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Zapata Bonilla SA, Fried M, Singer S, Hentschel L, Richter S, Hohenberger P, Kasper B, Andreou D, Pink D, Arndt K, Bornhäuser M, Schmitt J, Schuler MK, Eichler M. Working situation and burden of work limitations in sarcoma patients: results from the multi-center prospective PROSa study. J Cancer Res Clin Oncol 2023:10.1007/s00432-022-04556-3. [PMID: 36624191 PMCID: PMC10356622 DOI: 10.1007/s00432-022-04556-3] [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: 10/13/2022] [Accepted: 12/22/2022] [Indexed: 01/11/2023]
Abstract
PURPOSE We investigated predictors of limitations in work performance, odds of drop out of work, and odds of receiving disability pension in sarcoma patients. METHODS We measured clinical and sociodemographic data in adult sarcoma patients and recorded if the patients received a (1) disability pension at baseline or (2) had dropped out of work 1 year after initial assessment. (3) Work limitations were assessed using the Work-limitations questionnaire (WLQ©). We analyzed exploratively. RESULTS (1) Amongst 364 analyzed patients, odds to receive a disability pension were higher in patients with abdominal tumors, older patients, high grade patients and with increasing time since diagnosis. (2) Of 356 patients employed at baseline, 21% (n = 76) had dropped out of work after 1 year. The odds of dropping out of work were higher in bone sarcoma patients and in patients who received additive radiotherapy ± systemic therapy compared with patients who received surgery alone. Odds of dropping out of work were less amongst self-employed patients and dropped with increasing time since diagnosis. (3) Work limitations were higher in woman and increased with age. Patients with bone and fibrous sarcomas were more affected than liposarcoma patients. Patients with abdominal tumors reported highest restrictions. Sarcoma treatment in the last 6 months increased work limitations. CONCLUSION Work limitations, drop out of work and dependence on a disability pension occurs frequently in patients with sarcoma adding to the burden of this condition. We were able to identify vulnerable groups in both the socioeconomic and disease categories.
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Affiliation(s)
- Sergio Armando Zapata Bonilla
- Clinic and Polyclinic for Internal Medicine III, Haematology and Medical Oncology/University Centre for Tumor Diseases (UCT), University Hospital Johannes Gutenberg, University Hospital Mainz, Mainz, Germany.
| | - Marius Fried
- Clinic and Polyclinic for Internal Medicine III, Haematology and Medical Oncology/University Centre for Tumor Diseases (UCT), University Hospital Johannes Gutenberg, University Hospital Mainz, Mainz, Germany
| | - Susanne Singer
- Institute for Medical Biostatistics, Epidemiology and Informatics, University Hospital Mainz, Mainz, Germany
| | - Leopold Hentschel
- National Center for Tumor Diseases Dresden (NCT/UCC), Dresden, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany.,Faculty of Medicine and University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany.,Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Dresden, Germany
| | - Stephan Richter
- Clinic and Polyclinic for Internal Medicine I, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Peter Hohenberger
- Division of Surgical Oncology & Thoracic Surgery, Mannheim University Medical Center, University of Heidelberg, Heidelberg, Germany
| | - Bernd Kasper
- Sarcoma Unit, Mannheim Cancer Center (MCC), Mannheim University Medical Center, University of Heidelberg, Mannheim, Germany
| | - Dimosthenis Andreou
- Department of General Orthopedics and Tumor Orthopedics, University Hospital Munster, Munster, Germany.,Department of Orthopedics and Trauma, Medical University of Graz, Graz, Austria
| | - Daniel Pink
- Sarcoma Center Berlin-Brandenburg, Helios Hospital Bad Saarow, Brandenburg, Germany.,Department of Internal Medicine C, University Hospital Greifswald, Greifswald, Germany
| | - Karin Arndt
- German Sarcoma Foundation, Woelfersheim, Germany
| | - Martin Bornhäuser
- National Center for Tumor Diseases Dresden (NCT/UCC), Dresden, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany.,Faculty of Medicine and University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany.,Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Dresden, Germany.,Clinic and Polyclinic for Internal Medicine I, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Jochen Schmitt
- National Center for Tumor Diseases Dresden (NCT/UCC), Dresden, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany.,Faculty of Medicine and University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany.,Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Dresden, Germany.,Center for Evidence-Based Healthcare, Medizinische Fakultät Carl Gustav Carus, TU, Dresden, Germany
| | - Markus K Schuler
- Clinic and Polyclinic for Internal Medicine I, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Martin Eichler
- National Center for Tumor Diseases Dresden (NCT/UCC), Dresden, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany.,Faculty of Medicine and University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany.,Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Dresden, Germany.,Clinic and Polyclinic for Internal Medicine I, University Hospital Carl Gustav Carus, Dresden, Germany
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Zhang HT, Xiong H, Xiao HW, Zhang ZH, Huang CL, Huang MZ. Serum metabolomics reveals the effects of accompanying treatment on fatigue in patients with multiple myeloma. Support Care Cancer 2022; 31:43. [PMID: 36525141 DOI: 10.1007/s00520-022-07526-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 11/07/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE The renewal and iteration of chemotherapy drugs have resulted in more frequent long-term remissions for patients with multiple myeloma (MM). MM has transformed into a chronic illness for many patients, but the cancer-related fatigue (CRF) of many MM convalescent patients experience is frequently overlooked. We investigated whether the accompanying treatment of family members would affect MM patients' CRF and explore their serum metabolomics, so as to provide clinicians with new ideas for identifying and treating CRF of MM patients. METHODS This was a single-center study, and a total of 30 MM patients were included in the study. Patients were divided into two groups based on whether they have close family members accompanying them through the whole hospitalization treatment. These patients received regular chemotherapy by hematology specialists, and long-term follow-up was done by general practitioners. Patients' CRF assessment for several factors used the Chinese version of the Brief Fatigue Inventory (BFI-C). Face-to-face questionnaires were administered at a time jointly determined by the patient and the investigator. All questionnaires were conducted by a general practitioner. The LC-MS-based metabolomics analysis determined whether the patients' serum metabolites were related to their fatigue severity. A correlation analysis investigated the relationship between serum metabolites and clinical laboratory indicators. RESULTS The fatigue severity of MM patients whose family members participated in the treatment process (group A) was significantly lower than patients whose family members did not participate in the treatment process (group B). There was a statistically significant difference (fatigue severity composite score: t = - 2.729, p = 0.011; fatigue interference composite score: t = - 3.595, p = 0.001). There were no differences between the two groups of patients' gender, age, regarding clinical staging, tumor burden, blood routine, biochemical, or coagulation indexes. There were 11 metabolites, including guanidine acetic acid (GAA), 1-(Methylthio)-1-hexanethiol, isoeucyl-asparagine, L-agaritine, tryptophyl-tyrosine, and betaine, which significantly distinguished the two groups of MM patients. GAA had the strongest correlation with patient fatigue, and the difference was statistically significant (fatigue severity composite score: r = 0.505, p = 0.0044; fatigue interference composite score: r = 0.576, p = 0.0009). The results showed that GAA negatively correlated with albumin (r = - 0.4151, p = 0.0226) and GGT (r = - 0.3766, p = 0.0402). Meanwhile, GAA positively correlated with PT (r = 0.385, p = 0.0473), and the difference was statistically significant. CONCLUSION The study is the first to report that family presence throughout the whole hospitalization may alleviate CRF in MM patients. Moreover, the study evaluated serum metabolites linked to CRF in MM patients and found that CRF has a significant positive correlation with GAA. GAA may be a more sensitive biomarker than liver enzymes, PT, and serum albumin in predicting patient fatigue. While our sample may not represent all MM patients, it proposes a new entry point to help clinicians better identify and treat CRF in MM patients.
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Affiliation(s)
- Hui-Tao Zhang
- Stem Cell Laboratory, Academician (Expert) Workstation of Sichuan Province, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China.,Department of General Practice, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province, China
| | - Hao Xiong
- Stem Cell Laboratory, Academician (Expert) Workstation of Sichuan Province, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China
| | - Hong-Wen Xiao
- Department of Hematology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province, China
| | - Zhi-Hong Zhang
- Department of General Practice, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province, China
| | - Chun-Lan Huang
- Stem Cell Laboratory, Academician (Expert) Workstation of Sichuan Province, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China.
| | - Mei-Zhou Huang
- Stem Cell Laboratory, Academician (Expert) Workstation of Sichuan Province, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China.
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Tański W, Dudek K, Adamowski T. Work Ability and Quality of Life in Patients with Rheumatoid Arthritis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13260. [PMID: 36293837 PMCID: PMC9603111 DOI: 10.3390/ijerph192013260] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 10/10/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Reduced work participation has social implications (sickness absence, economic impact) and consequences for the individual patient (impoverishment, depression, limited social interaction). As patients with rheumatoid arthritis (RA) are more likely to experience job loss and/or at-work productivity loss and are at higher risk of sickness absence and, ultimately, permanent work productivity, consideration should be given to the association between work productivity or partial work capacity and quality of life (QoL). The aim of the study was to assess the relationship between QoL and the risk of work disability, as well as to estimate the risk of a future event and identify factors affecting the risk of work disability in RA inpatients. MATERIAL AND METHODS This cross-sectional study included 142 inpatients (65 male) aged 47 (38-58) years, who met the established criteria for a diagnosis of RA and treatment with biologic drugs. Only standardized tools were used to examine the patients: WHOQOL-BREF, MFIS and AS-WIS. RESULTS An analysis of the QoL scores on the WHOQOL-BREF demonstrated that the patients' QoL was lowest in the physical health domain and highest in the social relationships domain. The median WHOQOL-BREF total score in the group studied was 62.8, which indicates a moderate QoL. The median total score for the risk of work disability (AS-WIS) was 10.1, which indicates that the level of risk of work disability in the patients was higher than the average level reported in the literature. A multivariate analysis showed that the following were significant independent determinants of a higher risk of work disability: low QoL in the WHOQOL-BREF physical health (β = 0.961; p = 0.029) and psychological health (β = 1.752; p = 0.002) domains, being in a relationship (β = 0.043; p = 0.005) and the use of opioids for pain (β = 3.054; p = 0.012). CONCLUSIONS RA patients presented with moderate QoL, moderate fatigue (MFIS) and high risk of disability (AS-WIS). There is an association between a high risk of work disability and lower QoL, especially in the physical and psychological health domains. The lower the QoL in those domains, the higher the risk of work disability. The identification of factors increasing the risk of work disability will help in planning tailored interventions to improve at-work productivity loss and thus prevent work disability.
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Affiliation(s)
- Wojciech Tański
- Department of Internal Medicine, 4th Military Teaching Hospital, R. Weigla 5, 50-981 Wrocław, Poland
| | - Krzysztof Dudek
- Department of Transport Systems, Faculty of Mechanical Engineering, University of Technology, 50-370 Wrocław, Poland
| | - Tomasz Adamowski
- Department of Nursing and Obstetrics, Wroclaw Medical University, 51-618 Wrocław, Poland
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Eisapareh K, Nazari M, Mokarami H. Cross-cultural translation and psychometric properties of the Persian version Manchester respiratory activities of daily living questionnaire (MRADLQ-P). BMC Pulm Med 2022; 22:143. [PMID: 35413900 PMCID: PMC9006572 DOI: 10.1186/s12890-022-01920-4] [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: 06/01/2021] [Accepted: 03/29/2022] [Indexed: 11/10/2022] Open
Abstract
PURPOSE The present study was an attempt to investigate cross-cultural adaptability and evaluate the psychometric properties of the Persian version of the Manchester respiratory activities of daily living questionnaire ((MRADLQ-P). PATIENTS AND METHODS In a cross-sectional study, we selected 260 patients with severe respiratory diseases who needed to be admitted to the respiratory wards of this city hospital. The process of cultural localization of the questionnaire was performed based on a standard and valid process. Psychometric properties of the instrument were confirmed based on face and content validity assessments, convergent validity, discriminative validity and internal consistency. Data collected by demographic questionnaire, MRADL questionnaire and work ability index. Data were analyzed by SPSS 22 using descriptive statistics (mean and standard deviation), Spearman correlation coefficient, Cronbach's alpha coefficient, and Mann-Whitney test. RESULTS The mean age of participants was 48.8 ± 20.1 years. 176 (71.5%) were male. face content validity including content validity index (CVI) was 0.82 and content validity ratio and it was good. The questionnaire was measured at the same time as the work ability index, which Mann-Whitney test showed that the questionnaire has good differential power. Cronbach's alpha coefficient of 0.9 indicates a very good reliability of the questionnaire. CONCLUSION The results show that intercultural psychometrics of MRADL questionnaire has good validity, reliability, and differential power that can be a good tool for use in future studies. Also, the translation of this checklist included translation into the target language, backward translation of the Persian versions into the original language, and comparisons and ambiguities to obtain a final and acceptable version.
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Affiliation(s)
- Kumars Eisapareh
- Student Research Committee, Department of Health Promotion and Education, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahin Nazari
- Department of Health Promotion and Education, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Hamidreza Mokarami
- Department of Ergonomics, School of Health Shiraz, University of Medical Sciences, Shiraz, Iran
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5
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A Qualitative Study of Cancer Survivors' Experienced Outcomes of a Multidimensional Rehabilitation Program in Primary Healthcare. Cancer Nurs 2021; 45:E646-E654. [PMID: 34310389 DOI: 10.1097/ncc.0000000000000989] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Cancer survival rates are increasing, but survival is often followed by several late effects. Cancer survivors' need for complex rehabilitation is well documented, but this is mostly missing in primary healthcare. OBJECTIVE The aim of this study was to explore cancer survivors' experienced outcomes of a multidimensional rehabilitation program in primary healthcare. METHODS The study used a qualitative method with a descriptive research design. Fifty-six cancer survivors completed a 12-week rehabilitation program built upon the 5 elements of goal setting, physical exercise, psychoeducation, individual follow-up, and peer support. Data were collected at the end of the program via 8 focus group interviews, and systematic text condensation was used to analyze the data. RESULTS "Increased coping and participation" was identified as the overarching theme of the participants' experienced outcomes from the program, and this was elaborated by 3 main themes: (1) "increased energy and capacity," (2) "acceptance and understanding," and (3) "structure and hope." CONCLUSION The multidimensional rehabilitation program seemed to address cancer survivors' multiple challenges in survivorship. Proximity and accessibility to a local rehabilitation program and professionals' competence seemed to be essential factors for the participants' experienced outcomes of the program. IMPLICATION FOR PRACTICE A multidimensional rehabilitation program integrated in a Healthy Life Centre in primary healthcare may be beneficial for cancer survivors' coping and participation in everyday life. Cancer nurses play a crucial role in initiating and facilitating such programs.
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Maguire R, McCann L, Kotronoulas G, Kearney N, Ream E, Armes J, Patiraki E, Furlong E, Fox P, Gaiger A, McCrone P, Berg G, Miaskowski C, Cardone A, Orr D, Flowerday A, Katsaragakis S, Darley A, Lubowitzki S, Harris J, Skene S, Miller M, Moore M, Lewis L, DeSouza N, Donnan PT. Real time remote symptom monitoring during chemotherapy for cancer: European multicentre randomised controlled trial (eSMART). BMJ 2021; 374:n1647. [PMID: 34289996 PMCID: PMC8293749 DOI: 10.1136/bmj.n1647] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To evaluate effects of remote monitoring of adjuvant chemotherapy related side effects via the Advanced Symptom Management System (ASyMS) on symptom burden, quality of life, supportive care needs, anxiety, self-efficacy, and work limitations. DESIGN Multicentre, repeated measures, parallel group, evaluator masked, stratified randomised controlled trial. SETTING Twelve cancer centres in Austria, Greece, Norway, Republic of Ireland, and UK. PARTICIPANTS 829 patients with non-metastatic breast cancer, colorectal cancer, Hodgkin's disease, or non-Hodgkin's lymphoma receiving first line adjuvant chemotherapy or chemotherapy for the first time in five years. INTERVENTION Patients were randomised to ASyMS (intervention; n=415) or standard care (control; n=414) over six cycles of chemotherapy. MAIN OUTCOME MEASURES The primary outcome was symptom burden (Memorial Symptom Assessment Scale; MSAS). Secondary outcomes were health related quality of life (Functional Assessment of Cancer Therapy-General; FACT-G), Supportive Care Needs Survey Short-Form (SCNS-SF34), State-Trait Anxiety Inventory-Revised (STAI-R), Communication and Attitudinal Self-Efficacy scale for cancer (CASE-Cancer), and work limitations questionnaire (WLQ). RESULTS For the intervention group, symptom burden remained at pre-chemotherapy treatment levels, whereas controls reported an increase from cycle 1 onwards (least squares absolute mean difference -0.15, 95% confidence interval -0.19 to -0.12; P<0.001; Cohen's D effect size=0.5). Analysis of MSAS sub-domains indicated significant reductions in favour of ASyMS for global distress index (-0.21, -0.27 to -0.16; P<0.001), psychological symptoms (-0.16, -0.23 to -0.10; P<0.001), and physical symptoms (-0.21, -0.26 to -0.17; P<0.001). FACT-G scores were higher in the intervention group across all cycles (mean difference 4.06, 95% confidence interval 2.65 to 5.46; P<0.001), whereas mean scores for STAI-R trait (-1.15, -1.90 to -0.41; P=0.003) and STAI-R state anxiety (-1.13, -2.06 to -0.20; P=0.02) were lower. CASE-Cancer scores were higher in the intervention group (mean difference 0.81, 0.19 to 1.43; P=0.01), and most SCNS-SF34 domains were lower, including sexuality needs (-1.56, -3.11 to -0.01; P<0.05), patient care and support needs (-1.74, -3.31 to -0.16; P=0.03), and physical and daily living needs (-2.8, -5.0 to -0.6; P=0.01). Other SCNS-SF34 domains and WLQ were not significantly different. Safety of ASyMS was satisfactory. Neutropenic events were higher in the intervention group. CONCLUSIONS Significant reduction in symptom burden supports the use of ASyMS for remote symptom monitoring in cancer care. A "medium" Cohen's effect size of 0.5 showed a sizable, positive clinical effect of ASyMS on patients' symptom experiences. Remote monitoring systems will be vital for future services, particularly with blended models of care delivery arising from the covid-19 pandemic. TRIAL REGISTRATION Clinicaltrials.gov NCT02356081.
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Affiliation(s)
- Roma Maguire
- Computer and Information Sciences, University of Strathclyde, Glasgow, UK
| | - Lisa McCann
- Computer and Information Sciences, University of Strathclyde, Glasgow, UK
| | | | | | - Emma Ream
- University of Surrey, School of Health Sciences, Guildford, UK
| | - Jo Armes
- University of Surrey, School of Health Sciences, Guildford, UK
| | - Elisabeth Patiraki
- National and Kapodistrian University of Athens School of Health Sciences, Athens, Greece
| | - Eileen Furlong
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Patricia Fox
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Alexander Gaiger
- Department of Internal Medicine 1, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria
| | - Paul McCrone
- Department of Health Services and Population Research, King's College London Institute of Psychiatry Psychology and Neuroscience, London, UK
| | - Geir Berg
- Department of Health Sciences, NTNU, Gjøvik, Norway
| | | | | | | | | | - Stylianos Katsaragakis
- National and Kapodistrian University of Athens School of Health Sciences, Athens, Greece
| | - Andrew Darley
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Simone Lubowitzki
- Department of Internal Medicine 1, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria
| | - Jenny Harris
- University of Surrey, School of Health Sciences, Guildford, UK
| | - Simon Skene
- Surrey Clinical Trials Unit, University of Surrey, Guildford, UK
| | - Morven Miller
- Computer and Information Sciences, University of Strathclyde, Glasgow, UK
| | - Margaret Moore
- Computer and Information Sciences, University of Strathclyde, Glasgow, UK
| | - Liane Lewis
- Johnson and Johnson Medical, Norderstedt, Germany
| | - Nicosha DeSouza
- Population Health and Genomics, Medical School, University of Dundee, Dundee, UK
| | - Peter T Donnan
- Population Health and Genomics, Medical School, University of Dundee, Dundee, UK
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Abstract
A diagnosis of cancer is a major life stressor that can affect the physiological, psychological and physical state of the person concerned. Fatigue is a particularly common and troubling symptom that has a negative impact on quality of life throughout all phases of treatment and stages of the illness. The aim of this review is to provide background information on cancer-related fatigue. This review discusses cancer-related fatigue (CRF) in terms of the definition, prevalence, risk factors, aetiology, and the measurement scales used. The differences between definitions of symptoms and relevant theories will be explored and discussed to help explain the variety of instruments used in its measurement. The prevalence of fatigue will be assessed by looking critically at the evidence of fatigue and the factors that affect it. Potential treatment and management strategies for CRF will also be discussed. Finally, there will be an overview of the instruments used to measure fatigue. This review also provides important evidence for measuring and managing CRF that can help nurses to understand fatigue among patients with cancer. Assessing CRF should be routinely undertaken in clinical settings to help identify the proper interventions, treatments and management to reduce fatigue among cancer patients.
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Affiliation(s)
- Mohammed Al Maqbali
- Research Assistant, School of Applied Social and Policy Sciences, Ulster University, Magee Campus, Derry-Londonderry
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8
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Brock H, Friedrich M, Sender A, Richter D, Geue K, Mehnert-Theuerkauf A, Leuteritz K. Work ability and cognitive impairments in young adult cancer patients: associated factors and changes over time-results from the AYA-Leipzig study. J Cancer Surviv 2021; 16:771-780. [PMID: 34118000 PMCID: PMC9300567 DOI: 10.1007/s11764-021-01071-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 06/03/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE Although young adults represent a significant portion of the working population, little is known about the work ability and cognitive impairments in adolescent and young adult (AYA) cancer patients (including the long-term course) following cancer treatment. METHODS As part of the AYA-Leipzig study, we surveyed AYA cancer survivors (aged 18-39 years at diagnosis; time since diagnosis ≤ 4 years, including all cancer diagnoses) at two time points (t2 = 12 months after t1). Work ability (Work Ability Index, WAI-r) and cognitive impairments (Copenhagen Psychosocial Questionnaire, COPSOQ) were compared at both time points. We analysed predictors for work ability at, on average, 2 years post cancer diagnosis (t2) by using multivariate regression analyses. RESULTS A total of 502 patients (74.7% women) participated in both measurements. Mean work ability increased significantly from t1 (6.0; SD = 2.3) to t2 (6.8; SD = 2.2) (t = -9.3; p < 0.001). As many as 380 (76%) AYA cancer survivors reported reduced work ability at t1; 1 year later, this still applied to 287 (57%) of them. Decreased work ability (t2) was associated with more cognitive impairment, higher effort coping with the disease, comorbidities, sick leave > 6 months (since diagnosis), and having children (adj R2 = .48). Cognitive impairments occurred in approximately every fifth patient at both surveys. CONCLUSIONS Achieving maximum work ability is a major challenge for AYAs. Our results show the need for multimodal cancer survivorship and rehabilitation programmes with a special focus on improving cognitive and psychosocial functioning. IMPLICATIONS FOR CANCER SURVIVORS AYAs with cancer should receive targeted occupational counselling early in the course of the disease.
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Affiliation(s)
- Hannah Brock
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany.
| | - Michael Friedrich
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany
| | - Annekathrin Sender
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany
| | - Diana Richter
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany
| | - Kristina Geue
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany
| | - Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany
| | - Katja Leuteritz
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany
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9
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Bootsma TI, Schellekens MPJ, van Woezik RAM, Slatman J, van der Lee ML. Forming new habits in the face of chronic cancer-related fatigue: An interpretative phenomenological study. Support Care Cancer 2021; 29:6651-6659. [PMID: 33954822 PMCID: PMC8464573 DOI: 10.1007/s00520-021-06252-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 04/26/2021] [Indexed: 01/08/2023]
Abstract
Purpose The growing group of patients who suffer from chronic cancer-related fatigue (CCRF) after cancer have helpful and less helpful ways of responding to this long-lasting and disruptive problem. This qualitative study aimed to gain insight in essential elements of how patients respond to CCRF, with a focus on helpful responses to facilitate adaptation. Methods We conducted semi-structured interviews with a purposive sample of 25 participants who experienced severe CCRF for at least 3 months. Participants were recruited via media, patient associations, meetings, and health professionals until data saturation was attained. We used a topic guide with open-ended questions about lived experiences. Interpretative phenomenological analysis (IPA) was used for analysis of the transcripts. Results We identified five interrelated themes of how patients respond to CCRF: (1) discovering physical and emotional boundaries; (2) communicating support needs; (3) reorganizing and planning activities and rest; (4) letting go of one’s habitual identity; and (5) recognizing and accepting CCRF. Conclusion This study highlights the development of new habits and positive beliefs in the face of CCRF and the importance of (social) support in this process. This experiential knowledge on helpful responses can be used to inform patients and their significant others and improve self-efficacy. Health professionals could use these insights to improve recognition of CCRF and personalize treatment. Supplementary Information The online version contains supplementary material available at 10.1007/s00520-021-06252-3.
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Affiliation(s)
- Tom I Bootsma
- Scientific Research Department, Centre for Psycho-Oncology, Helen Dowling Institute, Professor Bronkhorstlaan 20, 3723 MB, Bilthoven, the Netherlands. .,Department of Culture Studies, School of Humanities and Digital Sciences, Tilburg University, Warandelaan 2, 5037 AB, Tilburg, the Netherlands.
| | - Melanie P J Schellekens
- Scientific Research Department, Centre for Psycho-Oncology, Helen Dowling Institute, Professor Bronkhorstlaan 20, 3723 MB, Bilthoven, the Netherlands.,Department of Medical and Clinical Psychology, School of Social and Behavioral Sciences, Tilburg University, Warandelaan 2, 5037 AB, Tilburg, the Netherlands
| | - Rosalie A M van Woezik
- Scientific Research Department, Centre for Psycho-Oncology, Helen Dowling Institute, Professor Bronkhorstlaan 20, 3723 MB, Bilthoven, the Netherlands
| | - Jenny Slatman
- Department of Culture Studies, School of Humanities and Digital Sciences, Tilburg University, Warandelaan 2, 5037 AB, Tilburg, the Netherlands
| | - Marije L van der Lee
- Scientific Research Department, Centre for Psycho-Oncology, Helen Dowling Institute, Professor Bronkhorstlaan 20, 3723 MB, Bilthoven, the Netherlands.,Department of Medical and Clinical Psychology, School of Social and Behavioral Sciences, Tilburg University, Warandelaan 2, 5037 AB, Tilburg, the Netherlands
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10
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Xian X, Zhu C, Chen Y, Huang B, Xu D. A longitudinal analysis of fatigue in colorectal cancer patients during chemotherapy. Support Care Cancer 2021; 29:5245-5252. [PMID: 33646366 PMCID: PMC8295141 DOI: 10.1007/s00520-021-06097-w] [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: 10/21/2020] [Accepted: 02/19/2021] [Indexed: 11/28/2022]
Abstract
Purpose The aim of this longitudinal study was to analyze trends in fatigue among colorectal cancer patients during chemotherapy and examine the predictors of multidimensional fatigue. Methods A mixed sample of colorectal cancer patients who were receiving chemotherapy (N = 200) was recruited in China. The patients completed the Cancer Fatigue Scale (CFS) at baseline (before chemotherapy) and after 3 and 6 months of chemotherapy. Repeated measures ANOVAs were conducted to evaluate the effect of time on the CFS score. The data on violations of the statistical assumptions (independence, normality, and sphericity) from the repeated measures ANOVAs were examined. Stepwise regression analyses were conducted to evaluate the associations of the potential predictor variables at baseline on the total fatigue score and subscale scores at follow-up. Results As chemotherapy progressed, significant increases in the three subscale scores and total scores were observed. Physical fatigue and total fatigue scores increased continuously during chemotherapy (P < 0.001). However, affective fatigue and cognitive fatigue scores increased significantly in the first 3 months (P < 0.001) and basically remained stable thereafter (P > 0.05). Multiple stepwise regression was used to analyze the predictors. The results showed that the baseline fatigue subscale score was the strongest predictor of each dimension of fatigue. In addition, age affected physical fatigue, and monthly income and education affected cognitive fatigue. Conclusion Fatigue increased during chemotherapy. Early assessment and intervention may be better for controlling fatigue, especially in patients with higher baseline fatigue level, older age, and lower economic and educational levels.
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Affiliation(s)
- Xuemei Xian
- Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, No. 3 East Qingchun Road, Hangzhou, 310016, China.
| | - Chenping Zhu
- Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, No. 3 East Qingchun Road, Hangzhou, 310016, China
| | - Yilin Chen
- Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, No. 3 East Qingchun Road, Hangzhou, 310016, China
| | - Binbin Huang
- Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, No. 3 East Qingchun Road, Hangzhou, 310016, China
| | - Didi Xu
- Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, No. 3 East Qingchun Road, Hangzhou, 310016, China
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11
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Fatigue in patients on oral targeted or chemotherapy for cancer and associations with anxiety, depression, and quality of life. Palliat Support Care 2021; 18:141-147. [PMID: 31535613 PMCID: PMC7489872 DOI: 10.1017/s147895151900066x] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Oral treatment (targeted or chemotherapy) for cancer is being increasingly used. While fatigue is a known side effect of intravenous chemotherapy, the rate of fatigue and the impact of fatigue on other patient-reported outcomes are not well described. METHOD At Massachusetts General Hospital Cancer Center, 180 adult patients prescribed oral targeted or chemotherapy for various malignancies enrolled in a randomized controlled trial of adherence and symptom management. Patients completed baseline self-reported measures of fatigue (Brief Fatigue Inventory; BFI), anxiety and depressive symptoms (Hospital Anxiety and Depression Scale; HADS), and quality of life, including subscales for physical, social, emotional, and functional well-being ([QOL] Functional Assessment of Cancer Therapy - General; FACT-G). We examined clinically relevant fatigue using a validated cut-off score for moderate-severe fatigue (BFI global fatigue ≥4) and tested the associations with anxiety symptoms, depressive symptoms, and QOL with independent samples t-tests. RESULTS At baseline, 45 of 180 participants (25.0%) reported moderate-severe fatigue. Fatigued patients experienced more anxiety symptoms (mean diff. 3.73, P < 0.001), more depressive symptoms (mean diff. 4.14, P < 0.001), and worse QOL on the total FACT-G score (mean diff. -19.58, P < 0.001) and all subscales of the FACT-G compared to patients without moderate-severe fatigue. SIGNIFICANCE OF RESULTS One in four patients on oral treatment for cancer experienced clinically relevant fatigue that is associated with greater anxiety and depressive symptoms and worse QOL.
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12
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Esselen K, Sinno A, Varughese J, Wethington S, Prendergast E, Chu C. Social needs in gynecologic oncology: A Society of Gynecologic Oncology (SGO) clinical practice statement. Gynecol Oncol 2020; 158:521-525. [DOI: 10.1016/j.ygyno.2020.06.497] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 06/18/2020] [Indexed: 01/22/2023]
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13
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Wolvers MDJ, Leensen MCJ, Groeneveld IF, Frings-Dresen MHW, De Boer AGEM. Longitudinal Associations Between Fatigue and Perceived Work Ability in Cancer Survivors. JOURNAL OF OCCUPATIONAL REHABILITATION 2019; 29:540-549. [PMID: 30406343 PMCID: PMC6675773 DOI: 10.1007/s10926-018-9814-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Purpose To examine the associations between changes of fatigue and changes of perceived work ability in cancer survivors. Furthermore, to examine the effects of physical job demands on these associations. Methods Data from a feasibility study on a multidisciplinary intervention to enhance return to work in patients with cancer receiving chemotherapy was used. Fatigue (Multidimensional Fatigue Inventory) and perceived work ability (first item of the Work Ability Index) were assessed at baseline, and after 6, 12, and 18 months. Change scores (S1, S2, S3) from each assessment to the next were calculated, thus encompassing three separate time periods of 6 months. Regression analyses were used to quantify associations between change of perceived work ability and (model 1) change of general fatigue, and (model 2) change of mental and physical fatigue for each 6-month period separately. For model 2, interaction effects of perceived physical job demands were studied. Results A total of 89 participants were included for analysis, among which 84% with a diagnosis of breast cancer. On average, in model 1, a reduction of five points on general fatigue was associated with an improvement of one point in perceived work ability in all three 6-month periods. Model 2 showed, similarly, that change of physical fatigue (S1 and S2: B = - 0.225; p < .001 and B = - 0.162; p = .012) and change of mental fatigue (S3: B = - 0.177; p = .027) were significantly inversely associated with change of perceived work ability. Interaction effects were not significant. Conclusion The inverse, longitudinal association between fatigue and perceived work ability supports previous findings from cross-sectional studies and shows potential occupational impact of targeting fatigue in cancer rehabilitation.
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Affiliation(s)
- M D J Wolvers
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - M C J Leensen
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - I F Groeneveld
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Rijnlands Rehabilitation Center, Leiden, the Netherlands
| | - M H W Frings-Dresen
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - A G E M De Boer
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
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14
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Paltrinieri S, Vicentini M, Mazzini E, Ricchi E, Fugazzaro S, Mancuso P, Giorgi Rossi P, Costi S. Factors influencing return to work of cancer survivors: a population-based study in Italy. Support Care Cancer 2019; 28:701-712. [PMID: 31129762 DOI: 10.1007/s00520-019-04868-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 05/09/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE Little is known about return to work (RTW) of cancer survivors (CSs) in Central and Southern Europe. This study investigates the RTW rate of Italian CSs, describes their sick leave (SL) pattern, and explores factors affecting their RTW process. METHODS A population-based cross-sectional survey involving CSs registered at the Cancer Registry of Reggio Emilia Province (Italy) was launched in July 2016. Eligibility was restricted to individuals with first diagnosis of cancer in 2012 (stages I-III), aged 20-59, and employed at the time of diagnosis. RESULTS Of the 266 individuals interviewed, 140 (52.6%) were reintegrated without difficulty, 113 (42.5%) returned to work with some difficulty, and 13 did not RTW (4.9%). The majority of CSs (56%) took SL for some periods during treatment. Age > 50 years and higher income seemed to facilitate RTW (RR = 0.65, 95% CI 0.49-0.88 and RR = 0.72, 95% CI 0.54-0.97, respectively), while being divorced acted as a barrier compared to being married (RR = 1.45, 95% CI 1.04-2.01). Individuals uncertain about the type of company they were working for reported greater difficulty in RTW (RR = 1.68, 95% CI 1.03-2.72). Individuals who had undergone chemotherapy and those perceiving physical limitations had a higher risk of difficulty in the RTW process (RR = 1.79, 95% CI 1.42-2.24 and RR = 1.59, 95% CI 1.25-2.02, respectively). CONCLUSIONS Most CSs did RTW, with 2/3 combining work and treatment. However, almost half reported difficulty in RTW process. Factors affecting this process should be addressed throughout context-specific social and healthcare pathways aimed at preventing difficulties and potential job loss in this population.
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Affiliation(s)
- Sara Paltrinieri
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Viale Risorgimento 80, 42123, Reggio Emilia, Italy
| | - Massimo Vicentini
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, 42122, Reggio Emilia, Italy
| | - Elisa Mazzini
- Medical Directorate, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Viale Umberto I 50, 42123, Reggio Emilia, Italy
| | - Elena Ricchi
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Viale Risorgimento 80, 42123, Reggio Emilia, Italy
| | - Stefania Fugazzaro
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Viale Risorgimento 80, 42123, Reggio Emilia, Italy
| | - Pamela Mancuso
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, 42122, Reggio Emilia, Italy
| | - Paolo Giorgi Rossi
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, 42122, Reggio Emilia, Italy
| | - Stefania Costi
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Viale Risorgimento 80, 42123, Reggio Emilia, Italy. .,Department of Surgery, Medicine, Dentistry and Morphological Sciences, Università di Modena e Reggio Emilia, Viale Umberto I 50, 42123, Reggio Emilia, Italy.
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Susanne K, Michael F, Thomas S, Peter E, Andreas H. Predictors of fatigue in cancer patients: a longitudinal study. Support Care Cancer 2019; 27:3463-3471. [DOI: 10.1007/s00520-019-4660-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 01/16/2019] [Indexed: 10/27/2022]
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16
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Targett K. In this issue of Occupational Medicine. Occup Med (Lond) 2017. [DOI: 10.1093/occmed/kqx175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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