were identified: (1) CCS are aware of general cancer history (age at diagnosis, treating hospital, cancer type), (2) CCS are unaware of treatment regimen (medications and duration), (3) CCS want to learn more about their treatment regimens and (4) potential late effects of treatment, (5) CCS use diverse resources to learn about their cancer histories and potential late effects, and (6) survivors' interests to learn about their cancer histories change over time. Limited knowledge of their cancer treatments leaves some CCS unprepared to manage their health needs as young adults or to address potential risk of late effects. CCS recognize their limited knowledge, but the resources available to them fall short of their information needs. Identifying the shortcomings of resources used by CCS provides evidence for how resources need to be improved to meet survivors' cancer education needs.
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Affiliation(s)
| | - Stephanie M Smith
- Division of Hematology/Oncology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - S Lochlann Jain
- Department of Anthropology, Stanford University, Stanford, CA, USA
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Weis J, Wolf LR, Boerries M, Kassahn D, Boeker M, Dresch C. Identification of the Needs and Preferences of Patients With Cancer for the Development of a Clinic App: Qualitative Study. JMIR Cancer 2023; 9:e40891. [PMID: 37498653 PMCID: PMC10415940 DOI: 10.2196/40891] [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: 07/11/2022] [Revised: 04/29/2023] [Accepted: 05/09/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND Mobile health (mHealth) tools were developed during the past decades and are increasingly used by patients in cancer care too. Scientific research in the development of mHealth services is required in order to meet the various needs of patients and test usability. OBJECTIVE The aim of this study is to assess patients' needs, preferences, and usability of an app (My University Clinic [MUC] app) developed by the Comprehensive Cancer Center Freiburg (CCCF) Germany. METHODS Based on a qualitative cross-sectional approach, we conducted semistructured interviews with patients with cancer, addressing their needs, preferences, and usability of the designed MUC app. Patients treated by the CCCF were recruited based on a purposive sampling technique focusing on age, sex, cancer diagnoses, and treatment setting (inpatient, outpatient). Data analysis followed the qualitative content analysis according to Kuckartz and was performed using computer-assisted software (MAXQDA). RESULTS For the interviews, 17 patients with cancer were selected, covering a broad range of sampling parameters. The results showed that patients expect benefits in terms of improved information about the disease and communication with the clinic staff. Demands for additional features were identified (eg, a list of contact persons and medication management). The most important concerns referred to data security and the potential restriction of personal contacts with health care professionals of the clinical departments of the CCCF. In addition, some features for improving the design of the MUC app with respect to usability or for inclusion of interacting tools were suggested by the patients. CONCLUSIONS The results of this qualitative study were discussed within the multidisciplinary team and the MUC app providers. Patients' perspectives and needs will be included in further development of the MUC app. There will be a second study phase in which patients will receive a test version of the MUC app and will be asked about their experiences with it. TRIAL REGISTRATION Deutsches Register Klinischer Studien DRKS00022162; https://drks.de/search/de/trial/DRKS00022162.
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Affiliation(s)
- Joachim Weis
- Chair for Self-Help Research, Comprehensive Cancer Center, Medical Faculty, University Clinic Freiburg, Freiburg, Germany
| | - Lucy Raphaela Wolf
- Chair for Self-Help Research, Comprehensive Cancer Center, Medical Faculty, University Clinic Freiburg, Freiburg, Germany
| | - Melanie Boerries
- Institut für Medizinische Bioinformatik und Systemmedizin, Medical Faculty University Freiburg, University Clinic Freiburg, Freiburg, Germany
| | - Daniela Kassahn
- Institut für Medizinische Bioinformatik und Systemmedizin, Medical Faculty University Freiburg, University Clinic Freiburg, Freiburg, Germany
| | - Martin Boeker
- Institute of Artificial Intelligence and Informatics in Medicine, Medical Center rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
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Marino C, Khan K, Groom MJ, Hall SS, Anderson S, Mcnally E, Murphy T, Hall CL. Patients' experience of accessing support for tics from primary care in the UK: an online mixed-methods survey. BMC Health Serv Res 2023; 23:788. [PMID: 37488511 PMCID: PMC10367334 DOI: 10.1186/s12913-023-09753-5] [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: 02/22/2023] [Accepted: 06/26/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND Tics are common in children and young people and may persist into adulthood. Tics can cause challenges with social, occupational, physical, and academic functioning. The current study explores the perceptions of adults with tics and parents/carers of young people with tics regarding their experience of accessing support from professionals in primary care in the UK. METHODS Two online cross-sectional surveys were completed by 33 adults with tics and 94 parents/carers of children with tics. Participants were recruited across three online tic support groups. Tic specialist psychologists, academic researchers, and people with lived experience of tics provided feedback on the surveys before they were made available online. Mixed-method analyses were conducted on the surveys. Qualitative data from the free-text responses were analysed using thematic analysis and triangulated with quantitative findings where appropriate. RESULTS While some participants felt supported by general practitioners (GPs), many felt dismissed. The impact of tics was not always explored, nor information on tics provided, during the consultation. Although 78.7% of participants were referred to secondary care for their tics, some struggled to get the referral. Within secondary care, most adult respondents were assessed by neurologists whilst young people were typically assessed by paediatricians or psychiatrists. Most of these secondary care clinicians did not specialise in tic disorders, with only 27.9% of participants being assessed by tic specialists. Mode waitlist time was 3-6 months for young people and longer for adult respondents. Some participants were referred to multiple secondary care services, spanning neurology, paediatrics, and psychiatry, with each stating that they do not provide support for tics. 21% of participants mentioned being discharged from secondary care with no ongoing support. Almost one-third of respondents accessed support within private healthcare. CONCLUSIONS Generally, more negative than positive experiences were reported. Possible contributing factors included a lack of clear tic referral pathways, long waitlists, a lack of information about tics provided in primary care appointments and a lack of support offered following diagnosis by secondary care services, together with poor access to tic specialist clinicians. This study highlights areas where improvements to UK services for tics can be made.
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Affiliation(s)
- Christina Marino
- School of Medicine, Leicester Medical School, College of Life Sciences, University of Leicester, Leicester, UK
| | - Kareem Khan
- Mental Health & Clinical Neurosciences, NIHR Nottingham Biomedical Research Centre, School of Medicine, NIHR MindTech Medtech Co-operative, University of Nottingham, Nottingham, UK
| | - Madeleine J Groom
- Mental Health & Clinical Neurosciences, NIHR Nottingham Biomedical Research Centre, School of Medicine, NIHR MindTech Medtech Co-operative, University of Nottingham, Nottingham, UK
| | - Sophie S Hall
- Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UK
| | | | | | - Tara Murphy
- Tic Disorder Service, PAMHS, Great Ormond Street Hospital, London, UK
| | - Charlotte L Hall
- Mental Health & Clinical Neurosciences, NIHR Nottingham Biomedical Research Centre, School of Medicine, NIHR MindTech Medtech Co-operative, University of Nottingham, Nottingham, UK.
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Ažukaitis K, Puronaitė R, Vaitkevičienė GE, Trinkūnas J, Jankauskienė A, Jankauskienė D. Integrated Collection of Patient-Reported Outcomes and Experiences in Children with Kidney and Hematological Diseases: A Pilot Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1245. [PMID: 37508742 PMCID: PMC10377830 DOI: 10.3390/children10071245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/14/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023]
Abstract
We aimed to explore the feasibility and potential relevance of integrated electronic collection of patient-reported outcome and experience measures (PROM and PREM) in children with special healthcare needs (CSHCN) by using the example of children with kidney and hematological diseases. We performed a cross-sectional, single-center study of children <18 years of age. Children (≥10 years) and their parents received Generic PedsQL Core Scale 4.0 and custom PREM surveys to their email addresses via the REDCap platform, and the results were integrated into the hospital's electronic health records system. A total of 192 patients (98 with kidney diseases and 94 with hematological diseases) were enrolled. The overall response rate was 51%, and the median time for completion of each proxy questionnaire was approximately three minutes. The lowest PROM scores were observed in the emotional and school functioning dimensions. More favorable experiences in the diagnosis establishment process were associated with higher scores in physical, social, school functioning, and total PROM scores. A better evaluation of the hospital's environment was associated with higher social functioning, while better information provision correlated with higher physical functioning and total PROM scores. Our data indicates that integrated electronic collection of PROMs and PREMs in the population of CSHCN is feasible, but efforts to increase the response rate are needed. The associations between PROMs and PREMs suggest that future studies exploring targeted interventions at the healthcare service level to improve subjective patient outcomes are needed.
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Affiliation(s)
- Karolis Ažukaitis
- Clinic of Pediatrics, Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania
- Vilnius University Hospital Santaros Klinikos, 08406 Vilnius, Lithuania
| | - Roma Puronaitė
- Vilnius University Hospital Santaros Klinikos, 08406 Vilnius, Lithuania
| | - Goda Elizabeta Vaitkevičienė
- Clinic of Pediatrics, Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania
- Vilnius University Hospital Santaros Klinikos, 08406 Vilnius, Lithuania
| | - Justas Trinkūnas
- Vilnius University Hospital Santaros Klinikos, 08406 Vilnius, Lithuania
- Faculty of Fundamental Sciences, Vilnius Gediminas Technical University, 10223 Vilnius, Lithuania
| | - Augustina Jankauskienė
- Clinic of Pediatrics, Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania
- Vilnius University Hospital Santaros Klinikos, 08406 Vilnius, Lithuania
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Ulman J, Serrant L, Dunham M, Probst H. Exploring women's experiences of breast or trunk lymphoedema following treatment for breast cancer. J Psychosoc Oncol 2023; 42:64-79. [PMID: 37377220 DOI: 10.1080/07347332.2023.2218374] [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] [Indexed: 06/29/2023]
Abstract
Background:The experiences of women who develop lymphoedema in the breast or trunk (BTL) after treatment for breast cancer have received little attention in either the academic or clinical setting. Consequently, women's support needs remain unrecognized.Objective and Design:As this study sought to gain an understanding of women's unheard experiences of a poorly understood condition, it was underpinned by The Silences Framework1 which facilitates research into sensitive or marginalized issues.Sample and Methods:Fourteen women with BTL participated in individual, unstructured interviews, some using photographs or drawings to reflect their experiences. The data was analyzed using the Listening Guide.2Findings:Participants revealed that they were unprepared for the development of BTL; for many, the symptoms were unfamiliar and distressing. Furthermore, their concerns were often dismissed by healthcare professionals (HCPs), leading to long delays in obtaining an accurate diagnosis and treatment. For some women, the practical and emotional impact of developing BTL was profound.Practice Implications:Increased awareness and education about the risk of BTL as a potential side-effect of treatment for breast cancer is required for HCPs and patients. This will alleviate distress, better prepare patients, and ensure timely referral for treatment to manage this chronic condition.
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Affiliation(s)
- Janet Ulman
- Sheffield Hallam University, Sheffield, United Kingdom
| | - Laura Serrant
- Manchester Metropolitan University, Manchester, United Kingdom
| | | | - Heidi Probst
- Sheffield Hallam University, Sheffield, United Kingdom
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Boele FW, Butler S, Nicklin E, Bulbeck H, Pointon L, Short SC, Murray L. Communication in the context of glioblastoma treatment: A qualitative study of what matters most to patients, caregivers and health care professionals. Palliat Med 2023; 37:834-843. [PMID: 36734532 PMCID: PMC10227096 DOI: 10.1177/02692163231152525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Patients with glioblastoma have a poor prognosis and treatment is palliative in nature from diagnosis. It is therefore critical that the benefits and burdens of treatments are clearly discussed with patients and caregivers. AIM To explore experiences and preferences around glioblastoma treatment communication in patients, family caregivers and healthcare professionals. DESIGN Qualitative design. A thematic analysis of semi-structured interviews. SETTING/PARTICIPANTS A total of 15 adult patients with glioblastoma, 13 caregivers and 5 healthcare professionals were recruited from Leeds Teaching Hospitals NHS Trust. RESULTS Four themes were identified: (1) Communication practice and preferences. Risks and side-effects of anti-tumour treatments were explained clearly, with information layered and repeated. Treatment was often understood to be 'the only option'. Understanding the impact of side-effects could be enhanced, alongside information about support services. (2) What matters most. Patients/caregivers valued being well-supported by a trusted treatment team, feeling involved, having control and quality of life. Healthcare professionals similarly highlighted trust, maintaining independence and emotional support as key. (3) Decision-making. With limited treatment options, trust and control are crucial in decision-making. Patients ultimately prefer to follow healthcare professional advice but want to be involved, consider alternatives and voice what matters to them. (4) Impact of COVID-19. During the pandemic, greater efforts to maintain good communication were necessary. Negative impacts of COVID-19 were limited, caregivers appeared most disadvantaged by pandemic-related restrictions. CONCLUSIONS In glioblastoma treatment communication, where prognosis is poor and treatmentwill not result in cure, building trusting relationships, maintaining a sense of control and being well-informed are identified as critical.
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Affiliation(s)
- Florien W Boele
- Leeds Institute of Medical Research, St James’s Hospital, University of Leeds, Leeds, UK
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Sean Butler
- Leeds Institute of Medical Research, St James’s Hospital, University of Leeds, Leeds, UK
| | - Emma Nicklin
- Leeds Institute of Medical Research, St James’s Hospital, University of Leeds, Leeds, UK
| | | | - Lucy Pointon
- Leeds Institute of Medical Research, School of Psychology, University of Leeds, Leeds, UK
| | - Susan C Short
- Leeds Institute of Medical Research, St James’s Hospital, University of Leeds, Leeds, UK
| | - Louise Murray
- Leeds Institute of Medical Research, St James’s Hospital, University of Leeds, Leeds, UK
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Schneider N, Bäcker A, Strauss B, Hübner J, Rubai S, Wagner S, Schwarz-Fedrow D, Hager L, Brenk-Franz K, Keinki C, Brandt F, Altmann U. Patient information, communication and competence empowerment in oncology: Results and learnings from the PIKKO study. Support Care Cancer 2023; 31:327. [PMID: 37154985 PMCID: PMC10165303 DOI: 10.1007/s00520-023-07781-9] [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: 10/27/2022] [Accepted: 04/25/2023] [Indexed: 05/10/2023]
Abstract
PURPOSE Many concepts for accompanying and supporting cancer patients exist and have been studied over time. One of them was PIKKO (a German acronym for "Patient information, communication and competence empowerment in oncology"), which combined a patient navigator, socio-legal and psychological counseling (with psychooncologists), courses dealing with various supportive aspects, and a knowledge database with validated and easy-to-understand disease-related information. The aim was to increase the patients' health-related quality of life (HRQoL), self-efficacy as well as health literacy and to reduce psychological complaints such as depression and anxiety. METHODS To this purpose, an intervention group was given full access to the modules in addition to treatment as usual, while a control group received only treatment as usual. Over twelve months, each group was surveyed up to five times. Measurements were taken using the SF12, PHQ-9, GAD, GSE, and HLS-EU-Q47. RESULTS No significant differences were found in scores on the mentioned metrics. However, each module was used many times and rated positively by the patients. Further analyses showed a tendency higher score in health literacy with higher intensity of use of the database and higher score in mental HRQoL with higher intensity of use of counseling. CONCLUSION The study was affected by several limitations. A lack of randomization, difficulties in recruiting the control group, a heterogeneous sample, and the COVID-19 lockdown influenced the results. Nevertheless, the results show that the PIKKO support was appreciated by the patients and the lack of measurable effects was rather due to the mentioned limitations than to the PIKKO intervention. TRIAL REGISTRATION This study was retrospectively registered in the German Clinical Trial Register under DRKS00016703 (21.02.2019, retrospectively registered). https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00016703.
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Affiliation(s)
- Nico Schneider
- Institute of Psychosocial Medicine, Psychotherapy and Psychoonocology (IPMPP), Jena University Hospital, Jena, Germany.
| | - Anna Bäcker
- Institute of Psychosocial Medicine, Psychotherapy and Psychoonocology (IPMPP), Jena University Hospital, Jena, Germany
| | - Bernhard Strauss
- Institute of Psychosocial Medicine, Psychotherapy and Psychoonocology (IPMPP), Jena University Hospital, Jena, Germany
| | - Jutta Hübner
- Department of Haematology and Medical Oncology, Jena University Hospital, Jena, Germany
| | | | | | | | - Lutz Hager
- SRH Fernhochschule - The Mobile University, Riedlingen, Germany
| | - Katja Brenk-Franz
- Institute of Psychosocial Medicine, Psychotherapy and Psychoonocology (IPMPP), Jena University Hospital, Jena, Germany
| | | | | | - Uwe Altmann
- Institute of Psychosocial Medicine, Psychotherapy and Psychoonocology (IPMPP), Jena University Hospital, Jena, Germany
- Department of Psychology, MSB Medical School Berlin GmbH, Berlin, Germany
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Rutherford C, Ju A, Kim B, Wiltink L, Acret L, White K. How consequences of colorectal cancer treatment are managed: a qualitative study of stakeholder experiences about supportive care and current practices. Support Care Cancer 2023; 31:255. [PMID: 37041401 PMCID: PMC10090022 DOI: 10.1007/s00520-023-07713-7] [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: 08/16/2022] [Accepted: 03/28/2023] [Indexed: 04/13/2023]
Abstract
PURPOSE Colorectal cancer (CRC) survivors experience treatment-effects such as symptoms and functional impairments. There is limited evidence about how these are managed and what services or supports are available in the community. We aimed to identify current practice and available supports for managing consequences of treatment from clinician and CRC survivor perspectives. METHODS This qualitative study, informed by an interpretivist constructionist paradigm, included semi-structured interviews. Clinicians with experience of treating CRC patients and adult CRC survivors were recruited across Australia. Interviews explored experiences about problems experienced after CRC treatment and how these were managed. Data collection and analysis, using thematic analysis, was iterative whereby emergent themes during analysis were incorporated into subsequent interviews. RESULTS We interviewed 16 clinicians and 18 survivors. Survivors experienced a range of consequences of treatment amendable to support including allied health, information, and self-management. Barriers to support access included clinicians' worry about patient out-of-pocket expenses, long waitlists, lack of awareness about existing supports, and perception no therapeutic options were available. Healthcare professionals with expertise in CRC were often difficult to identify outside of cancer settings. Survivorship care could be improved with individualised timely information and identification of pathways to access healthcare providers with expertise in managing consequences of CRC treatment within primary care. CONCLUSIONS To improve CRC survivor lives posttreatment, routine assessment of consequences of treatment, individualised care planning involving relevant healthcare professionals, access to supportive care when needed, and improved information provision and engagement of a range of health professionals in follow-up care are needed.
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Affiliation(s)
- Claudia Rutherford
- Cancer Care Research Unit (CCRU), Susan Wakil School of Nursing, University of Sydney, Sydney, Australia.
- University of Sydney, Faculty Science, School of Psychology, Quality of Life Office, Sydney, Australia.
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia.
| | - Angela Ju
- University of Sydney, Faculty Science, School of Psychology, Quality of Life Office, Sydney, Australia
| | - Bora Kim
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
| | - Lisette Wiltink
- Department of Radiation Oncology, Leiden University Medical Centre, Leiden, the Netherlands
| | - Louise Acret
- Cancer Care Research Unit (CCRU), Susan Wakil School of Nursing, University of Sydney, Sydney, Australia
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
| | - Kate White
- Cancer Care Research Unit (CCRU), Susan Wakil School of Nursing, University of Sydney, Sydney, Australia
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
- Sydney Local Health District, Sydney, Australia
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Diaz A, McErlane J, Jeon MH, Cunningham J, Sullivan V, Garvey G. Patient Information Resources on Cardiovascular Health After Cancer Treatment: An Audit of Australian Resources. JCO Glob Oncol 2023; 9:e2200361. [PMID: 37018632 DOI: 10.1200/go.22.00361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023] Open
Abstract
PURPOSE Up to one third of patients with cancer are thought to experience adverse cardiovascular events after their cancer diagnosis and treatment. High-quality information about cancer treatment-related cardiovascular disease can prepare patients and reduce anxiety. The aim of this project was to systematically identify Australian online information resources about cardiovascular health after cancer and assess the readability, understandability, actionability, and cultural relevance for Aboriginal and Torres Strait Islander patients. METHODS We conducted systematic Google and website searches to identify potentially relevant resources. Eligibility was assessed using predefined criteria. For each eligible resource, we summarized the content and assessed readability, understandability, actionability, and cultural relevance for Aboriginal and Torres Strait Islander people. RESULTS Seventeen online resources addressing cardiovascular health after cancer were identified: three focused solely on cardiovascular health and the remaining 14 dedicated between <1% and 48% of the word count to this topic. On average, three of 12 predefined content areas were covered by the resources. Only one resource was considered comprehensive, covering eight of 12 content areas. Overall, 18% of the resources were deemed readable for the average Australian adult, 41% deemed understandable, and only 24% had moderate actionability. None of the resources were considered culturally relevant for Aboriginal and Torres Strait Islander people, with 41% addressing only one of the seven possible criteria and the remainder addressing none of the criteria. CONCLUSION This audit confirms a gap in online information resources about cardiovascular health after cancer. New resources, especially for Aboriginal and Torres Strait Islander people, are needed. The development of such resources must be done through involvement and collaboration with Aboriginal and Torres Strait Islander patients, families, and carers, through a codesign process.
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Affiliation(s)
- Abbey Diaz
- First Nations Cancer and Wellbeing Research Team, School of Public Health, University of Queensland, Herston, QLD, Australia
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia
| | - Jorja McErlane
- First Nations Cancer and Wellbeing Research Team, School of Public Health, University of Queensland, Herston, QLD, Australia
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia
| | - Mi Hye Jeon
- First Nations Cancer and Wellbeing Research Team, School of Public Health, University of Queensland, Herston, QLD, Australia
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia
| | - Joan Cunningham
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia
| | - Victoria Sullivan
- First Nations Cancer and Wellbeing Research Team, School of Public Health, University of Queensland, Herston, QLD, Australia
| | - Gail Garvey
- First Nations Cancer and Wellbeing Research Team, School of Public Health, University of Queensland, Herston, QLD, Australia
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia
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Zhuo Q, Ma F, Cui C, Bai Y, Hu Q, Hanum AL, Wei W, Liang H. Effects of pre-operative education tailored to information-seeking styles on pre-operative anxiety and depression among patients undergoing percutaneous coronary intervention: A randomized controlled trial. Int J Nurs Sci 2023; 10:174-181. [PMID: 37128491 PMCID: PMC10148264 DOI: 10.1016/j.ijnss.2023.03.015] [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: 11/08/2022] [Revised: 02/06/2023] [Accepted: 03/19/2023] [Indexed: 05/03/2023] Open
Abstract
Objective This study aimed to evaluate the impact of pre-operative education tailored to percutaneous coronary intervention (PCI) patients' information-seeking styles on pre-operative anxiety and depression. Methods A single-blind randomized control trial was conducted. A total of 114 participants were recruited from the cardiology department in a tertiary hospital in Kunming, Southwest China from April to September 2020 and randomly allocated to the intervention group (n = 57) or control group (n = 57). All patients received oral pre-operative education as well as printed pre-operative education manuals and divided into monitors or blunters by the Chinese Version of the Monitoring Subscale of the Miller Behavioral Style Scale (C-MMBSS). The intervention group received pre-operative education tailored to information-seeking styles, while the control group received routine education. Anxiety and depression were measured at baseline and 1 h before the operation. Satisfaction with pre-operative education and length of stay were assessed at discharge. Results A total of 104 participants completed the study (52 participants in each group). Pre-operative education tailored to information-seeking styles was beneficial for reducing pre-operative anxiety (P < 0.01), reducing pre-operative depression (P < 0.01), and improving satisfaction with pre-operative education (P < 0.01) compared with routine education. There was no significant difference in length of stay between the intervention and control groups (P = 0.209). Conversely, pre-operative anxiety of patients was increased (P = 0.017) after pre-operative education in the control group. Conclusion This study confirmed that pre-operative education tailored to information-seeking styles effectively reduces pre-operative anxiety and depression and improves satisfaction with preoperative education.
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Affiliation(s)
- Qiqi Zhuo
- Oncology Center, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Fang Ma
- Department of Nursing, The First Affiliated Hospital of Kunming Medical University, Yunnan, China
| | - Changsheng Cui
- Department of Pharmacy, Army Medical Center of PLA, Chongqing, China
| | - Yangjuan Bai
- Cardiology Department, The First Affiliated Hospital of Kunming Medical University, Yunnan, China
| | - Qiulan Hu
- ICU in Geriatric Department, The First Affiliated Hospital of Kunming Medical University, Yunnan, China
| | - Ardani Latifah Hanum
- Department of Nursing, The First Affiliated Hospital of Kunming Medical University, Yunnan, China
| | - Wei Wei
- Gastrointestinal Surgery, The First Affiliated Hospital of Kunming Medical University, Yunnan, China
| | - Hongmin Liang
- Department of Nursing, The First Affiliated Hospital of Kunming Medical University, Yunnan, China
- Corresponding author.
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The Impact of Depression and Anxiety on Adult Cancer Patients’ Health-Related Quality of Life. J Clin Med 2023; 12:jcm12062196. [PMID: 36983197 PMCID: PMC10059703 DOI: 10.3390/jcm12062196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/02/2023] [Accepted: 03/09/2023] [Indexed: 03/14/2023] Open
Abstract
Background: Cancer patients are at high risk for mental illness and, in turn, poorer health-related quality of life. This study used nationally representative United States (US) data to examine nuances of the impact of depression and/or anxiety on HRQoL in different cancer groups (e.g., cancer only, cancer and depression, cancer and anxiety, cancer and both conditions). Methods: Adult patients aged 18 years and older with a cancer diagnosis were identified from the Medical Expenditure Panel Survey data for 2012–2016. HRQoL was measured using the SF-12 Physical and Mental Component Summary (PCS & MCS) scores. Multivariate linear regressions were used, controlling for a multitude of factors. Results: Around 12% of the 1712 identified patients with cancer had depression, 13% had anxiety, and 8.4% had both depression and anxiety. Patients with comorbid depression and anxiety had the lowest mean scores of both PCS and MCS compared to patients in other groups. In addition, cancer patients with either depression and/or anxiety were more likely to have lower MCS scores compared to those with cancer only (depression: β = −6.554; anxiety: β = −3.916; both conditions: β = −11.759, p < 0.001). Interestingly, patients with comorbid depression and anxiety were more likely to have higher PCS scores compared to those with cancer only. Conclusions: The psychological burden of cancer is immense, with a substantial impact on patients’ HRQoL. Routine screening for depression and anxiety, especially for women and those with low poverty status and comorbidities, should be conducted by healthcare providers to identify those with high odds of having a lower HRQoL. Additionally, early psychiatric interventions, such as psychotherapy and prescription drugs, may positively impact patients’ mental well-being and HRQoL.
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Verweij L, Ector GICG, Smit Y, van Vlijmen B, van der Reijden BA, Hermens RPMG, Blijlevens NMA. Effectiveness of digital care platform CMyLife for patients with chronic myeloid leukemia: results of a patient-preference trial. BMC Health Serv Res 2023; 23:228. [PMID: 36890512 PMCID: PMC9994406 DOI: 10.1186/s12913-023-09153-9] [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: 06/02/2022] [Accepted: 02/06/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Two most important factors determining treatment success in chronic myeloid leukemia (CML) are adequate medication compliance and molecular monitoring albeit still being suboptimal. The CMyLife platform is an eHealth innovation, co-created with and for CML patients, aiming to improve their care, leading to an increased quality of life and the opportunity of hospital-free care. OBJECTIVE To explore the effectiveness of CMyLife in terms of information provision, patient empowerment, medication compliance, molecular monitoring, and quality of life. METHODS Effectiveness of CMyLife was explored using a patient-preference trial. Upon completion of the baseline questionnaire, participants actively used (intervention group) or did not actively use (questionnaire group) the CMyLife platform for at least 6 months, after which they completed the post-intervention questionnaire. Scores between the intervention group and the questionnaire group were compared with regard to the within-subject change between baseline and post-measurement using Generalized Estimating Equation models. RESULTS At baseline, 33 patients were enrolled in the questionnaire group and 75 in the intervention group. Online health information knowledge improved significantly when actively using CMyLife and patients felt more empowered. No significant improvements were found regarding medication compliance and molecular monitoring, which were already outstanding. Self-reported effectiveness showed that patients experienced that using CMyLife improved their medication compliance and helped them to oversee their molecular monitoring. Patients using CMyLife reported more symptoms but were better able to manage these. CONCLUSIONS Since hospital-free care has shown to be feasible in time of the COVID-19 pandemic, eHealth-based innovations such as CMyLife could be a solution to maintain the quality of care and make current oncological health care services more sustainable. TRIAL REGISTRATION ClinicalTrials.gov NCT04595955 , 22/10/2020.
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Affiliation(s)
- Lynn Verweij
- Department of Hematology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands.
| | - Geneviève I C G Ector
- Department of Hematology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Yolba Smit
- Department of Hematology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Bas van Vlijmen
- Department of Pharmacy, Radboud University Medical Center, Nijmegen, Netherlands
| | - Bert A van der Reijden
- Department of Laboratory Medicine, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Rosella P M G Hermens
- Department of IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Nicole M A Blijlevens
- Department of Hematology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
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Mitsutake S, Takahashi Y, Otsuki A, Umezawa J, Yaguchi-Saito A, Saito J, Fujimori M, Shimazu T. Chronic Diseases and Sociodemographic Characteristics Associated With Online Health Information Seeking and Using Social Networking Sites: Nationally Representative Cross-sectional Survey in Japan. J Med Internet Res 2023; 25:e44741. [PMID: 36862482 PMCID: PMC10020913 DOI: 10.2196/44741] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/17/2023] [Accepted: 01/25/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND In an aging society, worsening chronic diseases increase the burden on patients and the health care system. Using online health information including health information via social networking sites (SNSs), such as Facebook and YouTube, may play an important role in the self-management of chronic diseases and health promotion for internet users. OBJECTIVE This study aims to improve strategies for promoting access to reliable information for the self-management of chronic diseases via the internet, and to identify populations facing barriers to using the internet for health, we examined chronic diseases and characteristics associated with online health information seeking and the use of SNSs. METHODS This study used data from the INFORM Study 2020, which was a nationally representative cross-sectional postal mail survey conducted using a self-administered questionnaire in 2020. The dependent variables were online health information seeking and SNS use. Online health information seeking was assessed using 1 question about whether respondents used the internet to find health or medical information. SNS use was assessed by inquiring about the following 4 aspects: visiting SNSs, sharing health information on SNSs, writing in an online diary or blog, and watching a health-related video on YouTube. The independent variables were 8 chronic diseases. Other independent variables were sex, age, education status, work, marital status, household income, health literacy, and self-reported health status. We conducted a multivariable logistic regression model adjusted for all independent variables to examine the associations of chronic diseases and other variables with online health information seeking and SNS use. RESULTS The final sample for analysis comprised 2481 internet users. Hypertension or high blood pressure, chronic lung diseases, depression or anxiety disorder, and cancer were reported by 24.5%, 10.1%, 7.7%, and 7.2% of respondents, respectively. The odds ratio of online health information seeking among respondents with cancer was 2.19 (95% CI 1.47-3.27) compared with that among those without cancer, and the odds ratio among those with depression or anxiety disorder was 2.27 (95% CI 1.46-3.53) compared with that among those without. Further, the odds ratio for watching a health-related YouTube video among those with chronic lung diseases was 1.42 (95% CI 1.05-1.93) compared with that among those without these diseases. Women, younger age, higher level of education, and high health literacy were positively associated with online health information seeking and SNS use. CONCLUSIONS For patients with cancer, strategies for promoting access to websites with reliable cancer-related information as well as access among patients with chronic lung diseases to YouTube videos providing reliable information may be beneficial for the management of these diseases. Moreover, it is important to improve the online environment to encourage men, older adults, internet users with lower education levels, and those with low health literacy to access online health information.
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Affiliation(s)
- Seigo Mitsutake
- Human Care Research Team, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Yoshimitsu Takahashi
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
| | - Aki Otsuki
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, National Cancer Center, Tokyo, Japan.,Division of Prevention, National Cancer Center Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Jun Umezawa
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Akiko Yaguchi-Saito
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, National Cancer Center, Tokyo, Japan.,Faculty of Human Sciences, Tokiwa University, Ibaraki, Japan
| | - Junko Saito
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Maiko Fujimori
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, National Cancer Center, Tokyo, Japan.,Division of Supportive Care, Survivorship and Translational Research, National Cancer Center Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Taichi Shimazu
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, National Cancer Center, Tokyo, Japan
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Punnett G, Fenemore J, Blackhall F, Yorke J. Support and information needs for patients with non-small cell lung cancer receiving concurrent chemo-radiotherapy treatment with curative intent: Findings from a qualitative study. Eur J Oncol Nurs 2023; 64:102325. [PMID: 37146348 DOI: 10.1016/j.ejon.2023.102325] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 03/09/2023] [Accepted: 03/10/2023] [Indexed: 03/14/2023]
Abstract
PURPOSE Concurrent chemotherapy and radiotherapy treatment (CCRT) is used to treat locally advanced Non-Small Cell Lung Cancer (NSCLC) in patients with suitable fitness. CCRT is associated with significant toxicity and time spent receiving treatment. Our aim was to identify the support and information needs of patients, and where possible their informal caregivers (IC), at key points along the CCRT pathway. METHODS Participants were NSCLC patients who were either about to undergo, currently receiving or had finished CCRT. Semi-structured interviews were conducted with participants, and their IC where applicable, at the treatment centre or participants' home. Interviews were audio recorded and transcribed prior to undergoing thematic analysis. RESULTS Fifteen patients were interviewed; five were interviewed with their IC. Themes of physical, psychological, and practical support needs are identified with associated subthemes exploring specific needs, such as dealing with late treatment effects, and how patients seek support. Information needs prior to, during and following CCRT were also established as predominant themes with subthemes detailing the needs at these time points. Examples include differences in participant desire for toxicity information and life after treatment. CONCLUSIONS The need for disease, treatment and symptom related information and support remains consistent throughout CCRT and beyond. Further information and support for other matters including engaging in regular activities may also be desired. Time allocated within consultations to establish changes in needs or desire for further information may benefit patient and IC experience and QOL.
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Informational Needs of Surgical Oncology Patients: A Cross-Sectional Patient Survey. J Surg Res 2023; 283:771-777. [PMID: 36470202 DOI: 10.1016/j.jss.2022.11.027] [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: 08/30/2022] [Revised: 10/24/2022] [Accepted: 11/12/2022] [Indexed: 12/05/2022]
Abstract
INTRODUCTION Patients newly diagnosed with cancer often seek information prior to being seen by a specialist. Little is known about the type of information desired and the sources used. We asked how patients find information about their new cancer diagnoses to improve information provision. METHODS An anonymous seven-question survey was provided to new patients in the surgical and medical oncology clinics at a comprehensive cancer center from February 2021 to June 2021. RESULTS Of 503 consecutive patients, 405 (81%) returned surveys; 49% female, 57% aged 51-75 y, and 71% Caucasian. Many (74%) sought information before their visit. Most (57%) relied on prior medical providers and 77% reported them as a trusted source. Nearly 80% of patients used at least one nonvalidated resource; 21% friends and relatives, 20% nongovernment or hospital resources, and 12% social media. Importantly, 23% found conflicting information. Respondents desired information on cancer treatment (58%), alternative therapies (35%), and nutrition and supplements (31%). CONCLUSIONS Patients with cancer trust information from medical providers but seek information from a variety of sources that can provide conflicting information. These data support encouraging patients to use validated sources, providing robust organization-based resources, and engaging patients on topics such as alternative therapies and nutrition.
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Arvanitou E, Nikoloudi M, Tsoukalas N, Parpa E, Mystakidou K. Factors associated with anxiety and depression in cancer patients: Demographic factors and the role of demoralization and satisfaction with care. Psychooncology 2023; 32:712-720. [PMID: 36797821 DOI: 10.1002/pon.6115] [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: 09/30/2022] [Revised: 02/01/2023] [Accepted: 02/03/2023] [Indexed: 02/18/2023]
Abstract
OBJECTIVE Anxiety and depression are common in cancer patients and seem to affect quality of life, treatment compliance and even survival. Defining factors related to anxiety and depression and exploring the role of demoralization and satisfaction with care, could contribute to the improvement of patients' quality of life and quality of health services as well. METHODS A convenience sample of 150 cancer inpatients and outpatients from two oncology centers, with various types of solid tumors, participated in a prospective cross-sectional observational study. The psychometric tools used were the Greek versions of the Hospital Anxiety and Depression Scale, FAMCARE-Patient Scale and Oncology Palliative Care (FAMCARESCALE) and Demoralization Scale (DEMORALIZATION SCALE II, DS-II). RESULTS Patients mean age was 62 years (20-85 years) and 89 patients (59.3%) were women. Among patients, 33% had breast, 24% gastrointestinal and 15% lung cancer. Eighty-two patients (54.7%) had metastatic disease. Women showed higher rates of anxiety (p = 0.054). Anxiety was inversely related to age (p = 0.043) and positively correlated with time since diagnosis (p = 0.076). Unmarried patients presented with higher rates of depression (p = 0.026). Multiple linear regression showed a statistically significant impact of Demoralization factor 'Meaning and Purpose' on anxiety (p < 0.001, R2 = 36.3%) and depression (p < 0.001, R2 = 49%). Moreover, higher educational level (p = 0.038, R2 = 3.1%) is related to higher levels of anxiety and higher scores of FAMCARESCALE factor-Information/interaction with the health care professionals, is related to lower levels of depression (p = 0.008, R2 = 2.7%). CONCLUSIONS The results highlight the significant impact of demoralization on anxiety and depression in cancer patients. Early recognition of demoralization and early referral to mental health professionals will hopefully alleviate the mental burden of cancer patients.
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Affiliation(s)
- Eleni Arvanitou
- Oncology Clinic, 401 General Military Hospital, Athens, Greece
| | - Maria Nikoloudi
- Department of Radiology, Pain Relief and Palliative Care Unit, Aretaieion Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Efi Parpa
- Department of Radiology, Pain Relief and Palliative Care Unit, Aretaieion Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Kyriaki Mystakidou
- Department of Radiology, Pain Relief and Palliative Care Unit, Aretaieion Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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Smith MD, Manning J, Nielsen M, Hayes SC, Plinsinga ML, Coppieters MW. Exploring women's experiences with persistent pain and pain management following breast cancer treatment: A qualitative study. FRONTIERS IN PAIN RESEARCH 2023; 4:1095377. [PMID: 36860333 PMCID: PMC9968918 DOI: 10.3389/fpain.2023.1095377] [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: 11/11/2022] [Accepted: 01/23/2023] [Indexed: 02/15/2023] Open
Abstract
This qualitative study aimed to explore experiences of women with persistent pain following breast cancer treatment, including their perceptions about the cause of their pain, how they manage their pain and their interactions with healthcare providers related to their pain during and following breast cancer treatment. Fourteen women who experienced pain for more than 3 months following breast cancer treatment were recruited from the general breast cancer survivorship community. Focus groups and in-depth, semi-structured interviews were conducted by one interviewer, audio-recorded, and transcribed verbatim. Transcripts were coded and analysed using Framework Analysis. Three main descriptive themes emerged from the interview transcripts: (1) characteristics of pain, (2) interactions with healthcare providers and (3) pain management. Women had various types and degrees of persistent pain, all of which they believed were related to breast cancer treatment. Most felt like they were not given enough information pre- or post-treatment and believed their experience and ability to cope with pain would have been better if they were given accurate information and advice about (the possibility of) experiencing persistent pain. Pain management strategies ranged from trial and error approaches, to pharmacotherapy, and to 'just coping with the pain". These findings highlight the importance of the provision of empathetic supportive care before, during and after cancer treatment that can facilitate access to relevant information, multidisciplinary care teams (including allied health professionals) and consumer support.
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Affiliation(s)
- Michelle D. Smith
- School of Health and Rehabilitation Sciences, Physiotherapy, The University of Queensland, Brisbane, QLD, Australia,Correspondence: Michelle D. Smith
| | - Joanne Manning
- School of Health and Rehabilitation Sciences, Physiotherapy, The University of Queensland, Brisbane, QLD, Australia
| | - Mandy Nielsen
- AcquiredBrain Injury Transitional Rehabilitation Service, Division of Rehabilitation, Princess Alexandra Hospital, Brisbane, QLD, Australia,Menzies Health Institute Queensland, Griffith University, Brisbane and Gold Coast, QLD, Australia
| | - Sandra C. Hayes
- Menzies Health Institute Queensland, Griffith University, Brisbane and Gold Coast, QLD, Australia
| | - Melanie L. Plinsinga
- Menzies Health Institute Queensland, Griffith University, Brisbane and Gold Coast, QLD, Australia
| | - Michel W. Coppieters
- Menzies Health Institute Queensland, Griffith University, Brisbane and Gold Coast, QLD, Australia,Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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