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Brick R, Turner R, Bender C, Douglas M, Eilers R, Ferguson R, Leland N, Lyons KD, Toto P, Skidmore E. Impact of non-pharmacological interventions on activity limitations and participation restrictions in older breast cancer survivors: A scoping review. J Geriatr Oncol 2021; 13:132-142. [PMID: 34598902 DOI: 10.1016/j.jgo.2021.09.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 08/20/2021] [Accepted: 09/15/2021] [Indexed: 11/18/2022]
Abstract
Cancer-related disability is a complex problem for older breast cancer survivors. One aspect of cancer-related disability is a survivor's inability to complete meaningful daily activities and engage in life roles, referred to as activity limitations and participation restrictions respectively. There is a limited understanding of how interventions influence activity limitations and participation restrictions in this population. A scoping review was undertaken to identify and characterize nonpharmacological interventions developed to address activity limitations and participation restrictions. A systematic search of electronic databases (Ovid Medline, Embase, EBSCO CINAHL, and Ovid PsycINFO) was conducted in April 2020 and updated October 2020. Eleven studies met inclusion criteria. Most frequently observed delivery features were in-person and one-on-one format. Six interventions incorporated telehealth delivery components. Interventions were often complex and varied in content. Exercise and behavioral strategies were among the most frequently used active ingredients. Activity limitations and participation restrictions were often secondary outcomes, and measures of these outcomes were varied in content and assessment method. Study samples were not representative of the current population of older adult breast cancer survivors. Future intervention research should clarify intervention delivery, content, and dose, prioritize comprehensive measurement of activity limitations and participation restrictions, as well as recruit and involve representative study samples to enhance generalizability of findings.
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Affiliation(s)
- Rachelle Brick
- University of Pittsburgh, Department of Occupational Therapy, Bridgeside Point I, 100 Technology Drive, Pittsburgh, PA 15219, United States of America.
| | - Rose Turner
- University of Pittsburgh, Health Sciences Library System, Falk Library, 200 Scaife Hall, 3550 Terrace Street, Pittsburgh, PA 15261, United States of America.
| | - Catherine Bender
- University of Pittsburgh, School of Nursing, 415 Victoria Building, 3500 Victoria Street, Pittsburgh, PA 15261, United States of America.
| | - Madilyn Douglas
- University of Pittsburgh, Department of Occupational Therapy, Bridgeside Point I, 100 Technology Drive, Pittsburgh, PA 15219, United States of America.
| | - Rachel Eilers
- University of Pittsburgh, Department of Occupational Therapy, Bridgeside Point I, 100 Technology Drive, Pittsburgh, PA 15219, United States of America.
| | - Robert Ferguson
- Center for Counseling and Cancer Support, 5220 Centre Avenue, Shadyside Medical Bldg, Suite 604, Pittsburgh, PA 15232, United States of America.
| | - Natalie Leland
- University of Pittsburgh, Department of Occupational Therapy, Bridgeside Point I, 100 Technology Drive, Pittsburgh, PA 15219, United States of America.
| | - Kathleen D Lyons
- 7750 Psychiatry Dept, Dartmouth-Hitchcock Medical Center, 1 Medical Center Dr, Lebanon, NH 03756, United States of America.
| | - Pamela Toto
- University of Pittsburgh, Department of Occupational Therapy, Bridgeside Point I, 100 Technology Drive, Pittsburgh, PA 15219, United States of America.
| | - Elizabeth Skidmore
- University of Pittsburgh, Department of Occupational Therapy, Bridgeside Point I, 100 Technology Drive, Pittsburgh, PA 15219, United States of America.
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Lim E, Humphris G. The relationship between fears of cancer recurrence and patient age: A systematic review and meta-analysis. Cancer Rep (Hoboken) 2020; 3:e1235. [PMID: 32671982 DOI: 10.1002/cnr2.1235] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 12/10/2019] [Accepted: 12/11/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Fears of cancer recurrence (FCR) is one of the most prevalent concerns and a common unmet need reported by cancer patients. Patient age is a demographic variable that has been linked to FCR, among others. Although it is recognised by researchers that age and FCR may be negatively correlated, the strength of this correlation has yet to be established. AIM The aims of this study were to (a) conduct a meta-analysis to investigate the overall association of patient age in years with FCR across studies from 2009 to February 2019 and (b) scrutinise for patterns of these effect sizes across studies. METHODS AND RESULTS Peer-reviewed papers were gathered from the literature via online databases (PubMed, EMBASE, MEDLINE, and PsycINFO). Systematic review guidelines including a quality assessment were applied to the 31 selected studies (pooled participant N size = 19 777). The meta-analysis demonstrated a significant negative association between age and FCR (ES = -0.12; 95% CI, -0.17, -0.07). Meta-regression revealed the association of patient age and FCR significantly reduced over the last decade. A significant effect (β = -0.17, P = 0.005) of breast cancer versus other cancers on this age by FCR association was also identified. CONCLUSION The reliable and readily accessible personal information of age of patient can be utilised as a weak indicator of FCR level especially in the breast cancer field, where the majority of studies were drawn. The suggestion that age and FCR association may be attenuated in recent years requires confirmation.
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Affiliation(s)
- Edward Lim
- Medical School, University of St Andrews, St Andrews, UK
| | - Gerald Humphris
- Medical School, University of St Andrews, St Andrews, UK.,Edinburgh Cancer Centre, Western General Hospital, Edinburgh, UK
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Life Quality Index Assessment in Breast Cancer Patients. Indian J Surg Oncol 2019; 10:476-482. [PMID: 31496595 DOI: 10.1007/s13193-019-00923-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 04/05/2019] [Indexed: 10/27/2022] Open
Abstract
Breast cancer (BC) is the most common cancer in Indian females whether they are from urban or rural area. Quality of life after treatment in BC patients is a very vital issue as its assessment will guide the clinicians, hospital authorities, and administrators to take appropriate steps to improve the delivery of treatment and address the concern. Improvement in QOL should be one of the ultimate aims of treatment in BC. The aim of this review is to collect and examine literature available on QOL in breast cancer patients and define what type of issues or domains should be studied. Four factors including chemotherapy treatment received by the patient, associated comorbidities, social support to patients from family, friends, support groups, and income of family have been found to have a strong association with QOL in BC patients/survivors. QOL assessment should include an instrument which assesses physical health, social health, psychological health, and spiritual health. There are less studies having all above domains so more studies are required for better understanding of QOL issue in BC patients/survivors.
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Angarita FA, Elmi M, Zhang Y, Look Hong NJ. Patient-reported factors influencing the treatment decision-making process of older women with non-metastatic breast cancer: a systematic review of qualitative evidence. Breast Cancer Res Treat 2018; 171:545-564. [PMID: 29974359 DOI: 10.1007/s10549-018-4865-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 06/22/2018] [Indexed: 01/23/2023]
Abstract
PURPOSE Older women (≥ 70 years old) with breast cancer undergo different treatments than young women. Studies have examined factors that influence this disparity, but synthesized patient-reported data are lacking in the literature. This study aims to identify, appraise, and synthesize the existing qualitative evidence on patient-reported factors influencing older women's decision to accept or decline breast cancer treatment. METHODS A systematic review was performed in accordance with Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA) principles. Medline, Embase, CINAHL, and PsycINFO were searched for qualitative studies describing patient-reported factors influencing the decision-making process of older women (≥ 70 years old) with non-metastatic invasive breast cancer. Quality was assessed using the Standards for Reporting Qualitative Research (SRQR) criteria. Common ideas were coded, thematically organized, and synthesized within a theoretical framework. RESULTS Of 5998 studies identified, 10 met eligibility criteria. The median SRQR total score was 13.04 (IQR 12.84-13.81). The studies represented a range of cancer treatments; most of the studies focused on surgery and primary endocrine therapy. Our data show that the most common patient-reported factors in the decision-making process included treatment characteristics, personal goals/beliefs, patient characteristics, physician's recommendation, and personal/family experience. These factors led the patient to either accept or decline treatment, and were not consistent across all studies included. Studies used different interview guides, which may have affected these results. CONCLUSIONS This systematic review highlights the complexity of factors that influence an older woman's treatment decision-making process. Acknowledging and addressing these factors may improve discussions about treatment choices between older women and their health care providers, and encourage maximization of a patient-centered approach.
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Affiliation(s)
- Fernando A Angarita
- Division of General Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Maryam Elmi
- Division of General Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Yimeng Zhang
- Division of General Surgery, Department of Surgery, University of Ottawa, Ottawa, ON, Canada
| | - Nicole J Look Hong
- Division of General Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
- Division of Surgical Oncology, Sunnybrook Health Sciences Centre, 2075 Bayview Ave., Room T2 102, Toronto, ON, M4N 3M5, Canada.
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Ghodraty Jabloo V, Alibhai SMH, Fitch M, Tourangeau AE, Ayala AP, Puts MTE. Antecedents and Outcomes of Uncertainty in Older Adults With Cancer: A Scoping Review of the Literature. Oncol Nurs Forum 2018. [PMID: 28632247 DOI: 10.1188/17.onf.e152-e167] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PROBLEM IDENTIFICATION Uncertainty is a major source of distress for cancer survivors. Because cancer is primarily a disease of older adults, a comprehensive understanding of the antecedents and outcomes of uncertainty in older adults with cancer is essential.
. LITERATURE SEARCH MEDLINE®, PsycINFO®, Scopus, and CINAHL® were searched from inception to December 2015. Medical Subject Headings (MeSH) terms and free text words were used for the search concepts, including neoplasms, uncertainty, and aging.
. DATA EVALUATION Extracted data included research aims; research design or analysis approach; sample size; mean age; type, stage, and duration of cancer; type and duration of treatment; uncertainty scale; and major results.
. SYNTHESIS Of 2,584 articles initially identified, 44 studies (30 qualitative, 12 quantitative, and 2 mixed-methods) were included. Evidence tables were developed to organize quantitative and qualitative data. Descriptive numeric and thematic analyses were used to analyze quantitative results and qualitative findings, respectively. Outcomes were reported under four main categories. CONCLUSIONS Uncertainty is an enduring and common experience in cancer survivorship. Uncertainty is affected by a number of demographic and clinical factors and affects quality of life (QOL) and psychological well-being.
. IMPLICATIONS FOR PRACTICE Uncertainty should be considered a contributing factor to psychological well-being and QOL in older adults with cancer. Nurses are in a unique position to assess negative effects of uncertainty and manage these consequences by providing patients with information and emotional support.
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Adejoh SO, Olorunlana A. Managing Breast Cancer: Echoes from Patients in Lagos, Nigeria. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2017; 32:892-900. [PMID: 27282586 DOI: 10.1007/s13187-016-1058-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Breast cancer is ranked second as the cause of cancer death among women. Of importance to the management of breast cancer is the interaction processes between the patients and their professional caregivers or healthcare providers. Against this background, this study explores the experiences of Nigerian women as breast cancer patients and their interaction with their caregivers in the management of their condition. The study was cross-sectional in design. Twenty diagnosed breast cancer patients participated in the study and were purposively selected using convenience and snow balling sampling technique. Patients affirmed that they were initially afraid when diagnosed but overcame their fear based on caregivers' supports. Physical interactions and the use of mobile phones were common means of communication while the fear of death and financial burden of the disease were of major concerns to the patients. The majority of the patients were satisfied with the quality of care and treatment received in the private hospitals as they were encouraged and supported. It was discovered that professional caregivers are germane to patients' survival from shock and adequate information on how to manage their condition and live a normal life.
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Affiliation(s)
| | - Adetayo Olorunlana
- Department of Sociology and Anthropology, Igbinedion University Okada, Benin City, Edo State, Nigeria
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Campbell-Enns HJ, Woodgate RL. The psychosocial experiences of women with breast cancer across the lifespan: a systematic review. Psychooncology 2016; 26:1711-1721. [PMID: 27648726 DOI: 10.1002/pon.4281] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 08/26/2016] [Accepted: 09/15/2016] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To summarize the psychosocial experience of women with breast cancer from a lifespan perspective by examining the findings of qualitative studies. METHODS A meta-aggregate review of 24 qualitative studies was undertaken. To be included, studies must include women with a breast cancer diagnosis and focus on younger or older women (as defined by the study), or compare a psychosocial issue across the lifespan. Eight databases were searched systematically. RESULTS Study participants ranged in age from 26 to 91 years. Sixteen studies focused on younger women, six focused on older women, and two included women across the lifespan. A total of 155 findings were extracted from the studies and were aggregated into 11 categories. These were synthesized into four synthesized findings: (a) dealing with cancer, (b) the importance of caring, (c) the aftermath of cancer, and (d) fertility and infertility. CONCLUSIONS Further research is required to explore these findings, and to examine the needs of older women in particular. Delineating the similarities and differences in the needs of women across the lifespan will inform the development of psychosocial interventions for all women with breast cancer.
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Affiliation(s)
- Heather J Campbell-Enns
- Department of Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.,Manitoba Palliative Care Research Unit, CancerCare Manitoba, Winnipeg, Canada
| | - Roberta L Woodgate
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
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Hagen KB, Aas T, Lode K, Gjerde J, Lien E, Kvaløy JT, Lash TL, Søiland H, Lind R. Illness uncertainty in breast cancer patients: Validation of the 5-item short form of the Mishel Uncertainty in Illness Scale. Eur J Oncol Nurs 2015; 19:113-9. [DOI: 10.1016/j.ejon.2014.10.009] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Revised: 10/11/2014] [Accepted: 10/24/2014] [Indexed: 10/24/2022]
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Burton M, Collins K, Caldon LJM, Wyld L, Reed MWR. Information Needs of Older Women Faced with a Choice of Primary Endocrine Therapy or Surgery for Early-Stage Breast Cancer: A Literature Review. CURRENT BREAST CANCER REPORTS 2014. [DOI: 10.1007/s12609-014-0159-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Sio TT, Chang K, Jayakrishnan R, Wu D, Politi M, Malacarne D, Saletnik J, Chung M. Patient age is related to decision-making, treatment selection, and perceived quality of life in breast cancer survivors. World J Surg Oncol 2014; 12:230. [PMID: 25052797 PMCID: PMC4113127 DOI: 10.1186/1477-7819-12-230] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Accepted: 07/04/2014] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Patients with breast cancer must choose among a variety of treatment options when first diagnosed. Patient age, independent of extent of disease, is also related to quality of life. This study examined the impact of patient age on treatment selected, factors influencing this selection, and perceived quality of life. METHODS A 62-question survey evaluating breast cancer treatment and quality of life was mailed to breast cancer survivors. Responses were stratified by age (<50, 50-65, >65 years) and extent of disease. RESULTS Of the 1,131 surveys mailed, 402 were included for analysis. There were 104, 179, and 119 women aged <50, 50-65, and >65 years, respectively. The median patient age was 58 years, and the average interval from diagnosis to survey participation was 31.5 months. CONCLUSIONS Young women were more likely to have undergone aggressive therapies and had better physical functioning than old women. Old patients reported good quality of life and body image. Clinicians should consider patient age when discussing breast cancer treatment options.
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Affiliation(s)
- Terence T Sio
- Department of Surgery, Warren Alpert Medical School of Brown University, Providence, RI, USA.
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11
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Trudel JG, Leduc N, Dumont S. Perceived communication between physicians and breast cancer patients as a predicting factor of patients' health-related quality of life: a longitudinal analysis. Psychooncology 2013; 23:531-8. [DOI: 10.1002/pon.3442] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Revised: 08/08/2013] [Accepted: 10/04/2013] [Indexed: 11/12/2022]
Affiliation(s)
- Julie G. Trudel
- Behavioural Sciences and Health Research Division; University Health Network, Toronto General Hospital; Toronto Ontario Canada
- Lawrence S. Bloomberg, Faculty of Nursing; University of Toronto; Toronto Ontario Canada
| | - Nicole Leduc
- Département d'Administration de la santé, Faculté de médecine; Université de Montréal; Montréal Québec Canada
| | - Serge Dumont
- École de service social, Pavillon Charles De-Koninck; Université Laval; Québec Canada
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Paredes TF, Canavarro MC, Simões MR. Social support and adjustment in patients with sarcoma: the moderator effect of the disease phase. J Psychosoc Oncol 2012; 30:402-25. [PMID: 22747105 DOI: 10.1080/07347332.2012.684852] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
This study examined the association between different types of perceived social support and adjustment of patients with sarcoma, and if these relationships would differ depending on the outcome measure and phase of disease. Forty-nine patients in the diagnostic phase, 43 in the treatment phase, and 59 in the follow-up phase were recruited. Participants completed the Medical Outcomes Study Social Support Survey Questionnaire, the Hospital Anxiety and Depression Scale, and World Health Organization Quality of Life Assessment. Positive social interaction, emotional/informational, affectionate, and tangible supports were significantly associated with depression scores, but not with anxiety. Except for affectionate support, all the associations with overall quality of life were significant. A moderating effect of the phase of the disease was also found in the association between tangible support and anxiety, and between affectionate support, depression, and overall quality of life. In clinical practice it is important to implement phase-specific psychosocial interventions and to take into consideration other factors beyond perceived social support while handling patients with sarcoma.
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Affiliation(s)
- Tiago F Paredes
- Institute of Cognitive Psychology, Vocational and Social Development, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal.
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Salonen P, Tarkka MT, Kellokumpu-Lehtinen PL, Koivisto AM, Aalto P, Kaunonen M. Effect of social support on changes in quality of life in early breast cancer patients: a longitudinal study. Scand J Caring Sci 2012; 27:396-405. [DOI: 10.1111/j.1471-6712.2012.01050.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Yip WK, Mordiffi SZ, Ang E. Reliability, validity and feasibility of quality of life instruments for adult patients with cancer undergoing chemotherapy: result from a systematic review. INT J EVID-BASED HEA 2012; 10:27-52. [DOI: 10.1111/j.1744-1609.2012.00252.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Burke NJ, Villero O, Guerra C. Passing through: meanings of survivorship and support among Filipinas with breast cancer. QUALITATIVE HEALTH RESEARCH 2012; 22:189-98. [PMID: 21876208 PMCID: PMC3368502 DOI: 10.1177/1049732311420577] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Breast cancer among Filipinas in the United States is a major but largely neglected cancer disparity. In 2004, a community- university partnership resulted in the first Filipina breast cancer support group in the San Francisco Bay Area. Building on this partnership, we explored the social and cultural contexts of Filipinas' experiences with breast cancer to inform development of culturally appropriate and sustainable support services and outreach. We utilized multiple qualitative methods (participant observation, individual and small group in-depth qualitative interviews) to identify meanings of survivorship and support. Interviews and observations revealed the influences of social context and immigration experiences on women's understandings of cancer, what "surviving" cancer means, and what it means to take care of someone with breast cancer (or be taken care of). Our findings highlight the importance of a transnational perspective for the study of immigrant women's experiences of cancer and survivorship.
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Affiliation(s)
- Nancy J Burke
- Department of Anthropology, History and Social Medicine, and Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, California 94158-9001, USA.
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Chopra I, Kamal KM. A systematic review of quality of life instruments in long-term breast cancer survivors. Health Qual Life Outcomes 2012; 10:14. [PMID: 22289425 PMCID: PMC3280928 DOI: 10.1186/1477-7525-10-14] [Citation(s) in RCA: 90] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2011] [Accepted: 01/31/2012] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Breast cancer is the most common cancer in women, representing 16% of all female cancers. According to the American Cancer Society, long-term cancer survival is defined as more than five years of survivorship since diagnosis, with approximately 2.5 million breast cancer survivors (BCS) in 2006. The long-term effects from breast cancer and its treatment have been shown to have positive and negative effects on both recovery and survivors' quality of life (QoL). The purpose of the study was to identify QoL instruments that have been validated in long-term BCS and to review the studies that have used the QoL instruments in this population. METHODS A systematic literature search was conducted from January 1990 to October 2010 using electronic databases. Instruments validated and used in BCS were included in the review. In addition, QoL studies in long-term BCS using the validated instruments were reviewed. The search was limited to studies in English language. Studies of BCS of less than five years after initial diagnosis, any clinical or review studies were excluded. RESULTS The review identified a total of 12 instruments (10 disease-specific, 2 condition-specific) validated in long-term BCS. According to the QoL framework proposed by Ferrell and colleagues, three instruments (Quality of Life-Cancer Survivors, Quality of Life in Adult Cancer Survivors Scale, and Quality of Life Index-Cancer Version) evaluated all four domains (physical, psychological, social, and spiritual) of QoL. A review of the psychometric evaluation showed that Quality of Life in Adult Cancer Survivors Scale has acceptable reliability, validity, and responsiveness in long-term BCS compared to other disease-specific instruments. The review also yielded 19 studies that used these QoL instruments. The study results indicated that age-group, ethnicity, and type of treatment influenced different aspects of QoL. CONCLUSIONS There is a significant impact of breast cancer on QoL in long-term BCS. The review can help researchers and clinicians select the most appropriate instruments to assess the changes in QoL in BCS.
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Affiliation(s)
- Ishveen Chopra
- Division of Clinical, Social and Administrative Sciences, Mylan School of Pharmacy, 418F Mellon Hall, Duquesne University, 600 Forbes Avenue, Pittsburgh, PA 15282, USA
| | - Khalid M Kamal
- Division of Clinical, Social and Administrative Sciences, Mylan School of Pharmacy, 418B Mellon Hall, Duquesne University, 600 Forbes Avenue, Pittsburgh, PA 15282, USA
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Kim SH, Lee R, Lee KS. Symptoms and uncertainty in breast cancer survivors in Korea: differences by treatment trajectory. J Clin Nurs 2011; 21:1014-23. [DOI: 10.1111/j.1365-2702.2011.03896.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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18
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Liu Y, Pérez M, Schootman M, Aft RL, Gillanders WE, Jeffe DB. Correlates of fear of cancer recurrence in women with ductal carcinoma in situ and early invasive breast cancer. Breast Cancer Res Treat 2011; 130:165-73. [PMID: 21553295 PMCID: PMC3227390 DOI: 10.1007/s10549-011-1551-x] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2010] [Accepted: 04/25/2011] [Indexed: 12/24/2022]
Abstract
Fear of cancer recurrence (FCR) is a common and persistent concern among breast cancer survivors. Little is known about factors associated with FCR in women with ductal carcinoma in situ (DCIS) or early invasive breast cancer (EIBC). Women with first primary DCIS, or stages I-IIA breast cancer were prospectively enrolled in a quality-of-life study and completed interviews at 4-6 weeks, 6 months, and 2 years after definitive surgical treatment. In three stepwise multivariable linear regression models, including both time-independent and time-varying variables measured at each respective interview, we identified independent correlates of mean FCR scores (range 1-6) using four items from the Concern About Recurrence Scale (CARS) at 2-year follow-up. Of 506 disease-free patients at 2-year follow-up (mean [SD] age, 58 [10] years; 81% White; 34% DCIS), the average FCR score of 2.0 was low. However, 145 (29%) reported moderate-to-high levels of FCR (scores 3.0-6.0). All three models showed that younger age, stage IIA breast cancer (vs. DCIS), lower social support, and elevated anxiety were consistently associated with higher FCR at 2-year follow-up (each P < 0.05; final models R (2) = 0.25-0.32). DCIS patients reported lower FCR than stage IIA patients (each P ≤ 0.01) but had similar FCR as stage I patients. Although mean FCR was low, 29% of DCIS and EIBC survivors reported moderate-to-high levels of FCR at 2-year follow-up. Management of anxiety, provision of social support, and patient education may help reduce FCR among DCIS and EIBC survivors, especially among younger survivors.
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Affiliation(s)
- Ying Liu
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, 63110, USA.
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Coreil J, Corvin JA, Nupp R, Dyer K, Noble C. Ethnicity and cultural models of recovery from breast cancer. ETHNICITY & HEALTH 2011; 17:291-307. [PMID: 22011254 DOI: 10.1080/13557858.2011.616188] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
OBJECTIVE Recovery narratives describe the culturally shared understandings about the ideal or desirable way to recover from an illness experience. This paper examines ethnic differences in recovery narratives among women participating in breast cancer support groups in Central Florida, USA. It compares groups serving African-American, Latina, and European American women, with the objective of better understanding the appeal of ethnic-specific illness support groups for culturally diverse populations. DESIGN A mixed-method study design combined qualitative and quantitative measures, including in-depth interviews, participant observation at support group meetings, collection of printed documents, and a structured survey. RESULTS Core elements of the recovery narrative drew from the dominant societal cancer discourse of optimism and personal transformation through adversity; however, important ethnic differences were evident in the meaning assigned to these themes. Groups gave distinctive salience to themes of faith and spirituality, empowerment through the migration experience, and becoming a better person through the journey of recovery. CONCLUSION The findings suggest that ethnic cancer support groups draw upon dominant societal discourses about cancer, but they espouse distinctive recovery narratives that are consonant with the groups' cultural models of illness. Similarity between ethnic members' individual recovery narratives and that of the group may contribute to the appeal of ethnic illness support groups for culturally diverse populations.
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Affiliation(s)
- Jeannine Coreil
- Department of Community and Family Health, University of South Florida, Tampa, FL 33612, USA.
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Strohschein FJ, Bergman H, Carnevale FA, Loiselle CG. Patient decision making among older individuals with cancer. QUALITATIVE HEALTH RESEARCH 2011; 21:900-926. [PMID: 21343431 DOI: 10.1177/1049732311399778] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Patient decision making is an area of increasing inquiry. For older individuals experiencing cancer, variations in health and functional status, physiologic aspects of aging, and tension between quality and quantity of life present unique challenges to treatment-related decision making. We used the pragmatic utility method to analyze the concept of patient decision making in the context of older individuals with cancer. We first evaluated its maturity in existing literature and then posed analytical questions to clarify aspects found to be only partially mature. In this context, we found patient decision making to be an ongoing process, changing with time, reflecting individual and relational components, as well as analytical and emotional ones. Assumptions frequently associated with patient decision making were not consistent with the empirical literature. Careful attention to the multifaceted components of patient decision making among older individuals with cancer provides guidance for research, supportive interventions, and targeted follow-up care.
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Cai C, Zhou Z, Yu L, Wan Y. Predictors of the health-related quality of life of patients who are newly diagnosed with lung cancer in China. Nurs Health Sci 2011; 13:262-8. [PMID: 21696528 DOI: 10.1111/j.1442-2018.2011.00612.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The purpose of this study was to explore the level and predictors of the health-related quality of life among patients who were newly diagnosed with lung cancer in China. A descriptive survey design was used to collect the data from 108 patients. The relationships among the variables were analyzed by using Pearson's correlation and multiple regression analyses. The results indicated that the patients in this sample had a poor quality of life in the physical, psychological, and environmental domains of the World Health Organization Quality of Life Questionnaire. Their age, annual family income, social support, and three dimensions of the health locus of control (internal, external, and chance) correlated significantly with the global quality of life. The stepwise multiple regressions showed that only the internal locus of control was statistically significant in predicting the patients' quality of life. The results suggest that healthcare professionals should pay particular attention to demographic characteristics, such as age and family income, and personal characteristics, such as the health locus of control and social support, when treating this patient group.
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Affiliation(s)
- Chunfeng Cai
- HOPE School of Nursing, Renmin Hospital, Wuhan University, Wuhan, China.
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Mordiffi SZ, Kin YW, Nk EA. Quality of life tools for adult patients with cancer undergoing chemotherapy: a systematic review. JBI LIBRARY OF SYSTEMATIC REVIEWS 2011; 9:2482-2532. [PMID: 27820298 DOI: 10.11124/01938924-201109570-00001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND The use of chemotherapeutic agents for treatment of cancer has expanded widely with multiple potent agents being administered at higher but more tolerable doses. The majority of these patients receive several cycles of chemotherapy over a period of months, resulting in a toxic physiologic environment that causes adverse effects. These adverse effects can lead to a significant impact on the patients' quality of life. Despite the amount of information regarding quality of life (QoL) instruments available in the literature, no systematic review has been conducted that examined QoL instrument that consists of all four subscales of physical, psychological, social and spiritual psychometric properties using a systematic approach. REVIEW OBJECTIVES The objective of this review was to critically analyse the literature and present the best available evidence related to QoL instruments, which can be used to assess adult patients with cancer on chemotherapy for use in clinical practice. INCLUSION CRITERIA This review included randomised control trials (RCTs) and observational studies without control group related to QoL instruments used for cancer chemotherapy. The types of participants for this review included all adults with cancer over the age of 18 years old whom have undergone chemotherapy. SEARCH STRATEGY A three-step search strategy was utilised to search for primary research articles published in English language from January 1998 to December 2009. An initial search of MEDLINE and CINAHL was undertaken followed by analysis of the text words contained in the title and abstract, and the text terms used to describe the article. A second search strategy using all the identified keywords and the index terms was used for the 20 databases. The relevant list of all identified articles were searched for additional articles. RESULTS A total of 3,149 references were retrieved during the initial search. Only 13 articles that had performed validation of the QoL instruments and contained the four subscales of physical, psychological, social and spiritual were included in this review. Four QoL instruments were identified. These include the City of Hope QOL - Ovarian Cancer Tool (QOL-OVCA), QOL-Breast cancer version (QOL-BC), New QOL tool India, and Quality of Life Index-Cancer version (QLI-CV). CONCLUSION The four QoL instruments included in this systematic review were validated comprehensively, which were feasible in clinical practice to assess patients with cancers undergoing chemotherapy. Although among the four QoL instruments, two are for specific types of cancer. IMPLICATIONS FOR PRACTICE The clinician needs to consider their specific population before selection of a suitable instrument, as not all of the identified instruments in this review are suitable for all types of cancer. The QOL-BC is breast cancer specific and QOL-OVCA is ovarian cancer specific. The QLI-CV instrument was used on patients with all types of cancer. However, male gender was absent or underrepresented with a high proportion of women with breast cancer recruited. IMPLICATIONS FOR RESEARCH Future research examining the validity of the shortened versions of QOL-BC, QOL-OVCA, and QLI-CV instruments and other QoL instruments comprising the four subscales are required. The new Indian QOL tool may be useful in the clinical setting but needs further psychometric testing in different settings or languages.
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Affiliation(s)
- Siti Zubaidah Mordiffi
- 1. Siti Zubaidah Mordiffi, Assistant Director of Nursing 2. Yip Wai Kin, Nurse Educator Telephone: 65 67724665 Facsimile: 65 67724032 3. Emily Ang NK, Deputy Director Telephone: 65 67724819 Facsimile: 65 68723137
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Chae YR, Seo K. Health-related quality of life in women with breast cancer in Korea: do sociodemographic characteristics and time since diagnosis make a difference? Oncol Nurs Forum 2010; 37:E295-303. [PMID: 20591793 DOI: 10.1188/10.onf.e295-e303] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To describe whether levels of health-related quality of life (HRQOL) differ by sociodemographic characteristics and time since breast cancer diagnosis in women in Korea. DESIGN A descriptive, cross-sectional study of women with breast cancer. SETTING An outpatient clinic of one large hospital in Seoul, Republic of Korea. SAMPLE A convenience sample of 244 women with breast cancer after mastectomy. METHODS Study participants completed sociodemographic characteristics and HRQOL questionnaires. Medical charts were reviewed to determine time since breast cancer diagnosis. MAIN RESEARCH VARIABLES Sociodemographic characteristics (age, marital status, employment status, education, monthly household income, and religion), time since diagnosis, and HRQOL. FINDINGS The psychological well-being domain scored the lowest among domains of HRQOL. Women who are younger, married, unemployed, highly educated, or religious, with higher monthly household income or with greater than one year elapsed time since diagnosis, had higher HRQOL. CONCLUSIONS Study findings will be useful to establish priorities in planning nursing interventions to enhance HRQOL in care of women with breast cancer. IMPLICATIONS FOR NURSING Nursing interventions can be provided to Korean women with breast cancer who are not religious, who are older, single or widowed, or employed, with lower education level, with lower monthly household income, or with one year or less elapsed time since breast cancer diagnosis.
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Affiliation(s)
- Young Ran Chae
- Department of Nursing, Kangwon National University, Chuncheon, Republic of Korea
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Abstract
The aims of this study were to examine the differences between older and younger breast cancer survivors in perceived social support, uncertainty, quality of life (QOL), and selected demographic variables, and to explore the role of these variables in explaining and predicting QOL. A descriptive research design was used. A sample of 163 older and 129 younger breast cancer survivors was recruited from the New York metropolitan area. Participants completed the Social Support Questionnaire, Mishel Uncertainty in Illness Scale Community Form, and the Quality of Life Index-Cancer Version III. Significant differences between younger and older cohorts were found in total social support, spouse and nurse social support subscales, and socioeconomic and psychological/spiritual QOL subscales. Uncertainty, additional illnesses, social support, older age, surgical treatment, and mastectomy were significant predictors of QOL. Understanding differences in perceived social support, uncertainty, and QOL of breast cancer survivors within a context of psychosocial stage and place in life may likely facilitate healthcare to better enhance QOL outcomes. Awareness of factors predictive of QOL will help breast cancer survivors in maintaining an acceptable QOL.
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John LD. Self-care strategies used by patients with lung cancer to promote quality of life. Oncol Nurs Forum 2010; 37:339-47. [PMID: 20439218 DOI: 10.1188/10.onf.339-347] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To describe self-care strategies used by patients with lung cancer to promote quality of life (QOL). RESEARCH APPROACH Qualitative study using a phenomenologic approach. SETTING Cancer clinics in central Texas. PARTICIPANTS Purposive sampling was used to enroll 10 adults with lung cancer who had completed primary treatment within the prior two years. METHODOLOGIC APPROACH One-on-one, semistructured, audiotaped interviews were conducted. MAIN RESEARCH VARIABLES QOL and self-care strategies. FINDINGS Participants identified family and social support, functional independence, physical well-being, and spirituality as important aspects of QOL. Participants identified fatigue as the factor most negatively affecting QOL. Self-care strategies identified to improve QOL were primarily related to fatigue management. Rest was the primary self-care strategy reportedly recommended by healthcare providers, but this strategy was ineffective. Helpful self-care strategies included budgeting time and energy, maintaining contact with family and friends for support, and prayer. CONCLUSIONS This study documents the negative effect of fatigue on QOL in patients with lung cancer. Use of rest to manage fatigue's pervasive negative effect on QOL is a common self-care strategy, reportedly recommended by healthcare providers, but is ineffective by itself to manage fatigue and improve QOL. INTERPRETATION Healthcare providers should assess self-care strategies used by patients with lung cancer to promote improved QOL. Because fatigue has a documented negative effect on QOL in patients with lung cancer, providers should encourage the use of multidimensional strategies that have been supported by research evidence to manage fatigue and improve QOL.
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Affiliation(s)
- Lauri D John
- School of Nursing, University of Texas, Arlington, TX, USA.
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Sammarco A, Konecny LM. Quality of life, social support, and uncertainty among Latina and Caucasian breast cancer survivors: a comparative study. Oncol Nurs Forum 2010; 37:93-9. [PMID: 20044344 DOI: 10.1188/10.onf.93-99] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To examine the differences between Latina and Caucasian breast cancer survivors in perceived social support, uncertainty, and quality of life (QOL), and the differences between the cohorts in selected demographic variables. DESIGN Descriptive, comparative study. SETTING Selected private hospitals and American Cancer Society units in a metropolitan area of the northeastern United States. SAMPLE 182 Caucasian and 98 Latina breast cancer survivors. METHODS Participants completed a personal data sheet, the Social Support Questionnaire, the Mishel Uncertainty in Illness Scale-Community Form, and the Ferrans and Powers QOL Index-Cancer Version III at home and returned the questionnaires to the investigators via postage-paid envelope. MAIN RESEARCH VARIABLES Perceived social support, uncertainty, and QOL. FINDINGS Caucasians reported significantly higher levels of total perceived social support and QOL than Latinas. CONCLUSIONS Psychiatric illness comorbidity and lower level of education in Latinas were factors in the disparity of QOL. IMPLICATIONS FOR NURSING Nurses should be mindful of the essential association of perceived social support, uncertainty, and QOL in Latina breast cancer survivors and how Latinas differ from Caucasian breast cancer survivors. Factors such as cultural values, comorbidities, and education level likely influence perceived social support, uncertainty, and QOL.
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Affiliation(s)
- Angela Sammarco
- Nursing Department at College of Staten Island, City University of New York, New York, USA.
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Liu Y, Pérez M, Aft RL, Massman K, Robinson E, Myles S, Schootman M, Gillanders WE, Jeffe DB. Accuracy of perceived risk of recurrence among patients with early-stage breast cancer. Cancer Epidemiol Biomarkers Prev 2010; 19:675-80. [PMID: 20160274 PMCID: PMC2836416 DOI: 10.1158/1055-9965.epi-09-1051] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Accurate breast cancer recurrence risk perceptions might motivate health-promoting behaviors and alleviate undue anxiety. Although a few studies have examined early-stage breast cancer survivors' perceived risk of recurrence, none have assessed the accuracy of survivors' perceived risk of recurrence. METHODS First primary ductal carcinoma in situ and early-invasive breast cancer survivors reported their perceived risk of recurrence during 6- and 12-month postsurgery interviews. We estimated the patients' 10-year risk of recurrence from published clinical trials, and for early-invasive breast cancer patients, risk of distant recurrence was based on their breast cancer-specific mortality calculated using Adjuvant! Online. Patients' perceived risk was compared with their calculated risk and categorized as "Accurate," "Underestimated," "Overestimated," and "Uncertain." Multinomial logit marginal effect models were fitted using Accurate as the reference. RESULTS Only 17% of 531 patients accurately perceived their risk at 6 months, most of whom inaccurately perceived their risk at 12 months (P = 0.0143). Patients who were nonwhite [odds ratio (OR), 1.70; 95% confidence interval (95% CI), 1.12-2.56] and received radiation therapy (OR, 2.01; 95% CI, 1.07-3.77) were more likely to underestimate their risk. Patients with ductal carcinoma in situ (OR, 1.76; 95% CI, 1.11-2.79), [corrected] lower social support (OR, 0.71; 95% CI, 0.53-0.95), and anxiety (OR, 1.58; 95% CI, 1.01-2.47) were more likely to overestimate their risk. CONCLUSION Few breast cancer survivors accurately perceived their risk of recurrence. IMPACT The accuracy of perceived risk may be increased by better physician-patient communications about their prognosis, provision of social support, and treatment for coexisting anxiety.
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Affiliation(s)
- Ying Liu
- Division of Health Behavior Research, Department of Medicine, Washington University School of Medicine, St. Louis, MO
| | - Maria Pérez
- Division of Health Behavior Research, Department of Medicine, Washington University School of Medicine, St. Louis, MO
| | - Rebecca L. Aft
- Department of Surgery, Washington University School of Medicine, St. Louis, MO
- Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, MO
- John Cochran Veterans Administration Hospital, St. Louis, MO
| | - Kerry Massman
- Division of Health Behavior Research, Department of Medicine, Washington University School of Medicine, St. Louis, MO
| | | | - Stephanie Myles
- Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, MO
| | - Mario Schootman
- Division of Health Behavior Research, Department of Medicine, Washington University School of Medicine, St. Louis, MO
- Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, MO
| | - William E. Gillanders
- Department of Surgery, Washington University School of Medicine, St. Louis, MO
- Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, MO
| | - Donna B. Jeffe
- Division of Health Behavior Research, Department of Medicine, Washington University School of Medicine, St. Louis, MO
- Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, MO
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Farren AT. Power, uncertainty, self-transcendence, and quality of life in breast cancer survivors. Nurs Sci Q 2010; 23:63-71. [PMID: 20026731 DOI: 10.1177/0894318409353793] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of the study was to examine the relations among power, uncertainty, self-transcendence, and quality of life in breast cancer survivors from the perspective of Rogers' science of unitary human beings. A correlational, cross-sectional study with purposive sampling (n = 104) was conducted. The results included statistically significant correlations, explained variance, and mediating relations among the pattern manifestations. The researcher concluded that there are complex and synergistic relations among the cluster of field pattern manifestations that contribute to quality of life in breast cancer survivors. Implications for theory, research, and practice are discussed.
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Shaha M, Pandian V, Choti MA, Stotsky E, Herman JM, Khan Y, Libonati C, Pawlik TM, Schulick RD, Belcher AE. Transitoriness in cancer patients: a cross-sectional survey of lung and gastrointestinal cancer patients. Support Care Cancer 2010; 19:271-9. [DOI: 10.1007/s00520-010-0815-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2009] [Accepted: 01/07/2010] [Indexed: 11/12/2022]
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Lee EH, Moon S, Song Y, Chun M. Relationships of Lymphedema, the Shoulder Range of Motion, Fatigue and Social Support to the Health Related Quality of Life in Patients with Breast Cancer. J Breast Cancer 2010. [DOI: 10.4048/jbc.2010.13.2.212] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Eun-Hyun Lee
- Graduate School of Public Health, Ajou University, Suwon, Korea
| | - Seongmi Moon
- Department of Nursing, University of Ulsan, Ulsan, Korea
| | - Yeongsuk Song
- Kyungpook National University College of Nursing, Daegu, Korea
| | - Mison Chun
- Department of Radiation Oncology, Ajou University College of Medicine, Suwon, Korea
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Older women, breast cancer, and social support. Support Care Cancer 2009; 18:1521-30. [PMID: 20967554 PMCID: PMC2959163 DOI: 10.1007/s00520-009-0774-4] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2009] [Accepted: 10/26/2009] [Indexed: 12/03/2022]
Abstract
Introduction One in ten women over the age of 65 will develop breast cancer. Despite this high incidence of breast cancer among older women, social support for them is often inadequate. This paper describes a qualitative study of the impact of a breast cancer diagnosis on older women from racially/ethnically diverse populations and their subsequent need for social support. Methods Forty-seven older African American, Asian American, Caucasian and Latina women between the ages of 65 to 83 participated in a larger study examining the impact of breast cancer on women from racially/ethnically diverse populations and the meaning and nature of social support. The women completed an in-depth qualitative interview on the psychosocial impact of breast cancer and the meaning and nature of social support. Results and Conclusion The results indicate that there are variations in reactions to a breast cancer diagnosis among older women, and that these reactions impact their experiences with seeking social support at diagnosis and during treatment. Respondents were concerned about their aging bodies, potential dependency on others, and loss of autonomy. At the same time, the severity of cancer treatment and existing co-morbidities often meant they needed to learn to receive support, and to reach out if they had no support. The implications of these findings underscore the older cancer patient’s need to strengthen her supportive networks at the time of diagnosis, during treatment, and post-treatment.
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Fu OS, Crew KD, Jacobson JS, Greenlee H, Yu G, Campbell J, Ortiz Y, Hershman DL. Ethnicity and persistent symptom burden in breast cancer survivors. J Cancer Surviv 2009; 3:241-50. [PMID: 19859813 DOI: 10.1007/s11764-009-0100-7] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2009] [Accepted: 09/19/2009] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Relatively few studies of breast cancer survivors have included nonwhite women or women who do not speak English. METHODS We administered a survey to patients who were >or=3 months post-completion of their adjuvant treatment for stage 0-III breast cancer at Columbia University Medical Center in order to assess the prevalence of 16 physical and emotional symptoms and identify sociodemographic factors associated with these symptoms. Univariate analysis, factor analysis, ANOVA, and multiple linear regression analysis were performed. RESULTS Of 139 patients surveyed, 58 were white, 63 Hispanic, and 18 black. The symptom most commonly reported was fatigue(76%), and the most common severe symptom was muscle aches(40%). Most patients(70%) complained of >or=6 symptoms. Hispanic women were more likely to report >10 symptoms (p < 0.05). Factor analysis reduced the 16 symptoms to 4 underlying symptom clusters that we categorized as 'depression', 'chemotherapy', 'hormone', and 'pain'-related. In the multiple linear regression models, Hispanic women were more likely to report chemotherapy-related symptoms (p < 0.05) and pain-related symptoms (p < 0.05). Unemployed women were more likely to report chemotherapy-related symptoms (p < 0.05). Women <45 years old were less likely to report chemotherapy (p < 0.05) and pain-related symptoms (p < 0.05). CONCLUSIONS The majority of women in this study, particularly those who were Hispanic, elderly, or unemployed, experienced persistent symptoms, most commonly fatigue and muscle aches. IMPLICATIONS FOR CANCER SURVIVORS Because Hispanic, elderly, or unemployed women experience greater symptom burden, efforts should made to address their unique needs.
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Affiliation(s)
- Olivia S Fu
- Department of Medicine and the Herbert Irving Comprehensive Cancer Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA
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Motyka CL, Nies MA, Walker D, Myers Schim S. Improving the Quality of Life of African Americans Receiving Palliative Care. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2009. [DOI: 10.1177/1084822309331609] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this pilot study was to examine the effects of personal characteristics on quality of life (QOL) among African Americans receiving palliative care. Although an important goal of palliative care is to improve the client’s QOL, no studies were found examining the QOL of African Americans receiving palliative care. The study sample included African Americans receiving palliative care in inpatient settings or through enrollment in a hospice program. Data were collected using a structured interview guided by five questionnaires to measure QOL, physical performance, spirituality, social support, and family support/satisfaction. Data were analyzed using descriptive statistics, Pearson r correlation coefficients, and multiple regression analysis. The total sample ( N = 16) was predominately single, female, and 50 to 59 years old. There was a significant relationship between QOL and religious and spiritual coping and between QOL and social support. Participant recruitment was a significant issue in this study.
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Ballinger RS, Fallowfield LJ. Quality of life and patient-reported outcomes in the older breast cancer patient. Clin Oncol (R Coll Radiol) 2008; 21:140-55. [PMID: 19056252 DOI: 10.1016/j.clon.2008.11.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2008] [Revised: 10/21/2008] [Accepted: 11/07/2008] [Indexed: 12/24/2022]
Abstract
As the world population ages, the incidence of cancer will probably also increase as it is a disease predominantly affecting older people. However, those aged 70 years or more have largely been excluded from clinical trials. This review focuses on breast cancer. Increasingly there is recognition that many older breast cancer patients are being undertreated and could and should be offered the same treatments as younger patients. Comprehensive assessment of the quality of any survival benefit from treatments is also needed to ensure that in the future older patients can make fully informed decisions about their treatment options. The aim of this overview is two-fold: first to describe methods by which to assess quality of life; and second to review the recent surgical, radiotherapy, chemotherapy and other studies that include such assessment with older breast cancer patients. Current studies are also outlined, including quality of life assessments, and recommendations are made for future research in this area.
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Affiliation(s)
- R S Ballinger
- Cancer Research UK Psychosocial Oncology Group, Brighton and Sussex Medical School, University of Sussex, Brighton, UK.
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Gustafson DH, Hawkins R, McTavish F, Pingree S, Chen WC, Volrathongchai K, Stengle W, Stewart JA, Serlin RC. Internet-Based Interactive Support for Cancer Patients: Are Integrated Systems Better? THE JOURNAL OF COMMUNICATION 2008; 58:238-257. [PMID: 21804645 PMCID: PMC3144782 DOI: 10.1111/j.1460-2466.2008.00383.x] [Citation(s) in RCA: 106] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
To compare the benefits of the Internet generally versus a focused system of services, 257 breast cancer patients were randomly assigned to a control group, access to the Internet with links to high-quality breast cancer sites, or access to an eHealth system (Comprehensive Health Enhancement Support System, CHESS) that integrated information, support, and decision and analysis tools. The intervention lasted 5 months, and self-report data on quality of life, health-care competence, and social support were collected at pretest and at 2-, 4-, and 9-month posttests. CHESS subjects logged on more overall than Internet subjects and accessed more health resources, but the latter used non health-related sites more. Subjects with access to the Internet alone experienced no better outcomes than controls at any of the 3 time points, compared to pretest levels. Subjects with CHESS experienced greater social support during the intervention period and had higher scores on all 3 outcomes at 9 months, 4 months after the intervention ended. CHESS subjects also scored higher than those with Internet access during the intervention period but not significantly after the intervention ended. Thus, CHESS (with one simple interface and integrated information, communication, and skills services) helped newly diagnosed breast cancer patients even after computers were removed. In contrast, patients received little benefit from Internet access, despite having links to a variety of high-quality sites.
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Affiliation(s)
- David H. Gustafson
- Department of Industrial Engineering and Preventive Medicine, University of Wisconsin–Madison, WI 53706-1572
| | - Robert Hawkins
- Department of Journalism and Mass Communication, University of Wisconsin–Madison, WI 53706-1572
| | - Fiona McTavish
- Center for Health Enhancement System Studies, University of Wisconsin–Madison, WI 53706-1572
| | - Suzanne Pingree
- Department of Life Sciences Communication, University of Wisconsin–Madison, WI 53706-1572
| | - Wei Chih Chen
- Industrial Engineering Department, University of Wisconsin–Madison, WI 53706-1572
| | - Kanittha Volrathongchai
- Center for Health Enhancement System Studies, University of Wisconsin–Madison, WI 53706-1572
| | - William Stengle
- Karmanos Cancer Institute, Wayne State University, Detroit, MI 48201
| | - James A. Stewart
- Comprehensive Cancer Center, University of Wisconsin–Madison, WI 53706-1572
| | - Ronald C. Serlin
- Department of Life Sciences Communication, University of Wisconsin–Madison, WI 53706-1572
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Shaha M, Cox CL, Talman K, Kelly D. Uncertainty in Breast, Prostate, and Colorectal Cancer: Implications for Supportive Care. J Nurs Scholarsh 2008; 40:60-7. [DOI: 10.1111/j.1547-5069.2007.00207.x] [Citation(s) in RCA: 102] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Smith SL, Bartlett WP, Gleeson PB, Sullivan NT, Mitchell K. Quality of Life Tools and Their Relevance for Females with Genital Lymphedema. ACTA ACUST UNITED AC 2008. [DOI: 10.1097/01274882-200832030-00003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Reb AM. Transforming the Death Sentence: Elements of Hope in Women With Advanced Ovarian Cancer. Oncol Nurs Forum 2007; 34:E70-81. [DOI: 10.1188/07.onf.e70-e81] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Étude ELIPPSE 65-80. Med Sci (Paris) 2007; 23 Spec No 3:52-4. [DOI: 10.1051/medsci/2007233s52] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Husain LS, Collins K, Reed M, Wyld L. Choices in cancer treatment: a qualitative study of the older women's (>70 years) perspective. Psychooncology 2007; 17:410-6. [PMID: 17847124 DOI: 10.1002/pon.1242] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
PURPOSE Primary endocrine therapy (PET) is the treatment of primary, operable breast cancer with drugs, such as tamoxifen, rather than surgery. It is in widespread use in the UK with 40% of women over 70 years old being treated in this way. PET is associated with inferior rates of local control compared with the standard surgical therapies, but there is no difference in overall survival. There has been no published research regarding the attitudes of older women concerning these two alternative approaches to treatment; what may influence their treatment choice or their experience of either treatment modality. This study aimed to address these questions. METHOD In-depth qualitative interviews were undertaken to explore the views of a group of 21 purposively selected older women (>70 years old), who had been treated by PET or surgery for breast cancer. The interviews were transcribed verbatim and analysed using Framework Analysis. RESULTS Both surgery and PET were well tolerated and had high satisfaction ratings from most women. This was the case even for those who had complications following surgery or needed a change of management in the PET group. Older women expressed no age-specific fears for operative procedures. The women were passive information seekers and relied heavily on 'expert' advice in making their treatment choices. Neither social support or age were factors in their decision-making. Their main concern was to ensure that their quality of life and independence remained unaffected. CONCLUSION Older women have no strong preference for either treatment option but are concerned that the treatment is effective and causes minimal disruption to their quality of life and independence. This study suggests that medical consultations may need to be adapted to reflect the passive acceptance of 'expert' advice in the majority of women in this age group.
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Affiliation(s)
- Lopa Sadia Husain
- Academic Surgical Oncology Unit, University of Sheffield, Sheffield, UK
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Perkins EA, Small BJ, Balducci L, Extermann M, Robb C, Haley WE. Individual differences in well-being in older breast cancer survivors. Crit Rev Oncol Hematol 2007; 62:74-83. [PMID: 17240157 PMCID: PMC1911161 DOI: 10.1016/j.critrevonc.2006.11.002] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2006] [Revised: 10/18/2006] [Accepted: 11/10/2006] [Indexed: 01/11/2023] Open
Abstract
Older women who survive breast cancer may differ significantly in their long-term well-being. Using a risk and protective factors model, we studied predictors of well-being in 127 women age 70 and above with a history of at least 1 year's survival of breast cancer. Mean post-cancer survivorship was 5.1 years. Using life satisfaction, depression and general health perceptions as outcome variables, we assessed whether demographic variables, cancer-related variables, health status and psychosocial resources predicted variability in well-being using correlational and hierarchical regression analyses. Higher age predicted increased depression but was not associated with life satisfaction or general health perceptions. Cancer-related variables, including duration of survival, and type of cancer treatment, were not significantly associated with survivors' well-being. Poorer health status was associated with poorer well-being in all three dependent variables. After controlling for demographics, cancer-related variables, and health status, higher levels of psychosocial resources including optimism, mastery, spirituality and social support predicted better outcome in all three dependent variables. While many older women survive breast cancer without severe sequelae, there is considerable variability in their well-being after survivorship. Successful intervention with older breast cancer survivors might include greater attention not only to cancer-specific concerns, but also attention to geriatric syndromes and functional impairment, and enhancement of protective psychosocial resources.
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Affiliation(s)
- Elizabeth A Perkins
- School of Aging Studies, University of South Florida, 4202 East Fowler Avenue, MHC 1308, Tampa, FL 33612, USA.
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Robb C, Haley WE, Balducci L, Extermann M, Perkins EA, Small BJ, Mortimer J. Impact of breast cancer survivorship on quality of life in older women. Crit Rev Oncol Hematol 2006; 62:84-91. [PMID: 17188505 DOI: 10.1016/j.critrevonc.2006.11.003] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2006] [Revised: 10/18/2006] [Accepted: 11/10/2006] [Indexed: 01/16/2023] Open
Abstract
Quality of life (QOL) is an important outcome for cancer survivors; but although age is a major risk factor, most breast cancer survivorship studies are conducted with younger women. The objective of our study was to compare QOL in a sample of older breast cancer survivors to a sample of older women who were never diagnosed with breast cancer. A sample of 127 older breast cancer survivors as identified by a cancer registry was compared to a demographically equated sample of 87 older women participating in an epidemiological study. Both groups completed a questionnaire and participated in an interview to measure QOL. The older breast cancer survivors scored worse in the Medical Outcomes Study-Short Form, a measure of health-related QOL. Survivors reported no more depressive symptoms or anxious mood than the comparison group, but scored lower in measures of positive psychosocial well-being, including life satisfaction, mastery, and spiritual well-being, and reported more depressed mood and days affected by fatigue. Older breast cancer survivors show multiple indications of decrements in their health-related quality of life, and lower psychosocial well-being than the comparison group. These decrements may represent deficits in reserve capacity that predispose older cancer survivors to functional disability but may not be readily detected in typical clinical evaluations given the multiple impairments common in geriatric populations. Results suggest a need for greater attention to promoting functioning and psychological well-being among older cancer survivors, even when they may not have obvious cancer-related medical complications.
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Affiliation(s)
- Claire Robb
- Department of Health Administration, Biostatistics and Epidemiology, College of Public Health, University of Georgia, Athens, GA 30602-7396, USA.
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Jackson JM, Rolnick SJ, Coughlin SS, Neslund-Dudas C, Hornbrook MC, Darbinian J, Bachman DJ, Herrinton LJ. Social support among women who died of ovarian cancer. Support Care Cancer 2006; 15:547-56. [PMID: 17177041 DOI: 10.1007/s00520-006-0197-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2006] [Accepted: 11/16/2006] [Indexed: 10/23/2022]
Abstract
GOALS OF WORK We investigated the effects of social support in the last 6 months of life for women who died of ovarian cancer. MATERIALS AND METHODS The study population included women enrolled in one of three Managed Care Organizations who died of ovarian cancer (1995-2000). Information was collected on demographics, living environment, presence of escorts to oncology encounters, comorbidities, medications, outpatient and inpatient encounters, and referrals to home health and hospice. Two characteristics of social support were examined: living with others and being escorted to one or more oncology visits. RESULTS Of 421 subjects, both aspects of social support were known for 345 (82%). Of these, 227 (66%) lived with others and were escorted, 33 (10%) lived with others but were never escorted, 59 (17%) lived alone but were escorted, and 26 (8%) lived alone and never were accompanied. Women living alone were less likely to be taking a psychotropic medication (57% vs 70%, p = 0.021) and were somewhat less likely to receive hospice referral (42% vs 53%, p = 0.054). Women who were never escorted had fewer outpatient encounters (12.60 vs 15.77, p = 0.033) and were less likely to be referred to home health (18% vs 30%, p = 0.046). CONCLUSIONS This study indicates that social support has some beneficial effects on receipt of personal health services. Friends and family may act as proponents for the patient in obtaining services. Health care professionals should be encouraged to assess the cancer patient's social situation and identify areas where help may be needed.
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Affiliation(s)
- Jody M Jackson
- HealthPartners Research Foundation, Minneapolis, MN 55440-1524, USA.
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Liu LN, Li CY, Tang ST, Huang CS, Chiou AF. Role of Continuing Supportive Cares in Increasing Social Support and Reducing Perceived Uncertainty Among Women With Newly Diagnosed Breast Cancer in Taiwan. Cancer Nurs 2006; 29:273-82. [PMID: 16871094 DOI: 10.1097/00002820-200607000-00004] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to explore the roles of continuing supportive care in increasing the social support and reducing the perceived uncertainty among women newly diagnosed with breast cancer in Taiwan. A longitudinal, quasi-experimental design was used in this study. Sixty-one women younger than 60 years, newly diagnosed with breast cancer and undergoing surgery, were recruited from 2 urban teaching hospitals in northern Taiwan. The experimental group was provided with additional continuing supportive care for 3 months. Two instruments, including the Social Support Questionnaire and an uncertainty questionnaire, were administered to participants at 3 time points: presurgery within 2 weeks after diagnosis, 1 month after surgery, and 3 months after diagnosis. The experimental group reported significantly higher social support and lower disease uncertainty compared with the control group at 1 month after surgery and 3 months after diagnosis. With knowledge of the role that continuing-care intervention plays in social support and disease uncertainty, nurses and other healthcare professionals can continue to explore and strengthen strategies to enhance the coping ability of women with breast cancer in Taiwan.
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Affiliation(s)
- Li-Ni Liu
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taipei, Taiwan
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