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Garpenhag L, Halling A, Calling S, Rosell L, Larsson AM. "Being ill was the easy part": exploring cancer survivors' reactions to perceived challenges in engaging with primary healthcare. Int J Qual Stud Health Well-being 2024; 19:2361492. [PMID: 38824662 PMCID: PMC11146241 DOI: 10.1080/17482631.2024.2361492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 05/24/2024] [Indexed: 06/04/2024] Open
Abstract
PURPOSE Cancer survivors experience barriers to primary healthcare (PHC) services. The aim was to explore reactions to and opinions about perceived challenges associated with PHC access and quality among cancer survivors in Sweden, including how they have acted to adapt to challenges. METHODS Five semi-structured focus group interviews were conducted with cancer survivors (n = 20) from Skåne, Sweden, diagnosed with breast, prostate, lung, or colorectal cancer or malignant melanoma. Focus groups were mixed in regard to diagnosis. Data were analysed using a descriptive template analysis approach. RESULTS In light of perceived challenges associated with access to adequate PHC, participants experienced that they had been forced to work hard to achieve functioning PHC contacts. The demands for self-sufficiency were associated with negative feelings such as loneliness and worry. Participants believed that cancer survivors who lack the ability to express themselves, or sufficient drive, risk missing out on necessary care due to the necessity of being an active patient. CONCLUSIONS The findings highlight negative patient experiences. They have implications for the organization of care for cancer survivors as they indicate a need for more efficient post-treatment coordination between cancer specialist care and PHC providers, as well as increased support for patients leaving primary cancer treatment.
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Affiliation(s)
- Lars Garpenhag
- Center for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University/Region Skåne, Lund, Sweden
- Division of Psychiatry, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Anders Halling
- Center for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University/Region Skåne, Lund, Sweden
- University Clinic Primary Care Skåne, Region Skåne, Sweden
| | - Susanna Calling
- Center for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University/Region Skåne, Lund, Sweden
- University Clinic Primary Care Skåne, Region Skåne, Sweden
| | - Linn Rosell
- Regional Cancer Center South, Lund, Sweden
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Anna-Maria Larsson
- Regional Cancer Center South, Lund, Sweden
- Division of Oncology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
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Torabi P, Chouinard MC, Sévigny MM, Bilodeau K. Health promotion nursing interventions for female breast cancer survivors: A scoping review. J Adv Nurs 2024. [PMID: 39011943 DOI: 10.1111/jan.16328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 05/23/2024] [Accepted: 06/29/2024] [Indexed: 07/17/2024]
Abstract
AIM Map the existing health promotion nursing interventions for female breast cancer survivors (BCS) to describe the approaches used and the characteristics of these interventions in the available studies. DESIGN A scoping review. DATA SOURCE Five electronic databases were systematically searched for eligible studies, published between 2002 and 2022. METHODS Following the Joanna Briggs Institute's methodology, two reviewers independently used Covidence to screen the title, abstract and full text of evidence against the inclusion criteria and extracted data using an extraction table. The PRISMA Extension for Scoping Reviews (PRISMA-ScR) guided the reporting. No patient or public contribution was necessary. RESULTS This review included 22 studies on nursing health promotion interventions for BCSs, primarily conducted in specialized care centres. In 20 of 22 studies, nurses employed the educational approach to promote the health of BCSs. Many interventions aimed to support survivors in adopting healthy lifestyles, improving their sexual health, promoting overall well-being and addressing their individual needs by equipping them with self-care skills. Nurses utilized self-monitoring, health education materials and technologies to support survivors' health. CONCLUSION The review concludes that the nurse used various approaches and interventions with different characteristics to improve the health of BCSs. This review also emphasizes that a limited number of determinants of health have been considered by nurses in the development of health promotion interventions. IMPACT The review highlights the important role that nurses can play in enhancing the health of female BCSs after cancer treatments. This review can guide future research for developing nursing health promotion interventions in primary care settings for female BCSs. Additionally, the review offers insights to support future research, education and training on diverse approaches and characteristics that nurses can utilize to establish interventions that enhance the health of female BCSs.
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Affiliation(s)
- Pegah Torabi
- Faculty of Nursing, University of Montreal, Montreal, Quebec, Canada
- Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Ile-de-Montréal Research Center, Montreal, Quebec, Canada
- Maisonneuve-Rosemont Hospital Research Centre, Montreal, Quebec, Canada
| | - Maud-Christine Chouinard
- Faculty of Nursing, University of Montreal, Montreal, Quebec, Canada
- Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Ile-de-Montréal Research Center, Montreal, Quebec, Canada
| | - Marie-Maxim Sévigny
- Centre Intégré Universitaire de Santé et de Services Sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec, Canada
| | - Karine Bilodeau
- Faculty of Nursing, University of Montreal, Montreal, Quebec, Canada
- Maisonneuve-Rosemont Hospital Research Centre, Montreal, Quebec, Canada
- Centre Intégré Universitaire de Santé et de Services Sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec, Canada
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Lim JW, Shon EJ, Yang EJ, Shin DW. Psychometric Testing of a New Instrument for Assessing Cancer Patient Preparedness for the Survivorship Transition. J Nurs Meas 2024; 32:241-255. [PMID: 37353319 DOI: 10.1891/jnm-2022-0094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2023]
Abstract
Background and Purpose: This study aimed to develop and examine the psychometric properties of the "Preparedness for Transition to Survivorship Care Instrument" (PTSCI) for cancer survivors. Methods: A cross-sectional study of cancer survivors in Korea was conducted to test the reliability and validity of the PTSCI. Exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and concurrent validity tests were conducted. Results: The EFA showed that the 7-factor structure of a 34-item PTSCI accounted for 61.5% of the total observed variance. In CFA, three competing models were created and compared to a 7-factor solution model. A 6-factor 31-item model showed the best fit and was chosen as the final PTSCI model. PTSCI is significantly associated with quality of life, psychological distress, and health promotion. Conclusions: PTSCI can be helpful in preparing for diverse psychosocial and behavioral issues faced by cancer survivors in the survivorship phase.
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Affiliation(s)
- Jung-Won Lim
- College of Social Welfare, Kangnam University, Yongin-si, South Korea
| | - En-Jung Shon
- Department of Social Welfare, Duksung Women's University, Seoul, South Korea
| | - Eun Joo Yang
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Bundang, South Korea
| | - Dong-Wook Shin
- Department of Family Medicine, Samsung Medical Center, Gangnam-gu, South Korea
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Larsen LL, Hoffmann Merrild C. Good cancer follow-up for socially disadvantaged patients in general practice? Perspectives from patients and general practitioners. Scand J Prim Health Care 2024; 42:316-326. [PMID: 38376126 PMCID: PMC11003317 DOI: 10.1080/02813432.2024.2317843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 02/07/2024] [Indexed: 02/21/2024] Open
Abstract
One of the core principles of providing care in general practice is giving more to those who need it most. We investigate some of the complexities of this ambition in the context of cancer care for patients defined as socially disadvantaged by their general practitioner (GP). We do this by exploring how care is sought, how it is offered, and what expectations patients and GPs carry with them when receiving and providing cancer care in the Danish welfare state. We carried out semi-structured interviews with eight GPs and seven socially disadvantaged cancer patients living with different types and stages of cancer. The interviews focused on needs and challenges in cancer follow-up in general practice and were thematically coded. Drawing on theoretical concepts of morality and Nordic individualism, we point to how one of the main challenges in cancer care and follow-up is to figure out how the doctor-patient relationship should be established, practiced, and maintained. Both GPs and patients stressed the importance of the relationship, but how it should be practiced amidst social norms about being a patient, a citizen and how care-seeking should unfold seems less clear. In conclusion we argue that giving more to those who need it the most is a difficult and ill-defined task that is shaped by the cultural, social, and political expectations of both GPs and patients.
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Levinsen AKG, Kjaer TK, Thygesen LC, Maltesen T, Jakobsen E, Gögenur I, Borre M, Christiansen P, Zachariae R, Christensen P, Laurberg S, de Nully Brown P, Hölmich LR, Johansen C, Kjær SK, van de Poll‐Franse L, Saltbæk L, Dalton SO. Social inequality in cancer survivorship: Educational differences in health-related quality of life among 27,857 cancer survivors in Denmark. Cancer Med 2023; 12:20150-20162. [PMID: 37772475 PMCID: PMC10587985 DOI: 10.1002/cam4.6596] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 08/30/2023] [Accepted: 09/16/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND With a growing population of cancer survivors in Denmark, the evaluation of health-related quality of life (HRQoL) has become increasingly important. We describe variations in HRQoL between educational groups in a national population of cancer survivors. METHODS We conducted a cross-sectional questionnaire study among breast, prostate, lung, and colon cancer survivors diagnosed in 2010-2019 in Denmark. We used the EORTC QLQ-C30 to assess HRQoL including physical, role, emotional, cognitive, social functioning, and symptoms (fatigue, nausea and vomiting, pain, dyspnea, insomnia, appetite loss, constipation, diarrhea, and financial difficulties). Information on educational level and clinical data were extracted from national registers and clinical databases. Levels of impaired functioning and severe symptoms were identified using newly established thresholds for clinical importance. Multivariate logistic regression was used to examine associations between education and HRQoL. All statistical tests were 2-sided. RESULTS In total, 27,857 (42%) participated in the study. Up to 72% and 75% of cancer survivors with short education (≤9 years) reported impaired functioning and severe symptoms, respectively. Cancer survivors with short compared to long education (>12 years) were more likely to report impaired functioning and severe symptoms, with for example significantly higher odds ratios (ORs) for impaired physical function (breast OR = 2.41, 99% CI = 2.01-2.89; prostate OR = 1.81, 99% CI = 1.48-2.21; lung OR = 2.97, 99% CI = 1.95-4.57; and colon cancer OR = 1.69, 99% CI = 1.28-2.24). CONCLUSIONS Cancer survivors with short education are at greater risk of impaired HRQoL than survivors with long education 2-12 years after diagnosis. This underscores the need for systematic screening and symptom management in cancer aftercare, in order to reach all cancer survivors, also cancer survivors with short education.
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Affiliation(s)
| | | | - Lau Caspar Thygesen
- National Institute of Public HealthUniversity of Southern DenmarkCopenhagenDenmark
| | - Thomas Maltesen
- Statistics and Data AnalysisDanish Cancer InstituteCopenhagenDenmark
| | - Erik Jakobsen
- Department of Thoracic surgeryOdense University hospitalOdenseDenmark
| | - Ismail Gögenur
- Dept. Surgery, Center for Surgical ScienceZealand University HospitalKøgeDenmark
- Institute for Clinical MedicineCopenhagen UniversityCopenhagenDenmark
| | - Michael Borre
- Department of UrologyAarhus University HospitalAarhusDenmark
| | - Peer Christiansen
- Danish Breast Cancer Group Center and Clinic for Late EffectsAarhusDenmark
- Department of Plastic and Breast SurgeryAarhus University HospitalAarhusDenmark
| | - Robert Zachariae
- Danish Breast Cancer Group Center and Clinic for Late EffectsAarhusDenmark
| | - Peter Christensen
- Danish Cancer Society Centre for Research on Survivorship and Late Adverse Effects After Cancer in the Pelvic Organs, Department of SurgeryAarhus University HospitalAarhusDenmark
| | - Søren Laurberg
- Danish Cancer Society Centre for Research on Survivorship and Late Adverse Effects After Cancer in the Pelvic Organs, Department of SurgeryAarhus University HospitalAarhusDenmark
| | | | | | | | - Susanne K. Kjær
- Unit of Virus, Lifestyle and GenesDanish Cancer InstituteCopenhagenDenmark
- Department of Gynecology, RigshospitaletUniversity of CopenhagenCopenhagenDenmark
| | - Lonneke van de Poll‐Franse
- Department of Psychosocial Research and EpidemiologyThe Netherlands Cancer InstituteAmsterdamThe Netherlands
- Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical PsychologyTilburg UniversityTilburgThe Netherlands
| | - Lena Saltbæk
- Survivorship and Inequality in CancerDanish Cancer InstituteCopenhagenDenmark
- Danish Research Center for Equality in Cancer, Department of Clinical Oncology & Palliative CareZealand University HospitalNæstvedDenmark
| | - Susanne Oksbjerg Dalton
- Survivorship and Inequality in CancerDanish Cancer InstituteCopenhagenDenmark
- Danish Research Center for Equality in Cancer, Department of Clinical Oncology & Palliative CareZealand University HospitalNæstvedDenmark
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Vos JAM, Wollersheim BM, Cooke A, Ee C, Chan RJ, Nekhlyudov L. Primary care physicians' knowledge and confidence in providing cancer survivorship care: a systematic review. J Cancer Surviv 2023:10.1007/s11764-023-01397-y. [PMID: 37171716 DOI: 10.1007/s11764-023-01397-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 04/28/2023] [Indexed: 05/13/2023]
Abstract
PURPOSE To systematically review existing literature on knowledge and confidence of primary care physicians (PCPs) in cancer survivorship care. METHODS PubMed, Ovid MEDLINE, CINAHL, Embase, and PsycINFO were searched from inception to July 2022 for quantitative and qualitative studies. Two reviewers independently assessed studies for eligibility and quality. Outcomes were characterized by domains of quality cancer survivorship care. RESULTS Thirty-three papers were included, representing 28 unique studies; 22 cross-sectional surveys, 8 qualitative, and 3 mixed-methods studies. Most studies were conducted in North America (n = 23) and Europe (n = 8). For surveys, sample sizes ranged between 29 and 1124 PCPs. Knowledge and confidence in management of physical (n = 19) and psychosocial effects (n = 12), and surveillance for recurrences (n = 14) were described most often. Generally, a greater proportion of PCPs reported confidence in managing psychosocial effects (24-47% of PCPs, n= 5 studies) than physical effects (10-37%, n = 8). PCPs generally thought they had the necessary knowledge to detect recurrences (62-78%, n = 5), but reported limited confidence to do so (6-40%, n = 5). There was a commonly perceived need for education on long-term and late physical effects (n = 6), and cancer surveillance guidelines (n = 9). CONCLUSIONS PCPs' knowledge and confidence in cancer survivorship care varies across care domains. Suboptimal outcomes were identified in managing physical effects and recurrences after cancer. IMPLICATIONS FOR CANCER SURVIVORS These results provide insights into the potential role of PCPs in cancer survivorship care, medical education, and development of targeted interventions.
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Affiliation(s)
- Julien A M Vos
- Department of General Practice, Amsterdam UMC, location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.
- Amsterdam Public Health, research programme Quality of Care, and Personalized Medicine, Amsterdam, the Netherlands.
| | - Barbara M Wollersheim
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066, CX, Amsterdam, The Netherlands
| | - Adelaide Cooke
- MS1 at University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Carolyn Ee
- NICM Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
| | - Raymond J Chan
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, South, Adelaide, Australia
| | - Larissa Nekhlyudov
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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Implementing a community-based shared care breast cancer survivorship model in Singapore: a qualitative study among primary care practitioners. BMC PRIMARY CARE 2022; 23:73. [PMID: 35395732 PMCID: PMC8991467 DOI: 10.1186/s12875-022-01673-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 03/21/2022] [Indexed: 12/24/2022]
Abstract
Background The adaptability of existing recommendations on shared care implementation to Asian settings is unknown. This qualitative study aims to elicit public- and private-sectors primary care practitioners’ (PCPs) perspectives on the sustainable implementation of a shared care model among breast cancer survivors in Singapore. Methods Purposive sampling was employed to engage 70 PCPs from SingHealth Polyclinics, National University Polyclinics, National Healthcare Group Polyclinics, and private practice. Eleven focus groups and six in-depth interviews were conducted between June to November 2018. All sessions were audio-recorded and transcribed verbatim. Guided by the RE-AIM framework, we performed deductive thematic analysis in QSR NVivo 12. Results PCPs identified low-risk breast cancer survivors who demonstrated clear acceptability of PCPs’ involvement in follow-up as suitable candidates for shared care. Engagement with institution stakeholders as early adopters is crucial with adequate support through PCP training, return pathways to oncologists, and survivorship care plans as communication tools. Implementation considerations differed across practices. Selection of participating PCPs could consider seniority and interest for public and private practice, respectively. Proposed adoption incentives included increased renumeration for private PCPs and work recognition for public PCPs. Public PCPs further proposed integrating shared care elements to their existing family medicine clinics. Conclusions PCPs perceived shared care favorably as it echoed principles of primary care to provide holistic and well-coordinated care. Contextual factors should be considered when adapting implementation recommendations to Asian settings like Singapore. With limited competitive pressure, the government is then pivotal in empowering primary care participation in survivorship shared care delivery. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-022-01673-3.
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Patient experiences of GP-led colon cancer survivorship care: a Dutch mixed-methods evaluation. Br J Gen Pract 2022; 73:e115-e123. [PMID: 36316164 PMCID: PMC9639600 DOI: 10.3399/bjgp.2022.0104] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 07/20/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Colon cancer survivorship care constitutes both follow-up and aftercare. GP involvement may help to personalise care. AIM To explore patients' experiences of GP-led versus surgeon-led survivorship care. DESIGN AND SETTING Patients with stage I to III colon cancer were recruited from eight Dutch hospitals and randomised to receive care by either the GP or surgeon. METHOD A mixed-methods approach was used to compare GP-led care with surgeon-led care. After 1 year the Consumer Quality Index (CQI) was used to measure quality aspects of care. Next, interviews were performed at various time points (3-6 years after surgery) to explore patients' experiences in depth. RESULTS A total of 261 questionnaires were returned by patients and 25 semi-structured interviews were included in the study. Overall, patients were satisfied with both GP-led and surgeon-led care (ratings 9.6 [standard deviation {SD} 1.1] versus 9.4 [SD 1.1] out of 10). No important differences were seen in quality of care as measured by CQI. Interviews revealed that patients often had little expectation of care from either healthcare professional. They described follow-up consultations as short, medically oriented, and centred around discussing follow-up test results. Patients also reported few symptoms. Care for patients in the GP-led group was organised in different ways, ranging from solely on patient's initiative to shared care. Patients sometimes desired a more guiding role from their GP, whereas others preferred to be proactive themselves. CONCLUSION Patients experienced a high quality of colon cancer survivorship care from both GPs and surgeons. If the GP is going to be more involved, patients require a clear understanding of roles and responsibilities.
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Asai-Sato M, Suzuki N, Sakai H, Itani Y, Sato S, Futagami M, Yoshida Y. Perceptions and practice patterns of cancer survivorship care among Japanese gynecologic oncologists: The JGOG questionnaire survey. J Gynecol Oncol 2022; 34:e10. [PMID: 36366812 PMCID: PMC9807361 DOI: 10.3802/jgo.2023.34.e10] [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: 05/12/2022] [Revised: 07/26/2022] [Accepted: 10/10/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE This study aimed to assess gynecologic oncologists (GOs)' perceptions and attitudes toward cancer survivorship to help improve survivor care. METHODS We conducted a web-based questionnaire survey about survivorship issues for the GOs belonging to the Japan Gynecologic Oncology Group. We analyzed the proactiveness of the participants toward addressing 25 survivor issues. In addition, the practice patterns and barriers to care for survivors' long-term health issues, such as second primary cancer (SPC) and lifestyle-related diseases (LSRD), and return-to-work (RTW) support were assessed. RESULTS We received 313 responses. The respondents had a mean of 22 years of physician experience. The ratio of men to women was approximately 7:3, and 84.7% worked at facilities for multidisciplinary cancer treatment. The respondents' proactiveness for addressing psychosocial problems was significantly lower than physical and gynecological issues (p<0.01 by χ² test). However, most GOs tried to contribute to such issues according to patients' demands. Women GOs were more proactively involved in some survivorship issues than the men (p<0.05 by logistic regression analysis). The rates of the respondents who proactively discussed SPC, LSRD, and RTW were unexpectedly high (60.7%, 36.1%, and 52.4%, respectively). However, the GOs only provided verbal support for these issues in many cases. CONCLUSION The Japanese GOs were enthusiastic about survivorship care. However, their tendency to deal with survivors' problems through their own knowledge and judgments raises concerns about the quality of care. Therefore, creating survivorship care guidelines and enhancing multidisciplinary collaboration should be prioritized.
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Affiliation(s)
- Mikiko Asai-Sato
- Department of Obstetrics and Gynecology, Nihon University, Tokyo, Japan.
| | - Nao Suzuki
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Hitomi Sakai
- Advanced Cancer Translational Research Institute, Showa University, Tokyo, Japan
| | - Yoshio Itani
- Palliative Care Center, Yao Municipal Hospital, Yao, Japan
| | - Shinya Sato
- Department of Obstetrics and Gynecology, Tottori University Faculty of Medicine, Yonago, Japan
| | - Masayuki Futagami
- Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Yoshio Yoshida
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
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Soto-Ruiz N, Escalada-Hernández P, Martín-Rodríguez LS, Ferraz-Torres M, García-Vivar C. Web-Based Personalized Intervention to Improve Quality of Life and Self-Efficacy of Long-Term Breast Cancer Survivors: Study Protocol for a Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12240. [PMID: 36231542 PMCID: PMC9564785 DOI: 10.3390/ijerph191912240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 06/16/2023]
Abstract
Long-term breast cancer survivors (>5 years free of disease) may suffer late sequelae of cancer that impact on their quality of life. The use of telehealth for cancer care is recommended but little is known about the effectiveness of digital interventions for long-term cancer survivors. This study aims to evaluate the effectiveness of a web-based personalized intervention based on artificial intelligence instead of usual primary health care to improve the quality of life of long-term survivors of breast cancer and self-efficacy for the management of late sequelae. A randomized controlled trial will be conducted. The sample will consist of long-term breast cancer survivors recruited from primary health centers. Women will be randomly assigned to the intervention group to receive a web-based personalized intervention or to the control group to receive standard primary health care by nurses. Data on quality of life of cancer survivors and self-efficacy for the management of late sequelae of cancer will be collected and assessed at preintervention, and at 3, 6, and 9 months. It is expected that, at the end of the programme, the experimental group will have improved quality of life and improved self-efficacy for the management of late sequelae of cancer.
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Affiliation(s)
- Nelia Soto-Ruiz
- Department of Health Science, Public University of Navarre, 31008 Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
| | - Paula Escalada-Hernández
- Department of Health Science, Public University of Navarre, 31008 Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
| | - Leticia San Martín-Rodríguez
- Department of Health Science, Public University of Navarre, 31008 Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
| | - Marta Ferraz-Torres
- Department of Health Science, Public University of Navarre, 31008 Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
| | - Cristina García-Vivar
- Department of Health Science, Public University of Navarre, 31008 Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
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Smith J, Essery R, Yardley L, Richardson A, Slodkowska-Barabasz J, Foster C, Watson E, Grimmett C, Geraghty AWA, Little P, Bradbury K. Implementing a Health Care Professional-Supported Digital Intervention for Survivors of Cancer in Primary Care: Qualitative Process Evaluation of the Renewed Intervention. JMIR Cancer 2022; 8:e36364. [PMID: 35363143 PMCID: PMC9015743 DOI: 10.2196/36364] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 03/16/2022] [Accepted: 03/16/2022] [Indexed: 01/12/2023] Open
Abstract
Background Primary care plays an important role in supporting survivors of cancer; however, support is limited because of practitioners’ perceived lack of expertise and time. A digital intervention for survivors of cancer could provide an efficient way for primary care staff to support survivors of cancer without the need to accumulate expertise and skills to help patients make behavior changes; providing very brief support alongside this could maximize adherence to digital interventions. Renewed is a digital intervention that combines web-based behavior change advice with brief health care practitioner support from a nurse or health care assistant. Knowledge about the views and experiences of primary care staff providing support alongside a digital intervention for survivors of cancer is sparse, limiting the understanding of the acceptability and feasibility of this type of intervention. Objective This study aims to explore supporters’ experiences of providing support to survivors of cancer using Renewed, understand potential barriers to and facilitators of the implementation of Renewed in practice, and investigate the strengths and weaknesses of the intervention from the perspective of health care professionals. Methods This was a qualitative process evaluation nested within a large trial evaluating Renewed. A total of 28 semistructured telephone interviews were conducted with nurses and health care assistants. Data were analyzed using inductive thematic analysis. Results Four themes were developed during the analysis, which reflected the factors that supporters identified as hindering or enabling them to provide support alongside Renewed Online: Renewed Online as an acceptable digital tool with some improvements, confidence in enacting the supporter role, practicalities of delivering support alongside a digital intervention, and managing a patient-led approach. The analysis suggests that supporters perceived that a digital intervention such as Renewed would be beneficial in supporting survivors of cancer in primary care and fit within current practices. However, barriers to providing support alongside the intervention were also identified, including concerns about how to facilitate rapport building and, in a minority, concerns about using a nondirective approach, in which most advice and support is provided through digital interventions, with brief additional support provided by primary care staff. Conclusions These findings add to the literature on how best to provide support alongside digital interventions, suggesting that although most practitioners cope well with a nondirective approach, a minority requires more training to feel confident in implementing this. This study suggests that the barriers to providing formal support to survivors of cancer in primary care could be successfully overcome with an approach such as Renewed, where a digital intervention provides most of the support and expertise, and health care practitioners provide additional brief human support to maximize engagement. Strategies to maximize the chances of successful implementation for this type of intervention are also discussed.
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Affiliation(s)
- Jazzine Smith
- Clinical and Community Applications of Health Psychology, School of Psychology, University of Southampton, Southampton, United Kingdom
| | - Rosie Essery
- Clinical and Community Applications of Health Psychology, School of Psychology, University of Southampton, Southampton, United Kingdom.,School of Psychological Science, University of Bristol, Bristol, United Kingdom
| | - Lucy Yardley
- Clinical and Community Applications of Health Psychology, School of Psychology, University of Southampton, Southampton, United Kingdom.,School of Psychological Science, University of Bristol, Bristol, United Kingdom
| | - Alison Richardson
- School of Health Sciences, University of Southampton, Southampton, United Kingdom.,Cancer Care Group, University Hospital Southampton, Southampton, United Kingdom
| | - Joanna Slodkowska-Barabasz
- Community and Public Health Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, United Kingdom
| | - Claire Foster
- School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Eila Watson
- Community and Public Health Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, United Kingdom
| | - Chloe Grimmett
- School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Adam W A Geraghty
- Primary Care Research, University of Southampton, Southampton, United Kingdom
| | - Paul Little
- Primary Care Research, University of Southampton, Southampton, United Kingdom
| | - Katherine Bradbury
- Clinical and Community Applications of Health Psychology, School of Psychology, University of Southampton, Southampton, United Kingdom
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12
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Vos JAM, de Best R, Duineveld LAM, van Weert HCPM, van Asselt KM. Delivering colon cancer survivorship care in primary care; a qualitative study on the experiences of general practitioners. BMC PRIMARY CARE 2022; 23:13. [PMID: 35172743 PMCID: PMC8761520 DOI: 10.1186/s12875-021-01610-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 12/13/2021] [Indexed: 05/10/2023]
Abstract
BACKGROUND With more patients in need of oncological care, there is a growing interest to transfer survivorship care from specialist to general practitioner (GP). The ongoing I CARE study was initiated in 2015 in the Netherlands to compare (usual) surgeon- to GP-led survivorship care, with or without access to a supporting eHealth application (Oncokompas). METHODS Semi-structured interviews were held at two separate points in time (i.e. after 1- and 5-years of care) to explore GPs' experiences with delivering this survivorship care intervention, and study its implementation into daily practice. Purposive sampling was used to recruit 17 GPs. Normalisation Process Theory (NPT) was used as a conceptual framework. RESULTS Overall, delivering survivorship care was not deemed difficult and dealing with cancer repercussions was already considered part of a GPs' work. Though GPs readily identified advantages for patients, caregivers and society, differences were seen in GPs' commitment to the intervention and whether it felt right for them to be involved. Patients' initiative with respect to planning, absence of symptoms and regular check-ups due to other chronic care were considered to facilitate the delivery of care. Prominent barriers included GPs' lack of experience and routine, but also lack of clarity regarding roles and responsibilities for organising care. Need for a monitoring system was often mentioned to reduce the risk of non-compliance. GPs were reticent about a possible future transfer of survivorship care towards primary care due to increases in workload and financial constraints. GPs were not aware of their patients' use of eHealth. CONCLUSIONS GPs' opinions and beliefs about a possible future role in colon cancer survivorship care vary. Though GPs recognize potential benefit, there is no consensus about transferring survivorship care to primary care on a permanent basis. Barriers and facilitators to implementation highlight the importance of both personal and system level factors. Conditions are put forth relating to time, reorganisation of infrastructure, extra personnel and financial compensation. TRIAL REGISTRATION Netherlands Trial Register; NTR4860 . Registered on the 2nd of October 2014.
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Affiliation(s)
- Julien A M Vos
- Department of General Practice, Amsterdam UMC, University of Amsterdam, Postbox 22660, Amsterdam, 1100 DD, the Netherlands.
- Program of Personalized Medicine & Quality of Care, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
| | - Robin de Best
- Department of General Practice, Amsterdam UMC, University of Amsterdam, Postbox 22660, Amsterdam, 1100 DD, the Netherlands
- Program of Personalized Medicine & Quality of Care, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Laura A M Duineveld
- Department of General Practice, Amsterdam UMC, University of Amsterdam, Postbox 22660, Amsterdam, 1100 DD, the Netherlands
- Program of Personalized Medicine & Quality of Care, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Henk C P M van Weert
- Department of General Practice, Amsterdam UMC, University of Amsterdam, Postbox 22660, Amsterdam, 1100 DD, the Netherlands
- Program of Personalized Medicine & Quality of Care, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Kristel M van Asselt
- Department of General Practice, Amsterdam UMC, University of Amsterdam, Postbox 22660, Amsterdam, 1100 DD, the Netherlands
- Program of Personalized Medicine & Quality of Care, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
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13
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Managing the Breast Cancer Survivor in Primary Care. J Nurse Pract 2021. [DOI: 10.1016/j.nurpra.2021.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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14
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Sandell T, Schütze H, Miller A. A Shared Cancer Follow-Up Model of Care Between General Practitioners and Radiation Oncologists for Patients With Breast, Prostate, and Colorectal Cancer: Protocol for a Mixed Methods Implementation Study. JMIR Res Protoc 2021; 10:e21752. [PMID: 33464209 PMCID: PMC7854032 DOI: 10.2196/21752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 11/10/2020] [Accepted: 12/08/2020] [Indexed: 01/15/2023] Open
Abstract
Background The rising incidence of cancer and increasing numbers of cancer survivors have resulted in the need to find alternative models of care for cancer follow-up care. The acceptability for follow-up care in general practice is growing, and acceptance increases with shared-care models where oncologists continue to oversee the care. However, a major barrier to this model is the effective exchange of information in real time between oncologists and general practitioners. Improved communication technology plays an important role in the acceptability and feasibility of shared cancer follow-up care. Objective The aim of this study is to evaluate the feasibility and acceptability of a shared cancer follow-up model of care between patients, general practitioners and radiation oncologists. Methods This is a mixed methods, multisite implementation study exploring shared follow-up care for breast, colorectal, and prostate cancer patients treated with curative radiotherapy in New South Wales, Australia. This study uses web-based technology to support general practitioners in performing some aspects of routine radiotherapy follow-up care, while being overseen by a radiation oncologist in real time. The study has two phases: Phase 1 is designed to establish the level of agreement between general practitioners and radiation oncologists and Phase 2 is designed to implement shared follow-up care into practice and to evaluate this implementation. Results Recruitment of radiation oncologists, patients, and general practitioners commenced in December 2020 and will continue until February 2021. Data collection will occur during 2021, and data will be ready for analysis by the end of 2021. Conclusions Few studies have investigated the role of health technologies in supporting communication deficiencies for shared cancer follow-up care. The implementation and evaluation of models of care need to be conducted using a person-centered approach that is responsive to patients’ preferences and needs. Should the findings of the study be acceptable and feasible to radiation oncologists, general practitioners, and patients, it can be quickly implemented and expanded to other tumor groups or to medical oncology and hematology. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12620001083987; http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380057 International Registered Report Identifier (IRRID) PRR1-10.2196/21752
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Affiliation(s)
- Tiffany Sandell
- Wollongong Hospital, Wollongong, Australia.,University of Wollongong, Wollongong, Australia
| | - Heike Schütze
- University of Wollongong, Wollongong, Australia.,University of New South Wales, Sydney, Australia
| | - Andrew Miller
- Wollongong Hospital, Wollongong, Australia.,University of Wollongong, Wollongong, Australia
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15
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Fok RWY, Low LL, Quah HMJ, Vasanwala F, Low SG, Soh LL, Mohamad F, Loh KWJ, Soong YL, Ke Y, Chan A, Tan NC. Roles and recommendations from primary care physicians towards managing low-risk breast cancer survivors in a shared-care model with specialists in Singapore-a qualitative study. Fam Pract 2020; 37:547-553. [PMID: 32030402 PMCID: PMC7474530 DOI: 10.1093/fampra/cmaa009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Breast cancer is prevalent and has high cure rates. The resultant increase in numbers of breast cancer survivors (BCS) may overwhelm the current oncology workforce in years to come. We postulate that primary care physicians (PCPs) could play an expanded role in comanaging survivors, provided they are given the appropriate tools and training to do so. OBJECTIVE To explore the perspectives of PCPs towards managing BCS in a community-based shared-care programme with oncologists. METHODS Eleven focus groups and six in-depth interviews were conducted with seventy PCPs recruited by purposive sampling. All sessions were audio-recorded, transcribed verbatim and coded by three independent investigators. Thematic data analysis was performed and the coding process facilitated by NVivo 12. RESULTS Majority of PCPs reported currently limited roles in managing acute and non-cancer issues, optimizing comorbidities and preventive care. PCPs aspired to expand their role to include cancer surveillance, risk assessment and addressing unmet psychosocial needs. PCPs preferred to harmonize cancer survivorship management of their primary care patients who are also BCS, with defined role distinct from oncologists. Training to understand the care protocol, enhancement of communication skills, confidence and trust were deemed necessary. PCPs proposed selection criteria of BCS and adequacy of their medical information; increased consultation time; contact details and timely access to oncologists (if needed) in the shared-care programme. CONCLUSIONS PCPs were willing to share the care of BCS with oncologists but recommended role definition, training, clinical protocol, resources and access to oncologist's consultation to optimize the programme implementation.
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Affiliation(s)
- Rose Wai-Yee Fok
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - Lian Leng Low
- Family Medicine and Continuing Care, Singapore General Hospital, Singapore.,Family Medicine Academy Clinical Programme, Duke-NUS Graduate Medical School Singapore, Singapore
| | - Hui Min Joanne Quah
- Family Medicine Academy Clinical Programme, Duke-NUS Graduate Medical School Singapore, Singapore.,SingHealth Polyclinics, Singapore
| | | | - Sher Guan Low
- Post-Acute and Continuing Care, Sengkang Community Hospital, Singapore
| | - Ling Ling Soh
- Post-Acute and Continuing Care, Sengkang Community Hospital, Singapore
| | - Farid Mohamad
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - Kiley Wei-Jen Loh
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - Yoke Lim Soong
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore
| | - Yu Ke
- Department of Pharmacy, National University of Singapore, Singapore
| | - Alexandre Chan
- Family Medicine Academy Clinical Programme, Duke-NUS Graduate Medical School Singapore, Singapore.,Department of Pharmacy, National University of Singapore, Singapore.,Department of Pharmacy, National Cancer Centre Singapore, Singapore
| | - Ngiap-Chuan Tan
- Family Medicine Academy Clinical Programme, Duke-NUS Graduate Medical School Singapore, Singapore.,SingHealth Polyclinics, Singapore
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16
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Abstract
PURPOSE OF REVIEW As more people live longer with cancer, the number of patients with cancer and multiple other chronic conditions (multimorbidity) has increased. The presence of multimorbidity impacts on all stages of cancer care, from prevention and early detection through to end of life care, but research into cancer and multimorbidity is in its infancy. This review explores the impact of multimorbidity on adults living with (and beyond) cancer, with particular attention paid to the role of primary care in supporting patients in this situation. RECENT FINDINGS Patterns of multimorbidity vary depending on cancer type and stage, as well as population characteristics and available data (e.g. number of conditions assessed). Cancer survivors are at increased risk of developing other chronic conditions, due to a combination of shared risk factors (e.g. smoking and obesity), effects of cancer treatments and psychosocial effects. SUMMARY Primary care has a central role to play in supporting multimorbid adults living with cancer, providing holistic care of physical and mental well being, while taking treatment burden and social circumstances into account. New models of person-centred and personalized cancer care include holistic needs assessments, care planning, treatment summaries and cancer care reviews, and depend on improved communication between oncologists and primary care colleagues.
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17
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Vos JAM, Wieldraaijer T, van Weert HCPM, van Asselt KM. Survivorship care for cancer patients in primary versus secondary care: a systematic review. J Cancer Surviv 2020; 15:66-76. [PMID: 32815087 PMCID: PMC7822798 DOI: 10.1007/s11764-020-00911-w] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 06/22/2020] [Indexed: 12/22/2022]
Abstract
Background Cancer survivorship care is traditionally performed in secondary care. Primary care is often involved in cancer management and could therefore play a more prominent role. Purpose To assess outcomes of cancer survivorship care in primary versus secondary care. Methods A systematic search of MEDLINE and EMBASE was performed. All original studies on cancer survivorship care in primary versus secondary care were included. A narrative synthesis was used for three distinctive outcomes: (1) clinical, (2) patient-reported, and (3) costs. Results Sixteen studies were included: 7 randomized trials and 9 observational studies. Meta-analyses were not feasible due to heterogeneity. Most studies reported on solid tumors, like breast (N = 7) and colorectal cancers (N = 3). Clinical outcomes were reported by 10 studies, patient-reported by 11, and costs by 4. No important differences were found on clinical and patient-reported outcomes when comparing primary- with secondary-based care. Some differences were seen relating to the content and quality of survivorship care, such as guideline adherence and follow-up tests, but there was no favorite strategy. Survivorship care in primary care was associated with lower societal costs. Conclusions Overall, cancer survivorship care in primary care had similar effects on clinical and patient-reported outcomes compared with secondary care, while resulting in lower costs. Implications for cancer survivors Survivorship care in primary care seems feasible. However, since the design and outcomes of studies differed, conclusive evidence for the equivalence of survivorship care in primary care is still lacking. Ongoing studies will help provide better insights.
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Affiliation(s)
- J A M Vos
- Department of General Practice, Amsterdam UMC, University of Amsterdam, Post-box 22660, 1100 DD, Amsterdam, the Netherlands.
| | - T Wieldraaijer
- Department of General Practice, Amsterdam UMC, University of Amsterdam, Post-box 22660, 1100 DD, Amsterdam, the Netherlands
| | - H C P M van Weert
- Department of General Practice, Amsterdam UMC, University of Amsterdam, Post-box 22660, 1100 DD, Amsterdam, the Netherlands
| | - K M van Asselt
- Department of General Practice, Amsterdam UMC, University of Amsterdam, Post-box 22660, 1100 DD, Amsterdam, the Netherlands
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18
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Luigjes-Huizer YL, van der Lee ML, de Wit NJ, Helsper CW. Study protocol of the BLANKET trial: a cluster randomised controlled trial on the (cost-) effectiveness of a primary care intervention for fear of cancer recurrence in cancer survivors. BMJ Open 2019; 9:e032616. [PMID: 31796488 PMCID: PMC7003381 DOI: 10.1136/bmjopen-2019-032616] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Many successfully treated patients with cancer suffer from fear of cancer recurrence (FCR), affecting their quality of life and their physical, emotional, cognitive and social functioning. Effective psychological interventions for FCR exist but are not widely available, as they are typically offered by specialised psycho-oncology professionals and institutes. Concurrently, the role of primary care in cancer and survivorship care is increasing. Therefore, there could be a role for general practitioners (GPs) and mental health workers (MHWs) working in primary care in supporting patients with FCR. In the current study, the effectiveness of a primary care delivered FCR intervention will be evaluated. METHODS AND ANALYSIS A two-armed cluster randomised trial will be conducted. The primary outcome will be FCR severity; secondary outcomes will be FCR-related distress, healthcare uptake and healthcare costs. Primary care practices in the Netherlands will be invited to participate in the study. Participating practices will be stratified by size and socioeconomic status and randomised. In the control arm, practices will provide care as usual. In the intervention arm, practices will offer the cognitive-behavioural FCR intervention that is being studied, which consists of an intake with the GP and five sessions with the MHW. Patients who have finished successful curative treatment for cancer between 3 months and 10 years ago will be invited to participate in the study by invitation letter from their GPs. Participating patients will fill out questionnaires at baseline, after 3 months and after 12 months. Data on healthcare use will be collected from their electronic health records. Qualitative interviews are held at T1 with patients and practitioners in the intervention group. ETHICS AND DISSEMINATION The Medical Research Ethics Committee (METC) Utrecht has reviewed the study in accordance with the Dutch Medical Research Involving Human Subjects Act (WMO) and other applicable Dutch and European regulations. Based on the requirements of the WMO, the METC Utrecht has issued an approval of the above-mentioned study. Any protocol amendments will be communicated to all relevant parties. Written consent is obtained from study participants. Results will be dispersed through peer-reviewed publications and scientific presentations. TRIAL REGISTRATION NUMBER NL7573 in the Netherlands Trial Register on 25-02-2019.
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Affiliation(s)
- Yvonne L Luigjes-Huizer
- Scientific Research, Helen Dowling Institute, Bilthoven, The Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | | | - Niek J de Wit
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Charles W Helsper
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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Abstract
OBJECTIVES To review the nature and scope of apps targeting individuals living with and beyond cancer. DESIGN Scoping review, searching the two largest app stores, Google Play and Apple's App store. App descriptions were exported verbatim, and summarised descriptively, thematically and by content coding. RESULTS We included 151 apps targeting individuals living with and beyond cancer. Most targeted all cancer types (n=89, 58.9%) or breast cancer (n=22, 14.6%) and originated in the USA (n=68, 45.0%). The country of origin was unclear for 31 (20.5%) apps. Most apps were developed by commercial companies/private individuals (n=64, 43%) or non-profit organisations (n=30, 19.9%) and marketed apps in terms of fighting metaphors, navigating a journey and becoming empowered to take control.App content could be summarised under five main categories: (1) imparting information about cancer; (2) planning and organising cancer care; (3) interacting with others (including others affected by cancer and healthcare professionals); (4) enacting management strategies and adjusting to life with or beyond cancer and (5) getting feedback about cancer management, for example, by sharing self-monitoring reports with professionals. We found some apps describing 'cures' for cancer or selling products, such as alkaline waters to cancer survivors. CONCLUSIONS Apps are currently available via on-line stores that cover a large spectrum of cancer survivorship activities. The effects of such apps on clinical consultations, patient work/burden and clinical outcomes merit further attention. Most apps are developed by commercial organisations, and promises of empowerment in the 'fight' against cancer are tempered by the potential for exaggerated claims and exploitation.
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Affiliation(s)
- Rosalind Adam
- Academic Primary Care, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Drew McMichael
- Academic Primary Care, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Daniel Powell
- Aberdeen Health Psychology Group, Institue of Applied Health Sciences, Rowett Institute, University of Aberdeen, Aberdeen, UK
| | - Peter Murchie
- Academic Primary Care, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
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20
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Patterns of primary health care service use of Indigenous Australians diagnosed with cancer. Support Care Cancer 2019; 28:317-327. [DOI: 10.1007/s00520-019-04821-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 04/16/2019] [Indexed: 12/19/2022]
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21
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Primary Care Nursing Is Essential to Fully Implement Survivorship Care Plans for Long-term Cancer Survivors and Their Families. Cancer Nurs 2019; 42:177-178. [DOI: 10.1097/ncc.0000000000000704] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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