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Hardcastle SJ, Maxwell-Smith C, Hagger MS. Predicting physical activity change in cancer survivors: an application of the Health Action Process Approach. J Cancer Surviv 2022; 16:1176-1183. [PMID: 34518960 PMCID: PMC9630182 DOI: 10.1007/s11764-021-01107-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 09/03/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE Previous research has not examined the utility of the Health Action Process Approach (HAPA) to predict physical activity (PA) change in cancer survivors. The aim of the study was to investigate the efficacy of a HAPA-based model in predicting temporal change in moderate-to-vigorous physical activity (MVPA) in cancer survivors. METHODS Participants enrolled in the Wearable Activity Technology and Action Planning (WATAAP) trial completed validated questionnaires (n = 64) to assess HAPA constructs (action and maintenance self-efficacy, outcome expectancies, action planning, risk perceptions, and intention) and wore an ActiGraph to measure PA at baseline, 12 weeks, and 24 weeks later. Data were analyzed using variance-based structural equation modeling with residualized change scores for model variables. RESULTS Consistent with predictions, changes in action self-efficacy (β = 0.490, p < 0.001, ES = 0.258) and risk perceptions (β = 0.312, p = 0.003, ES = 0.099) were statistically significant predictors of intention change over time. Changes in intention (β = 0.217, p = 0.029, ES = 0.040) and action planning (β = 0.234, p = 0.068, ES = 0.068) predicted changes in MVPA. Overall, the model accounted for significant variance in intention (R2 = 0.380) and MVPA (R2 = 0.228) change. CONCLUSIONS Changes in intention and action planning were important correlates of MVPA change over 24 weeks. Further, changes in action self-efficacy and risk perceptions predicted changes in intention. IMPLICATIONS FOR CANCER SURVIVORS interventions that foster risk perceptions and self-efficacy, strengthen intentions, and promote action planning may be effective in promoting sustained PA change in cancer survivors.
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Affiliation(s)
- Sarah J Hardcastle
- School of Health and Human Performance, Dublin City University, Dublin, Ireland.
- Institute for Health Research, The University of Notre Dame Australia, Fremantle, WA, Australia.
| | | | - Martin S Hagger
- Department of Psychological Sciences and Health Sciences Research Institute, University of California, Merced, CA, USA
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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Nixon J, Chan R, McKinnell E, Ward E, Pinkham E, Wishart L, Miller E, Brown B. Rethinking the Meaning of "Wellness" for a Person with Cancer: A Qualitative Study to Explore What Elements Constitute "Wellness". Asia Pac J Oncol Nurs 2021; 8:360-368. [PMID: 34159228 PMCID: PMC8186391 DOI: 10.4103/apjon.apjon-212] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 02/09/2021] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE This study explored what people with cancer and their family members define as wellness, and what they perceive to be the needs to support wellness during the cancer experience. METHODS This study utilized qualitative focus groups underpinned by an interpretative descriptive design. Participants included people with a cancer diagnosis having completed/currently undergoing cancer treatment, and/or family/friends. Participants were invited to share their experience and perceptions of cancer wellness, which was then mapped in relation to Hettler's six dimensions of wellness. RESULTS Twenty-six participants (16 people with cancer, ten family/friends) were involved in the process. All six dimensions of wellness were reported by the groups with 19 descriptive content categories that related to these domains. The data revealed that people with cancer and family/friends have individual and diverse meanings of wellness. Participants offered suggestions for strategies to promote wellness relating to the environment and supportive care interventions. CONCLUSIONS People with cancer and their families experience wellness individually. Cancer wellness models should consider the personal nature of wellness in relation to the six domains of wellness when developing wellness programs, including health professional access, an environment that supports wellness, the provision and access to reliable information, and support the key needs of being physically active and financial security.
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Affiliation(s)
- Jodie Nixon
- Department of Occupational Therapy, Princess Alexandra Hospital, Brisbane, Australia
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
| | - Raymond Chan
- Division of Cancer Services, Princess Alexandra Hospital, Brisbane, Australia
- School of Nursing, Queensland University of Technology, Brisbane, Australia
| | - Emma McKinnell
- Division of Cancer Services, Princess Alexandra Hospital, Brisbane, Australia
| | - Elizabeth Ward
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
- Centre for Functioning and Health Research, Metro South Health, Australia
| | - Elizabeth Pinkham
- Department of Physiotherapy, Princess Alexandra Hospital, Brisbane, Australia
| | - Laurelie Wishart
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
- Centre for Functioning and Health Research, Metro South Health, Australia
| | - Elizabeth Miller
- Division of Cancer Services, Princess Alexandra Hospital, Brisbane, Australia
| | - Bena Brown
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
- Centre for Functioning and Health Research, Metro South Health, Australia
- Department of Speech Pathology, Princess Alexandra Hospital, Brisbane, Australia
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Sira N, Lamson A, Foster CL. Relational and Spiritual Coping Among Emerging and Young Adult Cancer Survivors. J Holist Nurs 2019; 38:52-67. [PMID: 31535901 DOI: 10.1177/0898010119874983] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Cancer presents uncertainties for individuals of any age; however, emerging and young adults (EYA) are challenged to cope with developmental tasks in addition to cancer-related stressors. Guided by the double ABC-X model and biopsychosocial-spiritual framework, the current study investigates coping strategies used by this population and the role of psychological resources (perception of parental care/control and spirituality) on their coping ability. Recruited from online social media, 210 EYA cancer survivors self-reported demographic, medical information, and completed the Brief Cope scale. In addition, spirituality reliance, perceived parental care, and parental control were measured and examined in relation to coping ability. While nearly half of participants experienced positive adaptation in relation to multiple stressors, hierarchical multiple regression revealed the developmental nature of coping and indicated that higher spirituality reliance and higher degree of parental care were predictive of adaptive coping among EYA cancer survivors. Content analyses of the open-ended questions confirmed these results. In order to facilitate adaptive coping, attention must be paid to the unique biopsychosocial-spiritual and developmental needs of young cancer survivors while encouraging family support and spirituality reliance as significant tools in coping. Practical recommendations for nursing support and healthcare teams are discussed.
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Cohen JA, Shumay DM, Chesney MA, Goyal N, Barulich M, Levin AO. Survivorship Wellness: Insights from an Interdisciplinary Group-Based Survivorship Pilot Program at a Comprehensive Cancer Center. J Altern Complement Med 2019; 25:678-680. [DOI: 10.1089/acm.2019.0080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Affiliation(s)
- Jamie Alexis Cohen
- Helen Diller Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA
| | - Dianne M. Shumay
- Helen Diller Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA
| | - Margaret A. Chesney
- Osher Center for Integrative Medicine, University of California San Francisco, San Francisco, CA
| | - Neha Goyal
- Helen Diller Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA
| | - Mikela Barulich
- Helen Diller Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA
| | - Anna O. Levin
- Helen Diller Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA
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Le Boutillier C, Archer S, Barry C, King A, Mansfield L, Urch C. Conceptual framework for living with and beyond cancer: A systematic review and narrative synthesis. Psychooncology 2019; 28:948-959. [PMID: 30812066 PMCID: PMC6594071 DOI: 10.1002/pon.5046] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 02/22/2019] [Accepted: 02/25/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The concept of living with and beyond cancer is now emerging in policy and literature. Rather than viewing this notion simply as a linear timeline, developing an agreed understanding of the lived experience of people affected by cancer will aid the development of person-centred models of care. METHODS A systematic review was conducted. The review question was "What does the term 'living with and beyond cancer' mean to people affected by cancer?" The protocol for the review was preregistered in the PROSPERO database (PROSPERO CRD42017059860). All included studies were qualitative, so narrative synthesis was used to integrate descriptions and definitions of living with and beyond cancer into an empirically based conceptual framework. RESULTS Out of 2345 papers that were identified and 180 that were reviewed, a total of 73 papers were included. The synthesis yielded three interlinked themes: Adversity (realising cancer), Restoration (readjusting life with cancer), and Compatibility (reconciling cancer), resulting in the ARC framework. CONCLUSIONS Three themes describe the experience of living with and beyond cancer: adversity, restoration, and compatibility. The ARC framework provides an empirically informed grounding for future research and practice in supportive cancer care for this population.
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Affiliation(s)
- Clair Le Boutillier
- Department of Surgery, Cardiovascular and CancerImperial College Healthcare NHS TrustLondonUK
| | - Stephanie Archer
- Department of Surgery & Cancer, Faculty of MedicineImperial College LondonLondonUK
- Public Health and Primary CareUniversity of Cambridge, Strangeways Research LaboratoryCambridgeUK
| | - Claire Barry
- Department of Surgery, Cardiovascular and CancerImperial College Healthcare NHS TrustLondonUK
| | - Alex King
- Department of Surgery, Cardiovascular and CancerImperial College Healthcare NHS TrustLondonUK
| | | | - Catherine Urch
- Department of Surgery, Cardiovascular and CancerImperial College Healthcare NHS TrustLondonUK
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Yan AF, Stevens P, Holt C, Walker A, Ng A, McManus P, Basen-Enguist K, Weinhardt LS, Underwood SM, Asan O, Wang MQ. Culture, identity, strength and spirituality: A qualitative study to understand experiences of African American women breast cancer survivors and recommendations for intervention development. Eur J Cancer Care (Engl) 2019; 28:e13013. [PMID: 30761637 DOI: 10.1111/ecc.13013] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 01/08/2019] [Accepted: 01/17/2019] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Despite advancements in cancer treatment, racial disparities in breast cancer survival persist, with African American women experiencing lower survival rates and poorer quality of life than non-Hispanic White women. Using a social cognitive model of restorative well-being as a framework, this qualitative study sought: (a) to examine strength- and culture-related factors associated with African American female breast cancer survivors' cancer coping and post-treatment experiences and (b) to make recommendations for culturally sensitive intervention. METHODS Eight focus groups occurred with a total of 40 local African American breast cancer survivors. Focus groups were audiotaped and transcribed verbatim. Framework analyses were used to identify themes. NVivo qualitative analysis software-managed data. RESULTS Two major themes emerged from the focus group discussions: (a) God enables breast cancer survivorship and works every day in our lives and (b) the healthiest thing about us is that we are strong African American women. Recommendations for intervention planning and implementation were made towards intervention structure, content development and language framing in a local context. CONCLUSION Findings suggest a need for community-based participatory survivorship interventions that are culturally and spiritually consonant and peer-based. Such interventions may respond to the cancer-related and personal needs of the target population.
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Affiliation(s)
- Alice F Yan
- Joseph J. Zilber School of Public Health, University of Wisconsin Milwaukee, Milwaukee, Wisconsin
| | - Patricia Stevens
- Professor Emerita, College of Nursing, University of Wisconsin Milwaukee, Milwaukee, Wisconsin
| | - Cheryl Holt
- Department of Behavioral and Community Health, School of Public Health, University of Maryland College Park, College Park, Maryland
| | - Alonzo Walker
- Cancer Center, Froedtert & The Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Alexander Ng
- Exercise Science Program, College of Health Sciences, Marquette University, Milwaukee, Wisconsin
| | | | - Karen Basen-Enguist
- Department of Behavioral Science, Division of OVP, Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Lance S Weinhardt
- Joseph J. Zilber School of Public Health, University of Wisconsin Milwaukee, Milwaukee, Wisconsin
| | - Sandra M Underwood
- College of Nursing, University of Wisconsin Milwaukee, Milwaukee, Wisconsin
| | - Onur Asan
- School of Systems and Enterprises, Stevens Institute of Technology, Hoboken, New Jersey
| | - Min Qi Wang
- Department of Behavioral and Community Health, School of Public Health, University of Maryland College Park, College Park, Maryland
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Llewellyn A, Howard C, McCabe C. An exploration of the experiences of women treated with radiotherapy for breast cancer: Learning from recent and historical cohorts to identify enduring needs. Eur J Oncol Nurs 2019; 39:47-54. [PMID: 30850138 DOI: 10.1016/j.ejon.2019.01.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 01/08/2019] [Accepted: 01/10/2019] [Indexed: 01/10/2023]
Abstract
PURPOSE Recent decades have seen improvements in UK breast cancer services and treatments. Despite this, it is recognised that a range of patients' psychological and emotional needs remain unmet, both at the time of treatment and into survivorship. Using data from two distinct cohorts of women: those treated with radiotherapy for breast cancer historically, and women treated more recently, this study sought to identify and explore those needs and concerns that have continued to persist, despite advances in treatment and care. METHOD Data from N = 13 semi-structured interviews were analysed using Interpretative Phenomenological Analysis. An heuristic framework was applied to extract themes common to both participant cohorts. RESULTS Participants' data evidenced an enduring vulnerability amongst cancer patients that has not diminished with new treatment pathways. Themes common to both cohorts highlighted the ongoing importance of personal factors such as resilience, and strategies to help retain a sense of normality. Extrinsic support was important too, especially high quality communication by healthcare professionals and having access to ongoing emotional support from others, particularly when active treatment ends. Participants' suggestions for future service development included the provision of ongoing continuity of care and greater access to emotional support services. CONCLUSIONS This study highlights the psychological needs and concerns of breast cancer patients that have persisted, despite the many advances in patient-centred care. Findings are of value to nurses and other healthcare professionals in highlighting the ongoing importance of recognising, acknowledging and addressing patients' concerns and needs, even within current cancer care pathways.
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Affiliation(s)
- Alison Llewellyn
- Royal United Hospitals Bath NHS Foundation Trust, Combe Park, Bath, BA1 3NG, UK; Department of Nursing and Midwifery, University of the West of England, Glenside Campus, Bristol, BS16 1DD, UK.
| | - Claire Howard
- Royal United Hospitals Bath NHS Foundation Trust, Combe Park, Bath, BA1 3NG, UK
| | - Candida McCabe
- Royal United Hospitals Bath NHS Foundation Trust, Combe Park, Bath, BA1 3NG, UK; Department of Nursing and Midwifery, University of the West of England, Glenside Campus, Bristol, BS16 1DD, UK; Florence Nightingale Foundation, 11-13 Cavendish Square, London, UK
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Raque-Bogdan TL, Hoffman MA, Joseph EC, Ginter AC, White R, Schexnayder K, Piontkowski S. Everything Is More Critical: A Qualitative Study of the Experiences of Young Breast Cancer Survivors. COUNSELING AND VALUES 2018. [DOI: 10.1002/cvj.12089] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
| | - Mary Ann Hoffman
- Department of Counseling and Higher Education; University of Maryland, College Park
| | | | - Amanda C. Ginter
- Department of Family Studies and Community Development; Towson University
| | - Rachel White
- School of Medicine; University of Maryland; Baltimore
| | - Kelci Schexnayder
- Department of Environmental Science and Policy; University of Maryland, College Park
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Knowledge, attitudes, and practice of oncologists and oncology health care providers in promoting physical activity to cancer survivors: an international survey. Support Care Cancer 2018; 26:3711-3719. [PMID: 29740694 DOI: 10.1007/s00520-018-4230-1] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 04/26/2018] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To investigate knowledge, attitudes, and practices of oncologists towards physical activity (PA) in cancer survivors, and the association between oncologists' own PA behavior and PA promotion. METHODS Oncologists (n = 123) completed a survey based on the Theory of Planned Behavior (TPB). Participants reported PA promotion behavior, PA involvement, attitudes, intentions, social norm, perceived behavioral control (PBC), and confidence and knowledge of exercise prescription. Structural equation modeling (SEM) evaluated these associations. RESULTS Less than half of oncologists reported regularly promoting PA to patients (46%), with 20% providing written information and 23% referrals. Only 26% were physically active. TPB SEM pathways explained 54.6% of the variance in PA promotion (comparative fit index (CFI) = 0.905, standardized root mean square residual (SRMR) = 0.040). Social norm was not only the significant pathway to intention but also a significant indirect pathway to PA promotion (p = 0.007). Confidence to promote PA, PBC, and intentions were direct significant pathways to PA promotion (p < 0.05). Exploratory SEM pathways explained 19.6% of the variance of PA behavior, which in turn explained 13.1% social norm, 10.7% attitude, 10.0% confidence to recommend, and 17.8% PA promotion behavior (CFI = 0.921, SRMR = 0.076). Instrumental attitude was a direct significant pathway to PA behavior (p = 0.001). PA behavior was a direct significant pathway to social norms, attitude, confidence to recommend, and PA promotion (p < 0.05). CONCLUSIONS Oncologists reported a modest ability to promote PA, low PA promotion rates, and limited knowledge of exercise prescription. Patient physical activity promotion may be improved through strategies that increase oncologists' PBC, confidence, and their own personal PA participation.
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Mrig EH, Spencer KL. Political economy of hope as a cultural facet of biomedicalization: A qualitative examination of constraints to hospice utilization among U.S. end-stage cancer patients. Soc Sci Med 2018; 200:107-113. [PMID: 29421457 DOI: 10.1016/j.socscimed.2018.01.033] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 01/22/2018] [Accepted: 01/23/2018] [Indexed: 12/21/2022]
Abstract
A growing body of social science literature is devoted to describing processes of biomedicalization. The issue of biomedicalization is especially relevant for individuals suffering from end-stage cancer and hoping that aggressive end-of-life interventions, which are riddled with uncertainty around quantity or quality of life, will produce a 'cure'. To examine hospice underutilization among end-stage cancer patients, we apply the anthropological concept 'political economy of hope,' which describes how personal and collective 'hope' is associated with the political and economic structures that produce biomedicalization processes. Previous studies have examined hospice underutilization among end-stage cancer patients and have identified barriers stemming from patient and physician characteristics or health insurance reimbursement policies. Yet, these studies do not provide an organized synthesis of how barriers articulate, how they are part of the longitudinal decision-making process, or describe the sociocultural context surrounding hospice care enrollment decisions. This paper focuses on US-specific mechanisms and is based on qualitative, in-depth, interviews with physicians at an academic hospital (N = 24). We find that hospice underutilization results from a web of interconnected constraints surrounding end-stage cancer patients. Our research reveals how hospice care contradicts the political and economic structures associated with end-stage cancer care and illustrates how end-stage cancer patients are transformed into a form of biovalue, a fundamental commodity sustaining the political economy of hope.
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Park E, Yoon J, Choi EK, Kim IR, Kang D, Lee SK, Lee JE, Nam SJ, Ahn JS, Visser A, Cho J. A train the trainer program for healthcare professionals tasked with providing psychosocial support to breast cancer survivors. BMC Cancer 2018; 18:45. [PMID: 29306328 PMCID: PMC5756444 DOI: 10.1186/s12885-017-3965-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Accepted: 12/11/2017] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The objective of this study is to develop, implement, and evaluate a training program for healthcare providers to improve ability to provide psychosocial support to breast cancer survivors in Korea. METHODS Based on a needs assessment survey and in-depth interviews with breast cancer survivors, a multidisciplinary team developed two-day intensive training program as well as education materials and counseling notes. Participants' overall satisfaction was evaluated after the training. RESULTS The training program included a total of 16 lectures held over the course of seven sessions. Forty-one nurses and 3 social workers participated in the training program. Mean age was 37.5(± 6.4) years, and on average, they had 11.1 (± 5.6) years of experience. Participants' overall satisfaction was good as following: program contents (4.04), trainee guidebook (3.82), location and environment (4.10), and program organization (4.19). Among the participants, 31 (70.4%) received certification after submitting real consultation cases after the training. CONCLUSION Two day intensive training can provide a comprehensive and coordinated education to healthcare professionals for implementing survivorship care with an emphasis on psychosocial support. Furthermore, the program should resume as a periodic continuing education course for healthcare providers. Similar education for graduate students in oncology nursing would be beneficial.
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Affiliation(s)
- Eunyoung Park
- College of Nursing, Chungnam National University, Daejeon, South Korea
| | - Junghee Yoon
- Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, South Korea
| | - Eun-Kyung Choi
- Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Im Ryung Kim
- Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Danbee Kang
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, 81 Irwon-ro, Gangnam, Seoul, 06351, South Korea
| | - Se-Kyung Lee
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jeong Eon Lee
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Seok Jin Nam
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jin Seok Ahn
- Division of Hematology/Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | | | - Juhee Cho
- Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, South Korea. .,Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. .,Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, 81 Irwon-ro, Gangnam, Seoul, 06351, South Korea. .,Department of Epidemiology and Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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de Oliveira RAA, da Conceição VM, Araujo JS, Zago MMF. Concept analysis of cancer survivorship and contributions to oncological nursing. Int J Nurs Pract 2017; 24. [DOI: 10.1111/ijn.12608] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 09/05/2017] [Accepted: 09/13/2017] [Indexed: 01/02/2023]
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Barnard A, Clur L, Joubert Y. Returning to work: The cancer survivor's transformational journey of adjustment and coping. Int J Qual Stud Health Well-being 2016; 11:32488. [PMID: 27852419 PMCID: PMC5112348 DOI: 10.3402/qhw.v11.32488] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/20/2016] [Indexed: 11/14/2022] Open
Abstract
The aim of this study was to explore cancer survivors' return to work (RTW) experience with a specific focus on the adjustment and coping process underlying their journey. The study was conducted in the Southern Cape, South Africa, with eight cancer survivors having returned to work following successful treatment of various types of cancer. Unstructured interviews were conducted and data were analysed following the principles of hermeneutic phenomenological reflection and analysis. Four themes emerged, representing the changing adjustment responses and coping during the RTW journey. Participants evolve from being overwhelmed with emotions and applying avoidant coping to seeking understanding and positive affectivity in their attempt to comprehend the reality of their situation. Participants' external locus of control change to a more active approach and problem-solving orientation, demonstrating a need to take control and responsibility. Ultimately, adjustment and coping become most constructive when cancer survivors resolve to re-assess life and self through meaning-making, resulting in renewed appreciation of life, appropriate life style changes, and regained confidence in their relational role. A process perspective is proposed to facilitate an understanding of, and working with, cancer survivors' transition through the RTW journey towards optimal coping phases.
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Affiliation(s)
- Antoni Barnard
- Department of Industrial and Organisational Psychology, University of South Africa, Pretoria, South Africa;
| | - Loraine Clur
- Employee Wellness Consultant, Southern Cape, South Africa
| | - Yvonne Joubert
- Department of Human Resources Management, University of South Africa, Pretoria, South Africa
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Polley MJ, Jolliffe R, Boxell E, Zollman C, Jackson S, Seers H. Using a Whole Person Approach to Support People With Cancer: A Longitudinal, Mixed-Methods Service Evaluation. Integr Cancer Ther 2016; 15:435-445. [PMID: 27060342 PMCID: PMC5739159 DOI: 10.1177/1534735416632060] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 12/23/2015] [Accepted: 01/14/2016] [Indexed: 12/29/2022] Open
Abstract
Introduction. Improved models of care are needed to meet all the support needs of people with cancer, which encompass psychological, emotional, physical, spiritual, sexual, occupational, social and existential needs. The aim of this article is to (a) evaluate short- and long-term impacts of using a whole person approach to support people with cancer on the Living Well with the Impact of Cancer Course (LWC) and (b) use these data to inform strategic decisions about future service provision at Penny Brohn UK. Methods. Longitudinal mixed-methods service evaluation (n = 135). Data collected included health-related quality of life (HRQoL) (FACIT-SpEx); Concerns (types and severity–MYCaW); lifestyle behavior (bespoke questionnaire), and participants’ experiences over 12 months postcourse. Results. Statistically and clinically significant improvements from baseline to 12 months in severity of MYCaW Concerns (n = 64; P < .000) and mean total HRQoL (n = 66; P < .000). The majority of MYCaW concerns were “psychological and emotional” and about participants’ well-being. Spiritual, emotional, and functional well-being contributed most to HRQoL improvements at 12 months. Barriers to maintaining healthy lifestyle changes included lack of support from family and friends, time constraints, and returning to work. Three to 6 months postcourse was identified as the time when more support was most likely to be needed. Conclusions. Using a whole person approach for the LWC enabled the needs of participants to be met, and statistically and clinically significant improvements in HRQoL and MYCaW Concerns were reported. Qualitative data analysis explored how experiencing whole person support enabled participants to make and sustain healthy lifestyle changes associated with improved survivorship. Barriers experienced to making health behavior change were also identified. These data then informed wider and more person-centered clinical provision to increase the maintenance of positive long-term behavior changes. Comparison of whole person approaches to cancer treatment and support and standard care are now urgently needed.
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Cheung SY, Delfabbro P. Are you a cancer survivor? A review on cancer identity. J Cancer Surviv 2016; 10:759-71. [DOI: 10.1007/s11764-016-0521-z] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 01/29/2016] [Indexed: 11/27/2022]
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Makhoul R, Alva S, Wilkins KB. Surveillance and Survivorship after Treatment for Colon Cancer. Clin Colon Rectal Surg 2015; 28:262-70. [PMID: 26648797 PMCID: PMC4655110 DOI: 10.1055/s-0035-1564435] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Colorectal cancer is the third most common cancer diagnosed in the United States. Majority of patients have localized disease that is amenable to curative resection. Disease recurrence remains a major concern after resection. In addition, patients are at an increased risk for developing a second or metachronous colon cancer. The principal goal of surveillance following treatment of colon cancer is to improve disease-free and overall survival. Survivorship is a distinct phase following surveillance to help improve quality of life and promote longevity.
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Affiliation(s)
- Rami Makhoul
- Rutger-Robert Wood Johnson University Hospital, New Brunswick, New Jersey
| | - Suraj Alva
- Rutger-Robert Wood Johnson University Hospital, New Brunswick, New Jersey
| | - Kirsten B. Wilkins
- Rutger-Robert Wood Johnson University Hospital, New Brunswick, New Jersey
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Tichelli A, Rovó A. Survivorship after allogeneic transplantation-management recommendations for the primary care provider. Curr Hematol Malig Rep 2015; 10:35-44. [PMID: 25667128 DOI: 10.1007/s11899-014-0243-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Prognosis after allogeneic hematopoietic stem cell transplantation (HSCT) has greatly improved. Therefore, long-term survivorship becomes an important issue. A number of malignant and nonmalignant late effects can cause substantial morbidity, with considerable impact on health and quality of life. The main factors responsible for late effects after HSCT are total body irradiation-based conditioning and chronic graft-versus-host disease and its treatment. The knowledge on late effects serves as guidance for surveillance and management decision. Aftercare includes screening and counseling for prevention and treatment of late complications. The care of HSCT recipients tends with time to be transferred from the transplant center back to the primary care provider, who might not be however familiar with the unique needs of long-term survivors. A broad expertise is needed for the post-transplant management; therefore, transplant centers together with primary care providers should ensure complementary care delivery. Standardized follow-up guidelines on late effects represent the best tool to guaranty good management of long-term survivors. Distribution, broad promotion, and applications of these guidelines are therefore needed.
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Affiliation(s)
- André Tichelli
- Division of Hematology, University Hospital of Basel, Petersgraben 4, 4031, Basel, Switzerland,
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Recklitis CJ, Blackmon JE, Chang G. Screening young adult cancer survivors for distress with the Distress Thermometer: Comparisons with a structured clinical diagnostic interview. Cancer 2015; 122:296-303. [PMID: 26457669 DOI: 10.1002/cncr.29736] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 09/11/2015] [Accepted: 09/22/2015] [Indexed: 11/07/2022]
Abstract
BACKGROUND The validity of the Distress Thermometer (DT) as a screen for psychological distress in young adult cancer survivors was assessed by comparing it with the results of a psychiatric diagnostic interview, the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) (SCID), to evaluate the accuracy of the DT and identify optimal cutoff scores for this population. METHODS A total of 247 survivors aged 18 to 40 years completed the DT and SCID. Based on the SCID, participants were classified as having: 1) ≥ 1 SCID diagnoses; 2) significant symptoms, but no SCID diagnosis; or 3) no significant SCID symptoms. Receiver operating characteristic analyses determined the sensitivity and specificity of all possible DT cutoff scores for detecting survivors with a SCID diagnosis, and subsequently for survivors with significant SCID symptoms or a SCID diagnosis. RESULTS The recommended DT cutoff score of ≥5 failed to identify 31.81% of survivors with a SCID diagnosis (sensitivity of 68.18% and specificity of 78.33%), and 32.81% of survivors with either significant SCID symptoms or a SCID diagnosis. No alternative DT cutoff score met the criteria for acceptable sensitivity (≥85%) and specificity (≥75%). CONCLUSIONS The DT does not reliably identify young adult cancer survivors with psychiatric problems identified by a "gold standard" structured psychiatric interview. Therefore, the DT should not be used as a stand-alone psychological screen in this population. Cancer 2016;122:296-303. © 2015 American Cancer Society.
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Affiliation(s)
- Christopher J Recklitis
- Dana-Farber Cancer Institute, Perini Family Survivors' Center, Boston, Massachusetts.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Jaime E Blackmon
- Dana-Farber Cancer Institute, Perini Family Survivors' Center, Boston, Massachusetts
| | - Grace Chang
- Department of Psychiatry, VA Boston Healthcare System, Brockton, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
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Roaldsen BL, Sørlie T, Lorem GF. Cancer survivors’ experiences of humour while navigating through challenging landscapes – a socio‐narrative approach. Scand J Caring Sci 2015; 29:724-33. [DOI: 10.1111/scs.12203] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Accepted: 11/05/2014] [Indexed: 11/26/2022]
Affiliation(s)
- Bente Lisbet Roaldsen
- Department of Clinical Medicine Faculty of Health Sciences UiT The Arctic University of Norway Tromsø Norway
- Surgery Cancer and Women's Health Clinic University Hospital of North Norway Tromsø Norway
| | - Tore Sørlie
- Department of Clinical Medicine Faculty of Health Sciences UiT The Arctic University of Norway Tromsø Norway
- Department of General Psychiatry University Hospital of North Norway Tromsø Norway
| | - Geir F. Lorem
- Department of Health and Caring Sciences Faculty of Health Sciences UiT The Arctic University of Norway Tromsø Norway
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20
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Baker AM, Smith KC, Coa KI, Helzlsouer KJ, Caulfield LE, Peairs KS, Shockney LD, Klassen AC. Clinical care providers' perspectives on body size and weight management among long-term cancer survivors. Integr Cancer Ther 2015; 14:240-8. [PMID: 25716349 DOI: 10.1177/1534735415572882] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE To examine clinical care providers' perspectives on cancer survivors' body size and weight management. STUDY DESIGN In-depth, semi-structured, qualitative interviews. METHODS Interviews were conducted with 33 providers (eg. oncologists, surgeons, primary care providers, nurses, dietitians) across academic and community clinical settings. They were transcribed, coded, and analyzed thematically using constant comparative analysis. RESULTS Providers conceptualized weight in relation to acute treatment, cancer outcomes, or overall health/comorbidities. These patterns were reflected in their reported framing of weight discussions, although providers indicated that they counsel patients on weight to varying extents. Perspectives differed based on professional roles and patient populations. Providers reported that survivors are motivated to lose weight, particularly due to comorbidity concerns, but face numerous barriers to doing so. CONCLUSION Providers described survivor-level and capacity-level factors influencing survivors' weight management. Differences by provider type highlighted the role of provider knowledge, attitudes, and beliefs in clinical encounters. Opportunities for research and intervention include developing and disseminating evidence-based clinical resources for weight management among cancer survivors, addressing capacity barriers, and exploring communication strategies at interpersonal and population levels.
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Affiliation(s)
- Allison M Baker
- Drexel University School of Public Health, Philadelphia, PA, USA
| | - Katherine C Smith
- The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kisha I Coa
- The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kathy J Helzlsouer
- The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA Mercy Medical Center, Baltimore, MD, USA
| | - Laura E Caulfield
- The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | - Ann C Klassen
- Drexel University School of Public Health, Philadelphia, PA, USA The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Jones WC, Parry C, Devine S, Main DS, Okuyama S. Understanding distress in posttreatment adult leukemia and lymphoma survivors: a lifespan perspective. J Psychosoc Oncol 2015; 33:142-62. [PMID: 25671408 DOI: 10.1080/07347332.2014.1002658] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Using in-depth interviews, this paper explores the nature and sources of cancer-specific distress among 51 posttreatment adult leukemia and lymphoma survivors (LLS), focusing on the role of lifespan stage in shaping reported stressors. LLS (all ages) reported physical aftereffects of cancer treatment, with reported sources of emotional and financial distress varying by lifespan stage. Young adult survivors (18-39) reported a greater number of distress sources. Distress may persist up to 4 years posttreatment, particularly among younger LLS, who appear to be at greater risk of distress in multiple domains.
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Affiliation(s)
- Whitney C Jones
- a Colorado School of Public Health, University of Colorado Denver , Aurora , CO , USA
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DeNysschen C, Brown JK, Baker M, Wilding G, Tetewsky S, Cho MH, Dodd MJ. Healthy Lifestyle Behaviors of Breast Cancer Survivors. Clin Nurs Res 2014; 24:504-25. [PMID: 25349070 DOI: 10.1177/1054773814553298] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this secondary analysis was to describe the extent to which women with breast cancer, who participated in a randomized control trial on exercise, adopted American Cancer Society (ACS) guidelines for healthy lifestyle behaviors. Women in the study exercised during cancer treatment and for 6 months after completion of treatment. The sample included 106 women, average age 50.7 years (SD = 9.6). Adherence to guidelines for 5 servings of fruits and vegetables ranged from 36% (n = 28) to 39% (n = 36). Adherence with alcohol consumption guidelines was 71% (n = 28) to 83% (n = 30). Adherence with meeting a healthy weight ranged from 52% (n = 33) to 61% (n = 31). Adherence with physical activity guidelines ranged from 13% (n = 30) to 31% (n = 35). Alcohol and healthy weight guidelines were followed by more than half of the participants, but physical activity and dietary guidelines were followed by far fewer women. Further prospective clinical studies are indicated to determine whether interventions are effective in producing a healthy lifestyle in cancer survivors.
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Affiliation(s)
| | | | - Mark Baker
- The State University of New York, Buffalo, USA
| | | | | | - Maria H Cho
- California State University, East Bay, Hayward, USA
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Martin LA, Moye J, Street RL, Naik AD. Reconceptualizing cancer survivorship through veterans' lived experiences. J Psychosoc Oncol 2014; 32:289-309. [PMID: 24611460 DOI: 10.1080/07347332.2014.897782] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This study assessed the biopsychosocial impact of cancer on Veteran older adult survivors by garnering their accounts of their illness experiences. A narrative analysis of 73 cancer diagnosis and treatment stories reveals five “paths” Veterans are taking 18 months postdiagnosis. These paths indicate that cancer survivorship cannot be conceptualized as a one-size-fits-all experience but rather is a process of Veterans understanding and making sense of the effects of cancer on their lives. Our future goal is to develop a screening tool to help clinicians identify a patient's “path" to tailor survivorship care to meet specific needs.
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Affiliation(s)
- Lindsey Ann Martin
- a Michael E. DeBakey VA Medical Center, Health Services Research & Development , Houston , TX , USA
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24
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Dittus KL, Sprague BL, Pace CM, Dulko DA, Pollack LA, Hawkins NA, Geller BM. Primary Care Provider Evaluation of Cancer Survivorship Care Plans Developed for Patients in their Practice. ACTA ACUST UNITED AC 2014; 2:163. [PMID: 26451385 PMCID: PMC4595165 DOI: 10.4172/2329-9126.1000163] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Survivorship care plans (SCP), which describe a cancer survivor's diagnosis, treatment and follow-up, are recommended. The study objective was to evaluate primary care providers' (PCP) responses to SCPs developed for breast and colorectal cancer survivors in their practice and to determine whether PCP response to the SCPs varied according to characteristics of the practitioner and their practice. METHOD SCPs were created using the Journey Forward® Care Plan for breast and colorectal cancer patients in rural and urban settings. The SCP and a survey were sent to PCPs. PARTICIPANTS Primary care physicians. MAIN MEASURES Attitudes regarding survivorship care plans. RESULTS Thirty-nine (70.9% response rate) surveys were completed. Most felt the SCP was useful (90%), that it enhanced understanding (75%) and that detail was sufficient (>80%). However, 15% disagreed that the care plan helped them understand their role, a perception especially prevalent among PCPs in the rural setting. Among PCPs with ≤ 18 years in practice, 95% agreed that the SCP would improve communication with patients, contrasted with 60% of those with >21 years in practice. The most common barrier to providing follow-up care was limited access to survivors. CONCLUSIONS While SCPs appear to improve PCPs understanding of a cancer diagnosis and treatment, clear delineation of each provider's role in follow-up care is needed. Additional detail on which tests are needed and education on late and long term effects of cancer may improve coordination of care.
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Affiliation(s)
- Kim L Dittus
- Hematology/Oncology Division, University of Vermont, College of Medicine, Burlington, USA
| | - Brian L Sprague
- Department of Surgery and Office of Health Promotion Research, University of Vermont, Burlington, USA
| | - Claire M Pace
- Department of Radiation Oncology, Dartmouth Medical School, Lebanon, USA
| | - Dorothy A Dulko
- Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Lori A Pollack
- Centers for Disease Control and Prevention, Division of Cancer Prevention and Control, Atlanta, USA
| | - Nikki A Hawkins
- Centers for Disease Control and Prevention, Division of Cancer Prevention and Control, Atlanta, USA
| | - Berta M Geller
- Family Medicine and Radiology Departments, University of Vermont, College of Medicine, Burlington, USA
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Mayer DK, Gerstel A, Walton AL, Triglianos T, Sadiq TE, Hawkins NA, Davies JM. Implementing survivorship care plans for colon cancer survivors. Oncol Nurs Forum 2014; 41:266-73. [PMID: 24769591 PMCID: PMC4570231 DOI: 10.1188/14.onf.266-273] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To evaluate the feasibility, usability, and satisfaction of a survivorship care plan (SCP) and identify the optimum time for its delivery during the first 12 months after diagnosis. DESIGN Prospective, descriptive, single-arm study. SETTING A National Cancer Institute-designated cancer center in the southeastern United States. SAMPLE 28 nonmetastatic colon cancer survivors within the first year of diagnosis and their primary care physicians (PCPs). METHODS Regular screening identified potential participants who were followed until treatment ended. An oncology certified nurse developed the JourneyForward™ SCP, which then was delivered to the patient by the oncology nurse practitioner (NP) during a routine follow-up visit and mailed to the PCP. MAIN RESEARCH VARIABLES Time to complete, time to deliver, usability, and satisfaction with the SCP. FINDINGS During one year, 75 patients were screened for eligibility, 34 SCPs were delivered, and 28 survivors and 15 PCPs participated in the study. It took an average of 49 minutes to complete a surgery SCP and 90 minutes to complete a surgery plus chemotherapy SCP. Most survivors identified that before treatment ended or within the first three months was the preferred time to receive an SCP. CONCLUSIONS The SCPs were well received by the survivors and their PCPs, but were too time and labor intensive to track and complete. IMPLICATIONS FOR NURSING More work needs to be done to streamline processes that identify eligible patients and to develop and implement SCPs. Measuring outcomes will be needed to demonstrate whether SCPs are useful or not.
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Affiliation(s)
- Deborah K Mayer
- School of Nursing, University of North Carolina in Chapel Hill
| | - Adrian Gerstel
- School of Nursing, University of North Carolina in Chapel Hill
| | | | | | - Teresa E Sadiq
- University of North Carolina Cancer Hospital in Chapel Hill
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Brunet J, Love C, Ramphal R, Sabiston CM. Stress and physical activity in young adults treated for cancer: the moderating role of social support. Support Care Cancer 2013; 22:689-95. [PMID: 24203086 DOI: 10.1007/s00520-013-2023-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Accepted: 10/18/2013] [Indexed: 12/21/2022]
Abstract
PURPOSE The first objective of the current investigation was to explore the relationships between adolescents and young adults' (AYA) experiences of stress and social support resources (i.e., perceived social support and support group involvement) following treatment for cancer. The second objective was to examine the relationship between stress and physical activity behavior, and test if social support resources are moderators of this relationship. METHODS AYAs (N = 64; mean age = 28.8 years, standard deviation (SD) = 5.5 years; mean time since diagnosis = 2.9, SD = 3.0 years) completed an online questionnaire. Data were analyzed using correlation and hierarchical multivariate linear regression analyses. RESULTS Stress was negatively related to perceived social support, support group involvement, and physical activity behavior. Support group involvement, but not perceived social support, moderated the association between stress and physical activity behavior. CONCLUSIONS Findings suggest establishing support groups, as part of psychosocial rehabilitation services, may help to reduce stress and promote an active lifestyle in AYAs treated for cancer.
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Affiliation(s)
- Jennifer Brunet
- School of Human Kinetics, University of Ottawa, 125 University Pr., Montpetit Hall Room 339, Ottawa, ON, K1N 6N5, Canada,
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27
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Developing a nurse-led survivorship service for patients with lymphoma. Eur J Oncol Nurs 2013; 17:521-7. [DOI: 10.1016/j.ejon.2013.03.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Revised: 02/25/2013] [Accepted: 03/01/2013] [Indexed: 11/18/2022]
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Skeath P, Norris S, Katheria V, White J, Baker K, Handel D, Sternberg E, Pollack J, Groninger H, Phillips J, Berger A. The nature of life-transforming changes among cancer survivors. QUALITATIVE HEALTH RESEARCH 2013; 23:1155-67. [PMID: 23863850 PMCID: PMC3807572 DOI: 10.1177/1049732313499074] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Some cancer survivors report positive subjective changes they describe as "life transforming." We used a grounded theory approach to identify the content, underlying process, and identifying characteristics of self-defined "life-transforming" changes (LTCs) reported by 9 cancer survivors. To actualize their hopes for improvement, participants used a self-guided process centered on pragmatic action: researching options, gaining experience, and frankly evaluating results. Many participants discovered unanticipated personal abilities and resources, and those became highly useful in coping with other challenges apart from cancer. This made the increased personal abilities and resources "life transforming" rather than being substantially limited to reducing cancer-related problems. The action-oriented features and processes of LTCs seemed to be more fully described by experiential learning theory than by posttraumatic growth and coping. Supportive intervention to facilitate positive change processes could decrease suffering and enhance positive psychosocial and spiritual outcomes for cancer survivors.
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Affiliation(s)
- Perry Skeath
- Department of Health and Human Services, Bethesda, Maryland, USA.
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Glasser M, Nielsen K, Smith SN, Gray C. Psychosocial needs of rural survivors of cancer and their partners. J Psychosoc Oncol 2013; 31:319-33. [PMID: 23656258 DOI: 10.1080/07347332.2013.778935] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
It is important to understand the psychosocial needs of rural survivors of cancer to better serve this group. Survivors and partners filled out a pre-tested survey addressing general and mental health, quality of life and demographics. Twenty-nine survivors and 15 partners responded. Over 50% of both groups were at-risk for depression; 34% of the cancer survivors had some type of psychosocial problem requiring assistance. Areas to be targeted for psychosocial interventions for rural survivors include: management of side effects/complications of treatment; adjustment to changes in quality of life; emotional support; cancer impact on social relationships; uncertainty reduction.
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Affiliation(s)
- Michael Glasser
- National Center for Rural Health Professions, University of Illinois College of Medicine-Rockford, Rockford, IL 61107, USA.
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30
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Parelkar P, Thompson NJ, Kaw CK, Miner KR, Stein KD. Stress Coping and Changes in Health Behavior Among Cancer Survivors: A Report from the American Cancer Society's Study of Cancer Survivors-II (SCS-II). J Psychosoc Oncol 2013; 31:136-52. [DOI: 10.1080/07347332.2012.761322] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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31
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Hoffman MA, Lent RW, Raque-Bogdan TL. A Social Cognitive Perspective on Coping With Cancer. COUNSELING PSYCHOLOGIST 2012. [DOI: 10.1177/0011000012461378] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
With increases in the number of cancer survivors, many persons now experience cancer as a chronic disease followed by adaptation to a new reality of what is normal in their lives. In response, cancer survivorship researchers have begun attending to the multidimensional needs of survivors, including the need to promote optimal psychological adaptation and health. Theoretical models of well-being that account for the complexity of survivorship issues are needed. We present a social cognitive model of restorative well-being as a framework for reviewing recent research on coping with early stage adult cancer (i.e., stages I and II) and optimizing post-treatment adjustment. We focus on research on cancer-related coping strategies, efficacy beliefs, personality traits, and environmental supports, which have been linked to adjustment outcomes and which may inform psychosocial interventions. By grounding this research in a theoretical base, we highlight the potential for counseling psychologists’ contributions to cancer survivorship research.
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Mayer DK, Gerstel A, Leak AN, Smith SK. Patient and provider preferences for survivorship care plans. J Oncol Pract 2012; 8:e80-6. [PMID: 23181005 PMCID: PMC3396836 DOI: 10.1200/jop.2011.000401] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2011] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Survivorship care plans (SCPs) are tools used to assist in the transition from treatment to surveillance cancer care. However, few studies have investigated survivor and provider preferences regarding SCPs. Our purpose was to explore survivor and primary care provider preferences regarding content, format, and delivery of SCPs. METHODS Focus groups and provider interviews were performed in 2010. Five different templates were presented to study participants for their feedback. Each SCP included a treatment summary, surveillance schedule, and care plan for the same fictitious patient. Sessions were transcribed, and field notes taken. RESULTS Four focus groups (n = 29 survivors) and five primary care providers participated. No cancer survivors had ever received a written SCP. We found clear preferences for the Journey Forward format (with some modifications) and face-to-face delivery (print or electronic) to the survivor by his or her oncologist just before or soon after completion of treatment. Primary care providers preferred an abbreviated version. CONCLUSION Written SCPs were endorsed by all patients and primary care providers as helpful communication tools. However, if used alone, the SCP would be insufficient to ease the transition to follow-up care. Improved communication and care coordination were identified as important for survivorship care that went beyond what this document might provide.
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Affiliation(s)
- Deborah K Mayer
- School of Nursing and Lineberger Comprehensive Cancer Center, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA.
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33
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Grant M, Economou D, Ferrell B, Uman G. Educating health care professionals to provide institutional changes in cancer survivorship care. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2012; 27:226-232. [PMID: 22271583 PMCID: PMC3724461 DOI: 10.1007/s13187-012-0314-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The Institute of Medicine (IOM) 2006 report, From Cancer Patient to Cancer Survivor: Lost in Transition (In M. Hewitt, S. Greenfield and E. Stovall (Eds.), (pp. 9-186). Washington DC: The National Academies Press, 2006) identifies the key components of care that contribute to quality of life for the cancer survivor. As cancer survivorship care becomes an important part of quality cancer care oncology professionals need education to prepare themselves to provide this care. Survivorship care requires a varied approach depending on the survivor population, treatment regimens and care settings. The goal of this program was to encourage institutional changes that would integrate survivorship care into participating centers. An NCI-funded educational program: Survivorship Education for Quality Cancer Care provided multidiscipline two-person teams an opportunity to gain this important knowledge using a goal-directed, team approach. Educational programs were funded for yearly courses from 2006 to 2009. Survivorship care curriculum was developed using the Quality of Life Model as the core around the IOM recommendations. Baseline data was collected for all participants. Teams were followed-up at 6, 12 and 18 months postcourse for goal achievement and institutional evaluations. Comparison data from baseline to 18 months provided information on the 204 multidiscipline teams that participated over 4 years. Teams attended including administrators, social workers, nurse practitioners, registered nurses, physicians and others. Participating centers included primarily community cancer centers and academic centers followed by pediatric centers, ambulatory/physician offices and free standing cancer centers. Statistically significant changes at p = <0.05 levels were seen by 12 months postcourse related to the effectiveness, receptiveness and comfort of survivorship care in participant settings. Institutional assessments found improvement in seven domains of care that related to institutional change. This course provided education to participants that led to significant changes in survivorship care in their settings.
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Affiliation(s)
- Marcia Grant
- City of Hope, Division of Nursing Research and Education, Duarte, CA 91010, USA.
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McGrath P, Holewa H. What does the term 'survivor' mean to individuals diagnosed with a haematological malignancy? Findings from Australia. Support Care Cancer 2012; 20:3287-95. [PMID: 22549505 DOI: 10.1007/s00520-012-1453-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Accepted: 03/26/2012] [Indexed: 11/24/2022]
Abstract
PURPOSE The use of the word 'survivor' is now widely accepted in academic and clinical oncology culture. However, despite such prevalence, there is limited research exploring the meaning of the term survivor for the very individuals to which the term is applied. The article provides insights on the term survivor from a sub-set of findings taken from a Queensland study exploring the experience of survivorship for individuals diagnosed with a haematological malignancy. METHODS The qualitative study involved in-depth interviews with 50 individuals diagnosed with a haematological malignancy. The interviews were transcribed verbatim, coded and then analysed thematically. RESULTS The results indicated that the majority of participants actively disliked the term and did not embrace the notion of survivor in their post-diagnosis identity. Only a small number actively embraced the term. CONCLUSION The word survivor had a multiplicity of meanings depending on the individual interpretation of the term. RELEVANCE OF MANUSCRIPT TO INFORM RESEARCH, POLICIES AND/OR PROGRAMMES: The clear message from the research is that the term survivor needs to be used with care and sensitivity. The strong recommendation is that caution should be used when applying the term to individuals diagnosed with a haematological malignancy. The naming of support groups and newsletters should be sensitive to the wide range of meanings that individuals bring to this term. Indeed, the findings indicate that many do not identify with the term and require a more appropriate language to respond to their supportive care needs.
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Affiliation(s)
- Pam McGrath
- International Program of Psycho-Social Health Research, Centre of National Research on Disability and Rehabilitation Medicine, Griffith Health Institute, Griffith University, LO5, Level 1, Logan Campus, Meadowbrook, Logan City, QLD 4131, Australia.
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Thorne SE, Stajduhar KI. Patient perceptions of communications on the threshold of cancer survivorship: implications for provider responses. J Cancer Surviv 2012; 6:229-37. [DOI: 10.1007/s11764-012-0216-z] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2011] [Accepted: 02/16/2012] [Indexed: 12/31/2022]
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Survivors of breast cancer: patient perspectives on survivorship care planning. J Cancer Surviv 2011; 5:337-44. [PMID: 21643836 DOI: 10.1007/s11764-011-0185-7] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2010] [Accepted: 05/10/2011] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Survivors of breast cancer (SBC) constitute the largest population of cancer survivors. Needs for survivorship care may vary according to life stage and urban/rural place of residence. This study was conducted to better understand patient preferences for survivorship care plans (SCP). METHODS Patients were identified through cancer agency electronic records and invited to participate by mail. Sessions were stratified by age and rural/urban place of residence. Participants were asked about preferences for content and format of SCP. Focus groups were conducted using a semi-structured format with interviews being taped, transcribed, cross-checked for accuracy, and analyzed independently, using constant comparative methods. RESULTS Preferred SCP key elements included treatment summary, information on nutrition/exercise, expected side effects, signs and symptoms of recurrence, recommended follow-up schedule, information sent to primary care physician, and updates on changes. SBC emphasized preference for individualized content depending upon physical and psychosocial effects. No difference was observed between preferred SCP content among patients residing in urban/rural areas. Rural participants preferred electronic formats for ongoing information bulletins and communication with health care providers. DISCUSSION/CONCLUSIONS SBC from all age groups identify common preferences for key SCP elements with individualized content reflecting the wide variation observed among physical and psychosocial effects of breast cancer. Patterns of key psychological, social, and physical effects observed at different life stages may help SCP customization. IMPLICATIONS FOR CANCER SURVIVORS Results provide direction for designing key content and format of SCP and also provide information about elements of care planning that should be customized to individual patient needs.
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Garlan RW, Butler LD, Siegel ERA, Spiegel D. Perceived Benefits and Psychosocial Outcomes of a Brief Existential Family Intervention for Cancer Patients/Survivors. OMEGA-JOURNAL OF DEATH AND DYING 2011; 62:243-68. [DOI: 10.2190/om.62.3.c] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study assessed a range of benefits from participation in a brief existential intervention consisting of a semi-structured videotaped interview with cancer patients and their families designed to illuminate a life legacy for the family (the Life Tape Project [LTP]). Results indicated the majority reported intervention-specific benefits, especially in the areas of symbolic immortality (passing on personal values and philosophy), self-reflection and growth, and improved family cohesion and communication. Participants, particularly those who had perceived their cancer as a threat of death, serious injury, or threat to their physical integrity, and responded with intense fear or helplessness, also reported more general reductions in mood disturbance, improvements in aspects of well-being (including overall quality of life), satisfaction with the understanding they received, and enhanced cancer-related posttraumatic growth. In short, the LTP is a brief, inexpensive, existential intervention that can yield broad positive psychosocial changes for a majority of participants.
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Pieters HC, Heilemann MV, Grant M, Maly RC. Older Women's Reflections on Accessing Care Across Their Breast Cancer Trajectory: Navigating Beyond the Triple Barriers. Oncol Nurs Forum 2011; 38:175-84. [DOI: 10.1188/11.onf.175-184] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Katz ML, Reiter PL, Corbin S, de Moor JS, Paskett ED, Shapiro CL. Are rural Ohio Appalachia cancer survivors needs different than urban cancer survivors? J Cancer Surviv 2010; 4:140-8. [PMID: 20099044 DOI: 10.1007/s11764-010-0115-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2009] [Accepted: 01/08/2010] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Limited information is available about rural cancer survivors' needs and if they differ from urban cancer survivors. METHODS A convenience sample of cancer survivors completed a self-administered survey. RESULTS Rural Appalachia (n = 99) and urban non-Appalachia (n = 107) cancer survivors completed the survey. Urban survivors reported more needs than rural survivors (p < 0.001), but worry about cancer recurrence and concern about fatigue were reported most often by both urban and rural survivors. Urban survivors (n = 87; 81.3%) and rural survivors (n = 72; 72.9%) indicated that they searched for cancer information, but rural survivors were more likely to obtain information from family members and healthcare providers (p < 0.05). Rural survivors differed from urban survivors by reporting less effort to get the information they needed (p < 0.05) and less concern about the quality of the information (p < 0.01), but they reported having a harder time understanding the information they found (p < 0.05). DISCUSSION Rural and urban survivors' most frequent needs focused on cancer recurrence and fatigue. Rural survivors reported fewer needs compared to urban survivors; however, our findings suggest certain needs may be more important to rural survivors. While most survivors reported searching for information about cancer, rural and urban survivors use different sources for finding information and have varying experiences in their searches. IMPLICATIONS FOR CANCER SURVIVORS There is an ongoing need to provide survivorship care that is tailored to the unique needs of cancer survivors. It is essential to provide educational materials for all cancer survivors, but using different communication channels for urban versus rural survivors may be beneficial.
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Affiliation(s)
- Mira L Katz
- The Ohio State University, Columbus, OH, 43201, USA.
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Denlinger CS, Barsevick AM. The challenges of colorectal cancer survivorship. J Natl Compr Canc Netw 2009; 7:883-93; quiz 894. [PMID: 19755048 DOI: 10.6004/jnccn.2009.0058] [Citation(s) in RCA: 207] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2009] [Accepted: 06/04/2009] [Indexed: 01/11/2023]
Abstract
With advances in treatment, colorectal cancer (CRC) is being transformed from a deadly disease into an illness that is increasingly curable. With this transformation has come increased interest in the unique problems, risks, needs, and concerns of survivors who have completed treatment and are cancer-free. Research has shown that physical and mental quality of life for CRC survivors was inferior compared with age-matched individuals without cancer. Although issues and symptoms were most prominent during the first 3 years, long-term effects of treatment can persist and include fatigue, sleep difficulty, fear of recurrence, anxiety, depression, negative body image, sensory neuropathy, gastrointestinal problems, urinary incontinence, and sexual dysfunction. The unique challenges and issues of CRC survivors can and should be addressed by health care providers and the research community to ensure effective interventions and models of care to manage these problems. This article discusses what is known about the long-term effects of CRC treatment on quality of life, the care of survivors, and existing models of survivorship care.
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Affiliation(s)
- Crystal S Denlinger
- Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania 19111, USA.
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Establishing a general medical outpatient clinic for cancer survivors in a public city hospital setting. J Gen Intern Med 2009; 24 Suppl 2:S451-5. [PMID: 19838849 PMCID: PMC2763156 DOI: 10.1007/s11606-009-1027-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Many cancer centers and community hospitals are developing novel models of survivorship care. However, few are specifically focused on services for socio-economically disadvantaged cancer survivors. AIMS To describe a new model of survivorship care serving culturally diverse, urban adult cancer patients and to present findings from a feasibility evaluation. SETTING Adult cancer patients treated at a public city hospital cancer center. PROGRAM DESCRIPTION The clinic provides comprehensive medical and psychosocial services for patients within a public hospital cancer center where they receive their oncology care. PROGRAM EVALUATION Longitudinal data collected over a 3-year period were used to describe patient demographics, patient needs, and services delivered. Since inception, 410 cancer patients have been served. Demand for services has grown steadily. Hypertension was the most frequent comorbid condition treated. Pain, depression, cardiovascular disease, hyperlipidemia, and bowel dysfunction were the most common post-treatment problems experienced by the patients. Financial counseling was an important patient resource. DISCUSSION This new clinical service has been well-integrated into its public urban hospital setting and constitutes an innovative model of health-care delivery for socio-economically challenged, culturally diverse adult cancer survivors.
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