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Lax H, Baum J, Lehmann N, Merkel‐Jens A, Beelen DW, Jöckel K, Dührsen U. Patterns of follow-up care in adult blood cancer survivors-Prospective evaluation of health-related outcomes, resource use, and quality of life. Cancer Med 2024; 13:e7095. [PMID: 38549460 PMCID: PMC10979186 DOI: 10.1002/cam4.7095] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 01/11/2024] [Accepted: 02/29/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Information about follow-up care in blood cancer survivors is limited. The questionnaire-based "Aftercare in Blood Cancer Survivors" (ABC) study aimed to identify patterns of follow-up care in Germany and compare different types of follow-up institutions. METHODS The study's 18-month prospective part compared the follow-up institutions identified in the preceding retrospective part (academic oncologists, community oncologists, primary care physicians). The questionnaires were completed by the follow-up physicians. RESULTS Of 1070 physicians named by 1479 blood-cancer survivors, 478 (44.7%) consented to participate. For provision of care, most oncologists relied on published guidelines, while most primary care physicians depended on information from other physicians. Survivors with a history of allogeneic transplantation or indolent lymphoma were mainly seen by academic oncologists, whereas survivors with monoclonal gammopathy, multiple myeloma, or myeloproliferative disorders were often seen by community oncologists, and survivors with a history of aggressive lymphoma or acute leukemia by primary care physicians. Detection of relapse and secondary diseases was consistently viewed as the most important follow-up goal. Follow-up visits were most extensively documented by academic oncologists (574 of 1045 survivors cared for, 54.9%), followed by community oncologists (90/231, 39.0%) and primary care physicians (51/203, 25.1%). Relapse and secondary disease detection rates and the patients' quality of life were similar at the three institutions. Laboratory tests were most often ordered by academic oncologists, and imaging by primary care physicians. Psychosocial issues and preventive care were more often addressed by primary care physicians than by oncologists. CONCLUSIONS Patients at high risk of relapse or late complications were preferentially treated by academic oncologists, while patients in stable condition requiring continuous monitoring were also seen by community oncologists, and patients with curable diseases in long-term remission by primary care physicians. For the latter, transfer of follow-up care from oncologists to well-informed primary care providers appears feasible.
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Affiliation(s)
- Hildegard Lax
- Institut für Medizinische Informatik, Biometrie und EpidemiologieUniversität Duisburg‐EssenEssenGermany
| | - Julia Baum
- Klinik für HämatologieUniversitätsklinikum Essen, Universität Duisburg‐EssenEssenGermany
| | - Nils Lehmann
- Institut für Medizinische Informatik, Biometrie und EpidemiologieUniversität Duisburg‐EssenEssenGermany
| | - Anja Merkel‐Jens
- Institut für Medizinische Informatik, Biometrie und EpidemiologieUniversität Duisburg‐EssenEssenGermany
| | - Dietrich W. Beelen
- Klinik für KnochenmarktransplantationUniversitätsklinikum Essen, Universität Duisburg‐EssenEssenGermany
| | - Karl‐Heinz Jöckel
- Institut für Medizinische Informatik, Biometrie und EpidemiologieUniversität Duisburg‐EssenEssenGermany
| | - Ulrich Dührsen
- Klinik für HämatologieUniversitätsklinikum Essen, Universität Duisburg‐EssenEssenGermany
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Baum J, Lax H, Lehmann N, Merkel-Jens A, Beelen DW, Jöckel KH, Dührsen U. Impairment of vocational activities and financial problems are frequent among German blood cancer survivors. Sci Rep 2023; 13:22856. [PMID: 38129654 PMCID: PMC10739705 DOI: 10.1038/s41598-023-50289-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 12/18/2023] [Indexed: 12/23/2023] Open
Abstract
Little is known about changes in the personal living conditions of long-term blood cancer survivors in Germany. To gather information about social relationships, work life, overall well-being, and religion, we performed a questionnaire-based retrospective study on 1551 survivors who had been on follow-up for ≥ 3 years (median, 9 years). Most survivors reported that marital status and relationships with relatives and friends remained constant before and after blood cancer. Vocational activities were temporarily impaired for 47.5%, with a median time of 11 months to return to work. More than a third of the patients (35.6%) discontinued work permanently, with disability and retirement pension rates of 7.9% and 38.1%, respectively, at the time of the survey. Financial problems due to reduced income were reported by 26.2%, in particular after relapse or allogeneic transplantation. Patient reports addressing their quality of life showed large variations. It was best in acute leukemia survivors without a history of allogeneic transplantation and worst in patients with myeloproliferative disorders. Religion tended to become more important after blood cancer. In conclusion, vocational impairment and financial problems are frequent among German blood cancer survivors. Efforts should be made at an early stage to reestablish the patients' ability to work.
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Affiliation(s)
- Julia Baum
- Klinik für Hämatologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Germany
| | - Hildegard Lax
- Institut für Medizinische Informatik, Biometrie und Epidemiologie, Universität Duisburg-Essen, Essen, Germany
| | - Nils Lehmann
- Institut für Medizinische Informatik, Biometrie und Epidemiologie, Universität Duisburg-Essen, Essen, Germany
| | - Anja Merkel-Jens
- Institut für Medizinische Informatik, Biometrie und Epidemiologie, Universität Duisburg-Essen, Essen, Germany
| | - Dietrich W Beelen
- Klinik für Knochenmarktransplantation, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Germany
| | - Karl-Heinz Jöckel
- Institut für Medizinische Informatik, Biometrie und Epidemiologie, Universität Duisburg-Essen, Essen, Germany
| | - Ulrich Dührsen
- Klinik für Hämatologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Germany.
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3
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Granger CL. Physiotherapy management of blood cancers. J Physiother 2023; 69:70-78. [PMID: 36958978 DOI: 10.1016/j.jphys.2023.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 02/27/2023] [Indexed: 03/25/2023] Open
Affiliation(s)
- Catherine L Granger
- Department of Physiotherapy, The University of Melbourne, Melbourne, Australia; Department of Physiotherapy, The Royal Melbourne Hospital, Melbourne, Australia.
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4
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Murri MB, Caruso R, Christensen AP, Folesani F, Nanni MG, Grassi L. The facets of psychopathology in patients with cancer: Cross-sectional and longitudinal network analyses. J Psychosom Res 2023; 165:111139. [PMID: 36610333 DOI: 10.1016/j.jpsychores.2022.111139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 12/23/2022] [Accepted: 12/23/2022] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Cancer patients display heterogeneous psychopathology, comprising depressive, anxiety, hostility, and somatic symptoms. Often, clinical pictures evolve over time deteriorating the individual functioning and prognosis. Network models can reveal the relationships between symptoms, thus providing clinical insights. METHOD This study examined data of the Brief Symptom Inventory and the Distress Thermometer, from 1108 cancer outpatients. Gaussian Graphical Models were estimated using regularized and non-regularized Bayesian methods. In addition, we used community detection methods to identify the most relevant symptom groupings, and longitudinal network analyses on 515 participants to examine the connections between symptoms over three months. RESULTS The network models derived from baseline data suggested symptoms clustered into three main complexes (depression/anxiety, hostility, and somatic symptoms). Symptoms related to depression and hostility were highly connected with suicidal and death thoughts. Faintness, weakness, chest pain, and dyspnoea, among somatic symptoms, were more strongly connected with psychopathological features. Longitudinal analyses revealed that sadness, irritability, nervousness, and tension predicted each other. Panic and death thoughts predicted fearfulness and faintness. CONCLUSIONS Somatic symptoms, sadness, irritability, chronic and acute anxiety interact between each other, shaping the heterogeneous clinical picture of distress in cancer. This study, strengthened by robust methods, is the first to employ longitudinal network analyses in cancer patients. Further studies should evaluate whether targeting specific symptoms might prevent the onset of chronic distress and improve clinical outcomes in cancer patients.
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Affiliation(s)
- Martino Belvederi Murri
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Italy.
| | - Rosangela Caruso
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Italy
| | - Alexander P Christensen
- Department of Psychology, University of North Carolina at Greensboro, Greensboro, United States
| | - Federica Folesani
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Italy
| | - Maria Giulia Nanni
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Italy
| | - Luigi Grassi
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Italy
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5
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Dai H, Xu S, Han J, Li Z, Cao J, Hu T, Li H, Wei J, Dou X, Zhou F, Zheng J. Prevalence and factors associated with anxiety and depressive symptoms among patients hospitalized with hematological malignancies after chimeric antigen receptor T-cell (CAR-T) therapy: A cross-sectional study. J Affect Disord 2021; 286:33-39. [PMID: 33676261 DOI: 10.1016/j.jad.2021.02.041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 02/07/2021] [Accepted: 02/12/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND We conducted a survey to investigate the prevalence and factors associated with anxiety and depressive symptoms among patients hospitalized with hematological malignancies after chimeric antigen receptor T-cell (CAR-T) therapy. METHODS In total, 130 eligible patients completed the Self-Rating Anxiety Scale and Self-Rating Depression Scale at week 4 after CAR-T cell infusion. We collected sociodemographic information during the same period. We studied factors associated with anxiety and depressive symptoms using logistic regression analysis. RESULTS The prevalence of anxiety and depressive symptoms at week 4 after infusion were 13.8% and 40.0%, respectively. A cutoff value of 50 or above indicates significantly anxiety and depressive symptoms. Binary logistic regression analysis showed that high school education and above (OR = 0.22, 95% CI = 0.06-0.78) and middle age (OR = 0.16, 95% CI = 0.03-0.90) were associated with lower risk of anxiety symptoms, and increased odds of depressive symptoms was associated with old age (OR = 11.39, 95% CI = 2.50-51.88), non-manual occupations before illness (OR = 3.72, 95% CI = 1.20-11.58), and higher healthcare expenditure (OR = 3.93, 95% CI = 1.50-10.33), while lower risk of depressive symptoms was associated with rural household location (OR = 0.25, 95% CI = 0.08-0.76) and being cared for by spouse (OR = 0.12, 95% CI = 0.02-0.63). CONCLUSIONS Patients receiving CAR-T therapy with lower education background, old ages, urban household location, or who used to work as non-manual workers require more attention and psychological care. Support from a spouse and medical expense deductions from the government may help patients develop positive attitudes.
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Affiliation(s)
- Hongyuan Dai
- School of Nursing, Xuzhou Medical University, Jiangsu, China
| | - Shuya Xu
- School of Nursing, Xuzhou Medical University, Jiangsu, China; Intensive care unit, the Affiliated Hospital of Xuzhou Medical University, Jiangsu, China
| | - Jing Han
- School of Nursing, Xuzhou Medical University, Jiangsu, China
| | - Zhenyu Li
- Department of hematology, the Affiliated Hospital of Xuzhou Medical University, Jiangsu, China
| | - Jiang Cao
- Department of hematology, the Affiliated Hospital of Xuzhou Medical University, Jiangsu, China
| | - Tingyu Hu
- Department of hematology, the Affiliated Hospital of Xuzhou Medical University, Jiangsu, China
| | - Hongxia Li
- Department of hematology, the Affiliated Hospital of Xuzhou Medical University, Jiangsu, China
| | - Jing Wei
- Department of hematology, the Affiliated Hospital of Xuzhou Medical University, Jiangsu, China
| | - Xue Dou
- School of Nursing, Xuzhou Medical University, Jiangsu, China
| | - Fang Zhou
- School of Nursing, Xuzhou Medical University, Jiangsu, China.
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Martins-Klein B, Bamonti PA, Owsiany M, Naik A, Moye J. Age differences in cancer-related stress, spontaneous emotion regulation, and emotional distress. Aging Ment Health 2021; 25:250-259. [PMID: 31851838 PMCID: PMC7299731 DOI: 10.1080/13607863.2019.1693972] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVES Cancer risk increases with age, cancer-related stress is common and devastating to mental health of patients, yet little work has explored age differences in cancer-related stress. This study investigated sources of stress related to cancer diagnosis and treatment and its association with age and emotional health. Though not an a priori aim of the study, adaptive strategies mentioned within discussions of stress-which we classify as spontaneous emotion regulation (ER) - were also investigated. METHOD Participants (N = 147, aged 27-88) recruited from the VA (98% male) with oral-digestive cancers participated in semi-structured interviews regarding sources of stress 6-months post-diagnosis (T1) and treatment-related stress at 12-months post-diagnosis (T2). Patients also reported their emotional distress at T2 via the PROMIS-29. Inductive content analysis was used to classify sources of stress and ER into semantic themes and relative frequencies. RESULTS The greatest source of stress at diagnosis was psychological; physical symptoms were the greatest source of stress at treatment. Older adults less frequently reported psychological uncertainty, social stress, and situational stress, whereas age groups reported similar rates of physical stress. When describing stress, older adults more often made spontaneous references to emotion regulation (ER). Across age groups, those who reported stress without ER in qualitative comments had higher emotional distress on the PROMIS-29 than those reporting stress with ER or no stress. CONCLUSION ER may be key to psychological adjustment to cancer, especially in later-life. implications for assessment of stress at pivotal visits and mental health referral are discussed.
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Affiliation(s)
- Bruna Martins-Klein
- Department of Psychological and Brain Sciences, University of Massachusetts-Amherst, Amherst, MA, USA,VA Boston Healthcare System, Boston, MA, USA,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Patricia A. Bamonti
- VA Boston Healthcare System, Boston, MA, USA,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Montgomery Owsiany
- VA Boston Healthcare System, Boston, MA, USA,New England Geriatric Research, Education and Clinical Center, Boston, MA, USA
| | - Aanand Naik
- Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, USA,Baylor College of Medicine, Houston, TX, USA
| | - Jennifer Moye
- VA Boston Healthcare System, Boston, MA, USA,Department of Psychiatry, Harvard Medical School, Boston, MA, USA,New England Geriatric Research, Education and Clinical Center, Boston, MA, USA
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7
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Cheng Y, Sun F, D'Souza A, Dhakal B, Pisano M, Chhabra S, Stolley M, Hari P, Janz S. Autonomic nervous system control of multiple myeloma. Blood Rev 2020; 46:100741. [PMID: 32807576 DOI: 10.1016/j.blre.2020.100741] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 07/10/2020] [Accepted: 08/06/2020] [Indexed: 12/16/2022]
Abstract
The autonomic nervous system (ANS), which consists of antagonistic sympathetic (adrenergic) and parasympathetic (cholinergic) arms, has emerged as an important regulator of neoplastic development, yet little is known about its role in multiple myeloma (MM). Clinical findings that anti-adrenergic β-blocker intake reduces risk of disease-specific death and overall mortality in patients with MM have indicated that adrenergic input may worsen myeloma outcome. However, preclinical studies using β-adrenergic receptor agonists or antagonists produced controversial results as to whether sympathetic pathways promote or inhibit myeloma. Retrospective outcome data demonstrating that high message levels of cholinergic receptor genes predict inferior survival in the Multiple Myeloma Research Foundation CoMMpass trial suggest that parasympathetic input may drive myeloma progression in a subset of patients. Here we review the ill-defined role of the ANS in MM, put myeloma in the context of other cancers, and discuss knowledge gaps that may afford exciting research opportunities going forward.
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Affiliation(s)
- Yan Cheng
- Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee 53226, WI, USA
| | - Fumou Sun
- Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee 53226, WI, USA
| | - Anita D'Souza
- Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee 53226, WI, USA
| | - Binod Dhakal
- Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee 53226, WI, USA
| | - Michael Pisano
- Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee 53226, WI, USA
| | - Saurabh Chhabra
- Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee 53226, WI, USA
| | - Melinda Stolley
- Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee 53226, WI, USA
| | - Parameswaran Hari
- Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee 53226, WI, USA
| | - Siegfried Janz
- Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee 53226, WI, USA.
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Amweg LN, McReynolds J, Lansang K, Jones T, Snow C, Berry DL, Partridge AH, Underhill-Blazey ML. Hodgkin Lymphoma Survivor Wellness: Development of a Web-Based Intervention. Clin J Oncol Nurs 2020; 24:284-289. [PMID: 32441674 DOI: 10.1188/20.cjon.284-289] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Informational and supportive care resources are needed for Hodgkin lymphoma (HL) survivors. OBJECTIVES The aim of this article is to adapt and evaluate a previously developed survivorship care website for HL survivors. METHODS A mixed-methods, user-centered design, including one-time focus groups, was followed by iterative web design and user testing. Transcripts were content analyzed, and survey responses were summarized. FINDINGS HL survivors need survivorship care education and support. Tailored web-based resources may be an effective adjunct to clinical care. The Survivor Wellness website is a usable web-based resource for HL survivors that may facilitate survivorship care.
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Affiliation(s)
| | | | - Kristina Lansang
- Angeles Clinic and Research Institute Cedars Sinai Medical Center Affiliate
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9
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A meta-review of qualitative research on adult cancer survivors: current strengths and evidence gaps. J Cancer Surviv 2019; 13:852-889. [DOI: 10.1007/s11764-019-00803-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 08/19/2019] [Indexed: 12/22/2022]
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10
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Raphael D, Frey R, Gott M. Distress in post-treatment hematological cancer survivors: Prevalence and predictors. J Psychosoc Oncol 2019; 38:328-342. [PMID: 31642396 DOI: 10.1080/07347332.2019.1679320] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objectives: To calculate the prevalence of psychosocial distress, and identify factors that predict distress, in early post-treatment hematological cancer survivors.Design: Cross-sectional survey containing self-report measures.Sample/Methods: Post-treatment hematological cancer survivors in remission (>18 years) (n = 409) completed questionnaires. Distress was measured with the distress thermometer (DT). Logistic regression was used to identify predictors of distress.Findings: Overall 21.9% (n = 93) of respondents reported significant distress (DT ≥4). Significant distress was twice as high in those born overseas (OR = 2.09, p = .03), 3.5 times higher in those with lower social support (OR = 3.51, p = <.001) and five times higher in those with increased fear of recurrence (OR = 0.17, p = <.001).Implications for Psychosocial Providers: Early identification of distress may decrease psychosocial issues in the post-treatment period, especially as psychosocial services have been shown to improve wellbeing for those who are distressed.
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Affiliation(s)
- Deborah Raphael
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Rosemary Frey
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Merryn Gott
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
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11
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Proia-Lelouey N, Letrecher S. L’isolement en secteur protégé : une expérience extrême. Une revue de la littérature. PSYCHO-ONCOLOGIE 2019. [DOI: 10.3166/pson-2018-0045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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12
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Raphael D, Frey R, Gott M. The nature and timing of distress among post-treatment haematological cancer survivors. Eur J Cancer Care (Engl) 2018; 28:e12951. [PMID: 30284333 DOI: 10.1111/ecc.12951] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 08/19/2018] [Accepted: 09/12/2018] [Indexed: 11/26/2022]
Abstract
Many people with haematological cancers will not meet the diagnostic criteria for a psychological disorder, but will still suffer distress during treatment and beyond. The current study aimed to explore the nature and timing of psychosocial distress experienced by haematological cancer survivors. Twenty-three post-treatment haematological cancer survivors participated in a semi-structured interview. Data were analysed using thematic analysis which involved identifying, analysing and reporting themes. Four themes were identified: Apprehension about leaving the safety of the health care system comprises the struggles encountered when transitioning from patient to survivor, Uncertainty and life transitions in the post-treatment period encompasses the changes survivors face when attempting to re-enter their "normal" lives, Distress associated with ongoing physical problems or impairment describes issues associated with the ongoing physical sequelae, and Fear of recurrence encapsulates how the continuing threat of cancer recurrence impacted survivors. This study has found that distress is ongoing for many haematological cancer survivors in the post-treatment period. It is imperative that distress is identified and support offered to those in need to prevent further psychosocial issues. It is especially important to consider the psychosocial needs of survivors in the post-treatment stage who are discharged from the health system may be unsure where to seek help.
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Affiliation(s)
- Deborah Raphael
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Rosemary Frey
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Merryn Gott
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
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13
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Arts LPJ, Oerlemans S, Tick L, Koster A, Roerdink HTJ, van de Poll-Franse LV. More frequent use of health care services among distressed compared with nondistressed survivors of lymphoma and chronic lymphocytic leukemia: Results from the population-based PROFILES registry. Cancer 2018; 124:3016-3024. [PMID: 29698556 PMCID: PMC6055849 DOI: 10.1002/cncr.31410] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 04/03/2018] [Accepted: 04/04/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Follow-up care for a growing population of survivors of lymphoma and chronic lymphocytic leukemia (CLL) together with the adverse effects these survivors may experience as a result of their cancer and treatment have led to more pressure being placed on health care services. The objectives of the current study were to: 1) compare the use of medical care services by survivors with that of a normative population; 2) evaluate the use of medical and psychosocial care services among distressed and nondistressed survivors; and 3) identify associated sociodemographic and clinical factors. METHODS Survivors of lymphoma and CLL diagnosed between 1999 and 2012 were selected via the population-based Netherlands Cancer Registry and completed the Hospital Anxiety and Depression Scale questionnaire and questions regarding health care. Outcomes were compared with an age-matched and sex-matched normative population. RESULTS A total of 1444 survivors responded (69%). Survivors of lymphoma and CLL contacted their general practitioner (3.8 vs 2.3; P<.001) and medical specialist (5.7 vs 1.6; P<.001) more often within the last year compared with a normative population. In addition, psychologically distressed survivors had even more medical contacts and received psychosocial care more often compared with nondistressed survivors. In addition to psychological distress, comorbidity, female sex, and older age were found to be associated with a greater use of medical services, whereas younger age was associated with receiving psychosocial care. CONCLUSIONS Survivors of lymphoma and CLL, especially those who are psychologically distressed, report an increased use of health care services compared with a normative population. Further studies are needed to explore whether the use of widely applicable psychosocial interventions could reduce the frequency of medical contacts. Cancer 2018;124:3016-24. © 2018 Netherlands Comprehensive Cancer Organisation. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.
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Affiliation(s)
- Lindy P J Arts
- Department of Research, Netherlands Comprehensive Cancer Organisation, Utrecht, the Netherlands
| | - Simone Oerlemans
- Department of Research, Netherlands Comprehensive Cancer Organisation, Utrecht, the Netherlands.,Department of Medical and Clinical Psychology, Center of Research on Psychology in Somatic Diseases (CoRPS), Tilburg University, Tilburg, the Netherlands
| | - Lidwine Tick
- Department of Internal Medicine, Maxima Medical Centre, Eindhoven and Veldhoven, the Netherlands
| | - Ad Koster
- Department of Internal Medicine, VieCuri Medical Centre, Venlo and Venray, the Netherlands
| | - Henk T J Roerdink
- Department of Internal Medicine, Elisabeth-TweeSteden Hospital, Tilburg, the Netherlands
| | - Lonneke V van de Poll-Franse
- Department of Research, Netherlands Comprehensive Cancer Organisation, Utrecht, the Netherlands.,Department of Medical and Clinical Psychology, Center of Research on Psychology in Somatic Diseases (CoRPS), Tilburg University, Tilburg, the Netherlands.,Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, the Netherlands
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