Effects of the supportive care needs of patients with cancer on their comfort levels

BACKGROUND

Providing supportive care to patients with cancer and improving their comfort levels can promote their adjustment to the disease, compliance with treatment and improve their quality of life.

AIM

The aim of this cross-sectional, descriptive study was to identify the effects of the supportive care needs of cancer patients on their comfort levels.

METHODS

The study was performed in the oncology department of a university hospital. A total of 153 cancer patients undergoing chemotherapy constituted the sample. The data collection procedure included the Supportive Care Needs Survey (SCNS) and the General Comfort Questionnaire (GCQ).

RESULTS

The SCNS scores of the patients were low (Mean±SD: 75.13±27.93). The socio-cultural dimension of the GCQ was the most adversely influenced area of comfort. There was a negative relationship between needs and comfort levels (rs=-0.69, p<0.01). Lower scores of comfort were associated with higher scores of SCNS (ß=-0.487; ß=-0.316; ß=-0.958, respectively).

CONCLUSIONS

Cancer patients undergoing chemotherapy were supported in meeting their physical and psychological needs and performing their activities of daily living and care during their hospital stay. Patients with higher support needs had lower comfort levels.

A mixed-method systematic review of unmet care and support needs among Japanese cancer survivors

PURPOSE

To synthesize published studies regarding Japanese cancer survivors' needs/unmet needs of care/support, change of unmet needs over time, and preferred care/support providers.

METHODS

A mixed-method systematic review was conducted. MEDLINE, PsycINFO, CINAHL, and Ichu-shi were searched from inception to May 2022. Quantitative and qualitative studies were separately analyzed using narrative synthesis and meta-ethnography. Each finding was synthesized using a line of argument.

RESULTS

Twenty-four studies (13 quantitative and 11 qualitative studies) were included. Six quantitative studies reported unmet needs in survivors of adolescent and young adult (n=1) and adulthood (n=5) cancer. No longitudinal studies regarding changes in unmet needs were identified. One study reported that adults preferred care/support providers. The quantitative studies identified more help in physical (48.2-51.0%, n=2) and psychological issues (17.4-78.8%, n=5), information (27.9-58.0%, n=3), and healthcare services (25.3-67.1%, n=2) among adults. The qualitative studies emphasized more tailor-made information about life events for young cancer survivors. More empathic and trustworthy interactions with surrounding people, including healthcare professionals, were demanded, regardless of age. A line of argument illustrated that cancer survivors had insufficient resources for activities and empowerment to face life with cancer at all phases.

CONCLUSIONS

Japanese cancer survivors' unmet needs are diverse. More information and resources for psychological care/support and local healthcare services post-treatment are needed, which may hinder the optimal transition to survivorship.

IMPLICATIONS FOR CANCER SURVIVORS

The synthesized evidence should be utilized to implement a comprehensive care/support system in practice and educate people surrounding cancer survivors, regardless of age.

The Effectiveness of Telenursing Interventions on Patient Outcomes for Colorectal Cancer Patients: A Systematic Review and Meta-Analysis

OBJECTIVE

To systematically review existing telenursing interventions for patients with colorectal cancer and determine the effects of such interventions on health-related quality of life and health care service utilization.

DATA SOURCES

We conducted a systematic review and meta-analysis after protocol registration. International databases, including PUBMED, EMBASE, CINAHL, Web of Science, SCOPUS, and CENTRAL and Korean databases, were searched. The last search was conducted on June 8, 2021. Two authors independently selected relevant studies, evaluated their methodological quality, and extracted data. A meta-analysis of randomized controlled trials was conducted using the statistical software STATA 16.0. Of the 223 articles retrieved, 7 were included for narrative synthesis and 3 were used for the meta-analysis. There were 857 patients in the telenursing group and 842 patients in the conventional group. Three studies applied theoretical frameworks for designing the intervention.

CONCLUSION

The effect of telenursing intervention was not different from that of usual care. However, both readmission rates and emergency department visits were lower in the telenursing group than in the usual care group, although these trends were not statistically significant.

IMPLICATIONS FOR NURSING PRACTICE

These findings indicate that telenursing intervention did not differ from usual care in terms of health-related quality of life while reducing readmission and emergency department visits in a nonstatistically significant manner. Therefore, telenursing interventions could serve as a partial alternative to current face-to-face interventions for patients with colorectal cancer.

Supportive care needs and health-related quality of life in cancer patients receiving palliative care

Objective

Cancer patients receiving palliative care experience a variety of impairments in their quality of life (QoL), and have corresponding supportive care needs (SCNs). The aim of this study was to analyze the relationship between SCNs, satisfaction with QoL dimensions, and the perceived importance of these dimensions.

Method

A sample of 152 cancer patients receiving palliative care were included in this cross-sectional study. Eight dimensions of QoL were defined and assessed concerning SCNs, satisfaction, and subjective importance using a new assessment instrument with five-point scales (range 1-5) for each dimension.

Results

Among the eight specific domains examined, the greatest SCNs were observed for absence of pain (M = 3.18; SD = 1.29). The patients were least satisfied with their physical functioning (M = 2.60; SD = 0.84), and the dimension social relationships (M = 4.14; SD = 0.72) received the highest perceived importance ratings. The eight dimensions' SCNs scores were significantly correlated with each other (r between 0.29 and 0.79); the lowest correlations were found for social relationships. The correlations between the satisfaction scores and the SCNs differed from dimension to dimension, with coefficients between -0.32 (absence of pain) and - 0.57 (sleep quality).

Conclusion

The results show that detriments in QoL do not automatically indicate high levels of SCNs in those dimensions. Health care providers should consider both factors, QoL (as measured with QoL questionnaires) and subjectively expressed SCNs, to optimize their patients' care regimens.

Higher Stress in Oncology Patients is Associated With Cognitive and Evening Physical Fatigue Severity

CONTEXT

Cognitive and physical fatigue are common symptoms experienced by oncology patients. Exposure to stressful life events (SLE), cancer-related stressors, coping styles, and levels of resilience may influence the severity of both dimensions of fatigue.

OBJECTIVES

Evaluate for differences in global, cancer-specific, and cumulative life stress, as well as resilience and coping in oncology patients (n=1332) with distinct cognitive fatigue AND evening physical fatigue profiles.

METHODS

Latent profile analysis, which combined the two symptom scores, identified three subgroups of patients with distinct cognitive fatigue AND evening physical fatigue profiles (i.e., Low, Moderate, High). Patients completed measures of global, cancer-specific, and cumulative life stress as well measures of resilience and coping. Differences among the latent classes in the various measures were evaluated using parametric and nonparametric tests.

RESULTS

Compared to Low class, the other two classes reported higher global and cancer-specific stress. In addition, they reported higher occurrence rates for sexual harassment and being forced to touch prior to 16 years of age. Compared to the other two classes, High class reported lower resilience scores and higher use of denial, substance use, and behavioral disengagement.

CONCLUSION

To decrease both cognitive and evening physical fatigue, clinicians need to assess for relevant stressors and initiate interventions to increase resilience and the use of engagement coping strategies. Additional research is warranted on the relative contribution of various social determinants of health to both cognitive and physical fatigue in oncology patients receiving chemotherapy.

Resilience in adults with colorectal cancer: Refining a conceptual model using a descriptive qualitative approach

AIMS

To examine and refine a conceptual model of resilience in adult cancer care based on the perspectives and experiences of resilience in adults with colorectal cancer.

DESIGN

A descriptive qualitative study was performed.

METHODS

Twelve participants diagnosed with colorectal cancer that had completed cancer treatment with curative intent were recruited from a tertiary hospital in Australia from July to December 2019. The meaning of individual resilience was explored using in-depth individual interviews. Data were analysed using inductive thematic analysis. Following data analysis, the elements of the conceptual model of resilience were mapped against the themes and subthemes to refine the model.

RESULTS

Five themes were identified as key elements of individual resilience in adults with colorectal cancer: (1) seeking motivations to move forward; (2) striving for normality; (3) adapting and managing self; (4) drawing on external supports; (5) redefining self. A refined conceptual model of individual resilience in adults with colorectal cancer was developed based on the integration of the themes and the elements of the conceptual model of individual resilience.

CONCLUSIONS

Our refined conceptual model of individual resilience in adults with colorectal cancer could facilitate nurses' and other health professionals' understanding of the process of how resilient individuals with colorectal cancer overcome their illness-related adversity. This refined model may be used to further develop and test cancer-specific resilience measures and develop interventions to facilitate resilience in people living with colorectal cancer.

IMPACT

This research identified five features of resilience in adults with colorectal cancer and refined a conceptual model of resilience in adults with colorectal cancer. The findings could help nurses and other health professionals with identifying individuals who are at risk of adaptation difficulties and contribute to an early referral to psychosocial support services.

The supportive care needs and its influencing factors among thyroid cancer patients after surgery: A cross-sectional study

Objective

To study the supportive care needs (SCNS) of thyroid cancer (TC) patients after surgery, and to identity its influencing factors.

Methods

By convenience sampling method, total of 115 patients undergoing thyroid surgery who met the inclusion criteria from May 2021 to July 2021 were selected as the research objects. The general information questionnaire, Supportive Care Need Survey Short-Form (SCNS-SF34), functional subscale of European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) were used to investigate these patients.

Results

The average score for the items of SCNS-SF34 in 102 TC patients was 2.15 ± 0.71. The domain with the highest item average score was "health system information needs" (2.48 ± 1.17). The domain with the highest unsatisfied rate was "psychological needs" (69.6%). The item with the highest average score was "fear of cancer spreading" in the psychological needs domain (2.80 ± 1.48). The scores of physical function (r = -0.431, P < 0.001), role function (r = -0.428, P < 0.001), cognitive function (r = -0.531, P < 0.001), emotional function (r = -0.388, P < 0.001), social function (r = -0.464, P < 0.001) were correlated with the total score of SCNS-SF34. The univariate analysis of SCNS-SF34 scores showed that TC patients who were women (t = 2.013, P = 0.047), older (F = 1.353, P = 0.013), and with longer hospital stays (F = 3.705, P = 0.028) had higher demand of SCNS. The results of multiple linear regression analysis showed that the significant variables that entered the regression equation were gender, age, length of stay in hospital, cognitive function and social function (P < 0.05).

Conclusion

TC patients after surgery have many SCNS in different domains. It is necessary to focus on women, older patients, patients with long hospital stays and poor functioning. The implementation of a supportive care screening tool is recommended and the individualized interventions need to be developed to provide targeted support and care.

The needs of colorectal cancer patients/survivors: A narrative review

BACKGROUND

Identifying and addressing the needs of Colorectal cancer (CRC) patients/survivors' is important to improve patients/survivors' quality of life (QoL) and health. The present study aimed to review studies that have investigated CRC patients/survivors' needs.

MATERIALS AND METHODS

In this narrative review, databases including PubMed, Scopus, Web of Science, Iranmedex, ISC, SID, and Magiran were searched during 2011-2021 using keywords included need, CRC, colon cancer, rectal cancer.

RESULTS

The findings of the studies showed that the needs of the CRC patients/survivors' can be categorized into the 6 domains including informational, psychological, social, physical, financial, and spiritual needs.

CONCLUSIONS

By identifying CRC patients/survivors' needs, healthcare providers particularly nurses can develop and design comprehensive care programs tailored to the needs and priorities of these patients/survivors to improve their QoL and health.

Unmet supportive care needs of people with advanced cancer and their caregivers: a systematic scoping review

Examining and addressing unmet care needs is integral to improving the provision and quality of cancer services. This review explored the prevalence of unmet supportive care needs, and factors associated with unmet need, in adults with advanced cancers (solid and hematological malignancies) and their caregivers. Electronic databases (PubMed, CINAHL, EMBASE) were searched, producing 85 papers representing 81 included studies. People with advanced cancer reported the highest unmet needs in financial, health system and information, psychological, and physical and daily living domains, whereas caregivers reported the highest unmet needs in psychological, and patient care and support domains. Distress, depression, and anxiety were associated with higher unmet needs across all unmet need domains for people with advanced cancer and their caregivers. Substantial heterogeneity in study populations and methods was observed. Findings from this review can inform targeted strategies and interventions to address these unmet needs in people with advanced cancer.

Prevalence and Type of Unmet Needs Experienced by People Living with Dementia

Background: Accurately identifying the unmet needs of community-dwelling people with dementia allows targeted support to be provided to assist these individuals to stay at home. Objective: We developed a self-report instrument to identify the unmet needs of community-dwelling people with dementia and used this to explore the prevalence and type of unmet needs present in this population. Methods: This was a cross-sectional survey of people with dementia living in the community in Australia. Participants were recruited from geriatric clinics, respite centers, aged care providers, and carers attending support groups. Eligible people with dementia were provided with a study information pack and survey which included the self-report Unmet Needs Instrument for Dementia (UNI-D), sociodemographic characteristics and survey acceptability. Results: The UNI-D contained 26 items across 5 domains and demonstrated acceptable internal consistency, face and construct validity, and acceptability. Ninety-five eligible participants completed the survey (response rate 35%) with 85% identifying at least one unmet need (median = 4; IQR = 1–9). The items most frequently endorsed included needing more help with remembering things (64%), finding possible treatments for dementia (44%), understanding who to contact regarding a problem or concern related to dementia (36%), and to see friends and family more often (33%). Conclusion: The UNI-D is a promising tool to identify the self-reported needs of people with dementia. The development and rigorous testing of interventions targeting unmet needs related to health and wellbeing, dementia support, and meaningful activities appears warranted.

Acceptability and Feasibility of a Guided Biopsychosocial Online Intervention for Cancer Patients Undergoing Chemotherapy

Chemotherapy is a physically and psychologically highly demanding treatment, and specific Internet-based interventions for cancer patients addressing both physical side effects and emotional distress during chemotherapy are scarce. This study examined the feasibility and acceptability of a guided biopsychosocial online intervention for cancer patients undergoing chemotherapy (OPaCT). A pre-post, within-participant comparison, mixed-methods research design was followed. Patients starting chemotherapy at the outpatient clinic of the National Center for Tumor Diseases in Heidelberg, Germany, were enrolled. Feasibility and acceptability were evaluated through intervention uptake, attrition, adherence and participant satisfaction. As secondary outcomes, PHQ-9, GAD-7, SCNS-SF34-G and CBI-B-D were administered. A total of N = 46 patients participated in the study (female 76.1%). The age of participants ranged from 29 to 70 years (M = 49.3, SD = 11.3). The most prevalent tumour diseases were breast (45.7%), pancreatic (19.6%), ovarian (13.1%) and prostate cancer (10.8%). A total of N = 37 patients (80.4%) completed the OPaCT intervention. Qualitative and quantitative data showed a high degree of participant satisfaction. Significant improvements in the SCNS-SF34 subscale 'psychological needs' were found. Study results demonstrate the feasibility and acceptability of the intervention. The results show that OPaCT can be implemented well, both in the treatment process and in participants' everyday lives. Although it is premature to make any determination regarding the efficacy of the intervention tested in this feasibility study, these results suggest that OPaCT has the potential to reduce unmet psychological care needs of patients undergoing chemotherapy.

Avaliação da fadiga e da qualidade de vida de pacientes com câncer colorretal em quimioterapia

RESUMO Objetivo: Avaliar a fadiga e a qualidade de vida relacionada à saúde de pacientes com câncer colorretal em quimioterapia. Método: estudo descritivo, realizado com 69 pacientes entre janeiro a setembro/2019, em um hospital público de Minas Gerais. Instrumentos utilizados: questionário sociodemográfico e clínico, Quality of Life Questionnaire-Core30 e Escala de Fadiga de Piper, analisados segundo medidas de frequência, média e desvio padrão pelo softwarePSPP. Resultados: A maioria era mulheres, acima de 60 anos, casadas, aposentadas, donas de casa, com médio nível de escolaridade. Os escores de estado geral de saúde, das funções social, física, emocional e desempenho de papel foram considerados satisfatórios (médias50-70), da função cognitiva foi boa (média>70); sintomas mais prevalentes foram perda de apetite, fadiga, dor e insônia. Quanto à fadiga, todas as dimensões tiveram média <4, considerado fadiga leve. Conclusão: A qualidade de vida apresentou escores satisfatórios e a fadiga foi classificada como leve nos pacientes em quimioterapia.

Evaluation of fatigue and quality of life of colorectal cancer patients in chemotherapy

ABSTRACT Objective: To evaluate fatigue and health-related quality of life of colorectal cancer patients undergoing chemotherapy. Method: Descriptive study conducted with 69 patients between January and September/2019 in a public hospital in Minas Gerais. Instruments used: sociodemographic and clinical questionnaire, Quality of Life Questionnaire-Core30 and Piper Fatigue Scale, analyzed according to measures of frequency, mean and standard deviation by the software PSPP. Results: Most patients were women over 60 years old, married, retired and housewives, with an average level of education. The scores of general health status, social, physical, emotional and role functioning were considered satisfactory (means 50 to 70), cognitive function was good (mean higher than 70); the most prevalent symptoms were loss of appetite, fatigue, pain and insomnia. As for fatigue, all dimensions had a mean value <4, considered mild fatigue. Conclusion: Quality of life had satisfactory scores and fatigue was classified as mild in patients undergoing chemotherapy.

Psychological distress and its influencing factors among psychiatric nurses in China: A cross-sectional study

BACKGROUND

Psychiatric nurses often face abuse, attacks, escape, suicides, and other situations related to the care of patients with mental disorders, which are more likely to induce psychological distress.

AIMS

This study aimed to examine the relationship between coping styles and psychological distress among Chinese psychiatric nurses in Shandong and the significance of sleep quality as a mediating factor.

METHODS

A total of 812 psychiatric nurses in Shandong, China, were investigated using the Psychological Distress Scale (K10), Simplified Coping Style Questionnaire (SCSQ), Pittsburgh Sleep Quality Index (PSQI) and self-compiled general information questionnaire.

RESULTS

Psychological distress was detected in 571 psychiatric nurses (70.3%). The psychological distress of psychiatric nurses was significantly different with respect to professional title (χ² = 10.627, P < 0.05) and shift work (χ² = 9.120, P < 0.01). Psychological distress positively correlated with negative coping style (r = 0.266, P < 0.01) and sleep quality (PSQIT) (r = 0.532, P < 0.01). A significant positive correlation was found between psychological distress and all dimensions of sleep quality (r = 0.158-0.456, P < 0.05). Professional title, positive coping style, negative coping style, sleep quality (PSQIT), subjective sleep quality, sleep disorder and daytime dysfunction predicted psychological distress in psychiatric nurses (R ² = 0.363, F = 65.343, P < 0.01). The relationship between negative coping style and psychological distress was partially mediated by sleep quality, with the mediating effect accounting for 37.97% of the total effect.

CONCLUSIONS

Psychiatric nurses have a high rate of psychological distress, which is closely related to coping styles, and sleep quality has a certain regulatory effect.

A feasibility study of a peer discussion group intervention for patients with pancreatobiliary cancer and their caregivers

OBJECTIVES

The purpose of this feasibility study was to examine the impacts of a peer discussion group intervention called "the pancreatobiliary cancer salon" on psychological distress among patients with pancreatobiliary cancer and their caregivers.

METHODS

We recruited patients with pancreatic or biliary tract cancer and their caregivers. We conducted a within-group pre-post comparison study. Participants were grouped by the type of cancer and treatment. Each group consisted of four to five patients or caregivers. Hospital staff members facilitated group discussions where participants freely talked for 1 h. We evaluated participants' psychological condition using the Profile of Mood States (POMS) and their impressions of the pancreatobiliary cancer salon.

RESULTS

We analyzed data from 42 patients and 27 caregivers who joined the salon for the first time. Thirty-five patients (83.3%) had pancreatic cancer. Thirty-one patients (71.4%) had unresectable pancreatobiliary cancer and 14 patients (33.3%) were being treated with second-line or third-line chemotherapy at the time of the survey. Twenty-two patients (52.4%) participated in the salon within 6 months after diagnosis. Most participating caregivers were the patient's spouse/partner (51.9%) or child (34.6%). Both patients and caregivers experienced high levels of satisfaction with the pancreatobiliary cancer salon. Both patients and caregivers had significantly lower psychological distress as assessed by POMS after the salon.

SIGNIFICANCE OF RESULTS

A peer discussion group intervention might be well-received and has potential to benefit for patients with pancreatobiliary cancer and their caregivers.

Unmet supportive care needs and predictor of breast cancer patients in Bangladesh: A cross-sectional study

BACKGROUND

Breast cancer survivor goes through a period of needs in their post-treatment daily life. Relatively few studies have been conducted to understand the unmet needs among breast cancer survivors in Bangladesh. Recognize and measure patterns and predictors of unmet needs of breast cancer patients was the aim of the study.

OBJECTIVE

To identify and measure patterns and predictors of unmet needs of breast cancer patients in Bangladesh.

METHOD

A cross-sectional study among 138 breast cancer patients; conveniently selected from two public and two private cancer institutes. Face-to-face interview for data collection and medical record review for checklist was done. Unmet needs have been determined by the supportive care needs survey short form 34 scale. Logistic regression analyses were performed to identify the predictors of unmet needs.

RESULTS

The study indicated the top 10 moderate-to-high needs; among which the top five needs were from the information need domain. Surprisingly, private cancer treatment centers were identified as a significant predictor for unmet needs. Patients from private cancer institutes reported more explanation needs as well as needs with their physical and daily living and sexuality. Furthermore, the type of treatment like patient receiving combine treatment therapy reported more need for help compared to the patient receiving chemotherapy alone. Moreover, housewives reported the low need for patient care and support systems as a result of their reluctant behavior towards their health.

CONCLUSION

Individual's unmet need assessment should be a part of every treatment protocol of breast cancer for a better treatment outcome.

Describing Unmet Supportive Care Needs among Young Adults with Cancer (25-39 Years) and the Relationship with Health-Related Quality of Life, Psychological Distress, and Illness Cognitions

Few studies describe supportive care needs among young adults (YAs) with cancer ages 25 to 39 using validated questionnaires. Previous findings identified the need for psychological and information support and suggest that gender, age, psychological distress, and coping may be associated with greater need for this support. To substantiate these findings, this study aimed to (1) describe the supportive care needs of YAs in each domain of the Supportive Care Needs Survey and (2) explore the relationship between unmet supportive care needs and clinical and demographic factors, health-related quality of life, psychological distress, illness cognitions, and service needs using latent class analysis. Clinical teams from six hospitals in England invited eligible patients to a cross-sectional survey by post. A total of 317 participants completed the survey online or on paper. YAs expressed the most need in the psychological and sexuality domains. Using latent class analysis, we identified three classes of YAs based on level of supportive care need: no need (53.3%), low need (28.3%), and moderate need (18.4%). In each class, median domain scores in each domain were similar. Low and moderate need classes were associated with worse health-related quality of life and greater helplessness. Unmet service needs were associated with the moderate-need class only. Patients with unmet supportive care needs should be offered holistic care across supportive care domains.

Unmet Supportive Care Needs of Jordanian Patients with Colorectal Cancer: A Cross-Sectional Survey

Objective:

Colorectal cancer (CRC) is ranked the second most common cancer diagnosed in both men and women in Jordan. This paper aims to explore the unmet supportive care needs (USCNs), and their predictors among Jordanian survivors with CRC.

Methods:

A cross-sectional descriptive correlational research design with a convenience sample of 180 patients with CRC was conducted. Participants completed the Supportive Care Needs Survey-Short Form 34.

Results:

Jordanian patients with CRC reported their highest perceived level of need in the information and psychological domains. Multiple linear regression revealed that income and the number of chemotherapy sessions were significant predictors in the physical and daily living domains. Age, type of surgical treatment, and type of clinical setting were significant predictors of USCN in the psychological, patient care and support, and the health system and information domains.

Conclusions:

The health-care systems should work to meet all the supportive care needs for patients with CRC, particularly the informational and psychological needs domains where patients express unmet needs. Special care should be given according to age, type of surgery, and the doses of chemotherapy received. This study further confirms a disparity in the care and support provided to Jordanian cancer patients with different health-care settings in the country.

Psychological Distress and Its Association with Unmet Needs and Symptom Burden in Outpatient Cancer Patients: A Cross-Sectional Study

OBJECTIVES

To evaluate the relationships of sociodemographic and clinical characteristics, symptom burden, and supportive care needs of patients with a prevalence of psychological distress in outpatients with cancer.

DATA SOURCES

The study was carried out with 298 outpatient cancer patients at an oncology center in Turkey, and a descriptive correlational design was used. The data were collected through Hospital Anxiety-Depression Scale (HADS), Nightingale Symptom Assessment Scale (N-SAS), and Supportive Care Needs Scale Short Form (SCNS-SF34). Descriptive statistics and hierarchical regression analyses were performed.

CONCLUSION

The study determined that the anxiety and depression scores of a significant portion of cancer patients receiving outpatient treatment were clinically significant. It was observed that the physical and psychological symptom burden of the patients and the increase in unmet care needs related to psychological, physical, and activities of daily life contributed to the development of anxiety and depression. Of the sociodemographic and disease-related characteristics of the patients, female sex was found to be an important factor for both anxiety and depression, and advanced age was found to be an important factor for depression. These results indicate that cancer patients receiving outpatient treatment need intensive supportive psychosocial care.

IMPLICATIONS FOR NURSING PRACTICE

It is recommended that patients' psychological distress levels and supportive care needs be included in the care process as a routine component of care, as in symptom assessment, and to develop a more sensitive and supportive care environment in meeting psychosocial care needs and accessing support.

Self-Care Efficacy-Mediated Associations Between Healthcare Provider-Patient Communication and Psychological Distress Among Patients With Gastrointestinal Cancers

BACKGROUND

Both healthcare provider-patient communication and self-care efficacy affect psychological distress, which is prevalent among patients with gastrointestinal (GI) cancers. It is essential to explore the underlying mechanism among them to relieve psychological distress.

OBJECTIVE

The aim of this study was to examine whether self-care efficacy mediated the association between healthcare provider-patient communication and psychological distress among patients with GI cancers.

METHODS

A cross-sectional study was conducted between March 2018 and May 2019 in China. In total, 219 patients with GI cancers were recruited before discharge from chemotherapy. Healthcare provider-patient communication was assessed by the revised Physician-Patient Communication Scale; patient self-care efficacy was assessed by the Strategies Used by People to Promote Health; and psychological distress was assessed by the Distress Thermometer and the Hospital Anxiety and Depression Scale. Mediation analyses were conducted to examine the mediating effect of self-care efficacy on the association between healthcare provider-patient communication and psychological distress.

RESULTS

A total of 54.34% of patients experienced psychological distress. Patients reported a mean score of 89.93 (SD, 13.81) for healthcare provider-patient communication and 93.91 (SD, 23.39) for self-care efficacy. Self-care efficacy completely mediated the association between healthcare provider-patient communication and psychological distress, and communication outcome was the only domain that significantly influenced self-care efficacy.

CONCLUSION

Psychological distress is prevalent among patients with GI cancers. Healthcare provider-patient communication, especially communication outcome, promoted patients' self-care efficacy to reduce psychological distress.

IMPLICATIONS FOR PRACTICE

Healthcare providers should design interventions to improve communication outcomes and eventually increase self-care efficacy to relieve psychological distress among patients with GI cancers.

Trends of concerns from diagnosis in patients with advanced lung cancer and their family caregivers: A 2-year longitudinal study

BACKGROUND

Both advanced cancer patients and their family caregivers experience distress and have a range of concerns after cancer diagnosis. However, longitudinal studies on this topic have been lacking.

AIM

To investigate concerns in both patients with advanced lung cancer and their family caregivers longitudinally from diagnosis.

DESIGN

A multi-center prospective questionnaire-based study.

SETTING/PARTICIPANTS

We recruited patients with newly diagnosed advanced lung cancer and their family caregivers at 16 hospitals in Japan. We prospectively assessed the prevalence of their concerns using the Concerns Checklist and investigated the associations between their concerns and mental status as well as quality of life until 24 months after diagnosis.

RESULTS

A total of 248 patients and their 232 family caregivers were enrolled. The prevalence of serious concerns was highest at diagnosis (patients: 68.3%, family caregivers: 65.3%). The most common serious concern was concern about the future in both groups at diagnosis (38.2% and 40.5%, respectively) and this remained high in prevalence over time, while the high prevalence of concern about lack of information improved 3 months after diagnosis in both groups. Approximately one-third of patient-family caregiver dyads had discrepant reports of serious concerns. The presence of serious concerns was significantly associated with anxiety and depression continuously in both groups.

CONCLUSIONS

The majority of advanced lung cancer patients and their family caregivers have serious concerns from diagnosis, which is associated with their psychological distress. The spectrum of concerns alters over the disease trajectory, warranting efficient tailored care and support for both groups immediately after diagnosis.

Unmet supportive care needs and associated factors among young adult cancer patients in Japan

Background

Young adult cancer patients often face unique challenges and have potential unmet needs. This study aimed (1) to describe unmet supportive care needs among young adults with cancer in Japan, and (2) to identify its associated factors.

Methods

In a cross-sectional web-based survey, 206 young adults with cancer were assessed for supportive care needs. Multiple regression analysis examined whether demographics, clinical variables and social support were associated with unmet supportive care needs.

Results

A total of 206 patients (180 female) with a mean age of 33.7 years (SD = 4.3, range: 22–39) participated. One hundred and fifty-eight participants (76.7%) reported at least one unmet supportive care needs. The top 20 unmet needs included 9 of the 10 psychological needs, 3 of the 5 physical and daily living needs, 8 of the 11 health system and information needs and 1 of the 5 sexuality needs. Multiple regression analysis revealed that perceived poorer PS, experience of change in work/school after a cancer diagnosis and poor social support were significantly associated with higher supportive care needs. The total score of supportive care needs was significantly associated with both psychological distress and QOL.

Conclusions

More than 70% of young adult cancer patients reported unmet supportive care needs and most of those were psychological needs. The findings suggest potential opportunities for intervention in addressing psychological needs rather than physical and information needs.

Health services research in colorectal cancer: a quasi-experimental interventional pilot study on in- and outpatient oncology

Introduction

Due to frequent treatment side effects and weight loss, colorectal cancer patients require oncologic care and nutritional counseling both during and after hospitalization. The current study evaluated differences in discharge and side effects management and nutritional behavior between colorectal cancer patients of a control group without systematic counseling and of an intervention group with access to structured in- and outpatient oncology nurse and nutritional counseling.

Methods

The presented explorative, quantitative, single-center, interventional pilot study is a health services research project with a quasi-experimental design. Using a self-designed standardized questionnaire, data were collected from the control group (n = 75) before and from the intervention group (n = 114) after the introduction of in- and outpatient oncology nurse and structured systematic nutritional counseling. The in- and outpatient counseling services were developed and evaluated in the form of a structured nurse-led counseling concept.

Results

Intervention group patients profited significantly from inpatient oncology nurse counseling in seven different areas of discharge management. No differences were observed concerning patient-reported general and gastrointestinal side effects except for xerostomia and dysphagia, but of the patients participating in both in- and outpatient oncology nurse counseling, 90.0% were better able to cope with general side effects of treatment. Patients with in- and outpatient structured systematic nutritional counseling more frequently received nutritional information (p = 0.001), were better at gauging food intolerances (p = 0.023), and followed the dietician's advice in cases of gastrointestinal side effects significantly more often (p = 0.003) than control patients. Counselor-reported outcomes concerning gastrointestinal side effects showed improvement in most of the patients taking part in systematic in- and outpatient nutritional counseling, except for weight loss in 4 patients.

Conclusion

In- and outpatient counseling in discharge and side effects management and nutrition improve the outcomes of colorectal cancer patients. Outpatient counseling should be further developed and evaluated in future studies.

Factors Influencing Supportive Care Needs of Colorectal Cancer Survivors

PURPOSE

There is an increasing number of colorectal cancer survivors in South Korea. However, no research has identified supportive care needs of survivors of colorectal cancer in South Korea. Thus, the purpose of this study was to determine the level of supportive care needs and effects of emotional state and quality of life (QoL) on supportive care needs of colorectal cancer survivors.

METHODS

This cross-sectional study was conducted among 115 survivors of colorectal cancer in South Korean who had primary treatment of surgery for colorectal cancer. Data were collected from April to September 2016. Participants responded to self-reported questionnaires assessing supportive care needs, emotional state (Hospital Anxiety and Depression Scale), and QoL (Functional Assessment of Cancer Therapy-Colorectal scale).

RESULTS

The overall score of supportive care needs for colorectal cancer survivors was 1.22 ± 0.61 (full score: 3 points), with health care staff and social support needs garnering highest scores. Approximately, 20.0% and 21.7% of patients had anxiety and depression, respectively. The mean QoL score was 2.90 ± 0.53, with social and family status having the lowest QoL score. Multiple regression analysis showed that both the period after treatment and anxiety significantly influenced supportive care needs.

CONCLUSION

Appropriate interventions should be used immediately after completion of treatment to help reduce anxiety and meet supportive care needs of colorectal cancer survivors.

A population-based study of the humanistic burden among cancer patients in Japan

Aims: Understanding the burden of cancer in Japan is becoming increasingly important to address the socio-economic consequences of the disease. This study broadly examined the cancer burden in terms of: Health-Related Quality of Life (HRQoL), work productivity and activity impairment (WPAI), stress-related comorbidities, and indirect costs in patients diagnosed with (i) any type of cancer, (ii) breast cancer, (iii) colorectal cancer, compared to controls without cancer.Materials and methods: This cross-sectional study used data from the 2017 Japan National Health and Wellness Survey (NHWS). Patient outcomes included self-reported stress-related comorbidities, HRQoL assessed by Short Form 12-item Health Survey and EuroQoL 5-dimension scale (EQ-5D), and work productivity and indirect costs assessed by WPAI questionnaire. Multivariate analysis was performed to compare outcomes across groups. An ad-hoc analysis compared respondents currently and currently not receiving prescription medication (Rx).Results: A total of 1,540 patients with any type of cancer, 254 with breast cancer, 144 with colorectal cancer were included in the analyses and compared to 28,070 controls without cancer. After adjusting for potential confounding effects patients with any type of cancer had significantly lower mental component summary scores (45.70 vs. 46.45, p = .003), physical component summary scores (48.95 vs. 50.02, p < .001) and EQ-5D index (0.77 vs. 0.79, p < .001), and significantly increased absenteeism (5.13% vs. 2.68% p < .001) compared to controls. No significant differences were detected for indirect costs. Breast cancer patients had significantly increased odds of anxiety and migraine. Colorectal cancer patients had significantly increased odds of insomnia. Patients currently receiving Rx had significantly lower HRQoL and higher WPAI than both controls and cancer patients not receiving Rx.Conclusions: Japanese cancer patients experience a significantly decreased HRQoL, increased absenteeism and higher odds ratio for stress-related comorbidities. This has implications for future policy making and Health Technology Assessment in Japan.

Higher levels of stress and different coping strategies are associated with greater morning and evening fatigue severity in oncology patients receiving chemotherapy

PURPOSE

A cancer diagnosis and associated treatments are stressful experiences for most patients. Patients' perceptions of stress and their use of coping strategies may influence fatigue severity. This study extends our previous work describing distinct profiles of morning (i.e., Very Low, Low, High, and Very High) and evening (i.e., Low, Moderate, High, and Very High) fatigue in oncology patients by evaluating for differences in stress and coping strategies among these fatigue classes.

METHODS

This longitudinal study evaluated for changes in morning and evening fatigue in oncology patients (n = 1332) over two cycles of chemotherapy (CTX). Patients completed measures of cumulative exposure to stressful life events (SLEs) (i.e., the Life Stressor Checklist-Revised), general stress (i.e., Perceived Stress Scale [PSS]), cancer-specific stress (i.e., Impact of Event Scale-Revised [IES-R]), and coping strategies (i.e., Brief Cope). Differences among the latent classes were evaluated using analyses of variance, Kruskal-Wallis, or chi-square tests.

RESULTS

Patients in both the Very High morning and evening fatigue classes reported higher numbers of and a higher impact from previous SLEs and higher PSS scores than the other fatigue classes. The IES-R scores for the Very High morning fatigue class met the criterion for subsyndromal PTSD. Patients in the Very High evening fatigue class used a higher number of engagement coping strategies compared with the Very High morning fatigue class.

CONCLUSIONS

Our findings suggest that interventions to reduce stress and enhance coping warrant investigation to decrease fatigue in patients undergoing CTX.

Uncertainty and unmet care needs before and after surgery in patients with gastric cancer: A survey study

Uncertainty and unmet care needs constantly change in patients with cancer. However, there is a lack of information regarding the changing pattern of these variables. This study aimed to examine the changes in uncertainty and unmet care needs at diagnosis and after surgery among patients with gastric cancer. In total, 86 individuals completed a self-reported questionnaire. Data were collected twice - to measure uncertainty and unmet care needs at cancer diagnosis (T1), and after surgery (T2) - and analyzed using descriptive analysis and a dependent t-test. Uncertainty was moderate at both periods but significantly higher at T1. Unmet care needs were highest in the information domain and lowest in the sexuality domain at both T1 and T2. Only the physical/daily living domain were significantly higher at T2, whereas the information, psychological, and patient care/support domains were significantly higher at T1. Different levels of uncertainty and unmet needs were identified at T1 and T2. Healthcare providers should assess changing unmet care needs at each stage of the cancer trajectory and provide related nursing care and information to this population, even immediately after diagnosis.

Quality of life, care needs, and information needs among patients diagnosed with cancer during their treatment phase

Proper assessment of patients' needs might enhance patients' outcomes, ability to cope with new challenges, identify required resources, prioritize service needs, determine patients with higher need levels, and improve patients' quality of life. A cross-sectional descriptive design was used. Total of 113 patients from different settings completed the study surveys including demographic sheet, Short-form cancer needs questionnaire (CNQ-SF), Functional Assessment of Cancer Therapy-General (FACT-G), and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-INFO 25). Regression analysis indicated that care needs and information needs were predictors of QOL (R² = 0.688, adjusted R² = 0.61, F (1.17, p < 0.001)). A significant correlation exists between QOL, care needs and information needs. Daily nursing practices should include assessing patients; care needs, information needs, and QOL through using valid and reliable scales.

Supportive care needs, quality of life and psychological morbidity of advanced colorectal cancer patients

PURPOSE

This study describes the supportive care needs in a consecutive sample of Italian colorectal cancer (CRC) patients, evaluating their quality of life and psychological morbidity.

METHODS

This study used a cross-sectional design and self-assessment procedures and was conducted in an ambulatory setting. Demographics, basic clinical features, supportive care needs, quality of life and psychological morbidity of 203 CRC patients were gathered.

RESULTS

Approximately the 80% of the patients experienced one or more moderate- or high-level unmet need, notably regarding psychological concerns (approximately the 20% presented also signs of anxiety and depression). Functional roles and cognitive functioning were low. Symptoms of fatigue, nausea and vomiting and financial issues were frequent. The severity of anxiety, depression and quality of life impairment was significantly different across different levels of needs according to a unique linear relation. Patients with moderate or high needs had more severe anxiety and depression and a lower quality of life (i.e., lower level of functioning and more severe symptoms) than those with no needs or low needs.

CONCLUSIONS

The findings of this study suggest that meeting supportive care needs seems to improve psychological morbidity, functions and symptoms of CRC patients.

Supportive care needs of patients following treatment for colorectal cancer: risk factors for unmet needs and the association between unmet needs and health-related quality of life-results from the ColoREctal Wellbeing (CREW) study

Purpose

To investigate unmet needs of patients with colorectal cancer (CRC) at the end of treatment and whether unmet needs improve over time. Identify predictors of need following treatment and whether unmet need is associated with worse health-related quality of life (HRQoL).

Methods

As part of the UK ColoREctal Wellbeing (CREW) cohort study, patients treated for CRC completed the Supportive Care Needs Survey Short Form-34 (SCNS SF-34) 15 and 24 months following surgery, along with questionnaires measuring HRQoL, wellbeing, life events, social support, and confidence to manage their cancer before surgery, 3, 9, 15, and 24 months post-surgery.

Results

The SCNS SF-34 was completed by 526 patients at 15 months and 510 patients at 24 months. About one-quarter of patients had at least one moderate or severe unmet need at both time points. Psychological and physical unmet needs were the most common and did not improve over time. Over 60% of patients who reported 5 or more moderate or severe unmet needs at 15 months experienced the same level of unmet need at 24 months. HRQoL at the beginning of treatment predicted unmet needs at the end of treatment. Unmet needs, specifically physical, psychological, and health system and information needs, were associated with poorer health and HRQoL at the end of treatment.

Conclusions

Unmet needs persist over time and are associated with HRQoL. Evaluation of HRQoL at the start of treatment would help inform the identification of vulnerable patients. Assessment and care planning in response to unmet needs should be integrated into person-centred care.

Implications for Cancer Survivors

Early identification of CRC patients at risk of unmet needs will help infrom personalised survivorship care plans. The implementation of personalised and tailored services are likely to confer HRQoL gains.

Electronic supplementary material

The online version of this article (10.1007/s11764-019-00805-6) contains supplementary material, which is available to authorized users.

Prevalence and risk factors associated with the comprehensive needs of cancer patients in China

Background

The incidence and mortality rates of cancer have been increasing in developing countries, particularly in Asia. Therefore to provide optimal comprehensive care to the cancer patients, the care plan must focus on the comprehensive needs of cancer patients. The purpose of this study was to investigate the comprehensive needs of cancer patients, and explore the associated factors.

Methods

In a cross-sectional questionnaire study, a total of 200 cancer patient-caregiver dyads were selected and interviewed in Mainland China by convenient sampling method. Patients’ comprehensive needs were assessed with Comprehensive Needs Assessment Tool in cancer for Patients (CNAT), including seven domains (Information, Psychological Problems, Health Care Staffs, Physical Symptoms, Hospital Facilities and Services, Social/Religious/Spiritual Support and Practical Support). Both cancer patients and caregivers completed the sociodemographic survey. The mean differences in domain scores for different characteristics groups were compared by one-way ANOVA or non-parametric analyses, and influencing factors defined with multivariate regression analysis.

Results

The cancer patients’ need for Health Care Staffs (78.35 ± 13.08) was the highest among the seven domains, followed by the need for Information (71.18 ± 17.39) and the need for Hospital Facilities and Services (52.65 ± 13.35). The lowest score was the need for Physical Symptoms (35.12 ± 16.68). Patients who were female, with low family monthly income, at their own expense, and with highly educated caregivers had higher score of CNAT. Also sociodemographic characteristics were associated with each domain need of cancer patients.

Conclusion

This study shows that cancer patients experience high levels of needs for health-care staff and information, and the different needs are closely related to their sociological characteristics. The provision of health care can be adapted to meet the different needs of cancer patients of different epidemiological characteristics at different times during the course of treatment.

Supportive Care in Radiotherapy Based on a Mobile App: Prospective Multicenter Survey

BACKGROUND

Consumer electronics and Web-enabled mobile devices are playing an increasing role in patient care, and their use in the oncologic sector opens up promising possibilities in the fields of supportive cancer care and systematic patient follow-up.

OBJECTIVE

The objective of our study was to assess the acceptance and possible benefits of a mobile app-based concept for supportive care of cancer patients undergoing radiotherapy.

METHODS

In total, 975 patients presenting for radiotherapy due to breast or prostate cancer were screened; of them, 200 owned a smartphone and consented to participate in the survey. Patients were requested to complete a questionnaire at 2 time points: prior to the initiation (T0) and after the completion (T1) of radiotherapy. The questionnaire included questions about the habits of smartphone usage, technical knowledge and abilities of the participants, readiness to use a mobile app within the context of radiotherapy, possible features of the mobile app, and general attitude toward the different aspects of oncologic treatments. For quantitative analysis, sum scores were calculated for all areas of interest, and results were correlated with patient characteristics. Additionally, answers were quantitatively compared between time points T0 and T1.

RESULTS

Median patient age was 57 (range 27-78) years. Of the 200 participants, 131 (66.2%) reported having the ability to use their smartphones with minimal to no help and 75.8% (150/200) had not used their smartphones in a medical context before. However, 73.3% (146/200) and 83.4% (166/200) of patients showed a strong interest in using a mobile app for supportive care during radiotherapy and as part of the clinical follow-up, respectively. Patients most commonly requested functionalities regarding appointment scheduling in the clinic (176/200, 88.0%) and the collection of patient-reported outcome data regarding their illness, therapy, and general well-being (130/200, 65.0%). Age was identified as the most influential factor regarding patient attitude, with patients aged <55 years being significantly more inclined toward and versed in smartphone use (P<.001). The acceptance of mobile apps was significantly higher in patients exhibiting a Karnofsky performance index <80% (P=.01). Support in the context of therapy-related side effects was judged most important by patients with poor clinical performance (P=.006). The overall acceptance of mobile apps in the context of radiotherapy surveillance was high at a median item sum score of 71.4/100 and was not significantly influenced by tumor stage, age, gender, treatment setting, or previous radiotherapies.

CONCLUSIONS

The acceptance of mobile apps for the surveillance and follow-up of cancer patients undergoing radiotherapy is high; this high acceptance level will serve as a basis for future clinical trials investigating the clinical benefits of mobile app-based treatment support. Introduction of mobile apps into the clinical routine should be considered as an opportunity to improve and intensify supportive treatment for cancer patients.