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Karakuş Z, Özer Z. The effect of a fatigue self-management program based on individual and family self-management theory in cancer patients: A single-blinded randomized controlled trial. Eur J Oncol Nurs 2024; 69:102483. [PMID: 38417400 DOI: 10.1016/j.ejon.2023.102483] [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: 01/06/2023] [Revised: 11/20/2023] [Accepted: 11/23/2023] [Indexed: 03/01/2024]
Abstract
PURPOSE This study was conducted to investigate the effect of the Fatigue Self-Management Program based on the Individual and Family Self-Management Theory on fatigue, daily living activities, and well-being in cancer patients. METHODS This randomized controlled single-blind experimental study was carried out between November 2020 and April 2022. A total of 94 patients with advanced cancer, 47 in each group, were included in the study, and 57 participants completed the study. Data were collected using the Brief Fatigue Inventory, Katz Index of Independence in Activities of Daily Living, and Well-Being Questionnaire-22. The Fatigue Self-Management Program based on Individual and Family Self-Management Theory was delivered to the intervention group with two face-to-face and two tele-monitoring sessions. No intervention was applied to the control group, who received only routine care. RESULTS The mean score of fatigue in the intervention group compared to the control group decreased, and the difference was statistically significant (p < .05); daily living activities mean scores were higher than the control group, but there was no statistically significant difference (p > .05). The mean scores of depression and anxiety in the intervention group were lower than those in the control group; energy, positive well-being, and general well-being mean scores were found to be higher than those in the control group, and the difference was statistically significant (p < .05). CONCLUSIONS The Fatigue Self-Management Program effectively reduces the fatigue experienced by cancer patients and increases their well-being but it does not increase their independence in daily living activities. CLINICAL TRIAL REGISTRY NCT04822220.
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Affiliation(s)
- Zeynep Karakuş
- Department of Internal Medicine Nursing, Faculty of Nursing, Akdeniz University, Antalya, Turkey.
| | - Zeynep Özer
- Department of Internal Medicine Nursing, Faculty of Nursing, Akdeniz University, Antalya, Turkey
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Dural G, Çitlik Saritaş S. The Effect of the Neuman Systems Model-Based Training and Follow-up on Self-Efficacy and Symptom Control in Patients Undergoing Chemotherapy. Nurs Sci Q 2024; 37:154-165. [PMID: 38491883 DOI: 10.1177/08943184231224453] [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] [Indexed: 03/18/2024]
Abstract
In this article, the authors aimed to determine the effect of the training and follow-up based on the Neuman systems model provided to patients undergoing chemotherapy on their self-efficacy and symptom control. The study was carried out with a randomized controlled experimental study model design. The sample consisted of 102 patients including 52 in the experimental group and 50 in the control group. The data were collected using the Patient Information Form, the Cancer Behavior Inventory-Brief (CBI-B), and the Edmonton Symptom Assessment Scale (ESAS). A personal training program prepared according to the Neuman systems model was applied to the experimental group patients. In the intergroup comparison of the experimental and control group patients, there was an increase in the posttest CBI-B scores and a decrease in the ESAS scores in the experimental group compared to the control group, and the intergroup difference was statistically significant (p < .05). According to the results, to improve the self-efficacy and symptom control in patients undergoing chemotherapy, using this education and follow-up program is recommended.
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Affiliation(s)
- Gül Dural
- Department of Internal Medicine Nursing, Faculty of Health Sciences, Fırat University, Elazığ, Turkey
| | - Seyhan Çitlik Saritaş
- Department of Internal Medicine Nursing, Faculty of Health Sciences, Malatya Turgut Ozal University, Malatya, Turkey
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Zhang S, Zhang F, Yang F, Yang J, Zhang L, Xie J. Analysis of the status and factors influencing physical activity in patients undergoing ovarian cancer chemotherapy. Front Oncol 2023; 13:1290747. [PMID: 38156104 PMCID: PMC10753792 DOI: 10.3389/fonc.2023.1290747] [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: 09/08/2023] [Accepted: 11/29/2023] [Indexed: 12/30/2023] Open
Abstract
Background Ovarian cancer is a common gynecological malignancy, leading to approximately 200,000 deaths globally in 2020. Research has shown that regular physical activity can reduce the toxic side effects of cancer treatment, reduce morbidity and mortality, extend survival time, and improve quality of life. We aimed to evaluate physical activity regimens in patients undergoing chemotherapy for ovarian cancer and analyze the factors influencing physical activity levels. Methods To facilitate the selection of patients with ovarian cancer hospitalized for chemotherapy in the Third Affiliated Hospital of Zhengzhou University and the First Affiliated Hospital of Zhengzhou University from August 2022 to February 2023, questionnaire surveys were conducted using the General Information Questionnaire, International Physical Activity Questionnaire, Hospital Anxiety and Depression Scale, and Revised Piper Fatigue Scale. Results Data were collected from 167 patients with ovarian cancer. Overall, 96 (57.5%) patients had low physical activity levels, 53 (31.7%) had moderate physical activity levels, and 18 (10.8%) had high physical activity levels. Logistic regression analysis revealed that sleep status, social support, anxiety, depression, and cancer-related fatigue were the main factors influencing physical activity in patients undergoing chemotherapy for ovarian cancer. Conclusions Physical activity levels of patients undergoing ovarian cancer chemotherapy were generally low. Therefore, healthcare professionals should pay greater attention to the physical activity in these patients. Targeted and individualized health guidance is recommended, and activity interventions should be implemented according to the influencing factors to promote disease understanding and increase physical activity levels.
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Affiliation(s)
- Shasha Zhang
- Department of Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Fengzhi Zhang
- Department of Nursing, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Fangfang Yang
- Department of Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jimei Yang
- Department of Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Lin Zhang
- Department of Radiotherapy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Junfang Xie
- Department of Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Communicating is analogous to caring: A systematic review and thematic synthesis of the patient-clinician communication experiences of individuals with ovarian cancer. Palliat Support Care 2022; 21:515-533. [PMID: 35582975 DOI: 10.1017/s1478951522000621] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To systematically review and synthesize the patient-clinician communication experiences of individuals with ovarian cancer. METHODS The CINAHL, Embase, MEDLINE, PsycINFO, and Web of Science databases were reviewed for articles that described (a) original qualitative or mixed methods research, (b) the experiences of individuals with ovarian cancer, and (c) findings related to patient-clinician communication. Relevant data were extracted from study results sections, then coded for descriptive and analytical themes in accordance with Thomas and Harden's approach to thematic synthesis. Data were coded by two authors and discrepancies were resolved through discussion. RESULTS Of 1,390 unique articles, 65 met criteria for inclusion. Four descriptive themes captured participants' experiences communicating with clinicians: respecting me, seeing me, supporting me, and advocating for myself. Findings were synthesized into three analytical themes: communication is analogous to caring, communication is essential to personalized care, and communication may mitigate or exacerbate the burden of illness. SIGNIFICANCE OF RESULTS Patient-clinician communication is a process by which individuals with ovarian cancer may engage in self-advocacy and appraise the extent to which they are seen, respected, and supported by clinicians. Strategies to enhance patient-clinician communication in the ovarian cancer care setting may promote patient perceptions of patient-centered care.
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Banerjee R, Huang CY, Dunn L, Knoche J, Ryan C, Brassil K, Jackson L, Patel D, Lo M, Arora S, Wong SW, Wolf J, Martin Iii T, Dhruva A, Shah N. Digital Life Coaching during Stem Cell Transplantation: A Pilot Feasibility Study. JMIR Form Res 2022; 6:e33701. [PMID: 35039279 PMCID: PMC8933800 DOI: 10.2196/33701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 01/16/2022] [Accepted: 01/17/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND For patients with multiple myeloma receiving high-dose chemotherapy followed by autologous stem cell transplantation (SCT), acute life disruptions and symptom burden may lead to worsened quality of life (QOL) and increased emotional distress. Digital life coaching (DLC), whereby trained coaches deliver personalized wellbeing-related support via phone calls and text messages, has been shown to improve QOL among SCT survivors. However, DLC has not been investigated during the acute peri-SCT period which is generally characterized by symptomatic exacerbations and 2-week hospitalizations. OBJECTIVE We launched a single-arm pilot study to investigate the feasibility of patient engagement with DLC during this intensive period. METHODS We approached English-speaking adult patients with multiple myeloma undergoing autologous SCT at our center. Enrolled patients received 16 weeks of virtual access to a life coach beginning at Day -5 before SCT. Coaches used structured frameworks to help patients identify and overcome personal barriers to wellbeing. Patients chose the coaching topics and preferred communication styles. Our primary endpoint was ongoing DLC engagement, defined as bidirectional conversations occurring at least once every four weeks during the study period. Secondary endpoints were electronic patient-reported outcome (ePRO) assessments of QOL, distress, and sleep disturbances. Our study was registered as clinicaltrials.gov identifier NCT04432818. RESULTS Of 20 screened patients, 17 patients chose to enroll and 15 underwent SCT as planned. Of these 15 patients (median age 65, range 50-81), 73% (n = 11) demonstrated ongoing DLC engagement. The median frequency of bidirectional conversations during the 3-month study period was once per 6.2 days (range: 3.9-28). During index hospitalizations with median lengths of stay 16 days (range 14-31), the median frequency of conversations was once per 5.3 days (range 2.7-15). ePRO assessments (94% adherence) demonstrated an expected QOL nadir during the second week following SCT. The prevalence of elevated distress was highest immediately before and after SCT, with 69% of patients exhibiting elevated distress at Day -5 and at Day +2. CONCLUSIONS DLC may be feasible for older patients during intensive hospital-based cancer treatments such as autologous stem cell transplantation for multiple myeloma. Limitations of our study include small sample size, selection bias among enrolled patients, and heterogeneity in DLC usage. Based on the positive results of this pilot study, a larger phase 2 randomized study of DLC during SCT is under way to investigate its efficacy with regard to patient wellbeing. CLINICALTRIAL Our study was registered as clinicaltrials.gov identifier NCT04432818.
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Affiliation(s)
- Rahul Banerjee
- Division of Hematology/Oncology, Department of Medicine, University of California San Francisco, 400 Parnassus Avenue, San Francisco, US
| | - Chiung-Yu Huang
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, US
| | - Lisa Dunn
- Division of Hematology/Oncology, Department of Medicine, University of California San Francisco, 400 Parnassus Avenue, San Francisco, US
| | - Jennifer Knoche
- Division of Hematology/Oncology, Department of Medicine, University of California San Francisco, 400 Parnassus Avenue, San Francisco, US
| | - Chloe Ryan
- Division of Hematology/Oncology, Department of Medicine, University of California San Francisco, 400 Parnassus Avenue, San Francisco, US
| | | | | | | | - Mimi Lo
- Division of Hematology/Oncology, Department of Pharmacy, University of California San Francisco, San Francisco, US
| | - Shagun Arora
- Division of Hematology/Oncology, Department of Medicine, University of California San Francisco, 400 Parnassus Avenue, San Francisco, US
| | - Sandy Wai Wong
- Division of Hematology/Oncology, Department of Medicine, University of California San Francisco, 400 Parnassus Avenue, San Francisco, US
| | - Jeffrey Wolf
- Division of Hematology/Oncology, Department of Medicine, University of California San Francisco, 400 Parnassus Avenue, San Francisco, US
| | - Thomas Martin Iii
- Division of Hematology/Oncology, Department of Medicine, University of California San Francisco, 400 Parnassus Avenue, San Francisco, US
| | - Anand Dhruva
- Division of Hematology/Oncology, Department of Medicine, University of California San Francisco, 400 Parnassus Avenue, San Francisco, US
| | - Nina Shah
- Division of Hematology/Oncology, Department of Medicine, University of California San Francisco, 400 Parnassus Avenue, San Francisco, US
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Minvielle E, Fourcade A, Ricketts T, Waelli M. Current developments in delivering customized care: a scoping review. BMC Health Serv Res 2021; 21:575. [PMID: 34120603 PMCID: PMC8201906 DOI: 10.1186/s12913-021-06576-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 05/26/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In recent years, there has been a growing interest in health care personalization and customization (i.e. personalized medicine and patient-centered care). While some positive impacts of these approaches have been reported, there has been a dearth of research on how these approaches are implemented and combined for health care delivery systems. The present study undertakes a scoping review of articles on customized care to describe which patient characteristics are used for segmenting care, and to identify the challenges face to implement customized intervention in routine care. METHODS Article searches were initially conducted in November 2018, and updated in January 2019 and March 2019, according to Prisma guidelines. Two investigators independently searched MEDLINE, PubMed, PsycINFO, Web of Science, Science Direct and JSTOR, The search was focused on articles that included "care customization", "personalized service and health care", individualized care" and "targeting population" in the title or abstract. Inclusion and exclusion criteria were defined. Disagreements on study selection and data extraction were resolved by consensus and discussion between two reviewers. RESULTS We identified 70 articles published between 2008 and 2019. Most of the articles (n = 43) were published from 2016 to 2019. Four categories of patient characteristics used for segmentation analysis emerged: clinical, psychosocial, service and costs. We observed these characteristics often coexisted with the most commonly described combinations, namely clinical, psychosocial and service. A small number of articles (n = 18) reported assessments on quality of care, experiences and costs. Finally, few articles (n = 6) formally defined a conceptual basis related to mass customization, whereas only half of articles used existing theories to guide their analysis or interpretation. CONCLUSIONS There is no common theory based strategy for providing customized care. In response, we have highlighted three areas for researchers and managers to advance the customization in health care delivery systems: better define the content of the segmentation analysis and the intervention steps, demonstrate its added value, in particular its economic viability, and align the logics of action that underpin current efforts of customization. These steps would allow them to use customization to reduce costs and improve quality of care.
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Affiliation(s)
- Etienne Minvielle
- i3-Centre de Recherche en Gestion, Institut Interdisciplinaire de l’Innovation (UMR 9217), École polytechnique, Batiment Ensta, 828, Boulevard des Maréchaux, 91762 Palaiseau Cedex, France
- Institut Gustave Roussy, 114, rue Edouard Vaillant, 94800 Villejuif, France
| | - Aude Fourcade
- Institut Gustave Roussy, 114, rue Edouard Vaillant, 94800 Villejuif, France
| | - Thomas Ricketts
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina USA
| | - Mathias Waelli
- MOS (EA 7418), French School of Public Health, Rennes, France
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Sibande ZN, Roomaney R. Fatigue-management strategies among women with endometriosis in South Africa: a qualitative study. SOUTH AFRICAN JOURNAL OF PSYCHOLOGY 2021. [DOI: 10.1177/00812463211020173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Fatigue is a common, secondary symptom of endometriosis that has not been qualitatively explored. We conducted individual, face-to-face interviews with 25 women in South Africa about their experiences of endometriosis-related fatigue. Participants were recruited at a public hospital in Cape Town and through several South African endometriosis organizations. Interviews were conducted in English and Afrikaans and ranged from 30 min to 1 hr 16 min in duration. All interviews were audio recorded and transcribed. Interviews were analyzed using thematic analysis. We found that both the experience of fatigue and fatigue-management strategies were highly personalized. Participants reported using a variety of cognitive strategies, such as planning, pacing, and pushing through their fatigue to reduce the levels of fatigue. Participants also employed physical strategies such as rest, dietary changes, using supplements, and exercise. We found that while participants often tried fatigue-management strategies suggested to them by others, they struggled to maintain these strategies even when they were successful. There are currently no interventions aimed at reducing endometriosis-related fatigue. The findings of this study provide insight into the management of fatigue in women with endometriosis and may be used to develop a psychosocial intervention for fatigue among women with the disease.
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Bootsma TI, Schellekens MPJ, van Woezik RAM, van der Lee ML, Slatman J. Experiencing and responding to chronic cancer-related fatigue: A meta-ethnography of qualitative research. Psychooncology 2019; 29:241-250. [PMID: 31442340 PMCID: PMC7027742 DOI: 10.1002/pon.5213] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 08/19/2019] [Accepted: 08/21/2019] [Indexed: 11/24/2022]
Abstract
Objective One of the most prevalent and disrupting symptoms experienced by cancer patients is chronic cancer‐related fatigue (CCRF). A better understanding of the chronic nature of CCRF can provide valuable insights for theory and practice. The purpose of this meta‐ethnography was to derive an overarching interpretative narrative on patients' experiences and responses to CCRF. Methods We conducted a comprehensive systematic literature search in five databases (05‐03‐2018). In addition, papers from reference lists were retrieved. Two researchers independently screened the papers for eligibility and appraised quality (CASP‐criteria). We followed the seven phases of meta‐ethnography to extract, translate, and synthesise first‐order constructs (ie, patients' views) and second‐order constructs (ie, authors' views) from the selected studies into third‐order constructs (ie, new interpretations). Results Of the 1178 collected articles, 16 articles were included. Through synthesis, a new figure of six interrelated third‐order constructs was developed: (1) embodied experience entails the dominating presence of the body; (2) (mis)recognition includes lack of recognition of CCRF by patients, relatives, and health providers; (3) small horizon describes a resultant narrowed world; (4) role change encompasses adopting other life roles; (5) loss of self refers to the impact on one's identity; and (6) regaining one's footing describes the struggle against CCRF, adaptation to CCRF and finally acceptance of a “new normal with CCRF.” Conclusion A new embodiment figure of CCRF with social (eg, (mis)recognition), spatial (eg, small horizon) and temporal dimensions (eg, regaining one's footing) was developed. This figure can help professionals to recognise CCRF, inform patients, and personalise treatment.
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Affiliation(s)
- Tom I Bootsma
- Helen Dowling Institute, Centre for Psycho-Oncology, Scientific Research Department, Bilthoven, The Netherlands.,Tilburg University, School of Humanities and Digital Sciences, Culture Studies Department, Tilburg, The Netherlands
| | - Melanie P J Schellekens
- Helen Dowling Institute, Centre for Psycho-Oncology, Scientific Research Department, Bilthoven, The Netherlands
| | - Rosalie A M van Woezik
- Helen Dowling Institute, Centre for Psycho-Oncology, Scientific Research Department, Bilthoven, The Netherlands
| | - Marije L van der Lee
- Helen Dowling Institute, Centre for Psycho-Oncology, Scientific Research Department, Bilthoven, The Netherlands
| | - Jenny Slatman
- Tilburg University, School of Humanities and Digital Sciences, Culture Studies Department, Tilburg, The Netherlands
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Zhang Q, Li F, Zhang H, Yu X, Cong Y. Effects of nurse-led home-based exercise & cognitive behavioral therapy on reducing cancer-related fatigue in patients with ovarian cancer during and after chemotherapy: A randomized controlled trial. Int J Nurs Stud 2017; 78:52-60. [PMID: 28939343 DOI: 10.1016/j.ijnurstu.2017.08.010] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 08/13/2017] [Accepted: 08/18/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND High levels of fatigue have been documented in ovarian cancer patients. However, increased levels of fatigue are positively associated with a high risk of sleep disturbance and depression. OBJECTIVE To investigate the feasibility of a nurse-led home-based exercise and cognitive behavioral therapy (E&CBT) for ovarian cancer adults with cancer-related fatigue on outcomes of fatigue, plus other secondary outcomes (sleep disturbance and depression), either during or after completion of primary cancer treatment. DESIGN Randomized, single-blind control trial. SETTINGS Gynaecologic oncology department of the First Hospital of Jilin University in China. PARTICIPANTS 72 eligible women who recently had surgery and completed their first cycle of adjuvant chemotherapy were randomly assigned to two groups. INTERVENTION The experimental group received exercise and cognitive behavioral therapy. Five nurses with nursing master degree were trained to deliver this intervention. Patients received online interventions each week in the patient's place of residence or in the nurse-led clinic, as requested. Home visits, coupled with telephone-based motivational interviews twice a week were available with the permission of the participants. comparison group participants received services as usual. MEASUREMENTS The primary outcome was measured by the Chinese version of the Piper Fatigue Scale that has 4 subscales (Behavior, Affect, Sensory, and Cognition). Secondary outcomes were measured using the Self-Rating Depression Scale and the Pittsburgh Sleep Quality Index questionnaire. Repeated-measure ANOVA was used to examine the effectiveness of this intervention in reducing fatigue, depression, and improving sleep quality. RESULTS For baseline comparisons, no significant differences were found between the two groups. After the interventions, total fatigue scores were significantly reduced from T1 to T2, to T3 in the experimental group (4.37, 4.24, 3.90), respectively. The comparison group showed almost no change in total fatigue score over time. In the repeated measures ANOVA, the differences of behavioral fatigue score (F=11.647, p=0.001) and cognitive fatigue score (F=5.741, p=0.019) were statistically significant for the group by time interaction. After the interventions, the experimental group participants demonstrated significantly lower symptoms of depression compared with the comparison group (T2: p=0.001 and T3: p<0.001). Sleep duration, sleep dysfunction, daytime dysfunction as well as total sleep quality significantly improved. CONCLUSION Nurse-delivered home-based E&CBT have measurable benefits in helping women with ovarian cancer to decrease cancer-related fatigue, depressive symptoms, and improving their quality of sleep.
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Affiliation(s)
- Qi Zhang
- School of Nursing, Jilin University, Changchun, Jilin Province, China
| | - Feng Li
- School of Nursing, Jilin University, Changchun, Jilin Province, China
| | - Han Zhang
- School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Xiuli Yu
- Department of Obstetrics and Gynecology, First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Yunfeng Cong
- Department of Obstetrics and Gynecology, First Hospital of Jilin University, Changchun 130021, Jilin Province, China.
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