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Ragusa C, Pereira B, Balayssac D. Study of the relationship between psychoactive substance use and pain in cancer patients and cancer survivors: A French nationwide cross-sectional study. Int J Cancer 2024; 155:1078-1090. [PMID: 38747216 DOI: 10.1002/ijc.35006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 04/11/2024] [Accepted: 04/30/2024] [Indexed: 07/16/2024]
Abstract
Pain is a prevalent symptom among cancer patients and survivors. Psychoactive substance use (PSU) is associated with both the presence and severity of pain. However, little is known about this association in the context of cancer. The primary objective was to compare the prevalence of PSU and its relationship with pain during and after cancer. PSU was defined as the use of nonmedication substances (alcohol, tobacco, e-cigarettes, cannabidiol, and cannabis), with frequency categorized as at least yearly, monthly, weekly, or daily. Secondary objectives aimed to explore the relationships between PSU and pain characteristics, health-related quality of life, anxiety, depression, deprivation, and individual characteristics. Among the 1041 individuals included, pain prevalence was 44.7% (95% confidence interval [CI] 41.6%-47.8%). The overall prevalence of PSU at least monthly was 67.0% (95% CI 64.0%-69.8%). The proportions of chronic and neuropathic pains were higher for at least monthly use of cannabidiol compared to nonuse (70.0% vs. 39.3% and 55.7% vs. 28.1%, p < .001). In multivariate analysis, the monthly uses of tobacco and cannabidiol were higher in painful individuals than in nonpainful ones (odds ratio: 2.85 [95% CI 1.22-6.64] and 3.76 [95% CI 1.13-12.44], p < .05). From the point of view of the patient care, the study underscores the need for physicians to prioritize smoking cessation and pay attention to the use of cannabidiol during and after cancer.
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Affiliation(s)
- Charles Ragusa
- INSERM U1107, NEURO-DOL, Université Clermont Auvergne, Direction de la Recherche Clinique et de l'Innovation, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Bruno Pereira
- Direction de la Recherche Clinique et de l'Innovation, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - David Balayssac
- INSERM U1107, NEURO-DOL, Université Clermont Auvergne, Direction de la Recherche Clinique et de l'Innovation, CHU Clermont-Ferrand, Clermont-Ferrand, France
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Wu Y, Xu J, Gao Y, Zheng J. The relationship between health behaviors and quality of life: the mediating roles of activities of daily living and psychological distress. Front Public Health 2024; 12:1398361. [PMID: 38864012 PMCID: PMC11165072 DOI: 10.3389/fpubh.2024.1398361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Accepted: 05/17/2024] [Indexed: 06/13/2024] Open
Abstract
Objective The aim of this study is to examine the role of activities of daily living performance (ADLs) and psychological distress in mediating the process by which health behaviors affect QOL. Methods A non-probabilistic study was conducted among 1,065 older adult people older than 60 years. Participants were assessed using the Barthel Index, Functional Activities Questionnaire (FAQ), Kessler Psychological Distress Scale (K10), Australian Active Survey, and EQ-VAS score. The SPSS22.0 software was used to analyze the differences in QOL scores among older adults with different demographic characteristics. Pearson correlation analysis was used to analyze the correlation between health behaviors, psychological distress, ADLs, and QOL. Amos23.0 software was used to construct structural equation model (SEM) to analyze the path of health behavior affecting QOL and the mediating role of BADLs, IADLs and psychological distress. Results (1) The direct effect of health behaviors on QOL was not significant in the model; (2) ADLs had multiple mediating effects on the relationship between health behaviors and QOL, and the incidence of ADL limitation was negatively correlated with the reported QOL in the older adult; (3) Psychological distress had a significant mediating effect on the relationship between health behaviors and QOL. Conclusion The results of this study elucidated the mechanisms of the correlation between health behaviors and QOL, and added to the existing literature. In addition, these mediating factors and indirect pathways have been identified as targets for intervention to improve the QOL of older adult individuals, which is important for achieving healthy aging.
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Affiliation(s)
| | | | | | - Juan Zheng
- School of Management, Xuzhou Medical University, Xuzhou, Jiangsu, China
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García-Sáenz JA, Marmé F, Untch M, Bonnefoi H, Kim SB, Bear H, Mc Carthy N, Gelmon K, Martin M, Kelly CM, Reimer T, Toi M, Law E, Bhattacharyya H, Gnant M, Makris A, Seiler S, Burchardi N, Nekljudova V, Loibl S, Rugo HS. Patient-reported outcomes in high-risk HR+ /HER2- early breast cancer patients treated with endocrine therapy with or without palbociclib within the randomized PENELOPE B study. Eur J Cancer 2024; 196:113420. [PMID: 38000218 DOI: 10.1016/j.ejca.2023.113420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 10/31/2023] [Accepted: 11/01/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND The PENELOPEB trial investigating efficacy and safety of additional 1-year post-neoadjuvant palbociclib to standard endocrine therapy (ET) high-risk hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) early breast cancer patients failed to improve invasive disease-free survival (iDFS). This analysis compared patient-reported outcomes (PROs) between treatment groups. PATIENTS AND METHODS Patients received 13 cycles of palbociclib 125 mg/day (n = 631) or placebo (n = 619) orally for 3 out of 4 weeks + ET. European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire (EORTC QLQ-C30), its breast cancer (BR23) and fatigue (FA13) modules, mood questionnaire GAD7 and European Quality of Life 5 Dimensions (EQ-5D) instruments were used for the assessment of quality of life (QoL). Repeated-measures mixed-effects models were used to evaluate differences in PRO, changes of PRO over time, and treatment-by-time interactions. RESULTS 924 of 1250 patients (73.9%) completed baseline and at least one post-baseline questionnaire of all PRO instruments. General health status (GHS)/QoL based on EORTC QLQ-C30 was high in both arms (mean [SD]: palbociclib 70.1 [19.3], placebo 71.4 [18.8]) and was slightly higher in the placebo arm (LeastSquare mean difference: 0.82, p < 0.001). Higher fatigue was reported in the palbociclib arm (mean [SD]: 30.3 [23.8] vs. placebo 28.3 [22.7]; p < 0.001). No statistically significant differences were observed among FA13 physical, cognitive, and emotional fatigue subscales. CONCLUSION Patient-reported global QoL and fatigue did not substantially change in both treatment arms. Slight differences in GHS, physical functioning, and fatigue favored the placebo arm statistically without achieving clinically meaningful thresholds.
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Affiliation(s)
- José Angel García-Sáenz
- Instituto de Investigación Sanitaria Hospital Clinico San Carlos (IdISSC), Madrid, Spain, and Spanish Breast Cancer Group, GEICAM, Madrid, Spain
| | - Frederik Marmé
- Medical Faculty Mannheim, Heidelberg University, University Hospital Mannheim, Germany
| | | | - Hervé Bonnefoi
- Institut Bergonié and Université de Bordeaux INSERM U916, Bordeaux, France
| | - Sung-Bae Kim
- Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Harry Bear
- Division of Surgical Oncology, Massey Cancer Center, Virginia Commonwealth University, VCU Health, Richmond, VA, USA
| | - Nicole Mc Carthy
- Breast Cancer Trials Australia and New Zealand and University of Queensland, Icon Cancer Centre Wesley, Queensland, Australia
| | | | - Miguel Martin
- Instituto de Investigacion Sanitaria Gregorio Marañon, CIBERONC, Universidad Complutense, Madrid, Spain. Spanish Breast Cancer Group, GEICAM, Madrid, Spain
| | | | - Toralf Reimer
- Department of Obstetrics and Gynecology, University of Rostock, Rostock, Germany
| | - Masakazu Toi
- Tokyo Metropolitan Cancer and Infectious Disease Center, Komagome Hospital, Tokyo, Japan
| | - Ernest Law
- Outcome Research group, Pfizer, New York City, USA
| | | | - Michael Gnant
- Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Andreas Makris
- Institute of Cancer Research, Mount Vernon Cancer Centre, Northwood, United Kingdom
| | | | | | | | | | - Hope S Rugo
- University of California San Francisco Comprehensive Cancer Center, San Francisco, CA, USA
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Wang L, Wei T, Liu J, Peng S, Chen J, Hu M, Li X. Experiences and management needs of endocrine therapy-related symptoms in patients with breast cancer: a systematic review and qualitative evidence synthesis protocol. BMJ Open 2023; 13:e073915. [PMID: 38149416 PMCID: PMC10711849 DOI: 10.1136/bmjopen-2023-073915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 10/13/2023] [Indexed: 12/28/2023] Open
Abstract
INTRODUCTION Patients with breast cancer and endocrine therapy-related symptoms often experience pain, self-denial, anxiety, fear of recurrence and despair, which can be extremely physically and psychologically traumatising for the patients. Failure to receive effective support and management reduces adherence to medications, leading to a higher risk of relapse and mortality. Clearly, it is paramount to identify what support these patients may need and how to meet their symptom management needs. This paper outlines a protocol to synthesise qualitative evidence on endocrine therapy symptom experiences, management expectations and preferences of patients with breast cancer. METHODS AND ANALYSIS The following databases were searched in November 2023 with no date restriction applied: The Cochrane Library, PubMed, Embase, Web of Science, Scopus, CINAHL and OpenGrey. Published studies on qualitative or mixed-method on symptom experiences and management needs during endocrine therapy in patients with breast cancer will be retrieved. We will also search for reference lists and perform a forward citation search. Before inclusion in this review, two reviewers will independently apply the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Qualitative Research to ensure methodological validity. Any disagreements regarding the evaluation of the articles will be resolved through discussion with or by a third reviewer. Data will be extracted using the standardised data extraction tool EndNote20 for unified management, assessment, and review of information. The common sense model of self-regulation will guide data extraction and synthesis. The final synthesised findings will be graded according to the GRADE-CERQual approach to establish confidence. ETHICS AND DISSEMINATION This systematic review addressed previously published studies without personally identifiable participant information. Ethical approval from the research committee was not required. The findings of this systematic review will be disseminated to various key stakeholders and published in peer-reviewed journals. PROSPERO REGISTRATION NUMBER CRD42023406987.
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Affiliation(s)
- Lijie Wang
- Department of Nursing Teaching and Research, Hunan Cancer Hospital, Changsha, Hunan, China
- Department of Xiangya nursing school, Central South University, Changsha, Hunan, China
| | - Tao Wei
- Department of Anesthesia, Hunan Cancer Hospital, Changsha, Hunan, China
| | - Jiahui Liu
- Department of Breast Medicine, Hunan Cancer Hospital, ChangSha, Hunan, China
| | - Siyi Peng
- Department of Early Clinical Research Center, Hunan Cancer Hospital, Changsha, Hunan, China
| | - Jiejun Chen
- Department of Breast Medicine, Hunan Cancer Hospital, Changsha, Hunan, China
| | - Meihong Hu
- Department of Nursing Teaching and Research, Hunan Cancer Hospital, Changsha, Hunan, China
| | - Xuying Li
- Department of Nursing, Hunan Cancer Hospital, Changsha, Hunan, China
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Wagner MA, Koleck TA, Conway A, Bender CM, Conley YP. Variability of DNA Repair and Oxidative Stress Genes Associated with Worst Pain in Breast Cancer Survivors on Aromatase Inhibitors. Genes (Basel) 2023; 14:2031. [PMID: 38002974 PMCID: PMC10671149 DOI: 10.3390/genes14112031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/24/2023] [Accepted: 10/30/2023] [Indexed: 11/26/2023] Open
Abstract
Pain is a problem affecting women with breast cancer (HR+BrCa) receiving aromatase inhibitor (AI) therapy. We investigated the relationship between single-nucleotide polymorphisms (SNPs) in DNA repair and oxidative stress genes and perceived worst pain after 6 months of AI therapy. We explored 39 SNPs in genes involved in DNA repair (ERCC2, ERCC3, ERCC5, and PARP1) and oxidative stress (CAT, GPX1, SEPP1, SOD1, and SOD2) in women with HR+BrCa receiving adjuvant therapy (AI ± chemotherapy; n = 138). Pain was assessed via the Brief Pain Inventory. Hurdle regression was used to evaluate the relationship between each associated allele and (1) the probability of pain and (2) the severity of worst pain. ERCC2rs50872 and ERCC5rs11069498 were associated with the probability of pain and had a significant genetic risk score (GRS) model (p = 0.003). ERCC2rs50872, ERCC5rs11069498, ERCC5rs4771436, ERCC5rs4150360, PARP1rs3219058, and SEPP1rs230819 were associated with the severity of worst pain, with a significant GRS model (conditional mean estimate = 0.45; 95% CI = 0.29, 0.60; p < 0.001). These results suggest DNA repair and oxidative stress pathways may play a role in the probability of pain and the severity of worst pain. As healthcare delivery moves towards the model of precision healthcare, nurses may, in the future, be able to use these results to tailor patient care based on GRS.
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Affiliation(s)
- Monica A. Wagner
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH 44106, USA;
| | - Theresa A. Koleck
- School of Nursing, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Alex Conway
- School of Nursing, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | | | - Yvette P. Conley
- School of Nursing, University of Pittsburgh, Pittsburgh, PA 15260, USA
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Nilsen TS, Sæter M, Sarvari SI, Reinertsen KV, Johansen SH, Edvardsen ER, Hallén J, Edvardsen E, Grydeland M, Kiserud CE, Lie HC, Solberg PA, Wisløff T, Sharples AP, Raastad T, Haugaa KH, Thorsen L. Effects of Aerobic Exercise on Cardiorespiratory Fitness, Cardiovascular Risk Factors, and Patient-Reported Outcomes in Long-Term Breast Cancer Survivors: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e45244. [PMID: 36920460 PMCID: PMC10131898 DOI: 10.2196/45244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/31/2023] [Accepted: 01/31/2023] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Anthracycline-based chemotherapy has been mainstay of adjuvant breast cancer therapy for decades. Although effective, anthracyclines place long-term breast cancer survivors at risk of late effects, such as reduced cardiorespiratory fitness and increased risk of cardiovascular disease. Previous research has shown beneficial effects of exercise training on cardiorespiratory fitness, but the effects of exercise on limiting factors for cardiorespiratory fitness, cardiovascular risk factors, and patient-reported outcomes in long-term survivors are less clear. Whether previous exposure to breast cancer therapy modulates the effects of exercise is also unknown. OBJECTIVE The primary aim of the CAUSE (Cardiovascular Survivors Exercise) trial is to examine the effect of aerobic exercise on cardiorespiratory fitness in anthracycline-treated long-term breast cancer survivors. Secondary aims are to examine effects of exercise training on limiting factors for cardiorespiratory fitness, cardiovascular risk factors, and patient-reported outcomes, and to compare baseline values and effects of exercise training between similar-aged women with and those without prior breast cancer. A third aim is to examine the 24-month postintervention effects of aerobic exercise on primary and secondary outcomes. METHODS The CAUSE trial is a 2-armed randomized controlled trial, where 140 long-term breast cancer survivors, 8-12 years post diagnosis, are assigned to a 5-month nonlinear aerobic exercise program with 3 weekly sessions or to standard care. Seventy similar-aged women with no history of cancer will undergo the same exercise program. Cardiorespiratory fitness measured as peak oxygen consumption (VO2peak), limiting factors for VO2peak (eg, cardiac function, pulmonary function, hemoglobin mass, blood volume, and skeletal muscle characteristics), cardiovascular risk factors (eg, hypertension, diabetes, dyslipidemia, obesity, physical activity level, and smoking status), and patient-reported outcomes (eg, body image, fatigue, mental health, and health-related quality of life) will be assessed at baseline, post intervention, and 24 months post intervention. RESULTS A total of 209 patients were included from October 2020 to August 2022, and postintervention assessments were completed in January 2023. The 24-month follow-up will be completed in February 2025. CONCLUSIONS The findings from the CAUSE trial will provide novel scientific understanding of the potential benefits of exercise training in long-term breast cancer survivors. TRIAL REGISTRATION ClinicalTrials.gov NCT04307407; https://clinicaltrials.gov/ct2/show/NCT04307407. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/45244.
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Affiliation(s)
- Tormod Skogstad Nilsen
- Department of Physical Performance, The Norwegian School of Sport Sciences, Oslo, Norway
| | - Mali Sæter
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- ProCardio Center for Innovation, Department of Cardiology, Oslo University Hospital, Oslo, Norway
| | - Sebastian Imre Sarvari
- ProCardio Center for Innovation, Department of Cardiology, Oslo University Hospital, Oslo, Norway
| | - Kristin Valborg Reinertsen
- National Advisory Unit on Late Effects after Cancer Treatment, Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Sara Hassing Johansen
- Department of Physical Performance, The Norwegian School of Sport Sciences, Oslo, Norway
| | | | - Jostein Hallén
- Department of Physical Performance, The Norwegian School of Sport Sciences, Oslo, Norway
| | - Elisabeth Edvardsen
- Department of Physical Performance, The Norwegian School of Sport Sciences, Oslo, Norway
- Department of Pulmonary Medicine, Oslo University Hospital, Oslo, Norway
| | - May Grydeland
- Department of Physical Performance, The Norwegian School of Sport Sciences, Oslo, Norway
| | - Cecilie Essholt Kiserud
- National Advisory Unit on Late Effects after Cancer Treatment, Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Hanne Cathrine Lie
- Department of Behavioural Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Paul André Solberg
- Norwegian Olympic and Paralympic Committee and Confederation of Sports, Oslo, Norway
| | - Torbjørn Wisløff
- Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
| | - Adam Philip Sharples
- Department of Physical Performance, The Norwegian School of Sport Sciences, Oslo, Norway
| | - Truls Raastad
- Department of Physical Performance, The Norwegian School of Sport Sciences, Oslo, Norway
| | - Kristina Hermann Haugaa
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- ProCardio Center for Innovation, Department of Cardiology, Oslo University Hospital, Oslo, Norway
| | - Lene Thorsen
- National Advisory Unit on Late Effects after Cancer Treatment, Department of Oncology, Oslo University Hospital, Oslo, Norway
- Department for Clinical Service, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
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Ramezanzade Tabriz E, Aledavood SA, Ramezani M, Kavoosi F. Evaluating the psychometric properties of the Persian version of the Healthy Lifestyle Instrument for Breast Cancer Survivors (HLI-BCS). BMC Womens Health 2023; 23:55. [PMID: 36759845 PMCID: PMC9912493 DOI: 10.1186/s12905-023-02208-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 02/02/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Precise examination of breast cancer survivors' lifestyles can lead to improved planning and implementation of care and counseling interventions to increase their survival rate and improve their quality of life. Therefore, a valid and reliable instrument needs to be developed. Therefore, the present study aimed to determine the psychometric properties of the Persian version of the Healthy Lifestyle Instrument for Breast Cancer Survivors (HLI-BCS). METHODS This methodological study was conducted on 420 Iranian breast cancer survivors between May and November 2022. Participants were selected using convenience sampling. The face, content, construct validity, convergent, and reliability of the Persian version of the HLI-BCS were assessed. RESULTS After assessing face, content, and construct validity, the Persian version of the HLI-BCS with five factors and 20 items was provided. The total Cronbach's alpha and intra-class correlation coefficient (ICC) were calculated as 0.86 and 0.79, respectively, which were at acceptable levels. A healthy lifestyle in breast cancer survivors was observed to have strong and significant relationships with quality of life in general (p < 0.001, r = 0.832), physical health (r = 0.786), and mental health (r = 0.809). CONCLUSION The Persian version of the HLI-BCS has favorable properties, is consistent with the conditions of breast cancer survivors, and is valid and reliable. This version of the scale can provide adequate and precise information on the lifestyles of these patients.
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Affiliation(s)
- Elahe Ramezanzade Tabriz
- grid.411583.a0000 0001 2198 6209Department of Medical Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Amir Aledavood
- grid.411583.a0000 0001 2198 6209Cancer Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Monir Ramezani
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, School of Nursing and Midwifery, P.O. Box 9137913199, Ebne Sina St, Mashhad, Iran.
| | - Fateme Kavoosi
- grid.411583.a0000 0001 2198 6209Cancer Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Constanze E, Uwe G, Christoph T, Kavitha D, Dominik R, Urte S, Walter B. The role of trust in the acceptance of adjuvant endocrine therapy in breast cancer patients. Psychooncology 2022; 31:2122-2131. [PMID: 36251608 DOI: 10.1002/pon.6049] [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: 02/15/2022] [Revised: 10/03/2022] [Accepted: 10/06/2022] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Despite adjuvant endocrine therapy (AET) considerably reducing mortality and recurrence in hormonal receptor-positive (HR+) breast cancer (BC) patients, acceptance of AET remains an issue. The reasoning behind the lack of acceptance is complex and multifactorial, and some associated risk factors have been previously analyzed. Our study aims to assess women's beliefs and concerns toward AET and women's trust in the treating physician, focusing on determining the importance of these factors in the acceptance of AET. METHODS Out of n = 539, n = 269 women with HR + BC participated in a cross-sectional online survey. The main study variables were AET necessity beliefs and concerns (Beliefs about Medicines Questionnaire) and the trust in treating physicians. A binary hierarchical logistic regression was applied to predict AET acceptance. RESULTS We did not observe a meaningful mean difference in the necessity beliefs between women who accepted versus refused AET by the time of study conduct. Women with ongoing AET intake indicated significantly higher trust in their treating physician (d = 0.57) and have lower concerns (d = -1.65) regarding AET than women who had declined or discontinued AET prematurely. Results of the logistic regression demonstrated that after adjusting for clinical factors (e.g., prognosis, age), higher trust and lower concerns significantly increased the likelihood of accepting AET treatment. CONCLUSIONS Our results demonstrate the importance of discussing potential concerns regarding AET and establishing a trustful patient-physician relationship, which outweighs non-modifiable factors such as cancer prognosis.
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Affiliation(s)
- Elfgen Constanze
- Breast-Center Zurich, Zurich, Switzerland.,University of Witten-Herdecke, Faculty of Medicine, Zurich, Germany
| | - Güth Uwe
- Breast-Center Zurich, Zurich, Switzerland.,University of Basel, Faculty of Medicine, Zurich, Switzerland
| | - Tausch Christoph
- Breast-Center Zurich, Zurich, Switzerland.,University of Basel, Faculty of Medicine, Zurich, Switzerland
| | | | - Ritter Dominik
- University of Zurich, Faculty of Medicine and Dental Medicine, Zurich, Switzerland
| | - Scholz Urte
- Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Bierbauer Walter
- Department of Psychology, University of Zurich, Zurich, Switzerland
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Ahlstedt Karlsson S, Henoch I, Olofsson Bagge R, Wallengren C. Person-centred support programme (RESPECT intervention) for women with breast cancer treated with endocrine therapy: a feasibility study. BMJ Open 2022; 12:e060946. [PMID: 36198470 PMCID: PMC9535178 DOI: 10.1136/bmjopen-2022-060946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE The peRson-cEntred Support Programme EndoCrine Therapy intervention is a complex intervention encompassing a person-centred support programme for patients with breast cancer being treated with endocrine therapy (ET). The aim of this study was to explore the feasibility of the trial design and patient acceptability of the intervention and outcome measures and to provide data to estimate the parameters required to design the final intervention. DESIGN A controlled before-and-after design following the Consolidated Standards of Reporting Trials 2010 statement for feasibility trials. SETTING A surgical outpatient clinic in Sweden. PARTICIPANTS Forty-one patients (aged 47-85) with breast cancer who were treated with ET. INTERVENTIONS Eligible patients were assigned to the control group or intervention group, which included individual education material, an individualised learning plan and a personalised reminder letter using a person-centred approach. The intervention could be delivered as a telephone or digital follow-up during a 12-week follow-up. OUTCOME MEASURES The aims were to determine the recruitment rate, assess the rate of retention, explore whether the intervention was delivered according to the protocol, assess the preferred form of educational support, rate of education sessions, length per education session and length between each education session, determine the distribution of education materials and assess completion rates of patient-reported instruments, including the General Self-efficacy Scale, the Quality of Care from the Patient's Perspective Questionnaire and the Memorial Symptom Assessment Scale. RESULTS Eighty-six per cent of the patients in the intervention group completed the intervention and questionnaires 3 months after their inclusion. The call attendance was 90%. During the intervention, the contact nurse complied with the intervention protocol. For self-efficacy, symptoms and quality of care, there were no differences in effect size between the control and intervention groups. CONCLUSIONS This intervention seems to be feasible and acceptable among patients.
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Affiliation(s)
| | - Ingela Henoch
- Institute of Health and Care Sciences, Gothenburg University, Gothenburg, Sweden
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