1
|
Lyons KD, Wechsler SB, Ejem DB, Stevens CJ, Azuero A, Khalidi S, Hegel MT, dos Anjos SM, Codini ME, Chamberlin MD, Morency JL, Coffee-Dunning J, Thorp KE, Cloyd DZ, Goedeken S, Newman R, Muse C, Rocque G, Keene K, Pisu M, Echols J, Bakitas MA. Telephone-Based Rehabilitation Intervention to Optimize Activity Participation After Breast Cancer: A Randomized Clinical Trial. JAMA Netw Open 2024; 7:e242478. [PMID: 38517442 PMCID: PMC10960198 DOI: 10.1001/jamanetworkopen.2024.2478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 01/22/2024] [Indexed: 03/23/2024] Open
Abstract
Importance Following treatment, breast cancer survivors face challenges participating in valued activities. Objective To determine whether a telephone-based coaching rehabilitation intervention enhances activity participation in the year following breast cancer treatment. Design, Setting, and Participants In this multisite, single-blind randomized clinical trial (Optimizing Functional Recovery of Breast Cancer Survivors), recruitment occurred between August 28, 2019, and April 30, 2022. Data collection was completed by April 1, 2023. Participants were recruited from 2 cancer centers (Dartmouth College and the University of Alabama at Birmingham) and via social media advertisements. Women aged 18 years or older who had completed primary treatment for stage I to III breast cancer within 1 year and reported participation restrictions were eligible to participate. Randomization was stratified by site, treatment, and time since treatment. Interventions The intervention, delivered via telephone over 9 sessions, used behavioral activation and problem-solving principles to promote activity participation. The education-based attention control condition was delivered via telephone at matched intervals. Main Outcomes and Measures The primary outcome was participation, assessed using 5 measures, including Patient-Reported Outcomes Measurement Information System (PROMIS) social participation-satisfaction measure. One individualized outcome allowed participants to specify activities for which they wanted to foster recovery. Outcomes were collected by telephone by blinded coordinators at baseline and at 8, 20, and 44 weeks. The individualized outcome was assessed at the first and last intervention and control session. Results Among 1996 patients identified, 303 were eligible and enrolled. Of these, 284 women (94%; mean [SD] age, 56.1 [10.2] years) completed baseline assessments and were randomized, and 81% or more of each group completed the final assessment with no adverse events. Of those who completed the final assessment, 118 of 114 (82%) were in the intervention group, and 113 of 140 (81%) were attention control participants. Between-group differences were not statistically significant for the main measures of PROMIS satisfaction (week 20: Cohen d, 0.1 [95% CI, -0.09 to 0.29] and week 44: Cohen d, -0.08 [95% CI, -0.27 to 0.11]) and ability (week 20: Cohen d, 0.15 [95% CI, -0.06 to 0.37] and week 44: Cohen d, -0.08 [95% CI, -0.27 to 0.11]). On the individualized outcome, intervention participants reported significantly greater improvements in activity satisfaction (Cohen d, 0.76 [95% CI, 0.48-1.02]) and performance (Cohen d, 0.60 [95% CI, 0.32-0.87]). Conclusions and Relevance In this randomized clinical trial, the intervention catalyzed greater improvements in self-selected activity participation and goal disengagement but did not otherwise accelerate recovery compared with the control condition. Future research should determine what intervention features may lead to the greatest reductions in participation restrictions and other measures that may detect functional recovery. Trial Registration ClinicalTrials.gov Identifier: NCT03915548.
Collapse
Affiliation(s)
- Kathleen Doyle Lyons
- Department of Occupational Therapy, Massachusetts General Hospital Institute of Health Professions, Boston
| | - Stephen B. Wechsler
- Department of Occupational Therapy, Massachusetts General Hospital Institute of Health Professions, Boston
| | - Deborah B. Ejem
- School of Nursing, University of Alabama at Birmingham, Birmingham
| | - Courtney J. Stevens
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, New Hampshire
| | - Andres Azuero
- School of Nursing, University of Alabama at Birmingham, Birmingham
| | - Sarah Khalidi
- School of Nursing, University of Alabama at Birmingham, Birmingham
| | - Mark T. Hegel
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, New Hampshire
| | - Sarah M. dos Anjos
- School of Health Professions, Department of Occupational Therapy, University of Alabama at Birmingham, Birmingham
| | - Megan E. Codini
- Department of Rehabilitation, Berkshire Medical Center, Pittsfield, Massachusetts
| | - Mary D. Chamberlin
- Dartmouth Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - Jamme L. Morency
- Rehabilitation Medicine, Dartmouth Health, Lebanon, New Hampshire
| | | | - Karen E. Thorp
- Rehabilitation Medicine, Dartmouth Health, Lebanon, New Hampshire
| | | | - Susan Goedeken
- Department of Neurology, Mass General Brigham, Boston, Massachusetts
| | - Robin Newman
- Department of Occupational Therapy, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, Massachusetts
| | - Colleen Muse
- Department of Occupational Therapy, Massachusetts General Hospital Institute of Health Professions, Boston
| | - Gabrielle Rocque
- Department of Medicine, Division of Hematology and Oncology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham
- Department of Medicine, Division of Gerontology, Geriatrics, and Palliative Care, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham
- Center for Palliative and Supportive Care, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham
- O’Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham
| | - Kimberly Keene
- O’Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham
- Department of Radiation Oncology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham
| | - Maria Pisu
- O’Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham
- Division of Preventive Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham
| | - Jennifer Echols
- School of Nursing, University of Alabama at Birmingham, Birmingham
| | - Marie A. Bakitas
- School of Nursing, University of Alabama at Birmingham, Birmingham
- Center for Palliative and Supportive Care, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham
| |
Collapse
|
2
|
Ahmann E. Health and Wellness Coaching and Sustained Gains: A Rapid Systematic Review. Am J Lifestyle Med 2024; 18:162-180. [PMID: 38559782 PMCID: PMC10979731 DOI: 10.1177/15598276231180117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
The Transtheoretical Model of Change identifies key stages in behavior change, including a maintenance stage occurring when a behavior has been upheld for at least 6 months. Health and wellness coaching has demonstrated support for health behavior change, but maintenance of gains has received little attention. Our rapid systematic literature review characterizes both the research exploring sustained gains with health and wellness coaching and what is known about sustained gains after the completion of a health and wellness coaching engagement. Guided by The Cochrane Rapid Reviews Methods Group "Interim Guidance," we drew 231 studies from the 2018 and 2020 Sforzo et al "Compendium of the health and wellness coaching literature," and "Addendum…" appendices. Initial screening and coding for inclusion and exclusion criteria yielded 28 studies for data extraction. We examined studies across outcome categories (physiological, behavioral, psychological, and health risk assessment) to determine whether outcome measures were: not sustained; partially sustained; fully sustained; or improved from immediate post-intervention to a later follow-up period. Twenty-five of the 28 studies reviewed demonstrated partially, or fully, sustained or improved outcomes in one or more variables studied, with sustained gains demonstrated across outcome categories, strengthening confidence in HWC as a facilitator of lasting change.
Collapse
Affiliation(s)
- Elizabeth Ahmann
- Maryland University of Integrative Health, Laurel, MD, USA & Springer Institute, Cheverly, MD, USA
| |
Collapse
|
3
|
Martínez-Miranda P, Jiménez-Rejano JJ, Rosales-Tristancho A, Casuso-Holgado MJ. Comparative effect of different patient education modalities on quality of life in breast cancer survivors: A systematic review and network meta-analysis. Eur J Oncol Nurs 2023; 67:102411. [PMID: 37806151 DOI: 10.1016/j.ejon.2023.102411] [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: 05/12/2023] [Revised: 07/20/2023] [Accepted: 09/07/2023] [Indexed: 10/10/2023]
Abstract
PURPOSE To assess the comparative effect of patient education modalities (online, telephonic, mixed, in-person meetings) on the improvement of quality-of-life in breast cancer survivors. METHODS A search was conducted in different databases, being only included randomised controlled trials. The methodological quality and the risk of bias were assessed following the criteria of PEDro and Cochrane Rob-2 tools, respectively. The certainty of the evidence was judged using the GRADE tool. These evaluations were performed by two independent reviewers. When possible, data was pooled in a network meta-analysis (95% confidence interval [CI]). RESULTS Fourteen studies were included in the qualitative synthesis (1632 participants) and 11 in the quantitative (1482 participants). Network comparisons revealed that mixed educational modality was the highest ranked intervention at short (MD = 0.62; 95% CI [-0.35, 1.6]) and long -term (MD = 1.1; 95% CI [-1.5, 3.8); the control condition was the last in both cases, with a good convergence of the model observed. However, comparisons did not show significant differences. CONCLUSIONS Health policies could benefit from mixed modalities of patient education as it is expected to generate socio-economical savings and promote patient self-management. Probably, online mixed modalities, i.e. virtual face to face meetings, could be a more up-to-date option that fit best to nowadays patients' lifestyle. However, the limitations of this review force us to interpret our results with caution.
Collapse
Affiliation(s)
- Patricia Martínez-Miranda
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Seville, Spain; CTS 1110, UMSS Research Group, Andalusia, Spain
| | - José Jesús Jiménez-Rejano
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Seville, Spain.
| | - Abel Rosales-Tristancho
- Department of Statistics and Operational Research, Universidad de Sevilla, Avenida Reina Mercedes s/n, 41012, Seville, Spain
| | - María Jesús Casuso-Holgado
- Instituto de Biomedicina de Sevilla, IBiS, Departamento de Fisioterapia, Universidad de Sevilla, Seville, Spain; CTS 1110, UMSS Research Group, Andalusia, Spain
| |
Collapse
|
4
|
Poudel PG, Horan MR, Brinkman TM, Wang Z, Robison LL, Hudson MM, Huang IC. Interventions with Social Integration Components Addressing Psychosocial Outcomes of Young- and Middle-Aged Adult Cancer Individuals: A Systematic Review. Cancers (Basel) 2023; 15:4710. [PMID: 37835404 PMCID: PMC10571739 DOI: 10.3390/cancers15194710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 09/17/2023] [Accepted: 09/20/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND The majority of adult cancer patients/survivors encounter social challenges (e.g., obtaining social support, maintaining social relationships, feelings of social isolation). This systematic review summarizes intervention studies addressing social integration or social connectedness issues among young- and middle-aged cancer patients/survivors. METHODS We searched the PubMed, CINAHL, and Web of Science databases (January 2000-May 2021) to identify intervention studies that addressed social integration, social connectedness, social support, and social isolation for cancer patients/survivors in young- and middle-aged adulthood (18-64.9 years) through a randomized controlled trial (RCT). We categorized the interventions as technology-based, non-technology-based, and mixed-type (technology- and non-technology-based). RESULTS A total of 28 studies were identified. These interventions demonstrated improved social outcomes (e.g., increased social support, decreased loneliness), increased awareness of available cancer-related resources, and better patient-reported outcomes among patients/survivors versus controls. Specifically, the use of internet-based discussion sessions was associated with improved social cohesion and social support. Receiving social support from peers through networking sites was associated with improved physical activity. Additionally, implementing mixed-type interventions led to better social support from peer survivors, less fear of social interactions, and improved social connectedness. CONCLUSIONS Using existing technology- and/or non-technology-based platforms to facilitate social connectedness among cancer patients/survivors in young- or middle-aged adulthood can help them cope with stressful life circumstances and improve quality-of-life. Further interventions targeting social integration (e.g., social network interventions) are needed to improve the complex social integration challenges experienced by cancer patients and survivors.
Collapse
Affiliation(s)
- Pragya G. Poudel
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA; (P.G.P.); (M.R.H.); (T.M.B.); (Z.W.); (L.L.R.); (M.M.H.)
| | - Madeline R. Horan
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA; (P.G.P.); (M.R.H.); (T.M.B.); (Z.W.); (L.L.R.); (M.M.H.)
| | - Tara M. Brinkman
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA; (P.G.P.); (M.R.H.); (T.M.B.); (Z.W.); (L.L.R.); (M.M.H.)
- Department of Psychology and Biobehavioral Sciences, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA
| | - Zhaoming Wang
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA; (P.G.P.); (M.R.H.); (T.M.B.); (Z.W.); (L.L.R.); (M.M.H.)
- Department of Computational Biology, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA
| | - Leslie L. Robison
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA; (P.G.P.); (M.R.H.); (T.M.B.); (Z.W.); (L.L.R.); (M.M.H.)
| | - Melissa M. Hudson
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA; (P.G.P.); (M.R.H.); (T.M.B.); (Z.W.); (L.L.R.); (M.M.H.)
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA
| | - I-Chan Huang
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA; (P.G.P.); (M.R.H.); (T.M.B.); (Z.W.); (L.L.R.); (M.M.H.)
| |
Collapse
|
5
|
Setyowibowo H, Yudiana W, Hunfeld JAM, Iskandarsyah A, Passchier J, Arzomand H, Sadarjoen SS, de Vries R, Sijbrandij M. Psychoeducation for breast cancer: A systematic review and meta-analysis. Breast 2022; 62:36-51. [PMID: 35121502 PMCID: PMC8819101 DOI: 10.1016/j.breast.2022.01.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 12/24/2021] [Accepted: 01/11/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Psychoeducation has emerged as an intervention for women with breast cancer (BC). This meta-analysis evaluated the effectiveness of psychoeducation on adherence to diagnostic procedures and medical treatment, anxiety, depression, quality of life (QoL), and BC knowledge among patients with BC symptoms or diagnosis and BC survivors. METHODS A systematic literature search (in PubMed, Embase, PsycINFO and Cochrane) for randomised controlled trials (RCTs) comparing the effects of psychoeducation to control among patients with BC symptoms or diagnosis and BC survivors. Effects were expressed as relative risks (RRs) and standardized mean differences (SMDs) with their 95% confidence intervals. RESULTS Twenty-seven RCTs (7742 participants; 3880 psychoeducation and 3862 controls) were included. Compared with controls, psychoeducation had no significant effect on adherence to diagnostic procedures and medical treatment (RR 1.553; 95% CI 0.733 to 3.290, p = .16), but it significantly decreased anxiety (SMD -0.710, 95% CI -1.395 to -0.027, p = .04) and improved QoL with (SMD 0.509; 95% CI 0.096 to 0.923, p < .01). No effects were found for psychoeducation on depression (SMD -0.243, 95% CI -0.580 to 0.091, p = .14), or BC knowledge (SMD 0.718, 95% CI -0.800 to 2.236, p = .23). CONCLUSION We demonstrated that psychoeducation did not improve adherence to diagnostic procedures and treatment, depression and BC knowledge but was valuable for reducing anxiety and improving QoL. Future studies may explore the effectiveness of psychoeducation in promoting adherence across various types of cancer.
Collapse
Affiliation(s)
- Hari Setyowibowo
- Department of Clinical, Neuro, and Developmental Psychology and Amsterdam Public Health Institute, Vrije Universiteit Amsterdam, the Netherlands; Department of Educational Psychology, Universitas Padjadjaran, Jatinangor, Indonesia.
| | - Whisnu Yudiana
- Department of Experimental Psychology, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Joke A M Hunfeld
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Aulia Iskandarsyah
- Department of Clinical Psychology, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Jan Passchier
- Department of Clinical, Neuro, and Developmental Psychology and Amsterdam Public Health Institute, Vrije Universiteit Amsterdam, the Netherlands
| | - Homra Arzomand
- Department of Clinical, Neuro, and Developmental Psychology and Amsterdam Public Health Institute, Vrije Universiteit Amsterdam, the Netherlands
| | - Sawitri S Sadarjoen
- Department of Clinical Psychology, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Ralph de Vries
- Medical Library, Vrije Universiteit, Amsterdam, the Netherlands
| | - Marit Sijbrandij
- Department of Clinical, Neuro, and Developmental Psychology and Amsterdam Public Health Institute, Vrije Universiteit Amsterdam, the Netherlands; World Health Organization Collaborating Centre for Research and Dissemination of Psychological Interventions, Vrije Universiteit Amsterdam, the Netherlands
| |
Collapse
|
6
|
Khaleghi F, Pouraboli B, Abadian L, Dehghan M, Miri S. The Effect of Emotional Disclosure by Writing on the Depression of Hemodialysis Patients in Iran: A Randomized Clinical Trial. J Caring Sci 2021; 10:223-229. [PMID: 34849369 PMCID: PMC8609128 DOI: 10.34172/jcs.2021.035] [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: 02/27/2021] [Accepted: 03/09/2021] [Indexed: 11/28/2022] Open
Abstract
Introduction: Depression is the most common psychological problem in patients with renal failure, and it can lead to mortality in severe cases. Effective interventions are required to promote mental health in patients on hemodialysis with various types of mental disorders. The current study aimed to evaluate the effect of emotional disclosure by writing on depression of patients on hemodialysis in Iran.
Methods: This clinical trial study was carried out on 140 patients undergoing hemodialysis in hemodialysis centers of Kerman. Patients were randomly assigned into two groups of intervention and control after signing the written consent forms and completing the Depression Anxiety Stress Scale (DASS 21). The intervention group was requested to write daily the deepest emotions and intrusive thoughts within 15 to 20 minutes in four consecutive days. The control group received routine care. Then, the questionnaire was recompleted two weeks later. Finally, the data were analyzed by SPSS (version 13) using independent t-test and paired t-test.
Results: The mean depression score was either moderate or high. While depression scores seemed to decrease in the intervention group after the intervention, the depression scores continued to rise following the intervention in the control group. The difference in depression scores was statistically significant between the two groups before and after the intervention.
Conclusion: Emotional disclosure by writing can be effective on the level of depression in patients on hemodialysis.Simus adi omnimodipsa sam fugita dolenistiae inveles est doluptat.
Collapse
Affiliation(s)
- Fereshteh Khaleghi
- Department of Psychiatric Nursing, School of Nursing and Midwifery, University of Medical Sciences, Kerman, Iran
| | - Batool Pouraboli
- Department of Pediatric and Neonatal Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Abadian
- Department of Pediatric Nursing, School of Nursing and Midwifery, University of Medical Sciences, Kashan, Iran
| | - Mahlegha Dehghan
- Departement of Nursing Research Center, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Sakineh Miri
- Department of Psychiatric Nursing, Nursing Research Center, School of Nursing and Midwifery ،Kerman University of Medical Sciences, Kerman, Iran
| |
Collapse
|
7
|
Park YJ, Lee MK. Effects of nurse-led nonpharmacological pain interventions for patients with cancer: A systematic review and meta-analysis. J Nurs Scholarsh 2021; 54:422-433. [PMID: 34847285 DOI: 10.1111/jnu.12750] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 11/10/2021] [Accepted: 11/18/2021] [Indexed: 01/05/2023]
Abstract
PURPOSE The purposes of this study were to review the types of nurse-led nonpharmacological pain interventions (NPI) offered to cancer patients and/or family caregivers, and to determine a comprehensive and robust estimate of the effect size of nurse-led NPI for cancer patients on various pain-related outcomes. DESIGN Systematic review and meta-analysis. Studies assessing nurse-led NPIs targeting cancer patients and published between January 2008 and December 2020 were identified by searching multiple literature databases, including MEDLINE® , EMBASE, Google Scholar, Cochrane Library, ProQuest Medical Library, and CINAHL® . METHODS This review was conducted in accordance with the Preferred Reporting Item for Systematic Reviews and Meta-analyses guidelines. The selected randomized clinical trials were independently assessed for methodological quality. The effect sizes (ESs) of treatment were presented as standardized mean differences (Hedges' g) and 95% confidence intervals (CIs). FINDINGS A meta-analysis was performed to analyze data from 22 randomized clinical trials. Three types of nurse-led NPI were offered, mainly to cancer patients but also to some caregivers: music, physical, and psycho-educational interventions. The dose and duration of nonpharmacological interventions varied widely. The study participants ranged in age from 44.1 to 67.3 years. Meta-analysis indicated that, although these interventions had small effects in long-term (g = 0.24, 95% CI: 0.06-0.43, p = 0.011) to medium effects in short-term (g = 0.43, 95% CI: 0.32-0.53, p < 0.001), they significantly reduced patients' pain, increased their knowledge of pain management, reduced barriers to pain management and pain coping, and improved other physical and emotional symptoms. The significance of the ES differed according to the type of intervention, with psycho-educational and physical NPIs having a significant but medium short-term ES, whereas music NPI had a significant but large short-term ES. Only psycho-educational NPIs had significant long-term effects. CONCLUSION The combined ES showed that these nurse-led NPIs were significantly effective in both the short and long-term. Types of intervention as a potential moderator were associated with short-term and long-term effects of nonpharmacological interventions on patient outcomes. CLINICAL RELEVANCE Research-tested interventions should be provided to help patients cope effectively with pain.
Collapse
Affiliation(s)
- Youn Jin Park
- College of Nursing, Research Institute of Nursing Science, Kyungpook National University, Daegu, South Korea
| | - Myung Kyung Lee
- College of Nursing, Research Institute of Nursing Science, Kyungpook National University, Daegu, South Korea
| |
Collapse
|
8
|
Belay W, Kaba M, Labisso WL, Tigeneh W, Sahile Z, Zergaw A, Ejigu A, Baheretibeb Y, Gufue ZH, Haileselassie W. The effect of interpersonal psychotherapy on quality of life among breast cancer patients with common mental health disorder: a randomized control trial at Tikur Anbessa Specialized Hospital. Support Care Cancer 2021; 30:965-972. [PMID: 34432169 DOI: 10.1007/s00520-021-06508-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 08/15/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE To determine the effect of interpersonal psychotherapy on anxiety, depression, and quality of life among breast cancer patients with mental health disorders at Tikur Anbessa Specialized Hospital, Ethiopia. METHODS A two-arm parallel randomized controlled trial study was conducted among 114 (n = 57 intervention, and n = 57 control group) breast cancer patients with common mental health disorder at the oncology center of Tikur Anbessa Specialized Hospital. The hospital anxiety and depression measurement scale was used to assess depression and anxiety disorder and a 30-item quality of life questionnaire was used to assess the quality of life. General linear model analysis was done, confounding factors were controlled, and p < 0.05 was used to declare statistical significance. RESULTS Patients in the intervention group showed a significant improvement in the anxiety (coefficient - 3.68; 95% CI - 5.67, - 1.69; p < 0.001), depression (coefficient - 3.22; 95% CI - 4.7, - 1.69; p < 0.001), physical functioning (coefficient 10.55; 95% CI 3.13, 17.98; p = 0.006), health-related quality of life (coefficient 21.85; 95% CI 14.1, 29.59; p < 0.001), insomnia (coefficient - 19.56; 95% CI - 31.87, - 7.25; p = 0.002), and fatigue (coefficient - 11.37; 95% CI - 21.49, - 1.24; p = 0.028) respectively. CONCLUSIONS The adapted Ethiopian version of interpersonal psychotherapy had improved anxiety, depression, and some domains of health-related quality of life. Hence, health programmers should consider incorporating it as a treatment option in oncology centers. TRIAL REGISTRATION NUMBER PACTR202011629348967 granted on 20 November 2020 which was retrospectively registered.
Collapse
Affiliation(s)
- Winini Belay
- Department of Reproductive Health and Health Service Management, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Mirgissa Kaba
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Wajana Lako Labisso
- Department of Pathology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Wondemagegnehu Tigeneh
- Department of Oncology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Zekariyas Sahile
- Department of Public Health, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Ababi Zergaw
- Department of Reproductive Health and Health Service Management, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Abebe Ejigu
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yonas Baheretibeb
- Department of Psychiatry, School of Medicine and Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Zenawi Hagos Gufue
- Department of Public Health, College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia
| | - Werissaw Haileselassie
- Department of Reproductive Health and Health Service Management, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| |
Collapse
|
9
|
Stan DL, Cutshall SM, Adams TF, Ghosh K, Clark MM, Wieneke KC, Kebede EB, Donelan Dunlap BJ, Ruddy KJ, Hazelton JK, Butts AM, Jenkins SM, Croghan IT, Bauer BA. Wellness Coaching: An Intervention to Increase Healthy Behavior in Breast Cancer Survivors. Clin J Oncol Nurs 2021; 24:305-315. [PMID: 32441691 DOI: 10.1188/20.cjon.305-315] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Regular physical activity after breast cancer diagnosis improves survival rates and quality of life (QOL). However, breast cancer survivors rarely meet guidelines for recommended levels of physical activity. Wellness coaching interventions (WCIs) have improved exercise and health behaviors in other patient populations. OBJECTIVES This study assessed the feasibility and effectiveness of WCIs for increasing physical activity in breast cancer survivors; secondary measures included changes in dietary habits, weight, and QOL. METHODS 20 obese or overweight breast cancer survivors who recently completed active breast cancer treatment were recruited into a single-arm, 12-week WCI pilot feasibility study. The intervention was comprised of one in-person wellness coaching visit followed by four telephone calls over 12 weeks and 12 weekly emails containing wellness recommendations. FINDINGS Significant improvements from pre- to postintervention were seen in physical activity level, dietary habits, and in some aspects of QOL. Forty percent of participants achieved the 3% postintervention weight-loss goal, but this was not sustained at 30 weeks.
Collapse
|
10
|
Martínez-Miranda P, Casuso-Holgado MJ, Jesús Jiménez-Rejano J. Effect of patient education on quality-of-life, pain and fatigue in breast cancer survivors: A systematic review and meta-analysis. Clin Rehabil 2021; 35:1722-1742. [PMID: 34266300 DOI: 10.1177/02692155211031081] [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] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To synthesise the existing evidence about the effect of patient education, either used alone or as adjunctive therapy, on the improvement of quality of life, pain and fatigue in adult breast cancer survivors. DATA SOURCES We searched PubMed, Web of Science, CINAHL, SCOPUS, Cochrane Plus, PEDro, Dialnet and Clinicaltrials.gov databases. METHODS We conducted this systematic review in accordance with the PRISMA statement. Only randomised controlled trials with adult breast cancer survivors were included. We assessed the methodological quality of the studies using the PEDro scale and the Cochrane risk-of-bias tool. We synthesised evidence using the GRADE tool. RESULTS We included 14 studies (PEDro 4-8 points) comprising 1749 adult women who survived breast cancer, of which we included 12 in the quantitative analysis. There were statistically significant short-term benefits for improved global quality-of-life (standardised mean difference [SMD] = 0.43, P = 0.05, 95% CI [0.00, 0.85]; GRADE: low certainty; not important), emotional quality-of-life (SMD = 0.32, P = 0.04, 95% CI [0.02, 0.62]) and fatigue (SMD = 0.24, P = 0.0004, 95% CI [0.11, 0.37]; GRADE: low certainty; not important). However, there were not statistically significant for pain severity (SMD = -0.05, P = 0.67, 95% CI [-0.26, 0.17]; GRADE: low certainty; not important) and fear to recurrence (SMD = -0.05, P = 0.68, 95% CI [-0.31, 0.20]; GRADE: moderate certainty; not important). CONCLUSION Patient education have a significative effect in short-term global quality-of-life, emotional quality-of-life and fatigue, though all the results were classified as 'not important'.
Collapse
Affiliation(s)
- Patricia Martínez-Miranda
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Universidad de Sevilla, Sevilla, Spain
| | - María Jesús Casuso-Holgado
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Universidad de Sevilla, Sevilla, Spain
| | - José Jesús Jiménez-Rejano
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Universidad de Sevilla, Sevilla, Spain
| |
Collapse
|
11
|
Gorman JR, Drizin JH, Al-Ghadban FA, Rendle KA. Adaptation and feasibility of a multimodal mindfulness-based intervention to promote sexual health in cancer survivorship. Transl Behav Med 2021; 11:1885-1895. [PMID: 34165576 DOI: 10.1093/tbm/ibab083] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Sexual health concerns after cancer are common and distressing, and mindfulness-based interventions (MBIs) are effective in supporting women experiencing these concerns. The goals of this study were to: (i) systematically adapt and document modifications to a mindfulness-based sexual health intervention for cancer survivors in a community setting and (ii) assess feasibility, appropriateness, and acceptability, and to identify strategies to increase reach for future implementation and dissemination. Following the ADAPT-ITT model, we first conducted key informant interviews with 10 female cancer survivors and four healthcare providers to obtain feedback on perceived need and feasibility of the intervention approach, and preferences for content, structure, and delivery format. This feedback informed initial intervention adaptations, which we then pretested with five female cancer survivors. We tracked and coded intervention adaptations. Key informant cancer survivors and providers confirmed the lack of sexual health services, acceptability of a sexual health MBI, and identified initial adaptations including modifying the intervention for delivery in a community, rather than clinical, setting. Pretest participants (aged 48-57) were survivors of breast (n = 4) and cervical (n = 1) cancer. All participants completed the intervention attending an average of 7.2 of 8 weekly sessions. Qualitative and quantitative results suggest the intervention was feasible, appropriate and acceptable. Engaging stakeholders in the adaptation process is essential for creating a feasible, appropriate, and acceptable intervention. Tracking intervention modifications contributes to our overall understanding of how MBIs can be adapted for new populations and contexts.
Collapse
Affiliation(s)
- Jessica R Gorman
- School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Julia H Drizin
- School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Fatima A Al-Ghadban
- School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Katharine A Rendle
- Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Penn Center for Cancer Care Innovation, Philadelphia, PA, USA
| |
Collapse
|
12
|
Improvement in quality of life and psychological well-being associated with a culturally based psychosocial intervention for Chinese American breast cancer survivors. Support Care Cancer 2021; 29:4565-4573. [PMID: 33481114 DOI: 10.1007/s00520-020-05942-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 12/10/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE The purpose of this study was to investigate improvements in quality of life and psychological well-being among Chinese American breast cancer survivors who participated in a pilot community education and peer-mentor support program. METHODS One hundred and twenty-nine Chinese American breast cancer survivors who recently completed treatment participated in eight cohorts of the program, Joy Luck Academy, which included weekly education and peer-mentor support sessions. The education sessions covered topics designed to help participants adjust to new life after breast cancer treatment. The peer-mentor support component was designed to provide social support. Quality of life and psychological well-being (e.g., depressive symptoms, anxiety, and low- and high-arousal positive and negative affect) were assessed at baseline and immediately after the intervention. RESULTS Paired samples t tests indicated improvements in quality of life, low- and high-arousal positive affect, and reductions in depressive symptoms, anxiety, and low-arousal negative affect. CONCLUSION Our findings suggest that a psychosocial group intervention may improve quality of life and psychological well-being among Chinese American breast cancer survivors. Our intervention has the potential to be applied to other ethnic-minority cancer survivors. Future randomized controlled trials are warranted.
Collapse
|
13
|
Are Nursing Interventions Effective in Improving Quality of Life in Cancer Survivors? A Systematic Review. Cancer Nurs 2020; 45:E134-E145. [PMID: 33284148 DOI: 10.1097/ncc.0000000000000901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Cancer survivors (CSs) have needs that can negatively impact their quality of life (QoL). Oncology nurses play a key role in providing comprehensive care in cancer survivorship, although little is known about their impact on health outcomes. OBJECTIVE The aim of this study was to determine the effectiveness of nursing interventions to improve QoL and satisfaction with care of CSs. METHODS A systematic review was conducted. PubMed, CINAHL, PsycINFO, and Cochrane databases were searched for experimental studies. The Joanna Briggs Institute Checklist for Randomized Controlled Trials was used to verify the quality of the studies (Prospero reference: CRD42020148294). RESULTS Of the 8 clinical trials eligible for inclusion, 5 demonstrated that interventions conducted by nurses improved the overall QoL or some of its domains in CSs. The included studies focused on short-term survival; no studies in long-term CSs were identified. Two studies assessed satisfaction with care of survivors, obtaining positive results. CONCLUSIONS Nursing interventions seem to improve the QoL of short-term CSs. However, because of the low number of studies identified, the findings of this systematic review should be interpreted with caution. IMPLICATIONS FOR PRACTICE Further studies are necessary to strengthen the implementation of effective nursing intervention in cancer practice. Research should particularly be conducted with long-term CSs as there is lack of data on this specific stage of cancer.
Collapse
|
14
|
Ream E, Hughes AE, Cox A, Skarparis K, Richardson A, Pedersen VH, Wiseman T, Forbes A, Bryant A. Telephone interventions for symptom management in adults with cancer. Cochrane Database Syst Rev 2020; 6:CD007568. [PMID: 32483832 PMCID: PMC7264015 DOI: 10.1002/14651858.cd007568.pub2] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND People with cancer experience a variety of symptoms as a result of their disease and the therapies involved in its management. Inadequate symptom management has implications for patient outcomes including functioning, psychological well-being, and quality of life (QoL). Attempts to reduce the incidence and severity of cancer symptoms have involved the development and testing of psycho-educational interventions to enhance patients' symptom self-management. With the trend for care to be provided nearer patients' homes, telephone-delivered psycho-educational interventions have evolved to provide support for the management of a range of cancer symptoms. Early indications suggest that these can reduce symptom severity and distress through enhanced symptom self-management. OBJECTIVES To assess the effectiveness of telephone-delivered interventions for reducing symptoms associated with cancer and its treatment. To determine which symptoms are most responsive to telephone interventions. To determine whether certain configurations (e.g. with/without additional support such as face-to-face, printed or electronic resources) and duration/frequency of intervention calls mediate observed cancer symptom outcome effects. SEARCH METHODS We searched the following databases: the Cochrane Central Register of Controlled Trials (CENTRAL; 2019, Issue 1); MEDLINE via OVID (1946 to January 2019); Embase via OVID (1980 to January 2019); (CINAHL) via Athens (1982 to January 2019); British Nursing Index (1984 to January 2019); and PsycINFO (1989 to January 2019). We searched conference proceedings to identify published abstracts, as well as SIGLE and trial registers for unpublished studies. We searched the reference lists of all included articles for additional relevant studies. Finally, we handsearched the following journals: Cancer, Journal of Clinical Oncology, Psycho-oncology, Cancer Practice, Cancer Nursing, Oncology Nursing Forum, Journal of Pain and Symptom Management, and Palliative Medicine. We restricted our search to publications published in English. SELECTION CRITERIA We included randomised controlled trials (RCTs) and quasi-RCTs that compared one or more telephone interventions with one other, or with other types of interventions (e.g. a face-to-face intervention) and/or usual care, with the stated aim of addressing any physical or psychological symptoms of cancer and its treatment, which recruited adults (over 18 years) with a clinical diagnosis of cancer, regardless of tumour type, stage of cancer, type of treatment, and time of recruitment (e.g. before, during, or after treatment). DATA COLLECTION AND ANALYSIS We used Cochrane methods for trial selection, data extraction and analysis. When possible, anxiety, depressive symptoms, fatigue, emotional distress, pain, uncertainty, sexually-related and lung cancer symptoms as well as secondary outcomes are reported as standardised mean differences (SMDs) with 95% confidence intervals (CIs), and we presented a descriptive synthesis of study findings. We reported on findings according to symptoms addressed and intervention types (e.g. telephone only, telephone combined with other elements). As many studies included small samples, and because baseline scores for study outcomes often varied for intervention and control groups, we used change scores and associated standard deviations. The certainty of the evidence for each outcome was interpreted using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. MAIN RESULTS Thirty-two studies were eligible for inclusion; most had moderate risk of bias,often related to blinding. Collectively, researchers recruited 6250 people and studied interventions in people with a variety of cancer types and across the disease trajectory, although many participants had breast cancer or early-stage cancer and/or were starting treatment. Studies measured symptoms of anxiety, depression, emotional distress, uncertainty, fatigue, and pain, as well as sexually-related symptoms and general symptom intensity and/or distress. Interventions were primarily delivered by nurses (n = 24), most of whom (n = 16) had a background in oncology, research, or psychiatry. Ten interventions were delivered solely by telephone; the rest combined telephone with additional elements (i.e. face-to-face consultations and digital/online/printed resources). The number of calls delivered ranged from 1 to 18; most interventions provided three or four calls. Twenty-one studies provided evidence on effectiveness of telephone-delivered interventions and the majority appeared to reduce symptoms of depression compared to control. Nine studies contributed quantitative change scores (CSs) and associated standard deviation results (or these could be calculated). Likewise, many telephone interventions appeared effective when compared to control in reducing anxiety (16 studies; 5 contributed quantitative CS results); fatigue (9 studies; 6 contributed to quantitative CS results); and emotional distress (7 studies; 5 contributed quantitative CS results). Due to significant clinical heterogeneity with regards to interventions introduced, study participants recruited, and outcomes measured, meta-analysis was not conducted. For other symptoms (uncertainty, pain, sexually-related symptoms, dyspnoea, and general symptom experience), evidence was limited; similarly meta-analysis was not possible, and results from individual studies were largely conflicting, making conclusions about their management through telephone-delivered interventions difficult to draw. Heterogeneity was considerable across all trials for all outcomes. Overall, the certainty of evidence was very low for all outcomes in the review. Outcomes were all downgraded due to concerns about overall risk of bias profiles being frequently unclear, uncertainty in effect estimates and due to some inconsistencies in results and general heterogeneity. Unsubstantiated evidence suggests that telephone interventions in some capacity may have a place in symptom management for adults with cancer. However, in the absence of reliable and homogeneous evidence, caution is needed in interpreting the narrative synthesis. Further, there were no clear patterns across studies regarding which forms of interventions (telephone alone versus augmented with other elements) are most effective. It is impossible to conclude with any certainty which forms of telephone intervention are most effective in managing the range of cancer-related symptoms that people with cancer experience. AUTHORS' CONCLUSIONS Telephone interventions provide a convenient way of supporting self-management of cancer-related symptoms for adults with cancer. These interventions are becoming more important with the shift of care closer to patients' homes, the need for resource/cost containment, and the potential for voluntary sector providers to deliver healthcare interventions. Some evidence supports the use of telephone-delivered interventions for symptom management for adults with cancer; most evidence relates to four commonly experienced symptoms - depression, anxiety, emotional distress, and fatigue. Some telephone-delivered interventions were augmented by combining them with face-to-face meetings and provision of printed or digital materials. Review authors were unable to determine whether telephone alone or in combination with other elements provides optimal reduction in symptoms; it appears most likely that this will vary by symptom. It is noteworthy that, despite the potential for telephone interventions to deliver cost savings, none of the studies reviewed included any form of health economic evaluation. Further robust and adequately reported trials are needed across all cancer-related symptoms, as the certainty of evidence generated in studies within this review was very low, and reporting was of variable quality. Researchers must strive to reduce variability between studies in the future. Studies in this review are characterised by clinical and methodological diversity; the level of this diversity hindered comparison across studies. At the very least, efforts should be made to standardise outcome measures. Finally, studies were compromised by inclusion of small samples, inadequate concealment of group allocation, lack of observer blinding, and short length of follow-up. Consequently, conclusions related to symptoms most amenable to management by telephone-delivered interventions are tentative.
Collapse
Affiliation(s)
- Emma Ream
- School of Health Sciences, University of Surrey, Guildford, UK
| | | | - Anna Cox
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Katy Skarparis
- Department of Nursing, Midwifery & Health, Northumbria University, Newcastle, UK
| | - Alison Richardson
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Vibe H Pedersen
- Florence Nightingale School of Nursing and Midwifery, King's College London, London, UK
| | - Theresa Wiseman
- Health Services Research, The Royal Marsden NHS Foundation Trust, London, UK
| | - Angus Forbes
- Florence Nightingale School of Nursing and Midwifery, King's College London, London, UK
| | - Andrew Bryant
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| |
Collapse
|
15
|
Integrative review of breast cancer survivors’ transition experience and transitional care: dialog with transition theory perspectives. Breast Cancer 2020; 27:810-818. [DOI: 10.1007/s12282-020-01097-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 04/15/2020] [Indexed: 12/16/2022]
|
16
|
O'Hea E, Kroll-Desrosiers A, Cutillo AS, Michalak HR, Barton BA, Harralson T, Carmack C, McMahon C, Boudreaux ED. Impact of the mental health and dynamic referral for oncology (MHADRO) program on oncology patient outcomes, health care utilization, and health provider behaviors: A multi-site randomized control trial. PATIENT EDUCATION AND COUNSELING 2020; 103:607-616. [PMID: 31753521 PMCID: PMC7061075 DOI: 10.1016/j.pec.2019.10.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 10/11/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE The MHADRO assesses psychosocial and medical needs, provides tailored feedback reports, and connects patients to mental health providers. This study examined the MHADRO's effect on patient outcomes, health care utilization, and oncology provider documentation and behaviors. METHODS 836 patients were part of a multi-site RCT and assessments were conducted at baseline, 2, 6 and 12 months. RESULTS The intervention group engaged in less emergency calls to providers. There were no differences in psychosocial outcomes at follow up assessments. Providers of patients in the intervention group were more likely to: document psychosocial symptoms and history; refer to psychosocial services; encourage support groups; seek psychological evaluations during visits. Patients who agreed to a mental health referral had decreased hospitalizations, increased mental health care interactions, and stronger ratings of counseling potential benefits. This group also reported increased psychosocial distress at all follow-up assessments. CONCLUSION The MHADRO may increase access to mental health care, lessen utilization, and improve providers' management of psychosocial needs, but does not appear to impact overall functioning over time. PRACTICE IMPLICATIONS Providers are encouraged to consider incorporating programs, like the MHADRO, into patient care as they may have the potential to impact screening and management of patients' psychosocial needs.
Collapse
Affiliation(s)
- Erin O'Hea
- University of Massachusetts Medical School, Worcester, MA, and Department of Psychology, Stonehill University, Easton, MA, 320 Washington Street, Shields Science Center 212, Easton, MA, USA.
| | - Aimee Kroll-Desrosiers
- Biostatistician, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Alexandra S Cutillo
- Medical/Clinical Psychology Doctoral Program, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Hannah R Michalak
- Yale University Alzheimer's Disease Research Unit, One Church Street, Suite 600, New Haven, CT, 06510, United States
| | - Bruce A Barton
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | | | | | - Cori McMahon
- Anderson at Cooper Cancer Center, Camden, NJ, USA
| | - Edwin D Boudreaux
- Departments of Emergency Medicine, Psychiatry, and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| |
Collapse
|
17
|
Cuthbert CA, Farragher JF, Hemmelgarn BR, Ding Q, McKinnon GP, Cheung WY. Self‐management interventions for cancer survivors: A systematic review and evaluation of intervention content and theories. Psychooncology 2019; 28:2119-2140. [DOI: 10.1002/pon.5215] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 08/18/2019] [Accepted: 08/21/2019] [Indexed: 12/24/2022]
Affiliation(s)
- Colleen A. Cuthbert
- Department of Oncology, Cumming School of MedicineUniversity of Calgary Calgary Alberta Canada
| | - Janine F. Farragher
- Department of Community Health SciencesUniversity of Calgary Calgary Alberta Canada
| | - Brenda R. Hemmelgarn
- Department of Community Health SciencesUniversity of Calgary Calgary Alberta Canada
- Department of MedicineUniversity of Calgary Calgary Alberta Canada
| | - Qirui Ding
- Department of Molecular Genetics, Faculty of MedicineUniversity of Toronto Toronto Ontario Canada
| | - Geoffrey P. McKinnon
- Department of Oncology, Cumming School of MedicineUniversity of Calgary Calgary Alberta Canada
| | - Winson Y. Cheung
- Department of Oncology, Cumming School of MedicineUniversity of Calgary Calgary Alberta Canada
- Alberta Health Services Cancer ControlTom Baker Cancer Center Calgary Alberta Canada
| |
Collapse
|
18
|
Larson JL, Rosen AB, Wilson FA. The effect of telehealth interventions on quality of life of cancer survivors: A systematic review and meta-analysis. Health Informatics J 2019; 26:1060-1078. [PMID: 31566455 DOI: 10.1177/1460458219863604] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The objective of this study was to perform a systematic review and meta-analysis comparing the effect of telehealth interventions to usual care for cancer survivors' quality of life. A comprehensive search of four different databases was conducted. Manuscripts were included if they assessed telehealth interventions and usual care for adult cancer survivors and reported a measure of quality of life. Pooled random effects models were used to calculate overall mean effects for quality of life pre- and post-intervention. Eleven articles fit all systematic review and meta-analysis criteria. Initial analyses indicated that telehealth interventions demonstrated large improvements compared with usual care in quality of life measures (Δ = 0.750, p = 0.007), albeit with substantial heterogeneity. Upon further analysis and outlier removal, telehealth interventions demonstrated significant improvements in quality of life compared with usual care (Δ = 0.141-0.144, p < 0.05). The results of the systematic review with meta-analysis indicate that supplementary interventions through telehealth may have a positive impact on quality of life compared with in-person usual care.
Collapse
|
19
|
Soulia SL, Duffy EA, Morley KA, Smith EML. Implementation of a Survivorship Care Plan Program in a Community-Based Oncology Clinic. J Adv Pract Oncol 2019; 10:665-676. [PMID: 33391851 PMCID: PMC7517781 DOI: 10.6004/jadpro.2019.10.7.3] [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] [Indexed: 12/02/2022] Open
Abstract
There is conflicting evidence from the small number of randomized controlled trials (RCTs) that have assessed the benefit of survivorship care plans (SCPs) on improving patient outcomes. Yet, published quasi-experimental and descriptive studies provide preliminary evidence suggesting that using survivorship care plans in practice may improve patient knowledge, decrease worry and anxiety, and lead to patient and primary care physician satisfaction. Given the conflicting evidence and the paucity of RCTs, further research is needed to more fully explore the effect of SCP on patient outcomes. To address this knowledge gap, an SCP program was implemented in a community-based oncology clinic and used quality improvement methodology to assess the effect on patient knowledge of diagnosis, treatment, and follow-up, and to understand patients’ satisfaction with the current SCP program. A total of 30 cancer patients were recruited in Southeast Michigan to participate in an SCP quality improvement project and completed surveys to evaluate the SCP program. Data were collected between December 2017 and March 2018. We observed a statistically significant (p = .028) difference between pre- and postintervention (survivorship care plan visit) knowledge scores about cancer diagnosis, treatment received, and follow-up recommendations. Moreover, participants were satisfied with the survivorship care plan and visit.
Collapse
Affiliation(s)
| | | | | | - Ellen M L Smith
- University of Michigan School of Nursing, Ann Arbor, Michigan
| |
Collapse
|
20
|
Cipolletta S, Simonato C, Faccio E. The Effectiveness of Psychoeducational Support Groups for Women With Breast Cancer and Their Caregivers: A Mixed Methods Study. Front Psychol 2019; 10:288. [PMID: 30833920 PMCID: PMC6387958 DOI: 10.3389/fpsyg.2019.00288] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 01/29/2019] [Indexed: 11/25/2022] Open
Abstract
Background: Previous studies on the effectiveness of psychological interventions in oncology mainly used quantitative measures and no study was conducted with regard to both caregivers and patients. Aim: This study evaluates the effectiveness of psychoeducational support groups, both for women with breast cancer, and for their informal caregivers through the use of quantitative and qualitative measures. Methods: A longitudinal design was used comparing two psychoeducational support groups with other two groups in a standard care control condition. Participants were 28 women with a diagnosis of breast cancer in the care of a hospital in Northern Italy, and 21 family caregivers. The quantitative data were collected by Cognitive Behavioral Assessment for Outcome Evaluation (CBA-OE) and the qualitative data through the use of semi-structured interviews. Results: The statistical analysis showed a significant change attributable to the psychological intervention that proves the effectiveness of such an intervention in the patients’ and caregivers’ group. The qualitative analysis allowed us to interpret the behavioral and psychological profile emerging from CBA-OE, by considering the subjective experience of the treatment groups. The group experience offered affective, relational and informative support, and allowed participants to create a network and to feel understood and reassured. Conclusion: The results suggest the usefulness of psychoeducational support groups for women with breast cancer and for their caregivers. The value of this kind of intervention is not only at an individual level but also at a systems level, and family involvement ensures the best positive outcomes.
Collapse
Affiliation(s)
| | - Camilla Simonato
- Department of General Psychology, University of Padua, Padua, Italy
| | - Elena Faccio
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padua, Padua, Italy
| |
Collapse
|
21
|
Ruiz-Pérez I, Rodríguez-Gómez M, Pastor-Moreno G, Escribá-Agüir V, Petrova D. Effectiveness of interventions to improve cancer treatment and follow-up care in socially disadvantaged groups. Psychooncology 2019; 28:665-674. [PMID: 30695816 DOI: 10.1002/pon.5011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 01/14/2019] [Accepted: 01/23/2019] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To identify and characterize the interventions that aimed to improve cancer treatment and follow-up care in socially disadvantaged groups. To summarize the state of the art for clinicians and researchers. METHODS We conducted a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eligible studies were randomized controlled trials and quasi-experimental studies with a control group (usual care or enhanced usual care) conducted in Organization for Economic Co-operation and Development (OECD) member countries and published until 2016. RESULTS Thirty-one interventions were identified, the majority of which were conducted in the United States in patients with breast cancer. Most interventions aimed to decrease social inequalities based on ethnicity/race and/or socioeconomic level, with fewer interventions targeting inequalities based on geographical area. The most frequently assessed outcomes were quality of life (n = 20) and psychosocial factors (n = 20), followed by treatment adherence or satisfaction (n = 12,), knowledge (n = 11), pain management (n = 10), and lifestyle habits (n = 3). CONCLUSIONS The impact of interventions designed to improve cancer treatment and follow-up care in socially disadvantages groups is multifactorial. Multicomponent-intervention approaches and cultural adaptations are common, and their effectiveness should be evaluated in the populations of interest. More interventions are needed from outside the Unite States and in patients with cancers other than breast cancer, targeting gender or geographical inequalities and addressing key outcomes such as treatment adherence or symptom management.
Collapse
Affiliation(s)
- Isabel Ruiz-Pérez
- Andalusian School of Public Health, Granada, Spain.,Centro de Investigacion Biomedica en Red de Epidemiologia y Salud Publica, Madrid, Spain.,Instituto de Investigación Biosanitaria (ibs. GRANADA), Granada, Spain
| | | | - Guadalupe Pastor-Moreno
- Andalusian School of Public Health, Granada, Spain.,Centro de Investigacion Biomedica en Red de Epidemiologia y Salud Publica, Madrid, Spain
| | - Vicenta Escribá-Agüir
- Department of Nursing, University of Valencia, Valencia, Spain.,Fundación para el fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (FISABIO), Valencia, Spain
| | - Dafina Petrova
- Andalusian School of Public Health, Granada, Spain.,Centro de Investigacion Biomedica en Red de Epidemiologia y Salud Publica, Madrid, Spain.,Instituto de Investigación Biosanitaria (ibs. GRANADA), Granada, Spain
| |
Collapse
|
22
|
İnan FŞ, Üstün B. After the Psychoeducational Intervention: Turkish Breast Cancer Survivors' Experiences. Eur J Breast Health 2019; 15:37-42. [PMID: 30816352 PMCID: PMC6385716 DOI: 10.5152/ejbh.2018.4255] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 08/29/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To explore breast cancer survivors' life experiences and perceptions about participating in a psychoeducational intervention that aimed at reducing psychological distress and in improvement of the quality of life. MATERIALS AND METHODS This study was a post-trial qualitative descriptive study. Data were collected at semi-structured interviews three months after the psychoeducational intervention. Interviews were conducted with 32 Turkish breast cancer survivors. Obtained data were analyzed with inductive content analysis. RESULTS The data were categorized into three themes: personal growth, unmet needs and recommendations about the quality of the psychoeducation. Survivors explained that they had positive changes in their self-concept, view of life and relationships after the psychoeducational intervention. In addition, they mentioned the unmet needs to join support groups and raise public awareness to decrease stigma over breast cancer patients in the society. CONCLUSION The results of the present study provide new insights into experiences of breast cancer survivors who participated a psychoeducational intervention and provide guidance for attempts to improve survivorship care via psychoeducation to professionals. Psychoeducational interventions should be continuously offered to provide psychosocial support for breast cancer survivors. Future research into psychoeducation for breast cancer survivors should be restructured to involve social support.
Collapse
Affiliation(s)
- Figen Şengün İnan
- Department of Psychiatric Nursing, Dokuz Eylül University Faculty of Nursing, İzmir, Turkey
| | - Besti Üstün
- Department of Nursing, Üsküdar University Faculty of Health, İstanbul, Turkey
| |
Collapse
|
23
|
Barre PV, Padmaja G, Rana S, Tiamongla. Stress and Quality of Life in Cancer Patients: Medical and Psychological Intervention. Indian J Psychol Med 2018; 40:232-238. [PMID: 29875530 PMCID: PMC5968644 DOI: 10.4103/ijpsym.ijpsym_512_17] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Cancer pervades many dimensions of an individual's life - demanding a holistic treatment approach. However, studies with combined medical and psychological interventions (MPIs) are sparse. High-level stress and poor quality of life (QoL) can hinder patients' prognosis. The study thus aimed to analyze the impact of combined medical and psychological (psychoeducation, relaxation technique-guided imagery, and cognitive therapy) interventions on stress and QoL of cancer patients - head and neck, breast, and lung cancers. METHODS The study was conducted in cancer hospitals employing one-group pretest-posttest-preexperimental design. Descriptive statistics, paired t-test, Cohen's d, and bar graphs were used to analyze the data. RESULTS Findings showed high impact of the combined MPIs in reducing both the overall stress as well as the various components of the stress scale-fear, psychosomatic complaints, information deficit, and everyday life restrictions. Significant changes were also seen in QoL and its domains - global health status, besides functional and symptom scales. Results showed a significant improvement in physical, role and emotional functioning scale, while decrement in fatigue, pain, insomnia, appetite loss, diarrhea, and constipation of symptoms scales. CONCLUSIONS It can be concluded that combined MPI has a positive impact - decreasing stress and improving QoL in cancer patients, which can further enhance their prognosis.
Collapse
Affiliation(s)
| | - Gadiraju Padmaja
- Centre for Health Psychology, University of Hyderabad, Hyderabad, Telangana, India
| | - Suvashisa Rana
- Centre for Health Psychology, University of Hyderabad, Hyderabad, Telangana, India
| | - Tiamongla
- Centre for Health Psychology, University of Hyderabad, Hyderabad, Telangana, India
| |
Collapse
|
24
|
|
25
|
Bourmaud A, Rousset V, Regnier-Denois V, Collard O, Jacquin JP, Merrouche Y, Lapoirie J, Tinquaut F, Lataillade L, Chauvin F. Improving Adherence to Adjuvant Endocrine Therapy in Breast Cancer Through a Therapeutic Educational Approach: A Feasibility Study
. Oncol Nurs Forum 2017; 43:E94-E103. [PMID: 27105205 DOI: 10.1188/16.onf.e94-e103] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To develop and test the feasibility of a tailored therapeutic educational program, with the aim of improving adherence to oral endocrine adjuvant chemotherapy in women with breast cancer.
. DESIGN A qualitative study to identify educational needs and a feasibility study assessing the efficacy of the program.
. SETTING A comprehensive cancer center, the Lucien Neuwirth Cancer Institute in Saint-Priest-en-Jarez, France.
. SAMPLE Two consecutive samples (N = 11, N = 6) of women taking adjuvant oral endocrine chemotherapy for breast cancer.
. METHODS A mixed qualitative and quantitative method was used. The participants' representations of disease and treatment were explored through one-on-one interviews and then translated into educational needs, which were used to develop a tailored therapeutic education program. The pilot study evaluated the reach and efficacy using before-and-after comparisons.
. MAIN RESEARCH VARIABLES Educational objectives, knowledge, trust in the treatment, and anxiety.
. FINDINGS Five educational objectives (acquiring knowledge, improving communication skills, managing anxiety, managing side effects, and improving adherence) were identified through 11 interviews. A three-session program was developed. Eight of the 23 patients invited to participate in a pilot study accepted, and six completed the intervention. Knowledge improved from 38.9 of 100 preintervention to 69.4 of 100 postintervention (p = 0.045). Trust in treatment showed a trend to improvement from 5.5 of 10 to 8 of 10 (p = 0.14), but anxiety did not change significantly; anxiety went from 6 to 7 (p = 0.88).
. CONCLUSIONS Results from the feasibility study showed promising efficacy for the educational objectives and provided information about how the program could be improved.
. IMPLICATIONS FOR NURSING Tailored educational programs conducted by trained nurses may help patients to adhere to and live with the effects of endocrine therapy.
Collapse
|
26
|
Cheng KKF, Lim YTE, Koh ZM, Tam WWS. Home-based multidimensional survivorship programmes for breast cancer survivors. Cochrane Database Syst Rev 2017; 8:CD011152. [PMID: 28836379 PMCID: PMC6483678 DOI: 10.1002/14651858.cd011152.pub2] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND The prognosis and survival rate of women with breast cancer have significantly improved worldwide. Effective home-based multidimensional programmes for breast cancer survivors have gained an ever greater emphasis in survivorship care to maximise women's quality of life for their successful transition to rehabilitation and normal life. It is important to summarise the best available evidence to evaluate the effects of home-based multidimensional survivorship programmes on quality of life in women within 10 years of the completion of surgery or adjuvant cancer therapy for breast cancer, or both. OBJECTIVES To assess the effects of home-based, multidimensional survivorship (HBMS) programmes on maintaining or improving the quality of life in breast cancer survivors. SEARCH METHODS In April 2016 we searched the Cochrane Breast Cancer Specialised Register, CENTRAL, PubMed, Embase, CINAHL Plus, PsycINFO, Web of Science, and the World Health Organization's International Clinical Trials Registry Platform (WHO ICTRP) and ClinicalTrials.gov. We also screened reference lists of all identified studies and contacted study authors. SELECTION CRITERIA Randomised controlled trials (RCTs) and quasi-RCTs assessing the effects of HBMS programmes in maintaining or improving quality of life in women with stages 0 to 3 breast cancer who completed primary cancer treatment (surgery or adjuvant cancer therapy, or both) up to 10 years earlier. We considered studies where the interventions included more than one of the following listed components: educational (such as information provision and self-management advice), physical (such as exercise training and resistance training) and psychological (such as counselling and cognitive therapies), to constitute a multidimensional programme. Interventions had to be allowed to be carried out at home. DATA COLLECTION AND ANALYSIS Two authors independently assessed eligible studies for inclusion, and performed quality assessment and extracted relevant data of the included studies. Quality of life was the primary outcome of the review. MAIN RESULTS We included 22 RCTs and four quasi-RCTs on 2272 participants. We categorised the intervention components into four groups: educational and psychological; educational and physical; physical and psychological; and educational, physical and psychological. Most of the studies used usual care (routine medical follow-up services) as the comparator. A few studies used a lower level or different type of intervention (e.g. stress management or exercise) or attention control as the comparator.We used the Functional Assessment of Cancer Therapy-Breast (FACT B), European Organisation for Research and Treatment of Cancer Quality of Life C30 (EORTC C30), Quality of Life (QoL) Breast Cancer, and SF36 questionnaires to assess quality of life. HBMS programmes may increase breast cancer-specific quality of life and global quality of life immediately after the intervention, as measured by FACT-B and EORTC C30 (FACT-B: mean difference (MD) 4.55, 95% confidence interval (CI) 2.33 to 6.78, 7 studies, 764 participants; EORTC: MD 4.38, 95% CI 0.11 to 8.64, 6 studies; 299 participants; moderate-quality evidence). There was no evidence of a difference in quality of life as measured by QoL-Breast Cancer or SF-36 (QoL-Breast Cancer: MD 0.42, 95% CI -0.02 to 0.85, 2 studies, 111 participants, very low-quality evidence; physical composite score SF36: MD 0.55, 95% CI -3.52 to 4.63, 2 studies, 308 participants, low-quality evidence).We observed a similar pattern at one to three months after the intervention: FACT-B (MD 6.10, 95% CI 2.48 to 9.72, 2 studies, 426 participants), EORTC-C30 (MD 6.32, 95% CI 0.61 to 12.04, 2 studies; 172 participants) and QoL-Breast Cancer (MD 0.45, 95% CI -0.19 to 1.09, 1 study, 61 participants). At four to six months and 12 months, there was no evidence of a difference in quality of life between groups (four to six months: EORTC - MD 0.08, 95% CI -7.28 to 7.44, 2 studies; 117 participants; SF-36 - MD -1.05, 95% CI -5.60 to 3.51, 2 studies, 308 participants; 12 months: EORTC - MD 2.04, 95% CI -9.91 to 13.99, 1 study; 57 participants).Functional status was incorporated into the quality of life subscale findings. HBMS programmes may decrease anxiety (MD of Hospital Anxiety and Depression Scale (HADS) -1.01, 95% CI -1.94 to -0.08, 5 studies, 253 participants, low-quality evidence) compared to control immediately after the intervention but the effect did not persist at four to six months. There was no evidence of improvements in depression immediately after HBMS (MD of HADS -1.36, 95% CI -2.94 to 0.22, 4 studies, 213 participants, low-quality evidence) or at follow-up. HBMS programmes may also decrease fatigue (MD -1.11, 95% CI -1.78 to -0.45, 3 studies, 127 participants; low-quality evidence) and insomnia (MD -1.81, 95% CI -3.34 to -0.27, 3 studies, 185 participants, low-quality evidence).None of the included studies reported service needs and utilisation and cost of care, and therefore the effect of HBMS programmes on healthcare utilisation and cost is unknown. Due to the variations in assessment methods of adherence among the eight studies, we could not combine the results for meta-analysis. We synthesised the results narratively, with the reported adherence rates of 58% to 100%. AUTHORS' CONCLUSIONS The results of this systematic review and meta-analysis revealed that HBMS programmes in breast cancer survivors appear to have a short-term beneficial effect of improving breast cancer-specific quality of life and global quality of life as measured by FACT-B and EORTC-C30, respectively. In addition, HBMS programmes are associated with a reduction in anxiety, fatigue and insomnia immediately after the intervention. We assessed the quality of evidence across studies as moderate for some outcomes, meaning that we are fairly confident about the results, while we assessed other outcomes as being low-quality, meaning that we are uncertain about the result.
Collapse
Affiliation(s)
- Karis Kin Fong Cheng
- National University of Singapore, National University Health SystemAlice Lee Centre for Nursing StudiesSingaporeSingapore
| | - Yee Ting Ethel Lim
- National University of Singapore, National University Health SystemAlice Lee Centre for Nursing StudiesSingaporeSingapore
| | - Zhi Min Koh
- National University of Singapore, National University Health SystemAlice Lee Centre for Nursing StudiesSingaporeSingapore
| | - Wilson Wai San Tam
- National University of Singapore, National University Health SystemAlice Lee Centre for Nursing StudiesSingaporeSingapore
| | | |
Collapse
|
27
|
Barakat S, Boehmer K, Abdelrahim M, Ahn S, Al-Khateeb AA, Villalobos NÁ, Prokop L, Erwin PJ, Fleming K, Serrano V, Spencer-Bonilla G, Murad MH. Does Health Coaching Grow Capacity in Cancer Survivors? A Systematic Review. Popul Health Manag 2017. [PMID: 28636526 DOI: 10.1089/pop.2017.0040] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Interventions that grow patient capacity to do the work of health care and life are needed to support the health of cancer survivors. Health coaching may grow capacity. This systematic review of health coaching interventions explored coaching's ability to grow capacity of cancer survivors. The authors included randomized trials or quasi-experimental studies comparing coaching to alternative interventions, and adhered to PRISMA reporting guidelines. Data were analyzed using the Theory of Patient Capacity (BREWS: Capacity is affected by factors that influence ability to reframe Biography ["B"], mobilize or recruit Resources ["R"], interact with the Environment of care ["E"], accomplish Work ["W"]), and function Socially ["S"]). The authors reviewed 2210 references and selected 12 studies (6 randomized trials and 6 pre-post). These studies included 1038 cancer survivors, mean age 57.2 years, with various type of cancers: breast, colorectal, prostate, and lung. Health coaching was associated with improved quality of life, mood, and physical activity but not self-efficacy. Classified by potential to support growth in patient capacity, 67% of included studies reported statistically significant outcomes that support "B" (quality of life, acceptance, spirituality), 75% "R" (decreased fatigue, pain), 67% "W" (increased physical activity), and 33% "S" (social deprivation index). None addressed changing the patient's environment of care. In cancer survivors, health coaching improved quality of life and supported patient capacity by several mechanisms, suggesting an important role for "Capacity Coaching." Future interventions that improve self-efficacy and patients' environments of care are needed. Capacity Coaching may improve health and quality of life of cancer survivors.
Collapse
Affiliation(s)
| | | | | | - Sangwoo Ahn
- 2 University of Minnesota , Minneapolis, Minnesota
| | | | - Neri Álvarez Villalobos
- 1 Mayo Clinic , Rochester, Minnesota.,4 Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario "Dr. José E. González," Monterrey, México
| | | | | | | | - Valentina Serrano
- 1 Mayo Clinic , Rochester, Minnesota.,5 Pontificia Universidad Católica de Chile , Escuela de Medicina, Alameda, Chile
| | - Gabriela Spencer-Bonilla
- 1 Mayo Clinic , Rochester, Minnesota.,6 University of Puerto Rico Medical Sciences Campus , San Juan, Puerto Rico
| | | |
Collapse
|
28
|
Zhang Q, Zhang L, Yin R, Fu T, Chen H, Shen B. Effectiveness of telephone-based interventions on health-related quality of life and prognostic outcomes in breast cancer patients and survivors-A meta-analysis. Eur J Cancer Care (Engl) 2017; 27. [PMID: 28090704 DOI: 10.1111/ecc.12632] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2016] [Indexed: 12/24/2022]
Abstract
The aim of this meta-analysis was to evaluate the effect of telephone-based interventions on prognostic outcomes and health-related quality of life (HRQoL) in breast cancer patients and survivors. A systematic search of the Cochrane Library, Web of science, Medline, EMBASE, CNKI and CBM database was carried out. Randomised, controlled trials (RCTs) examining the effects of telephone-based intervention versus a control group receiving no telephone intervention, on prognostic outcomes and HRQoL with breast cancer were included. A meta-analysis was conducted to quantify the effects of telephone-based interventions on anxiety, depression, fatigue, self-efficiency, physiological function, social-domestic function and quality of life. In total, 14 studies involving 2002 participants were included. Due to the effect of telephone-based interventions, statistically significant results were found on anxiety (standard mean difference [SMD] = -0.16, 95% confidence intervals [CI] [0.01, 0.30], p = .04), self-efficiency (SMD = 0.22, 95% CI [-0.34, -0.10], p = .0004), social-domestic function (SMD = 0.19, 95% CI [-0.35, -0.03], p = .02) and quality of life (SMD = 0.54, 95% CI [-1.00, -0.08], p = .02). Although the effects on depression, fatigue and physiological function were in the expected direction, these effects were not statistically significant (p > .05) based on the insufficient evidence.
Collapse
Affiliation(s)
- Q Zhang
- Department of Nursing, The Second Affiliated Hospital of Nantong University, Nantong, China.,School of Nursing, Nantong University, Nantong, China
| | - L Zhang
- Department of Nursing, The Second Affiliated Hospital of Nantong University, Nantong, China.,School of Nursing, Nantong University, Nantong, China
| | - R Yin
- Department of Nursing, The Second Affiliated Hospital of Nantong University, Nantong, China.,School of Nursing, Nantong University, Nantong, China
| | - T Fu
- Department of Nursing, The Second Affiliated Hospital of Nantong University, Nantong, China.,School of Nursing, Nantong University, Nantong, China
| | - H Chen
- Department of Nursing, The Second Affiliated Hospital of Nantong University, Nantong, China
| | - B Shen
- Department of Nursing, The Second Affiliated Hospital of Nantong University, Nantong, China
| |
Collapse
|
29
|
Evaluation of effectiveness of survivorship programmes: how to measure success? Lancet Oncol 2017; 18:e51-e59. [DOI: 10.1016/s1470-2045(16)30563-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 08/26/2016] [Accepted: 09/01/2016] [Indexed: 11/23/2022]
|
30
|
A pilot randomized controlled trial testing a minimal intervention to prepare breast cancer survivors for recovery. Cancer Nurs 2016; 38:E48-56. [PMID: 24831043 DOI: 10.1097/ncc.0000000000000152] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Interventions addressing cancer survivors' posttreatment concerns can be time-intensive and require specialized staff. Research is needed to identify feasible minimal intervention strategies to improve survivors' quality of life after treatment. OBJECTIVES The objective of this study was to evaluate the feasibility and short-term impact of a minimal clinic intervention on breast cancer survivors' quality of life, unmet needs, distress, and cancer worry. INTERVENTIONS/METHODS In this randomized controlled pilot trial, we enrolled breast cancer survivors at the end of treatment and administered baseline surveys. Participants were randomized to study arm (4-week video plus educational booklet intervention group and usual care group) and completed follow-up surveys at 10 weeks. Linear regression was used to examine intervention effects on quality of life outcomes controlling for clinical and demographic factors. Open-ended questions were used to examine program satisfaction and obtain feedback to improve the intervention. RESULTS We enrolled 92 survivors in the trial. Participants rated the intervention highly and reported feeling less isolated and having more realistic expectations about their recovery after completing the program. Despite positive qualitative findings, no significant intervention effects were observed for quality of life, unmet needs, distress, or cancer worry in unadjusted or adjusted analyses. CONCLUSIONS Future research is needed to define optimal intervention elements to prepare breast cancer survivors for the posttreatment period. IMPLICATIONS FOR PRACTICE Effective survivorship interventions may require more intensive components such as clinical input and longer follow-up periods.
Collapse
|
31
|
Challinor JM, Galassi AL, Al-Ruzzieh MA, Bigirimana JB, Buswell L, So WK, Steinberg AB, Williams M. Nursing's Potential to Address the Growing Cancer Burden in Low- and Middle-Income Countries. J Glob Oncol 2016; 2:154-163. [PMID: 28717695 PMCID: PMC5495453 DOI: 10.1200/jgo.2015.001974] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Affiliation(s)
- Julia M. Challinor
- Julia M. Challinor, International Network for Cancer Treatment and Research, Brussels, Belgium; Annette L. Galassi and Makeda Williams, National Cancer Institute, Bethesda, MD; Majeda A. Al-Ruzzieh, King Hussein Cancer Center, Amman, Jordan; Jean Bosco Bigirimana, Inshuti Mu Buzima, Rwinkwavu, Rwanda; Lori Buswell, Partners in Health, Boston, MA; Winnie K. W. So, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, People’s Republic of China; and Allison Burg Steinberg, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center at Sibley Memorial Hospital, Washington, DC
| | - Annette L. Galassi
- Julia M. Challinor, International Network for Cancer Treatment and Research, Brussels, Belgium; Annette L. Galassi and Makeda Williams, National Cancer Institute, Bethesda, MD; Majeda A. Al-Ruzzieh, King Hussein Cancer Center, Amman, Jordan; Jean Bosco Bigirimana, Inshuti Mu Buzima, Rwinkwavu, Rwanda; Lori Buswell, Partners in Health, Boston, MA; Winnie K. W. So, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, People’s Republic of China; and Allison Burg Steinberg, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center at Sibley Memorial Hospital, Washington, DC
| | - Majeda A. Al-Ruzzieh
- Julia M. Challinor, International Network for Cancer Treatment and Research, Brussels, Belgium; Annette L. Galassi and Makeda Williams, National Cancer Institute, Bethesda, MD; Majeda A. Al-Ruzzieh, King Hussein Cancer Center, Amman, Jordan; Jean Bosco Bigirimana, Inshuti Mu Buzima, Rwinkwavu, Rwanda; Lori Buswell, Partners in Health, Boston, MA; Winnie K. W. So, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, People’s Republic of China; and Allison Burg Steinberg, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center at Sibley Memorial Hospital, Washington, DC
| | - Jean Bosco Bigirimana
- Julia M. Challinor, International Network for Cancer Treatment and Research, Brussels, Belgium; Annette L. Galassi and Makeda Williams, National Cancer Institute, Bethesda, MD; Majeda A. Al-Ruzzieh, King Hussein Cancer Center, Amman, Jordan; Jean Bosco Bigirimana, Inshuti Mu Buzima, Rwinkwavu, Rwanda; Lori Buswell, Partners in Health, Boston, MA; Winnie K. W. So, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, People’s Republic of China; and Allison Burg Steinberg, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center at Sibley Memorial Hospital, Washington, DC
| | - Lori Buswell
- Julia M. Challinor, International Network for Cancer Treatment and Research, Brussels, Belgium; Annette L. Galassi and Makeda Williams, National Cancer Institute, Bethesda, MD; Majeda A. Al-Ruzzieh, King Hussein Cancer Center, Amman, Jordan; Jean Bosco Bigirimana, Inshuti Mu Buzima, Rwinkwavu, Rwanda; Lori Buswell, Partners in Health, Boston, MA; Winnie K. W. So, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, People’s Republic of China; and Allison Burg Steinberg, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center at Sibley Memorial Hospital, Washington, DC
| | - Winnie K.W. So
- Julia M. Challinor, International Network for Cancer Treatment and Research, Brussels, Belgium; Annette L. Galassi and Makeda Williams, National Cancer Institute, Bethesda, MD; Majeda A. Al-Ruzzieh, King Hussein Cancer Center, Amman, Jordan; Jean Bosco Bigirimana, Inshuti Mu Buzima, Rwinkwavu, Rwanda; Lori Buswell, Partners in Health, Boston, MA; Winnie K. W. So, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, People’s Republic of China; and Allison Burg Steinberg, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center at Sibley Memorial Hospital, Washington, DC
| | - Allison Burg Steinberg
- Julia M. Challinor, International Network for Cancer Treatment and Research, Brussels, Belgium; Annette L. Galassi and Makeda Williams, National Cancer Institute, Bethesda, MD; Majeda A. Al-Ruzzieh, King Hussein Cancer Center, Amman, Jordan; Jean Bosco Bigirimana, Inshuti Mu Buzima, Rwinkwavu, Rwanda; Lori Buswell, Partners in Health, Boston, MA; Winnie K. W. So, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, People’s Republic of China; and Allison Burg Steinberg, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center at Sibley Memorial Hospital, Washington, DC
| | - Makeda Williams
- Julia M. Challinor, International Network for Cancer Treatment and Research, Brussels, Belgium; Annette L. Galassi and Makeda Williams, National Cancer Institute, Bethesda, MD; Majeda A. Al-Ruzzieh, King Hussein Cancer Center, Amman, Jordan; Jean Bosco Bigirimana, Inshuti Mu Buzima, Rwinkwavu, Rwanda; Lori Buswell, Partners in Health, Boston, MA; Winnie K. W. So, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, People’s Republic of China; and Allison Burg Steinberg, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center at Sibley Memorial Hospital, Washington, DC
| |
Collapse
|
32
|
Agboola SO, Ju W, Elfiky A, Kvedar JC, Jethwani K. The effect of technology-based interventions on pain, depression, and quality of life in patients with cancer: a systematic review of randomized controlled trials. J Med Internet Res 2015; 17:e65. [PMID: 25793945 PMCID: PMC4381812 DOI: 10.2196/jmir.4009] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Revised: 02/18/2015] [Accepted: 02/18/2015] [Indexed: 02/06/2023] Open
Abstract
Background The burden of cancer is increasing; projections over the next 2 decades suggest that the annual cases of cancer will rise from 14 million in 2012 to 22 million. However, cancer patients in the 21st century are living longer due to the availability of novel therapeutic regimens, which has prompted a growing focus on maintaining patients’ health-related quality of life. Telehealth is increasingly being used to connect with patients outside of traditional clinical settings, and early work has shown its importance in improving quality of life and other clinical outcomes in cancer care. Objective The aim of this study was to systematically assess the literature for the effect of supportive telehealth interventions on pain, depression, and quality of life in cancer patients via a systematic review of clinical trials. Methods We searched PubMed, EMBASE, Google Scholar, CINAHL, and PsycINFO in July 2013 and updated the literature search again in January 2015 for prospective randomized trials evaluating the effect of telehealth interventions in cancer care with pain, depression, and quality of life as main outcomes. Two of the authors independently reviewed and extracted data from eligible randomized controlled trials, based on pre-determined selection criteria. Methodological quality of studies was assessed by the Cochrane Collaboration risk of bias tool. Results Of the 4929 articles retrieved from databases and relevant bibliographies, a total of 20 RCTs were included in the final review. The studies were largely heterogeneous in the type and duration of the intervention as well as in outcome assessments. A majority of the studies were telephone-based interventions that remotely connected patients with their health care provider or health coach. The intervention times ranged from 1 week to 12 months. In general, most of the studies had low risk of bias across the domains of the Cochrane Collaboration risk of bias tool, but most of the studies had insufficient information about the allocation concealment domain. Two of the three studies focused on pain control reported significant effects of the intervention; four of the nine studies focus on depression reported significant effects, while only the studies that were focused on quality of life reported significant effects. Conclusions This systematic review demonstrates the potential of telehealth interventions in improving outcomes in cancer care. However, more high-quality large-sized trials are needed to demonstrate cogent evidence of its effectiveness.
Collapse
Affiliation(s)
- Stephen O Agboola
- Partners Healthcare Center for Connected Health, Boston, MA, United States.
| | | | | | | | | |
Collapse
|
33
|
Leung J, Pachana NA, McLaughlin D. Social support and health-related quality of life in women with breast cancer: a longitudinal study. Psychooncology 2014; 23:1014-20. [PMID: 24700668 DOI: 10.1002/pon.3523] [Citation(s) in RCA: 139] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Revised: 02/25/2014] [Accepted: 02/26/2014] [Indexed: 11/06/2022]
Abstract
OBJECTIVES A breast cancer diagnosis is a distressing event that impacts on physical and psychological functioning. This study examined the longitudinal relationships among a diagnosis of breast cancer, social support, and health-related quality of life (HRQOL). METHODS Participants were 412 women from the 1946-1951 birth cohort of the Australian Longitudinal Study on Women's Health who self-reported a new diagnosis of breast cancer between 1998 and 2007. The three surveys of longitudinal data analyzed included data 3 years before diagnosis, at diagnosis (baseline), and 3 years after diagnosis (follow-up). Social support was measured using the 19-item Medical Outcomes Study Social Support Survey; HRQOL was measured using the Medical Outcomes Study 36-item Short-Form Health Survey. RESULTS Compared with pre-diagnosis HRQOL, women newly diagnosed with breast cancer reported significantly poorer HRQOL in subscales related to pain, physical functioning, and health and vitality. At 3-year follow-up, HRQOL had improved in most domains to levels consistent with pre-diagnosis. Levels of social support remained stable across time. The structural equation model showed that social support was positively predictive of better physical and mental HRQOL at 3-year follow-up. CONCLUSIONS Longitudinal analyses indicate that social support appears to be an important predictor of HRQOL in women diagnosed with breast cancer. In particular, positive emotional and informational support that may normally be provided by a partner is important in maintaining HRQOL. Identification of those lacking social support, especially patients without partners, will enable them to be guided to appropriate support networks and programs.
Collapse
Affiliation(s)
- Janni Leung
- The University of Queensland, School of Population Health, Brisbane, Queensland, Australia
| | | | | |
Collapse
|
34
|
Matsuda A, Yamaoka K, Tango T, Matsuda T, Nishimoto H. Effectiveness of psychoeducational support on quality of life in early-stage breast cancer patients: a systematic review and meta-analysis of randomized controlled trials. Qual Life Res 2014; 23:21-30. [PMID: 23881515 PMCID: PMC3929036 DOI: 10.1007/s11136-013-0460-3] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2013] [Indexed: 01/08/2023]
Abstract
PURPOSE Most breast cancer patients receive psychosocial support interventions. However, the effectiveness of these interventions has not yet been clarified. Quality of life (QOL) was an important construct that should be considered when assessing these interventions. The purpose was to evaluate the effectiveness of psychosocial and especially psychoeducational support interventions for early-stage breast cancer patients since the follow-up was bound up to 6 months after finishing the intervention. METHODS We conducted a systematic review and meta-analysis to identify randomized controlled trials with early-stage breast cancer patients receiving psychosocial (psychoeducational and other) support in which QOL was measured as a treatment outcome. We compared mean differences at less than 6 months post-intervention with a control group. The primary outcome was Global Health Status/QOL scale (Global QOL), and secondary outcomes were the subscales of QOL. RESULTS No significant effect was observed for Global QOL; however, individuals receiving psychosocial support scored higher on the Breast Cancer Symptoms subscale. For psychoeducational support in the psychosocial support, significant effect was observed on the Emotional subscale. CONCLUSIONS Our analysis strengthens the evidence of the effectiveness of psychosocial support in improving breast cancer symptoms and psychoeducational support in improving emotional well-being within 6 months post-intervention.
Collapse
Affiliation(s)
- Ayako Matsuda
- Surveillance Division, Center for Cancer Control and Information Services, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan,
| | | | | | | | | |
Collapse
|
35
|
Mendoza TR, Zhao F, Cleeland CS, Wagner LI, Patrick-Miller LJ, Fisch MJ. The validity and utility of the M. D. Anderson Symptom Inventory in patients with breast cancer: evidence from the symptom outcomes and practice patterns data from the eastern cooperative oncology group. Clin Breast Cancer 2013; 13:325-34. [PMID: 23816985 DOI: 10.1016/j.clbc.2013.02.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Revised: 12/21/2012] [Accepted: 02/04/2013] [Indexed: 12/27/2022]
Abstract
BACKGROUND The M. D. Anderson Symptom Inventory (MDASI) is a psychometrically validated patient-reported outcome measurement that assesses the severity and impact of multiple symptoms related to cancer and its treatment. With the MDASI, patients rate 13 common "core" symptoms and 6 items that reflect symptom interference with functioning. Several MDASI modules (core symptom and interference items plus additional symptoms specific to a particular cancer type or treatment modality) have been developed. Although the original MDASI validation study encompassed various cancer types, the instrument's psychometric properties have not been examined in a homogenous sample of patients with breast cancer in a national multicenter study. MATERIALS AND METHODS We performed a secondary analysis of data from an Eastern Cooperative Oncology Group study to establish the reliability, validity, and sensitivity of the MDASI in a large sample of patients with breast cancer (n = 1544), 78% of whom were receiving treatment. The instrument was administered twice, approximately 1 month apart. RESULTS Internal consistency and test-retest reliability were adequate, with Cronbach α values ≥ 0.85 and intraclass correlations ≥ 0.76 for all subscales. Known-group validity was evaluated by using performance status, tumor response, and disease stage. Sensitivity to change in patient-reported quality of life was established. CONCLUSION The MDASI is a valid, reliable, and sensitive symptom-assessment instrument that can enhance descriptive and clinical studies of symptom status in patients with breast cancer. Future studies might include cognitive debriefing and qualitative interviews to identify additional disease-specific items for inclusion in a MDASI breast cancer module.
Collapse
Affiliation(s)
- Tito R Mendoza
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, TX.
| | | | | | | | | | | |
Collapse
|
36
|
Wheelock A, Mihalis E, Hamolsky D, Ernest ML, Lopez NS, Hwang J, Melisko M. Survivorship clinic group educational sessions: adoption, acceptance, and attendance. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2013; 28:79-83. [PMID: 23355280 DOI: 10.1007/s13187-013-0452-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The number of breast cancer survivors now exceeds 2.5 million in the USA. In the near future, it is likely that existing systems will not be sufficient to provide follow-up care and services for all these patients. Because survivors have many concerns in common and providers may not have enough time to address them individually, group educational sessions (GES) provide an opportunity to inform patients of current breast cancer-related health issues, treatment updates, and follow-up guidelines in an efficient and structured environment. At the University of California San Francisco Breast Care Center, we implemented a GES for patients referred into the Survivorship Clinic. To improve content and convenience, patients were asked at the end of each session to complete a survey measuring their satisfaction with the GES. Clinic staff tracked GES attendance, reasons for declining participation in the GES, and utilization of the Survivorship Clinic for follow-up care. Of the 381 patients referred to the Survivorship Clinic, 177 patients have attended the GES, and 204 ultimately have not attended the GES. Eighty four of the 177 patients who attended completed a survey at the end of the GES. Ninety-five percent of these patients agreed or somewhat agreed that the information presented was clear and understandable. Eighty-five percent of patients agreed or somewhat agreed that they learned about resources for recovery. Utilization of follow-up appointments within the Survivorship Clinic was significantly higher among those who attended the GES compared to those who did not attend. Overall, the GES allows for efficient patient education, and evaluation of the GES leads to new innovations to improve survivorship care.
Collapse
Affiliation(s)
- Alyse Wheelock
- San Francisco Breast Care Center, University of California, San Francisco, CA 94115, USA
| | | | | | | | | | | | | |
Collapse
|
37
|
So WKW, Leung DYP, Ho SSM, Lai ETL, Sit JWH, Chan CWH. Associations between social support, prevalent symptoms and health-related quality of life in Chinese women undergoing treatment for breast cancer: a cross-sectional study using structural equation modelling. Eur J Oncol Nurs 2012; 17:442-8. [PMID: 23238353 DOI: 10.1016/j.ejon.2012.11.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Revised: 11/04/2012] [Accepted: 11/10/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND There is little in the literature exploring the inter-relationship of social support, prevalent symptoms and health-related quality of life (HRQoL) among breast cancer patients. This study examines the inter-relationships among the three variables using the 'Theory of Unpleasant Symptoms' as a framework. METHODS 279 Chinese breast cancer patients undergoing treatment were recruited for face-to-face interviews. The instruments used were Chinese versions of the Brief Fatigue Inventory, Brief Pain Inventory, Hospital Anxiety and Depression Scales, Medical Outcomes Study Social Support Survey and Functional Assessment of Cancer Therapy for Breast Cancer. RESULTS Goodness-of-fit and misfit indices were obtained for the final model (SRMR = 0.034, robust RMSEA = 0.051 and robust CFI = 0.981), and the results showed that social support had large total effects on social/family (total effect = 0.704, P < 0.05) and functional well-being (total effect = 0.450, P < 0.05), but a minimal effect on the breast cancer scale (total effect = 0.036, P > 0.05). CONCLUSIONS The inter-relationships among the three variables give us a better understanding of breast cancer patients' experience and provide guidance for developing effective strategies to improve their HRQoL and relieving unpleasant symptoms.
Collapse
Affiliation(s)
- Winnie K W So
- The Nethersole School of Nursing, The Chinese University of Hong Kong, 7/F., Esther Lee Building, Shatin, New Territories, Hong Kong Special Administrative Region.
| | | | | | | | | | | |
Collapse
|
38
|
Yavuzsen T, Karadibak D, Cehreli R, Dirioz M. Effect of Group Therapy on Psychological Symptoms and Quality of Life in Turkish Patients with Breast Cancer. Asian Pac J Cancer Prev 2012; 13:5593-7. [DOI: 10.7314/apjcp.2012.13.11.5593] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|