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Bergholdt SH, Hansen DG, Johnsen AT, Boman BS, Jensen PT. A NEw MOdel of individualized and patient-centered follow-up for women with gynecological cancer (the NEMO study)-protocol and rationale of a randomized clinical trial. Trials 2023; 24:74. [PMID: 36726187 PMCID: PMC9890753 DOI: 10.1186/s13063-022-07022-0] [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: 05/09/2022] [Accepted: 12/15/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Follow-up programs for gynecological cancer patients are currently under revision. There is limited evidence that traditional follow-up and clinical examinations improve survival in an early-stage gynecological setting. Further, traditional follow-up programs fail to accommodate the patient's need for psychosocial and sexual supportive care and to actively involve patients and their relatives in the follow-up process. Individualized programs may replace traditional routine follow-up with fixed intervals and length. Focusing on alarm-symptoms and self-reporting may ensure detection of recurrence while allowing a continuous attention to the patient's well-being and return to daily life. In this study, a nurse-led, individualized, and need-based intervention with a specific focus on patient empowerment is tested against a standard physician-led model primarily focusing on the detection of recurrence. METHODS The study is designed as a clinical, randomized trial conducted in one of four national onco-gynecological centers in Denmark. Patients with early-stage cervical or endometrial cancer are eligible for inclusion. The intervention group undergoes individualized, nurse-led follow-up supporting patient empowerment including repeated use of electronic patient-reported outcome measures (ePROMs) before each contact as a dialogue support tool. The follow-up contacts are mainly conducted by telephone. All project nurses attended a special training program before project start and are all well-educated and dedicated onco-gynecological nurses. The control group receives standard, physician-led, follow-up without use of ePROMs or specific focus on empowerment. The effect of the intervention is evaluated by questionnaires completed by patients at baseline (3 months after surgery) and 12, 18, and 36 months after surgery. Outcomes include empowerment using the Skill and technique subscale of the HEI-Q questionnaire as the primary outcome while fear of cancer recurrence and health-related quality of life as well as the remaining subscales of the HEI-Q represent secondary outcomes. Data is collected by use of the REDCap technology, which also provides a customized visual support function for the dialogue tool. DISCUSSION This study will provide new information about follow-up in early-stage gynecological cancer settings and thereby contribute to improvement of future follow-up programs. Importantly, the study will provide knowledge about the impact of specific focus on patient empowerment in follow-up programs and, further, how to facilitate empowerment among patients. TRIAL REGISTRATION The study is registered at clinicaltrials.gov: ID no. NCT03838861. Registered on 6 February 2019. Protocol version 2, issue date 21 November 2022.
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Affiliation(s)
- Stinne Holm Bergholdt
- grid.10825.3e0000 0001 0728 0170Department of Clinical Medicine, Faculty of Health Science, University of Southern Denmark, Odense, Denmark ,grid.7143.10000 0004 0512 5013Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark
| | - Dorte Gilsaa Hansen
- grid.7143.10000 0004 0512 5013Center for Shared Decision Making, Lillebaelt Hospital, University Hospital of Southern Denmark, Odense, Denmark ,grid.10825.3e0000 0001 0728 0170Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark ,grid.10825.3e0000 0001 0728 0170Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Anna Thit Johnsen
- grid.10825.3e0000 0001 0728 0170Department of Psychology, University of Southern Denmark, Odense, Denmark ,grid.476266.7Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Roskilde, Denmark
| | | | - Pernille Tine Jensen
- grid.10825.3e0000 0001 0728 0170Department of Clinical Medicine, Faculty of Health Science, University of Southern Denmark, Odense, Denmark ,grid.154185.c0000 0004 0512 597XDepartment of Gynecology and Obstetrics, Aarhus University Hospital, Aarhus, Denmark ,grid.7048.b0000 0001 1956 2722Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
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Skorstad M, Vistad I, Fegran L, Berntsen S, Johannessen B. Nurse-led consultations reinforced with eHealth technology: a qualitative study of the experiences of patients with gynecological cancer. BMC Nurs 2022; 21:326. [PMID: 36434602 PMCID: PMC9701034 DOI: 10.1186/s12912-022-01104-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 11/14/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND During the last decade, the health care profession has moved toward personalized care and has focused on the diversity of survivorship needs after initial cancer treatment. Health care providers encourage empowering patients to participate actively in their own health management and survivorship. Consequently, we developed and piloted a new follow-up model for patients at a Norwegian hospital, referred to as the Lifestyle and Empowerment Techniques in Survivorship of Gynecologic Oncology (LETSGO) model. Using LETSGO, a dedicated nurse replaces the physician in every second follow-up consultation, providing patients who have undergone cancer treatment with self-management techniques that are reinforced with eHealth technology via a specially designed app. Encouraging behavioral change and evaluating the late effects of treatment and recurrence symptoms are central components of self-management techniques. In addition, the app encourages physical activity and positive lifestyle changes, helps identify recurrence-related symptoms, and provides reminders of activity goals. This study aims to investigate experiences with nurse-led consultations supported by eHealth technology among the patients who piloted the LETSGO intervention. METHODS Semi-structured qualitative interviews were conducted to analyze the participants' experiences with the LETSGO intervention after six to seven months. RESULTS The participants in the LETSGO pilot felt safe and well cared for. They thought the nurse was less busy than the doctors appear to be, which made it easy for them to share any cancer-related challenges. Many participants reported increased empowerment and confidence in recognizing symptoms of cancer recurrence, and participants who used the app regularly were motivated to increase their physical activity levels. However, the participants also experienced some limitations and technical errors with the app. CONCLUSIONS Generally, the participants positively received the nurse-led consultations and eHealth technology, but an intervention study is required for further evaluation. In addition, the reported technical app errors should be resolved and tested prior to eHealth application implementation. Regardless, this study may be useful in planning personalized survivorship care studies. TRIAL REGISTRATION ClinicalTrials.gov, NCT03453788 . Registration March 5, 2018.
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Affiliation(s)
- Mette Skorstad
- grid.417290.90000 0004 0627 3712Department of Gynecology and Obstetrics, Sorlandet Hospital HF, Egsveien 100, 4615 Kristiansand, Norway ,grid.7914.b0000 0004 1936 7443Clinical Institute II, Medical Department, University of Bergen, Haukelandsveien 28, 5009 Bergen, Norway
| | - Ingvild Vistad
- grid.417290.90000 0004 0627 3712Department of Gynecology and Obstetrics, Sorlandet Hospital HF, Egsveien 100, 4615 Kristiansand, Norway ,grid.7914.b0000 0004 1936 7443Clinical Institute II, Medical Department, University of Bergen, Haukelandsveien 28, 5009 Bergen, Norway
| | - Liv Fegran
- grid.23048.3d0000 0004 0417 6230Department of Health and Nursing Science, University of Agder, Universitetsveien 25, 4630 Kristiansand, Norway
| | - Sveinung Berntsen
- grid.23048.3d0000 0004 0417 6230Department of Sport Science and Physical Education, University of Agder, Universitetsveien 25, 4630 Kristiansand, Norway
| | - Berit Johannessen
- grid.23048.3d0000 0004 0417 6230Department of Health and Nursing Science, University of Agder, Universitetsveien 25, 4630 Kristiansand, Norway
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Pang NQ, Lau J, Fong SY, Wong CYH, Tan KK. Telemedicine Acceptance Among Older Adult Patients With Cancer: Scoping Review. J Med Internet Res 2022; 24:e28724. [PMID: 35348462 PMCID: PMC9006130 DOI: 10.2196/28724] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 10/11/2021] [Accepted: 02/19/2022] [Indexed: 12/11/2022] Open
Abstract
Background Cancer is likely to remain the most prevalent noncommunicable disease in high-income countries with an older population. Interestingly, no review of attitudes toward telemedicine among older adults has been performed. This is likely to be the group most affected by both cancer and the increasing use of technology in health care. Objective We aimed to map research on the acceptance of telemedicine among older adults who are cancer patients. Methods We conducted a scoping review. PubMed, EMBASE, PsycINFO, CINAHL, and the Cochrane Central Register of Controlled Trials were systematically searched from inception to September 2020. Articles were included if the study population had a mean or median age ≥65 years, with cancer diagnoses and if the study assessed patients’ acceptance of a telemedicine intervention. Quantitative, qualitative, and mixed method studies were included. Results Out of a total of 887 articles that were identified, 19 were included in the review. Interventions were delivered via telephone, videoconference, web portal, mobile app, wearable technology, and text messaging and included teleconsultation, monitoring and follow-up, psychosocial support and nursing care, and prompts. The most often cited facilitating factor was convenience. Other facilitators included an increase in telemedicine care accessibility, previous positive experiences of telemedicine, appropriate technical knowledge and support, decreased cost, physician recommendations, and privacy conferred by the telemedicine intervention. Barriers include a preference for conventional care along with negative perceptions of telemedicine, concerns about technical difficulties, and confidentiality concerns in the adoption of telemedicine. Conclusions None of the studies explored the ability of tailored interventions to address facilitators and barriers of the acceptance of telemedicine in order to increase its adoption by older adults. Facilitators and barriers will likely differ across different cultural contexts and by type of telemedicine; however, this is a gap in current knowledge. In-depth studies are necessary to determine if interventions could potentially address the barriers identified in this review, to increase acceptability.
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Affiliation(s)
- Ning-Qi Pang
- Division of Hepatobiliary & Pancreatic Surgery and Liver Transplantation, National University of Singapore, Singapore, Singapore
| | - Jerrald Lau
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Si-Ying Fong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Celine Yu-Hui Wong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ker-Kan Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Division of Colorectal Surgery, University Surgical Cluster, National University Hospital, Singapore, Singapore
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Collins A, Taylor A, Guttery DS, Moss EL. Innovative Follow-up Strategies for Endometrial Cancer. Clin Oncol (R Coll Radiol) 2021; 33:e383-e392. [PMID: 34172343 DOI: 10.1016/j.clon.2021.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 04/26/2021] [Accepted: 06/01/2021] [Indexed: 01/22/2023]
Abstract
Increasing recognition of the heterogeneous nature of endometrial cancer, the excellent prognosis of low-risk cases and improvements in risk stratification offer opportunities for innovative, personalised follow-up strategies. This review article outlines the evidence base for alternative follow-up strategies in the different risk categories of endometrial cancer, cancer survivorship programmes and considers future directions in endometrial cancer follow-up, including emerging new techniques, such as the liquid biopsy, and opportunities for combining molecular and clinicopathological features to personalise endometrial cancer follow-up.
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Affiliation(s)
- A Collins
- Leicester Cancer Research Centre, University of Leicester, Leicester, UK
| | - A Taylor
- Royal Marsden NHS Foundation Trust, London, UK
| | - D S Guttery
- Leicester Cancer Research Centre, University of Leicester, Leicester, UK
| | - E L Moss
- Leicester Cancer Research Centre, University of Leicester, Leicester, UK.
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Miller RC, Simone BA, Lombardo JF, Taylor J, Nowak-Choi K, Ko K, Ferguson L, Donnelly A, Ali AS, Shi W, Dicker AP, Simone NL. A Pilot Trial Using Telemedicine in Radiation Oncology: The Future of Health Care Is Virtual. TELEMEDICINE REPORTS 2021; 2:171-178. [PMID: 34250522 PMCID: PMC8259074 DOI: 10.1089/tmr.2021.0007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/04/2021] [Indexed: 06/13/2023]
Abstract
Background: Social determinants of health directly affect cancer survival. Driven by advances in technology and recent demands due to COVID-19, telemedicine has the ability to improve patient access to care, lower health care costs, and increase workflow efficiency. The role of telemedicine in radiation oncology is not established. Materials and Methods: We conducted an IRB-approved pilot trial using a telehealth platform for the first post-radiation visit in patients with any cancer diagnosis. The primary endpoint was feasibility of using telehealth defined by completion of five telehealth visits per month in a single department. Secondary endpoints included the ability to assess patients appropriately, patient and physician satisfaction. Physicians were surveyed again during the pandemic to determine whether viewpoints changed. Results: Between May 27, 2016 and August 1, 2018, 37 patients were enrolled in the Telehealth in Post-operative Radiation Therapy (TelePORT) trial, with 24 evaluable patients who completed their scheduled telehealth visit. On average, 1.4 patients were accrued per month. All patients were satisfied with their care, had enough time with their physician and 85.7% believed the telehealth communication was excellent. All physicians were able to accurately assess the patient's symptoms via telehealth, whereas 82.3% felt they could accurately assess treatment-related toxicity. Physicians assessing skin toxicity from breast radiation were those who did not feel they were able to assess toxicity. Discussion and Conclusions: Both health care providers and patients have identified telemedicine as a suitable platform for radiation oncology visits. Although there are limitations, telemedicine has significant potential for increasing access of cancer care delivery in radiation oncology.
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Affiliation(s)
- Ryan C. Miller
- Department of Radiation Oncology, Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Brittany A. Simone
- Department of Radiation Oncology, Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
- Department of Radiation Oncology, Upstate Cancer Center, SUNY Upstate Medical University, Syracuse, New York, USA
| | - Joseph F. Lombardo
- Department of Radiation Oncology, Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - James Taylor
- Department of Radiation Oncology, Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Kamila Nowak-Choi
- Department of Radiation Oncology, Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Kevin Ko
- Department of Radiation Oncology, Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Linda Ferguson
- Department of Radiation Oncology, Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Ann Donnelly
- Department of Radiation Oncology, Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Ayesha S. Ali
- Department of Radiation Oncology, Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Wenyin Shi
- Department of Radiation Oncology, Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Adam P. Dicker
- Department of Radiation Oncology, Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Nicole L. Simone
- Department of Radiation Oncology, Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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6
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Torres-Vigil I, Cohen MZ, Million RM, Bruera E. The role of empathic nursing telephone interventions with advanced cancer patients: A qualitative study. Eur J Oncol Nurs 2020; 50:101863. [PMID: 33246247 DOI: 10.1016/j.ejon.2020.101863] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 10/29/2020] [Indexed: 12/30/2022]
Abstract
PURPOSE Effective symptom management and provider-patient communication are critical components of quality palliative cancer care. Studies suggest nurse-telephone-interventions are feasible, acceptable and may improve the provision and satisfaction with care. However, little is known about what specific elements of nurse-telephone-interventions are most beneficial. The study's purpose was to describe the nature and key elements of therapeutic calls made by nurses to advanced cancer patients to understand what may have previously contributed to improvement in patients who received the intervention. METHODS As part of a larger study on methylphenidate and/or a nurse-telephone-intervention for fatigue in advanced cancer patients from a tertiary hospital, nurse calls were made to 95 patients. This qualitative descriptive study used thematic analysis of transcribed telephone calls between nurses and advanced cancer patients. RESULTS The overarching theme of these calls was supporting patients with empathy. Empathy in these conversations included nurses' efforts to understand patients' experiences, nurses communicating their understanding back to patients and nurses taking action in response to their understanding of patients' experiences. While humor and validation were used to communicate empathy, problem solving and providing support constituted the content of empathic communication. CONCLUSIONS This study illustrates a nurse-telephone-interventions that embraced multiple components of clinical empathy. Nurse-telephone-interventions are feasible and acceptable with diverse, advanced cancer patients. The growing evidence base underscoring the numerous benefits of medical empathy may serve as a basis for adopting simple, feasible and accessible approaches such as empathic nurse-telephone-interventions in both research and clinical practice.
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Affiliation(s)
- I Torres-Vigil
- The University of Houston, Graduate College of Social Work, 3511 Cullen Blvd Room 110HA, Office #409, Houston, TX, 77204-4013, USA; The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX, 77030, USA.
| | - M Z Cohen
- University of Nebraska Medical Center, College of Nursing, 985330 Nebraska Medical Center, Omaha, NE, USA; Veterans Administration Nebraska Western Iowa Health Care System, 4101 Woolworth Ave, Omaha, NE 68105, USA.
| | - R M Million
- University of Nebraska Medical Center, College of Nursing, 985330 Nebraska Medical Center, Omaha, NE, USA; Missouri State University, School of Nursing, 901 S. National Ave, Springfield, MO, 65897, USA
| | - E Bruera
- The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX, 77030, USA
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Sharma T, Sharma S, Eastwood J, Jackson R, Wells J. Patient satisfaction with patient-led follow-up for endometrial cancer. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2020; 29:s4-s10. [PMID: 32972229 DOI: 10.12968/bjon.2020.29.17.s4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND The 5-year hospital follow-up after treatment for endometrial cancer can increase anxiety for patients and not directly pick up cancer recurrence. AIMS The aim of this study was to assess patient satisfaction with a patient-led follow-up and identify cancer recurrence. METHODS This study population was 104 women with early uterine cancer who had undergone surgery. They were given information regarding symptoms suspicious for recurrence and started on a patient-led follow-up, which included a yearly phone call from the nursing team, and a questionnaire was completed. FINDINGS Most patients (92%) scored ≥9 on the 10-point satisfaction survey. Nine women came back to the clinic for pain or bleeding. There was no recurrence of cancer in this study population. CONCLUSION Patients are satisfied with a patient-led, telephone follow-up. This data has influenced a change in the regional Cancer Alliance guidance on cancer follow-up emphasising risk stratification.
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Affiliation(s)
| | - Sandeep Sharma
- Consultant in Gynaecology, Department of Obstetrics and Gynaecology, Pinderfields Hospital, Wakefield
| | - Jodie Eastwood
- Clinical Nurse Specialist, Department of Obstetrics and Gynaecology, Pinderfields Hospital, Wakefield
| | - Ros Jackson
- Clinical Nurse Specialist, Department of Obstetrics and Gynaecology, Pinderfields Hospital, Wakefield
| | - Janey Wells
- Clinical Nurse Specialist, Department of Obstetrics and Gynaecology, Pinderfields Hospital, Wakefield
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Garg S, Williams NL, Ip A, Dicker AP. Clinical Integration of Digital Solutions in Health Care: An Overview of the Current Landscape of Digital Technologies in Cancer Care. JCO Clin Cancer Inform 2019; 2:1-9. [PMID: 30652580 DOI: 10.1200/cci.17.00159] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Digital health constitutes a merger of both software and hardware technology with health care delivery and management, and encompasses a number of domains, from wearable devices to artificial intelligence, each associated with widely disparate interaction and data collection models. In this review, we focus on the landscape of the current integration of digital health technology in cancer care by subdividing digital health technologies into the following sections: connected devices, digital patient information collection, telehealth, and digital assistants. In these sections, we give an overview of the potential clinical impact of such technologies as they pertain to key domains, including patient education, patient outcomes, quality of life, and health care value. We performed a search of PubMed ( www.ncbi.nlm.nih.gov/pubmed ) and www.ClinicalTrials.gov for numerous terms related to digital health technologies, including digital health, connected devices, smart devices, wearables, activity trackers, connected sensors, remote monitoring, electronic surveys, electronic patient-reported outcomes, telehealth, telemedicine, artificial intelligence, chatbot, and digital assistants. The terms health care and cancer were appended to the previously mentioned terms to filter results for cancer-specific applications. From these results, studies were included that exemplified use of the various domains of digital health technologies in oncologic care. Digital health encompasses the integration of a vast array of technologies with health care, each associated with varied methods of data collection and information flow. Integration of these technologies into clinical practice has seen applications throughout the spectrum of care, including cancer screening, on-treatment patient management, acute post-treatment follow-up, and survivorship. Implementation of these systems may serve to reduce costs and workflow inefficiencies, as well as to improve overall health care value, patient outcomes, and quality of life.
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Affiliation(s)
- Shivank Garg
- Shivank Garg, Noelle L. Williams, and Adam P. Dicker, Sidney Kimmel Medical College at Thomas Jefferson University Philadelphia, PA; and Andrew Ip, Winship Cancer Institute at Emory University, Atlanta, GA
| | - Noelle L Williams
- Shivank Garg, Noelle L. Williams, and Adam P. Dicker, Sidney Kimmel Medical College at Thomas Jefferson University Philadelphia, PA; and Andrew Ip, Winship Cancer Institute at Emory University, Atlanta, GA
| | - Andrew Ip
- Shivank Garg, Noelle L. Williams, and Adam P. Dicker, Sidney Kimmel Medical College at Thomas Jefferson University Philadelphia, PA; and Andrew Ip, Winship Cancer Institute at Emory University, Atlanta, GA
| | - Adam P Dicker
- Shivank Garg, Noelle L. Williams, and Adam P. Dicker, Sidney Kimmel Medical College at Thomas Jefferson University Philadelphia, PA; and Andrew Ip, Winship Cancer Institute at Emory University, Atlanta, GA
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Passarello K, Kurian S, Villanueva V. Endometrial Cancer: An Overview of Pathophysiology, Management, and Care. Semin Oncol Nurs 2019; 35:157-165. [PMID: 30867105 DOI: 10.1016/j.soncn.2019.02.002] [Citation(s) in RCA: 108] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To provide an overview of the etiology, diagnosis, treatment, and survivorship concerns surrounding endometrial cancer. DATA SOURCES A review of articles dated 2006-2018 from PubMed and NCCN guidelines. CONCLUSION Endometrial cancer is the most common gynecologic malignancy. Staging and treatment are primarily surgical, with adjuvant radiation and chemotherapy administered as indicated by grade and stage. IMPLICATIONS FOR NURSING PRACTICE Cancer prevention, response to treatment, and quality of life can be affected by lifestyle factors, including nutrition, exercise, and tobacco use. Nurses in diverse roles and practice settings can educate patients about lifestyle choices that can affect individuals across the cancer trajectory.
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Affiliation(s)
- Kelly Passarello
- The University of Texas MD Anderson Cancer Center -The Woodlands, The Woodlands, TX.
| | - Shiney Kurian
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Valerie Villanueva
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
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10
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Suh SR, Lee MK. Effects of Nurse-Led Telephone-Based Supportive Interventions for Patients With Cancer: A Meta-Analysis. Oncol Nurs Forum 2018. [PMID: 28632251 DOI: 10.1188/17.onf.e168-e184] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PROBLEM IDENTIFICATION To evaluate the effects of nurse-led telephone-based supportive interventions (NTSIs) for patients with cancer.
. LITERATURE SEARCH Electronic databases, including EMBASE®, MEDLINE, Google Scholar,
Cochrane Library CENTRAL, ProQuest Medical Library, and CINAHL®, were searched through February 2016.
. DATA EVALUATION 239 studies were identified; 16 were suitable for meta-analysis. Cochrane's risk of bias tool and the Comprehensive Meta-Analysis software were used.
. SYNTHESIS The authors performed a meta-analysis of 16 trials that met eligibility criteria. Thirteen randomized, controlled trials (RCTs) and three non-RCTs examined a total of 2,912 patients with cancer. Patients who received NTSIs were compared with those who received attentional control or usual care (no intervention).
. CONCLUSIONS Telephone interventions delivered by a nurse in an oncology care setting reduced cancer symptoms with a moderate effect size (ES) (-0.33) and emotional distress with a small ES (-0.12), and improved self-care with a large ES (0.64) and health-related quality of life (HRQOL) with a small ES (0.3). Subgroup analyses indicated that the significant effects of NTSIs on cancer symptoms, emotional distress, and HRQOL were larger for studies that combined an application of a theoretical framework, had a control group given usual care, and used an RTC design.
. IMPLICATIONS FOR RESEARCH The findings suggest that an additional tiered evaluation that has a theoretical underpinning and high-quality methodology is required to confirm the efficacy of NTSI for adoption of specific care models.
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Beaver K, Williamson S, Sutton C, Hollingworth W, Gardner A, Allton B, Abdel-Aty M, Blackwood K, Burns S, Curwen D, Ghani R, Keating P, Murray S, Tomlinson A, Walker B, Willett M, Wood N, Martin-Hirsch P. Comparing hospital and telephone follow-up for patients treated for stage-I endometrial cancer (ENDCAT trial): a randomised, multicentre, non-inferiority trial. BJOG 2016; 124:150-160. [PMID: 27062690 DOI: 10.1111/1471-0528.14000] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate the effectiveness of nurse-led telephone follow-up (TFU) for patients with stage-I endometrial cancer. DESIGN Multicentre, randomised, non-inferiority trial. SETTING Five centres in the North West of England. SAMPLE A cohort of 259 women treated for stage-I endometrial cancer attending hospital outpatient clinics for routine follow-up. METHODS Participants were randomly allocated to receive traditional hospital based follow-up (HFU) or nurse-led TFU. MAIN OUTCOME MEASURES Primary outcomes were psychological morbidity (State Trait Anxiety Inventory, STAI-S) and patient satisfaction with the information provided. Secondary outcomes included patient satisfaction with service, quality of life, and time to detection of recurrence. RESULTS The STAI-S scores post-randomisation were similar between groups [mean (SD): TFU 33.0 (11.0); HFU 35.5 (13.0)]. The estimated between-group difference in STAI-S was 0.7 (95% confidence interval, 95% CI -1.9 to 3.3); the confidence interval lies above the non-inferiority limit (-3.5), indicating the non-inferiority of TFU. There was no significant difference between groups in reported satisfaction with information (odds ratio, OR 0.9; 95% CI 0.4-2.1; P = 0.83). Women in the HFU group were more likely to report being kept waiting for their appointment (P = 0.001), that they did not need any information (P = 0.003), and were less likely to report that the nurse knew about their particular case and situation (P = 0.005). CONCLUSIONS The TFU provides an effective alternative to HFU for patients with stage-I endometrial cancer, with no reported physical or psychological detriment. Patient satisfaction with information was high, with similar levels between groups. TWEETABLE ABSTRACT ENDCAT trial shows effectiveness of nurse-led telephone follow-up for patients with stage-I endometrial cancer.
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Affiliation(s)
- K Beaver
- School of Health Sciences, University of Central Lancashire, Preston, UK
| | - S Williamson
- School of Health Sciences, University of Central Lancashire, Preston, UK
| | - C Sutton
- Lancashire Clinical Trials Unit, University of Central Lancashire, Preston, UK
| | - W Hollingworth
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - A Gardner
- Women's Health Research Department, Lancashire Teaching Hospitals NHS Foundation Trust, Royal Preston Hospital, Preston, UK
| | - B Allton
- Department of Obstetrics & Gynaecology, University Hospitals of Morecambe Bay NHS Foundation Trust, Royal Lancaster Infirmary, Lancaster, UK
| | - M Abdel-Aty
- Gynaecology Department, East Lancashire Hospitals NHS Trust, Burnley General Hospital, Burnley, UK
| | - K Blackwood
- Women's Healthcare Unit, Wrightington, Wigan & Leigh NHS Foundation Trust, Hanover Diagnostic and Treatment Centre, Wigan, UK
| | - S Burns
- Women's Healthcare Unit, Wrightington, Wigan & Leigh NHS Foundation Trust, Hanover Diagnostic and Treatment Centre, Wigan, UK
| | - D Curwen
- Gynaecological Unit, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, UK
| | - R Ghani
- Department of Obstetrics & Gynaecology, University Hospitals of Morecambe Bay NHS Foundation Trust, Royal Lancaster Infirmary, Lancaster, UK
| | - P Keating
- Women's Health Directorate, Lancashire Teaching Hospitals NHS Foundation Trust, Royal Preston Hospital, Preston, UK
| | - S Murray
- Women's Health Directorate, Lancashire Teaching Hospitals NHS Foundation Trust, Royal Preston Hospital, Preston, UK
| | - A Tomlinson
- Corporate Cancer Team, Lancashire Teaching Hospitals NHS Foundation Trust, Royal Preston Hospital, Preston, UK
| | - B Walker
- Gynaecology Department, East Lancashire Hospitals NHS Trust, Burnley General Hospital, Burnley, UK
| | - M Willett
- Gynaecology Department, East Lancashire Hospitals NHS Trust, Burnley General Hospital, Burnley, UK
| | - N Wood
- Women's Health Directorate, Lancashire Teaching Hospitals NHS Foundation Trust, Royal Preston Hospital, Preston, UK
| | - P Martin-Hirsch
- Women's Health Directorate, Lancashire Teaching Hospitals NHS Foundation Trust, Royal Preston Hospital, Preston, UK
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