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Paltrinieri S, Cavuto S, Contri A, Bassi MC, Bravi F, Schiavi M, Fugazzaro S, Guberti M, Costi S. Needs of breast cancer survivors: a systematic review of quantitative data. Crit Rev Oncol Hematol 2024; 201:104432. [PMID: 38955309 DOI: 10.1016/j.critrevonc.2024.104432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 06/21/2024] [Accepted: 06/25/2024] [Indexed: 07/04/2024] Open
Abstract
This systematic review aimed to update the perceived needs of individuals with breast cancer (BC). Databases were searched for studies reporting quantitative data collected through validated assessment tools. Needs of adults with BC were reported by survivorship phase. The post-diagnosis and the post-surgery phases revealed the most needs; health system and information needs represented the greatest concern, with average Supportive Care Needs Survey-Short Form (SCNS-SF34) scores ranging from 62.0 to 75.8 post-diagnosis and from 45.0 to 67.8 post-surgery. Needs then seemed to decrease or remain stable up to within one year from diagnosis, when needs in all domains increased again; health system and information needs remained a priority. Younger age, side effects, type of treatment, and advanced stage were associated with the occurrence of unmet needs. The needs of BC survivors vary over the course of their cancer experience. This knowledge can assist the planning of appropriate assessments.
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Affiliation(s)
- S Paltrinieri
- Research and EBP Unit, Health Professions Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy; Public Health Sciences PhD Program, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
| | - S Cavuto
- Statistics Unit, Clinical Trial Center, SOC Infrastructure, Research and Statistics, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - A Contri
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - M C Bassi
- Medical Library, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - F Bravi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - M Schiavi
- Research and EBP Unit, Health Professions Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy; Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - S Fugazzaro
- Physical Medicine and Rehabilitation Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - M Guberti
- Research and EBP Unit, Health Professions Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - S Costi
- Physical Medicine and Rehabilitation Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy; Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
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Güvener YÖ. The Significance of Religion and Spirituality Among Turkish Women Surviving Breast Cancer Without Treatment: A Qualitative Study. JOURNAL OF RELIGION AND HEALTH 2024; 63:2727-2744. [PMID: 38619687 PMCID: PMC11319412 DOI: 10.1007/s10943-024-02039-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/20/2024] [Indexed: 04/16/2024]
Abstract
The health of breast cancer survivors is a global concern. It is crucial to adopt a holistic approach when understanding their journey from illness to wellness in order to ensure that the transition is as smooth as possible. This study focused on the experiences of Muslim women who had overcome breast cancer and were adapting to life post-treatment. Snowball sampling was used to select the participants for this qualitative study. Fifteen women who had successfully completed breast cancer treatment and been declared cancer-free were interviewed. These interviews were semi-structured, using open-ended questions to explore their experiences in-depth. The interviews were conducted by phone, and the data were analyzed using qualitative content analysis. The study identified four main themes, nine subthemes, and 41 codes. The main themes were as follows: (a) a life changed by cancer and the difficulties encountered; (b) transition from active treatment to treatment-free living; (c) coping mechanisms; and (d) future hopes and expectations. The findings highlighted the survivors' desire to move past their experience of cancer and normalize their lives, as well as emphasizing their need for support. The participants shared detailed accounts of their journey, the obstacles they encountered during this transition, and the critical role of religion and spirituality in overcoming these challenges. Understanding and effectively managing the experiences of women after breast cancer treatment is vital not only for improving survival rates but also for facilitating their healing process.
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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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Abdelrahman H, Qadire MA, Zehry H. Reliability and Validity of the Arabic Version of the Short Form Supportive Care Needs Survey Questionnaire (SCNS-SF34-A). Semin Oncol Nurs 2024; 40:151646. [PMID: 38735783 DOI: 10.1016/j.soncn.2024.151646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 04/05/2024] [Accepted: 04/10/2024] [Indexed: 05/14/2024]
Abstract
OBJECTIVE This study aimed to assess the psychometric properties of the Arabic version of the Supportive Care Needs Survey Short Form 34 (SCNS-SF34-A) among heterogonous group of cancer patients. METHOD This was a multicenter, prospective, descriptive-correlational survey that included 297 cancer patients recruited from two hospitals. The tool construct validity, internal consistency, and test-retest reliability were evaluated. RESULTS The participants comprised 60.6% females, with ages ranging from 18 to 82 years. The majority were married (71.7%) and had mainly breast cancer (28.3%). Exploratory factor analysis supported a four-factor structure that are: health system information and patient support domain, psychological domain, physical and daily living domain, and sexuality domain. This tool explained 64.2% of the variance. The SCNS-SF34-A demonstrated excellent internal consistency for the whole scale (Cronbach's alpha = 0.954) and high test-retest reliability (ICC = 0.954) for the subscales (Cronbach's alpha ranged from 0.82 to 0.95 and ICC ranged from 0.950 to 0.960. CONCLUSION SCNS-SF34-A exhibits robust psychometric properties and holds promise for enhancing cancer care in the Arab world, contributing to a more tailored and effective approach to addressing patients' supportive care needs. The four-factor structure aligns with international studies, emphasizing the nuanced nature of variations. Further validation in diverse Arabic-speaking populations and the exploration of additional forms of validity are recommended. IMPLICATIONS FOR NURSING PRACTICE The SCNS-SF34-A presents a reliable, culturally adapted, and sensitive assessment tool for the diverse supportive care needs of cancer patients in Oman and the Arab world. It contributes to the improvement of the quality of cancer care and patient-centered approach in clinical practice.
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Affiliation(s)
- Hanan Abdelrahman
- College of Nursing, Sultan Qaboos University, Muscat, Sultanate of Oman, Oman; Faculty of Nursing, Suez Canal University, Egypt; Principles and Practice of Clinical Research, Harvard T.H. Chan School of Public Health, Boston, MA.
| | - Mohammad Al Qadire
- College of Nursing, Sultan Qaboos University, Muscat, Sultanate of Oman, Oman; Faculty of Nursing, Al Al-Bayt University, Mafraq, Jordan
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Askjær T, Juhl CB, Maribo T, Christiansen AF, Oestergaard LG. Telephone consultation for cancer survivors with unclarified need for rehabilitation in a primary healthcare setting: a mixed methods process evaluation. Disabil Rehabil 2024; 46:2901-2909. [PMID: 37480338 DOI: 10.1080/09638288.2023.2238599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 07/06/2023] [Accepted: 07/15/2023] [Indexed: 07/24/2023]
Abstract
PURPOSE To evaluate the implementation of telephone consultations to assess cancer patients' needs for rehabilitation, with focus on patients' acceptance, health professionals' experience and contextual factors. METHODS A mixed methods process evaluation was conducted at a primary healthcare rehabilitation clinic. Cancer survivors above 18 years of age with an unclarified rehabilitation need at discharge from hospital, was offered a telephone consultation provided by health professionals. Data on implementation and acceptability were collected using medical records systems, data collection forms and semi-structured interviews with six patients and two health professionals. RESULTS Eighty-one cancer survivors were referred to the intervention, and 54% continued to further rehabilitation. The telephone consultations were executed approximately eight days after referral and took on average 44 min to deliver. Overall, the patients found that the telephone consultation addressed what they considered the most important topics, and the health professionals found the intervention to be acceptable. Both patients and health professionals reported challenges regarding the referral process. CONCLUSION Patient acceptance of the intervention was high, and the telephone consultation was implemented to a high degree, resulting in more than half of the patients continuing to further rehabilitation. Patients' and health professionals' perspectives provided valuable insights about contextual factors.
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Affiliation(s)
- Tenna Askjær
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Department of Public Health, Health and Care, Municipality of Aarhus, Aarhus, Denmark
- Centre for Rehabilitation Research, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Carsten B Juhl
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital, Herlev and Gentofte, Denmark
| | - Thomas Maribo
- Centre for Rehabilitation Research, Department of Public Health, Aarhus University, Aarhus, Denmark
- DEFACTUM, Central Denmark Region, Aarhus, Denmark
| | | | - Lisa Gregersen Oestergaard
- Centre for Rehabilitation Research, Department of Public Health, Aarhus University, Aarhus, Denmark
- DEFACTUM, Central Denmark Region, Aarhus, Denmark
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Ayvat İ, Atli Ozbas A. Is There a Difference in Unmet Supportive Care Needs Between Older and Younger Outpatients Receiving Chemotherapy? J Palliat Care 2024; 39:115-121. [PMID: 34665068 DOI: 10.1177/08258597211044248] [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: 11/16/2022]
Abstract
Objective: This study investigated whether there was a difference in unmet supportive care needs between older and younger cancer patients who receive chemotherapy. Background: Physiological, physical, cognitive, and social functions, which play a key role in coping with cancer, are impaired due to aging. Age-related physiological changes and psychosocial factors and comorbid medical conditions make some of the needs of older cancer patients unique and complex. At the heart of meeting these needs lies the concept of supportive care. First step of meeting their needs is to determine these needs. Study Design and Methods: The study was conducted in the Daytime Treatment Unit of the oncology hospital of a university in Ankara, Turkey. The study sample consisted of 93 patients aged 65 years or older and 93 patients under 65 years of age. Both groups were similar in terms of sex, cancer type, and chemotherapy protocols. Data were collected using a Patient Information Form and Supportive Care Needs Scale-Short Turkish Version and analyzed using descriptive statistics, Mann-Whitney U test, Kruskal-Wallis H test, and Bonferroni correction. Results: Participants had a median total score of 1.92. Their "daily life needs" and "sexuality needs" subscale scores were highest and lowest, respectively. Older patients had lower median total scores than younger patients. Younger patients had higher median "health care and information needs" and "sexuality needs" subscale scores than older patients. Conclusion: Elderly patients reported fewer unmet needs than younger patients. This may be due to age-related cultural factors as they may have difficulty expressing their needs. Implications: Results suggest to focus on the fact that patients' needs change with age and that they have difficulty expressing their needs.
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Affiliation(s)
- İrem Ayvat
- Faculty of Nursing, Psychiatric Nursing Department, Hacettepe University, Turkey
| | - Azize Atli Ozbas
- Faculty of Nursing, Psychiatric Nursing Department, Hacettepe University, Turkey
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Sandager MT, Rossen S, Hofland DT, Nielsen CV, Maribo T. Health-related quality of life, needs, and concerns among cancer survivors referred to rehabilitation in primary healthcare setting. Acta Oncol 2024; 63:76-82. [PMID: 38482717 PMCID: PMC11332470 DOI: 10.2340/1651-226x.2024.19636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 01/29/2024] [Indexed: 08/21/2024]
Abstract
BACKGROUND AND PURPOSE There is a growing need for rehabilitation services beyond hospitals. This study aims to describe challenges faced by cancer survivors (CSs) referred for rehabilitation in primary healthcare, employing standardized scales measuring health-related quality of life (HRQOL) and open-ended questions. Furthermore, the study explores the applicability of patient-reported outcomes (PROs) in comprehensively understanding challenges encountered by CSs. MATERIAL AND METHODS This cross-sectional study involves CSs referred for cancer rehabilitation in a primary healthcare setting, including those participating in PROs as a part of routine practice. HRQOL was assessed using the Functional Assessment of Cancer Therapy-General (FACT-G). The International Classification of Functioning, Disability and Health (ICF) framed the analysis of responses to open-ended questions 'what concerns you the most?' and 'what matters to you?' Results: FACT-G showed the lowest scores for functional well-being (14.4) and emotional well-being (16.6), with higher scores for physical well-being (18.9) and social/family well-being (21.1). Responses to open-ended questions unveiled worries about everyday life and how cancer will impact family well-being presently and in the future. Furthermore, CSs reported a need to maintain normality and proactively address the challenges posed by the disease. INTERPRETATION CSs referred for rehabilitation in primary healthcare experience comprehensive challenges necessitating a holistic rehabilitation approach. This includes interventions supporting CSs in dealing with uncertainty, regaining a sense of control, and addressing family well-being concerns. When using PROs for need assessment, the combination of validated HRQOL scales and open-ended questions is crucial for an in-depth understanding of CSs' challenges.
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Affiliation(s)
- Mette T Sandager
- Copenhagen Centre for Cancer and Health, Municipality of Copenhagen, Copenhagen, Denmark
| | - Sine Rossen
- Copenhagen Centre for Cancer and Health, Municipality of Copenhagen, Copenhagen, Denmark.
| | - Dorte T Hofland
- Copenhagen Centre for Cancer and Health, Municipality of Copenhagen, Copenhagen, Denmark
| | - Claus V Nielsen
- Department of Public Health, Aarhus University, Aarhus, Denmark; DEFACTUM Central Denmark Region, Aarhus, Denmark; Social Medicine and Rehabilitation, Region Hospital Goedstrup, Denmark
| | - Thomas Maribo
- Department of Public Health, Aarhus University, Aarhus, Denmark; DEFACTUM Central Denmark Region, Aarhus, Denmark
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Zeng K, Zhong Y, Chen X, Zhang L. Perceived communication efficacy and unmet needs for chemotherapy-associated symptom management in patients with lung and colorectal cancer: a cross-sectional study. BMC Palliat Care 2024; 23:71. [PMID: 38481297 PMCID: PMC10936018 DOI: 10.1186/s12904-024-01376-9] [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: 07/23/2023] [Accepted: 02/05/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Understanding cancer patients' unmet needs for chemotherapy-related symptom management will assist clinicians in developing tailored intervention programs. Little is known about the association between perceived communication efficacy and unmet care needs for symptom management in patients with lung and colorectal cancer. OBJECTIVES To examine the unmet care needs for symptom management of patients with lung and colorectal cancer and their association with perceived communication efficacy. METHODS A cross-sectional survey was conducted in a tertiary hospital in China from July to November 2020. A convenience sample of 203 patients with lung and colorectal cancer undergoing chemotherapy completed survey questionnaires, including the MD Anderson Symptom Inventory Scale and the Perceived Efficacy in Patient‒Physician Interactions Scale. RESULTS Approximately 43% of participants had at least one symptom with unmet needs. Fatigue was reported as the symptom with the highest occurrence (66%), the highest demand for supportive care (36%), and the highest prevalence of unmet needs (19%). Low levels of perceived communication efficacy independently predicted participants' unmet needs for symptom management (β=-0.13, p = 0.011). CONCLUSIONS This study highlights the necessity of introducing clinical assessment tools and guidelines to address fatigue and other chemotherapy-induced symptoms in patients with lung and colorectal cancer. Clinical programs designed to actively engage cancer patients to voice their needs and strengthen their communication efficacy are also warranted.
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Affiliation(s)
- Kai Zeng
- School of Nursing, Southern Medical University, No.1023-1063 Shatai South Road, Baiyun District, Guangzhou, 510515, China
| | - Yaping Zhong
- Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Xiaofang Chen
- The Third Affiliated Hospital, Southern Medical University, Guangzhou, China
| | - Lili Zhang
- School of Nursing, Southern Medical University, No.1023-1063 Shatai South Road, Baiyun District, Guangzhou, 510515, China.
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9
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Yu Y, Li Y, Zhao J, Yao J, Duan Y, Shao Y, Xie J, Zhu L. The longitudinal relationship between self-compassion and cancer patients' unmet supportive care needs. Psychooncology 2024; 33:e6319. [PMID: 38497821 DOI: 10.1002/pon.6319] [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: 07/25/2023] [Revised: 12/20/2023] [Accepted: 02/25/2024] [Indexed: 03/19/2024]
Abstract
OBJECTIVES Unmet supportive care needs are associated with psychological symptoms such as depression and anxiety. However, so far, few studies have explored the protective psychological factors of unmet needs. Therefore, this study intends to explore the protective effect of self-compassion on unmet needs of Chinese cancer patients and to examine the predictive role of self-compassion on these needs during treatment. METHODS A longitudinal study was performed at Shaanxi Provincial Cancer Hospital in Xi'an, China. A total of 153 heterogeneous cancer patients were assessed after the first diagnosis (T1), at the beginning (T2) and end (T3) of medical treatment. Hierarchical linear regression analyses were used to examine the research questions. RESULTS Cross-sectional regression analyses showed that self-compassion at T1 was significantly related to psychological needs at T1. Negative self-compassion at T1 was significantly related to total unmet needs, psychological needs, health system, and information and sexual needs. Longitudinal regression analyses showed that self-compassion at T1 significantly predicted total unmet needs; health system and information (HSI) needs at T2, psychological needs at T3, and negative self-compassion at T1 significantly predicted total unmet needs, HSI needs, physical needs, and patient care needs at T2 when controlling for unmet needs at T1. Positive self-compassion was not a predictor of unmet needs. CONCLUSIONS Self-compassion can be a protective factor of unmet needs in cancer patients. Future intervention studies should focus on improving the overall level of self-compassion and reducing the level of negative self-compassion in cancer patients to reduce patients' unmet needs.
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Affiliation(s)
- Yunlei Yu
- School of Psychology, Shaanxi Normal University, Xi'an, China
| | - Yanze Li
- School of Psychology, Shaanxi Normal University, Xi'an, China
| | - Jiang Zhao
- Shaanxi Provincial Cancer Hospital, Xi'an, China
| | - Juntao Yao
- Shaanxi Provincial Cancer Hospital, Xi'an, China
| | - Yaokun Duan
- School of Psychology, Shaanxi Normal University, Xi'an, China
| | - Yufei Shao
- School of Psychology, Shaanxi Normal University, Xi'an, China
| | - Juan Xie
- Shaanxi Provincial Cancer Hospital, Xi'an, China
| | - Lei Zhu
- School of Psychology, Shaanxi Normal University, Xi'an, China
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Deuning-Smit E, Custers JAE, Braam CIW, Hermens RPMG, Prins JB. Toward implementation of an evidence-based intervention for fear of cancer recurrence: Feasibility in real-world psycho-oncology practice. Psychooncology 2024; 33:e6297. [PMID: 38282226 DOI: 10.1002/pon.6297] [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: 09/27/2023] [Revised: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 01/30/2024]
Abstract
OBJECTIVE Few evidence-based interventions addressing high levels of fear of cancer recurrence (FCR) have been implemented. Understanding how these might be implemented is crucial to bridge the research-practice gap. This study investigated the feasibility of implementing the blended Survivors' Worries of Recurrent Disease (SWORD) intervention in real-world psycho-oncology practice. METHODS SWORD was offered for 15 months (2021-2022) as the standard care for clinical FCR in a university hospital, a general hospital, and psycho-oncological center. We evaluated using a mixed-methods design six feasibility outcomes based on Bowen's framework: demand, limited effectiveness, degree of execution, acceptability, practicality, and integration. Anonymous data were collected for all oncology patients on referral. Study participants completed questionnaires before and after treatment, including the Cancer Worry Scale (CWS-6) as the primary measure of effectiveness. Qualitative data included interviews with patients and psychologists, and field notes. RESULTS Regarding demand, 81 of 644 patients referred (13%) were eligible for SWORD. The uptake of SWORD was 79% (n = 63/80) and the completion rate 73% (n = 46/63). SWORD was effective in reducing FCR (p < 0.001, ηp2 = 0.694). Regarding execution, a variability in the length, planning and number of treatment sessions was found between different settings. Adherence to the treatment manual's content was high (89%). Regarding acceptability, most patients were satisfied with SWORD (average 8.2/10) and psychologists valued the blended format. Psychologists reported SWORD was practical to deliver given their knowledge and skills. Although differences between settings were found, SWORD integrated well into practice. Referral for FCR and a reluctance to contract new eHealth providers were barriers for implementation. CONCLUSIONS Despite differences between healthcare settings, the implementation of SWORD was evaluated well. The feasibility of SWORD in different settings should inform a national implementation strategy.
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Affiliation(s)
- Esther Deuning-Smit
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - José A E Custers
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Cheyenne I W Braam
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Rosella P M G Hermens
- Department of IQ Health, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Judith B Prins
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
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11
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Mendes-Santos C, Nóbrega C, Quinta-Gomes AL, Weiderpass E, Santana R, Andersson G. Validation of the Portuguese version of the supportive care needs survey short-form questionnaire (SCNS-SF34-Pt) and the breast cancer supplementary module (SCNS-BR8-Pt). J Psychosoc Oncol 2023; 42:486-505. [PMID: 37975563 DOI: 10.1080/07347332.2023.2282015] [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] [Indexed: 11/19/2023]
Abstract
OBJECTIVE This study aimed to test the psychometric properties of the Portuguese Supportive Care Needs Survey-Short Form-34 (SCNS-SF34-Pt) and its breast cancer-specific complementary module (SCNS-BR8-Pt). A further aim was to characterize Portuguese Breast Cancer Survivors' (BCS) unmet supportive care needs, using these measures. METHODS A convenient sample of BCS was recruited from five hospitals in Portugal and invited to complete SCNS-SF34-Pt and SCNS-BR8-Pt, EORTCQLQC30 and QLQBR23, the Generalized Anxiety Disorder, and the Patient Health-Questionnaire. The validity (i.e. convergent, discriminant and convergent validity) and reliability of SCNS-SF34-Pt and SCNS-BR8-Pt were statistically evaluated. BCS' unmet supportive care needs were descriptively assessed. FINDINGS 336 BCS participated in the study. A four-factor solution was produced for SCNS-SF34-Pt. This solution included the Physical and daily living needs, Psychological needs, Sexuality needs, and Health system, information, and patient support needs dimensions (73% of the total variance; Cronbach's alpha=.82 to .97). SCNS-SF34-Pt demonstrated good convergent validity. It could also discriminate between known-groups regarding age, disease staging, treatment performed, and ECOG performance status. SCNS-BR8-Pt revealed a single-factor structure (62% of the total variance; Cronbach's alpha=.91).Portuguese BCS' most prevalent unmet supportive care needs were associated with the Psychological, and Physical and daily living domains. Fear of cancer spreading, the inability to do things as usual, and lack of energy/tiredness were perceived as issues requiring further supportive care. CONCLUSIONS SCNS-SF34-Pt and the SCNS-BR8-Pt are valid and reliable tools to assess Portuguese BCS' unmet supportive care needs. Fear of cancer spreading and lack of energy/tiredness concerns should be a target of supportive care services.
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Affiliation(s)
| | - Catarina Nóbrega
- Center for Psychology at the University of Porto, Porto, Portugal
| | | | | | - Rui Santana
- NOVA National School of Public Health, Public Health Research Centre, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Stockholm, Sweden
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12
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Roseleur J, Edney LC, Jung J, Karnon J. Prevalence of unmet supportive care needs reported by individuals ever diagnosed with cancer in Australia: a systematic review to support service prioritisation. Support Care Cancer 2023; 31:676. [PMID: 37934313 PMCID: PMC10630245 DOI: 10.1007/s00520-023-08146-y] [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: 07/08/2023] [Accepted: 10/26/2023] [Indexed: 11/08/2023]
Abstract
PURPOSE Improved health outcomes for individuals ever diagnosed with cancer require comprehensive, coordinated care that addresses their supportive care needs. Implementing interventions to address these is confounded by a lack of evidence on population needs and a large pool of potential interventions. This systematic review estimates the point prevalence of different supportive care needs stratified by the tool used to measure needs and cancer type in Australia. METHODS We searched MEDLINE, Embase, and Scopus from 2010 to April 2023 to identify relevant studies published on the prevalence of supportive care needs in Australia. RESULTS We identified 35 studies that met the inclusion criteria. The highest prevalent unmet need across all cancers was 'fear of cancer spreading' (20.7%) from the Supportive Care Needs Survey Short-Form 34 (SCNS-SF34), ranging from 9.4% for individuals ever diagnosed with haematological cancer to 36.3% for individuals ever diagnosed with gynaecological cancer, and 'concerns about cancer coming back' (17.9%) from the Cancer Survivors' Unmet Needs (CaSUN), ranging from 9.7% for individuals ever diagnosed with prostate cancer to 37.8% for individuals ever diagnosed with breast cancer. Two studies assessed needs in Aboriginal and Torres Strait Islander populations, reporting the highest needs for financial worries (21.1%). CONCLUSIONS Point prevalence estimates presented here, combined with estimates of the costs and effects of potential interventions, can be used within economic evaluations to inform evidence-based local service provision to address the supportive care needs of individuals ever diagnosed with cancer. IMPLICATIONS FOR CANCER SURVIVORS Local health services can use local evidence to prioritise the implementation of interventions targeted at unmet needs.
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Affiliation(s)
- Jackie Roseleur
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.
| | - Laura Catherine Edney
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Jayda Jung
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Jonathan Karnon
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
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Yoon J, Lee H, Son H. Effects of an interactive coaching intervention on quality of life and psychological factors for colorectal cancer survivors: A single group pre and posttest design. Eur J Oncol Nurs 2023; 66:102413. [PMID: 37776600 DOI: 10.1016/j.ejon.2023.102413] [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: 05/23/2023] [Revised: 07/25/2023] [Accepted: 09/07/2023] [Indexed: 10/02/2023]
Abstract
OBJECTIVE To develop and evaluate the effects of an interactive coaching intervention, using a self-management mobile application, on quality of life and physical and psychological factors for colorectal cancer survivors. METHODS We developed a self-management mobile application providing social support services for post-treatment CRC survivors and evaluated its effects through baseline and post-intervention surveys. Using the biopsychosocial holistic model as the theoretical framework, automated interactive coaching technology was applied for six weeks to provide supportive services tailored for each user. To evaluate the effects of the application, self-efficacy, health practice index, depression, fear of cancer recurrence, and quality of life measures were administered to participants. A total of 34 men and 5 women were included in the analysis. RESULTS Participants' mean age were 54.10 years and 78% of them had been diagnosed within the last five years. There were significant increases in self-efficacy (z = 2.09, p = .04), health practice index (t = 2.35, p = .02), and quality of life (t = 2.03, p = .05). More specifically, the emotional functional score increased (z = 2.23, p = .03) while both of the total symptom score (t = 2.10, p = .04) and the fatigue symptom score (z = 2.54, p = .01) decreased after six weeks of using the mobile application. CONCLUSIONS Interventions supporting colorectal cancer survivors' self-management are critical for addressing the challenges they face after treatment and improving their quality of life. Providing social support through mobile applications could be a good strategy in terms of usability and effectiveness.
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Affiliation(s)
- Jaehee Yoon
- Wolchon Elementary School, 132, Mokdongjungang-ro, Yangcheon-gu, Seoul, 07989, South Korea.
| | - HyunHae Lee
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, 06974, South Korea
| | - Heesook Son
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, 06974, South Korea.
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14
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Nicoll I, Lockwood G, Fitch MI. Cancer Survivors Living in Rural Settings: A Qualitative Exploration of Concerns, Positive Experiences and Suggestions for Improvements in Survivorship Care. Curr Oncol 2023; 30:7351-7365. [PMID: 37623014 PMCID: PMC10453435 DOI: 10.3390/curroncol30080533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 07/25/2023] [Accepted: 08/01/2023] [Indexed: 08/26/2023] Open
Abstract
In Canada, the number of cancer survivors continues to increase. It is important to understand what continues to present difficulties after the completion of treatment from their perspectives. Various factors may present barriers to accessing help for the challenges they experience following treatment. Living rurally may be one such factor. This study was undertaken to explore the major challenges, positive experiences and suggestions for improvement in survivorship care from rural-dwelling Canadian cancer survivors one to three years following treatment. A qualitative descriptive analysis was conducted on written responses to open-ended questions from a national cross-sectional survey. A total of 4646 individuals living in rural areas responded to the survey. Fifty percent (2327) were male, and 2296 (49.4%) were female; 69 respondents were 18 to 29 years (1.5%); 1638 (35.3%) were 30 to 64 years; and 2926 (63.0%) were 65 years or older. The most frequently identified major challenges (n = 5448) were reduced physical capacity and the effects of treatment. Positive experiences included family and friend support and positive self-care practices. The suggestions for improvements focused on the need for better communication and information about self-care, side effect management, and programs and services, with more programs available locally for practical and emotional support.
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Affiliation(s)
| | | | - Margaret I Fitch
- Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON M4C 4V9, Canada
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Drury A, O'Brien A, O'Connell L, Cosgrave S, Hannan M, Smyth C, Fessele K, Harkin M, Rogers L. Setting a Patient-Driven Agenda for Cancer Research Priorities in Geriatric Oncology: A Qualitative Study. Semin Oncol Nurs 2023; 39:151463. [PMID: 37419848 PMCID: PMC11166470 DOI: 10.1016/j.soncn.2023.151463] [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: 03/15/2023] [Revised: 05/09/2023] [Accepted: 05/24/2023] [Indexed: 07/09/2023]
Abstract
OBJECTIVES This study aims to explore older adults' perceptions of priorities for research in cancer and hematological malignancies and proposes an agenda of patient-driven priorities for cancer care research in the field of geriatric oncology. DATA SOURCES Sixteen older adults (≥65 years) living with or after a diagnosis of cancer participated in a descriptive qualitative study. Participants were purposively recruited via a regional cancer center and cancer advocacy organizations. Semistructured telephone interviews explored participants' experiences of cancer and perceptions of priorities for future cancer-related research. CONCLUSION Participants reported positive experiences of cancer care. However, positive and negative experiences of information, symptoms, and support both within and beyond the hospital setting were highlighted. Forty-two research priorities in six thematic areas were identified: 1) recognition of the signs and symptoms of cancer; 2) research about cancer treatment; 3) assessment and management of comorbidities; 4) unmet needs of older adults living with and after cancer; 5) impact of COVID-19; and 6) impact on caregivers and family members of people living with and after cancer. IMPLICATIONS FOR NURSING PRACTICE The results of this study provide a basis for future priority-setting activities that are culturally and contextually sensitive to health care systems, resources, and needs of older adults living with and after cancer. Based on the findings of this study, we make recommendations for the development of interventions that can build awareness, capacity, and competence in geriatric oncology among cancer care professionals and consideration of the diverse needs of older adults in the development of interventions to address unmet information and supportive care needs.
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Affiliation(s)
- Amanda Drury
- Associate Professor in General Nursing, School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland.
| | - Aoife O'Brien
- Research Assistant, School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, Ireland
| | - Liz O'Connell
- Haematology Advanced Nurse Practitioner, Haematology Department, Tallaght University Hospital, Dublin, Ireland
| | - Sarah Cosgrave
- Registered Advanced Nurse Practitioner, Caritas Day Hospital, St Vincent's Hospital, Dublin, Ireland
| | - Michelle Hannan
- Advanced Nurse Practitioner in Geriatric Oncology, Department of Medical Oncology, University Hospital Waterford, Waterford, Ireland
| | - Caroline Smyth
- Advanced Nurse Practitioner, Community Intervention Team, Anam Cara, Dublin, Ireland
| | - Kristen Fessele
- Nurse Scientist, Memorial Sloan Kettering Office of Nursing Research, New York, New York
| | - Mary Harkin
- Research & Evaluation Manager, Age & Opportunity Lisa Rogers, Assistant Professor, School of Nursing, Midwifery and Health Systems, Dublin, Ireland
| | - Lisa Rogers
- Research Assistant, School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, Ireland
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Webb K, Sharpe L, Butow P, Dhillon H, Zachariae R, Tauber NM, O'Toole MS, Shaw J. Caregiver fear of cancer recurrence: A systematic review and meta-analysis of quantitative studies. Psychooncology 2023; 32:1173-1191. [PMID: 37303263 DOI: 10.1002/pon.6176] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/10/2023] [Accepted: 05/25/2023] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Fear of cancer recurrence (FCR) is reported by both cancer survivors and caregivers however less is known about caregiver FCR. This study aimed to (a) conduct a meta-analysis to compare survivor and caregiver FCR levels; (b) examine the relationship between caregiver FCR and depression, and anxiety; (c) evaluate psychometric properties of caregiver FCR measures. METHODS CINAHL, Embase, PsychINFO and PubMed were searched for quantitative research examining caregiver FCR. Eligibility criteria included caregivers caring for a survivor with any type of cancer, reporting on caregiver FCR and/or measurement, published in English-language, peer-review journals between 1997 and November 2022. The COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) taxonomy was used to evaluate content and psychometric properties. The review was pre-registered (PROSPERO ID: CRD42020201906). RESULTS Of 4297 records screened, 45 met criteria for inclusion. Meta-analysis revealed that caregivers reported FCR levels as high as FCR amongst survivors, with around 48% of caregivers reporting clinically significant FCR levels. There was a strong correlation between anxiety and depression and medium correlation with survivor FCR. Twelve different instruments were used to measure caregiver FCR. Assessments using the COSMIN taxonomy revealed few instruments had undergone appropriate development and psychometric testing. Only one instrument met 50% or more of the criteria, indicating substantial development or validation components were missing in most. CONCLUSIONS Results suggest FCR is as often a problem for caregivers as it is for survivors. As in survivors, caregiver FCR is associated with more severe depression and anxiety. Caregiver FCR measurement has predominately relied on survivor conceptualisations and unvalidated measures. More caregiver-specific research is urgently needed.
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Affiliation(s)
- Kyra Webb
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
- The Psycho-oncology Co-operative Group (PoCoG), School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
| | - Louise Sharpe
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
| | - Phyllis Butow
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
- The Psycho-oncology Co-operative Group (PoCoG), School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
| | - Haryana Dhillon
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
- The Psycho-oncology Co-operative Group (PoCoG), School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
- Centre for Medical Psychology & Evidence-Based Decision Making (CeMPED), School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
| | - Robert Zachariae
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
- Department of Oncology, Unit for Psychooncology and Health Psychology (EPoS), Aarhus University Hospital, Aarhus, Denmark
| | - Nina Møller Tauber
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Mia Skytte O'Toole
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Joanne Shaw
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
- The Psycho-oncology Co-operative Group (PoCoG), School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
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Bae KR, Ahn Y, Park JW, Kim SJ. Exploring Fear of Cancer Recurrence (FCR) in cancer survivors from a medical social work perspective: A qualitative study of medical social workers in South Korea. PLoS One 2023; 18:e0288059. [PMID: 37410785 DOI: 10.1371/journal.pone.0288059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 06/18/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND Fear of Cancer Recurrence (FCR) in cancer survivors has been insufficiently addressed despite its imperativeness in cancer journey. Although several studies have investigated healthcare professionals' experience with FCR in cancer survivors, a medical social work perspective has rarely been reflected. This study aimed to explore Korean medical social workers' experience with intervening FCR in cancer survivors. METHODS Snowball sampling recruited 12 experienced medical social workers intervening with cancer survivors at tertiary or university cancer hospitals in South Korea. Individual and focus-group interviews (FGI) were conducted with the medical social workers. The interviews were recorded, transcribed, and analyzed by using an inductive qualitative content analysis. RESULTS Content analysis of the interviews extracted the following major themes regarding FCR in cancer survivors. First, when and how FCR among cancer survivors emerged at the early stage of medical social work interventions was identified. Second, how medical social workers dealt with FCR in cancer survivors was illustrated. Third, the responses of cancer survivors to medical social work interventions for FCR were assessed. Finally, the internal and external issues underlying the medical social work interventions for FCR among cancer survivors were revealed and discussed. CONCLUSION Based on the results, this study suggested the implications on dealing with FCR in cancer survivors in the realm of medial social work profession. Furthermore, it expanded the discussion about FCR in cancer survivors from cancer hospitals to community.
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Affiliation(s)
- Ka Ryeong Bae
- Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, South Korea
| | - Yeojin Ahn
- Patient-Centered Outcomes Research Institute, Samsung Medical Center, Seoul, South Korea
| | - Joung Won Park
- Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, South Korea
- Division of Social Work, Samsung Medical Center, Seoul, South Korea
| | - Seok-Joo Kim
- Department of Social Welfare, College of Social Sciences, Daegu University, Gyeongbuk, South Korea
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18
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Filipponi C, Chichua M, Masiero M, Mazzoni D, Pravettoni G. Cancer Pain Experience Through the Lens of Patients and Caregivers: Mixed Methods Social Media Study. JMIR Cancer 2023; 9:e41594. [PMID: 37399067 PMCID: PMC10365594 DOI: 10.2196/41594] [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: 08/01/2022] [Revised: 05/12/2023] [Accepted: 06/05/2023] [Indexed: 07/04/2023] Open
Abstract
BACKGROUND Cancer pain represents a challenge for cancer patients and their family members. Despite progression in pain management, pain is still underreported and undertreated, and there is limited information on the related needs that patients and caregivers may have. Online platforms represent a fundamental tool for research to reveal the unmet needs of these users and their emotions outside the medical setting. OBJECTIVE This study aimed to (1) reveal the unmet needs of both patients and caregivers and (2) detect the emotional activation associated with cancer pain by analyzing the textual patterns of both users. METHODS A descriptive and quantitative analysis of qualitative data was performed in RStudio v.2022.02.3 (RStudio Team). We analyzed 679 posts (161 from caregivers and 518 from patients) published over 10 years on the "cancer" subreddit of Reddit to identify unmet needs and emotions related to cancer pain. Hierarchical clustering, and emotion and sentiment analysis were conducted. RESULTS The language used for describing experiences related to cancer pain and expressed needs differed between patients and caregivers. For patients (agglomerative coefficient=0.72), the large cluster labeled unmet needs included the following clusters: (1A) reported experiences, with the subclusters (a) relationship with doctors/spouse and (b) reflections on physical features; and (1B) changes observed over time, with the subclusters (a) regret and (b) progress. For caregivers (agglomerative coefficient=0.80), the main clusters were as follows: (1A) social support and (1B) reported experiences, with the subclusters (a) psychosocial challenges and (b) grief. Moreover, comparison between the 2 groups (entanglement coefficient=0.28) showed that they shared a common cluster labeled uncertainty. Regarding emotion and sentiment analysis, patients expressed a significantly higher negative sentiment than caregivers (z=-2.14; P<.001). On the contrary, caregivers expressed a higher positive sentiment compared with patients (z=-2.26; P<.001), with trust (z=-4.12; P<.001) and joy (z=-2.03; P<.001) being the most prevalent positive emotions. CONCLUSIONS Our study emphasized different perceptions of cancer pain in patients and caregivers. We revealed different needs and emotional activations in the 2 groups. Moreover, our study findings highlight the importance of considering caregivers in medical care. Overall, this study increases knowledge about the unmet needs and emotions of patients and caregivers, which may have important clinical implications in pain management.
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Affiliation(s)
- Chiara Filipponi
- Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Mariam Chichua
- Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Marianna Masiero
- Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Davide Mazzoni
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Gabriella Pravettoni
- Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
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Ebbestad FE, Ammitzbøll G, Horsbøll TA, Andersen I, Johansen C, Zehran B, Dalton SO. The long-term burden of a symptom cluster and association with longitudinal physical and emotional functioning in breast cancer survivors. Acta Oncol 2023; 62:706-713. [PMID: 36912039 DOI: 10.1080/0284186x.2023.2185909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 02/25/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND Fatigue, insomnia and pain are some of the most common and distressing symptoms experienced during breast cancer (BC) treatment and survivorship. The symptoms have been found to impact one another and to form a symptom cluster, and greater severity of the symptoms may be negatively associated with physical and emotional functioning in survivorship. In exploratory analyses from a randomized controlled trial examining the effect of progressive resistance training on the development of lymphedema after BC, we aimed to examine the burden of the symptom cluster fatigue-pain-insomnia, and its prognostic value for long-term symptom severity as well as emotional and physical functioning. MATERIAL AND METHODS Latent profile analysis was used to identify groups with similar severity of pain, fatigue and insomnia among 158 patients with BC two weeks after surgery. Mixed effects Tobit regression models were used to estimate fatigue, pain, insomnia, and physical and emotional functioning 20 weeks, 1 year and 3.5 years after surgery. RESULTS Two symptom burden groups were identified: 80% of women had a low severity while 20% of women had a high severity of the three symptoms after BC surgery. 3.5 years later, the women with high symptom burden post-surgery still had higher pain, insomnia and fatigue scores than women with low symptom burden. High symptom burden post-surgery was associated with worse physical functioning 3.5 years later, while emotional functioning was only negatively impacted during the first year. DISCUSSION These findings warrant larger studies investigating if symptom burden early in BC trajectory can be used for risk stratification for persistent symptoms and diminished physical functioning with the purpose of developing and implementing targeted interventions.
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Affiliation(s)
- Freja Ejlebæk Ebbestad
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Gunn Ammitzbøll
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
- COMPAS, Danish Research Center for Equality in Cancer, Zealand University Hospital, Næstved, Denmark
| | | | - Ingelise Andersen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Christoffer Johansen
- Cancer Survivorship and Treatment Late Effects (CASTLE), Centre for Cancer and Organ Diseases, Rigshospitalet, Copenhagen, Denmark
- Institute of Clinical Medicine, Faculty of Health, University of Copenhagen, Denmark
| | - Bo Zehran
- Clinical Physiology and Nuclear Medicine, Herlev and Gentofte Hospital, Denmark
| | - Susanne Oksbjerg Dalton
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
- COMPAS, Danish Research Center for Equality in Cancer, Zealand University Hospital, Næstved, Denmark
- Institute of Clinical Medicine, Faculty of Health, University of Copenhagen, Denmark
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20
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Fan R, Wang L, Bu X, Wang W, Zhu J. Unmet supportive care needs of breast cancer survivors: a systematic scoping review. BMC Cancer 2023; 23:587. [PMID: 37365504 PMCID: PMC10294377 DOI: 10.1186/s12885-023-11087-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 06/19/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Breast cancer is the most common type of cancer in women worldwide. Though improved treatments and prolonged overall survival, breast cancer survivors (BCSs) persistently suffer from various unmet supportive care needs (USCNs) throughout the disease. This scoping review aims to synthesize current literature regarding USCNs among BCSs. METHODS This study followed a scoping review framework. Articles were retrieved from Cochrane Library, PubMed, Embase, Web of Science, and Medline from inception through June 2023, as well as reference lists of relevant literature. Peer-reviewed journal articles were included if USCNs among BCSs were reported. Inclusion/exclusion criteria were adopted to screen articles' titles and abstracts as well as to entirely assess any potentially pertinent records by two independent researchers. Methodological quality was independently appraised following Joanna Briggs Institute (JBI) critical appraisal tools. Content analytic approach and meta-analysis were performed for qualitative and quantitative studies respectively. Results were reported according to the PRISMA extension for scoping reviews. RESULTS A total of 10,574 records were retrieved and 77 studies were included finally. The overall risk of bias was low to moderate. The self-made questionnaire was the most used instrument, followed by The Short-form Supportive Care Needs Survey questionnaire (SCNS-SF34). A total of 16 domains of USCNs were finally identified. Social support (74%), daily activity (54%), sexual/intimacy (52%), fear of cancer recurrence/ spreading (50%), and information support (45%) were the top unmet supportive care needs. Information needs and psychological/emotional needs appeared most frequently. The USCNs was found to be significantly associated with demographic factors, disease factors, and psychological factors. CONCLUSION BCSs are experiencing a large number of USCNs in fearing of cancer recurrence, daily activity, sexual/intimacy, psychology and information, with proportions ranging from 45% to 74%. Substantial heterogeneity in study populations and assessment tools was observed. There is a need for further research to identify a standard evaluation tool targeted to USCNs on BCSs. Effective interventions based on guidelines should be formulated and conducted to decrease USCNs among BCSs in the future.
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Affiliation(s)
- Rongrong Fan
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, No.37, Guoxue Lane, Wuhou District, Chengdu, Sichuan China
| | - Lili Wang
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, No.37, Guoxue Lane, Wuhou District, Chengdu, Sichuan China
| | - Xiaofan Bu
- The School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Wenxiu Wang
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, No.37, Guoxue Lane, Wuhou District, Chengdu, Sichuan China
| | - Jing Zhu
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, No.37, Guoxue Lane, Wuhou District, Chengdu, Sichuan China
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21
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Loh KP, McLaughlin EM, Krok-Schoen JL, Odejide OO, El-Jawahri A, Qi L, Shadyab AH, Johnson LG, Paskett ED. Correlates of common concerns in older cancer survivors of leukemia and lymphoma: results from the WHI LILAC study. J Cancer Surviv 2023; 17:769-780. [PMID: 35982359 PMCID: PMC9938088 DOI: 10.1007/s11764-022-01249-1] [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: 07/26/2022] [Accepted: 08/12/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE Older survivors of leukemia and lymphoma often experience long-term effects of chemotherapy. We described common concerns related to their cancer and treatment in older survivors of leukemia and non-Hodgkin lymphoma (NHL) and assessed correlates of these concerns. METHODS We utilized data from the Women's Health Initiative (WHI) Life and Longevity After Cancer (LILAC) study that recruited post-menopausal women aged 50-79. Participants diagnosed with leukemia and NHL were included (n = 420). They were asked about 14 areas of current concerns related to their cancer and treatment and to rate each from 0 (no concern) to 2 (major concern), with total scores ranging from 0 to 28. Linear regression was used to assess factors correlated with the concern score, and logistic regression for factors correlated with the three most common concerns. RESULTS Mean age at assessment was 81 years (range 69-99); 72% reported at least one concern, and median concern score among these survivors was 3.5 (Q1-Q3 2-5). Factors significantly correlated with concern scores were sadness, pain, distress, higher prior symptom count, and loneliness (all p < 0.05). Significant factors correlated with common concerns were (1) fatigue/sleep: sadness/depression, distress, higher prior symptom count, greater loneliness, and worse physical functioning; (2) physical functioning/activity: older age, public insurance, higher body mass index, pain, worse QoL, and higher treatment-related comorbidities; (3) memory/concentration: prior chemotherapy or radiation, worse QoL, higher prior symptom count, and greater loneliness (all p < 0.05). CONCLUSIONS AND IMPLICATIONS FOR CANCER SURVIVORS Almost three-quarters of older survivors of leukemia and lymphoma reported at least one concern; a multifaceted intervention may be needed to address these concerns.
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Affiliation(s)
- Kah Poh Loh
- Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center, 601 Elmwood Avenue, Box 704, Rochester, NY, 14642, USA.
| | - Eric M McLaughlin
- Center for Biostatistics, The Ohio State University, Columbus, OH, USA
| | - Jessica L Krok-Schoen
- Division of Health Sciences, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Oreofe O Odejide
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Center for Lymphoma, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Areej El-Jawahri
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Lihong Qi
- Department of Public Health Sciences, University of California Davis, Davis, CA, USA
| | - Aladdin H Shadyab
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, USA
| | - Lisa G Johnson
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Electra D Paskett
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA
- Division of Cancer Prevention and Control, College of Medicine, The Ohio State University, Columbus, OH, USA
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22
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Athira B, Idicula SM, Jones J, Kulanthaivel A. An answer recommendation framework for an online cancer community forum. MULTIMEDIA TOOLS AND APPLICATIONS 2023:1-27. [PMID: 37362684 PMCID: PMC10184082 DOI: 10.1007/s11042-023-15477-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 05/31/2022] [Accepted: 04/18/2023] [Indexed: 06/28/2023]
Abstract
Health community forums are a kind of online platform to discuss various matters related to management of illness. People are increasingly searching for answers online, particularly when they are diagnosed with cancer like life-threatening diseases. People seek suggestions or advice through these platforms to make decisions during their treatments. However, locating the correct information or similar people is often a great challenge for them. In this scenario, this paper proposes an answer recommendation system in an online breast cancer community forum that provide guidance and valuable references to users while making decisions. The answer is the summary of already discussed topic in the forum, so that they do not need to go through all the answer posts which spans over multiple pages or initiate a thread once again. There are three phases for the answer recommendation system, including query similarity model to retrieve the past similar query, query-answer pair generation and answer recommendation. Query similarity model is employed by a Siamese network with Bi-LSTM architecture which could achieve an F1-score of 85.5%. Also, the paper shows the efficacy of transfer learning technique to generalize the model well in our breast cancer query-query pair data set. The query-answer pairs are generated by an extractive summarization technique that is based on an optimization algorithm. The effectiveness of the generated summary is evaluated based on a manually generated summary, and the result shows a ROUGE-1 score of 49%.
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Affiliation(s)
- B. Athira
- Deparment of CS & IT, School of Computing, Amrita Vishwa Vidyapeetham, Kochi, India
| | - Sumam Mary Idicula
- Department of Computer Science, Muthoot Institute of Technology and Science, Kochi, India
| | - Josette Jones
- BioHealth Informatics Department, IUPUI, Indianapolis, IN 46202 USA
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23
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Deuning-Smit E, Custers JAE, Kwakkenbos L, Hermens RPMG, Prins JB. Evaluating the capacity of the distress thermometer to detect high fear of cancer recurrence. Psychooncology 2023; 32:266-274. [PMID: 36385563 PMCID: PMC10099705 DOI: 10.1002/pon.6066] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/31/2022] [Accepted: 11/06/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Fear of cancer recurrence (FCR) is common and burdensome to patients, but often remains undetected. Oncology professionals report need for tools to improve FCR detection in routine care. Oncology care guidelines recommend the Distress Thermometer (DT) for distress screening, but it has not been validated for FCR. This study evaluated the capacity of the DT and accompanying problem list to detect FCR. METHODS Amalgamated data of two studies with 149 breast cancer and 74 colorectal cancer survivors were used. We evaluated the Dutch DT including the DT score, problem list fears item and emotional domain score using Receiver Operating Characteristic analyses. The Dutch Cancer Worry Scale-6 (CWS-6) was used as reference measure, with validated cut-off scores ≥10 and ≥12 for high FCR. Sensitivity, specificity, negative and positive predictive values were calculated. RESULTS The DT score showed poor performance in discriminating between low and high FCR. The recommended cut-off ≥4 had low sensitivity (65% for CWS-6≥10; 72% for CWS-6 ≥12) and specificity (67% and 58%). No other cut-off had an acceptable combination of sensitivity and specificity. The fears item had low sensitivity (29% and 44.9%) and high specificity (95% and 94%). The emotional domain score had fair performance in discriminating between low and high FCR but there was no cut-off with acceptable sensitivity and specificity. CONCLUSION The DT as currently recommended in oncology care guidelines is not suitable to effectively detect FCR in routine care. To improve patients access to psychosocial care, it should be investigated how FCR-specific measures can be integrated in oncology practice.
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Affiliation(s)
- Esther Deuning-Smit
- Department of Medical Psychology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - José A E Custers
- Department of Medical Psychology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Linda Kwakkenbos
- Department of Medical Psychology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.,Clinical Psychology, Radboud University, Nijmegen, The Netherlands.,Department of Psychiatry, Radboudumc Center for Mindfulness, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Rosella P M G Hermens
- Department of IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Judith B Prins
- Department of Medical Psychology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
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24
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Koczwara B, Chan A, Jefford M, Lam WWT, Taylor C, Wakefield CE, Bhoo-Pathy N, Gyawali B, Harvet G, Lou Y, Pramesh CS, Takahashi M, Ke Y, Chan RJ. Cancer Survivorship in the Indo-Pacific: Priorities for Progress. JCO Glob Oncol 2023; 9:e2200305. [PMID: 36749908 PMCID: PMC10166466 DOI: 10.1200/go.22.00305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Affiliation(s)
- Bogda Koczwara
- Department of Medical Oncology, Flinders Medical Centre, College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Alexandre Chan
- School of Pharmacy and Pharmaceutical Sciences, University of California, Irvine, CA.,Department of Oncology Pharmacy, National Cancer Centre Singapore, Singapore
| | - Michael Jefford
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia
| | - Wendy W T Lam
- Jockey Club Institute of Cancer Care, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China.,Centre for Psycho-oncology Research and Training, School of Public Health, The University of Hong Kong, Hong Kong, China
| | | | - Claire E Wakefield
- School of Clinical Medicine, UNSW Medicine & Health, Discipline of Paediatrics and Child Health, Sydney, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Nirmala Bhoo-Pathy
- Centre for Epidemiology and Evidence Based Practice, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Bishal Gyawali
- Queen's Global Oncology Program, Department of Oncology, Queen's University, Kingston, Canada
| | - Gregory Harvet
- Department of Paediatrics, Centre Hospitalier Territorial, Nouméa, New Caledonia
| | - Yan Lou
- School of Nursing, Department of Medicine, Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - C S Pramesh
- Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Miyako Takahashi
- Japan Cancer Survivorship Network, Tokyo, Japan.,Iwate Medical University, Iwate, Japan
| | - Yu Ke
- Tokyo Jikei University School of Medicine, Tokyo, Japan
| | - Raymond Javan Chan
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, Australia
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25
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Miroševič Š, Selič-Zupančič P, Prins J, Homar V, Klemenc-Ketiš Z. Psychometric properties of the Slovenian version of the Cancer Survivors’ Unmet Needs (CaSUN-SL) measure in post-treatment cancer survivors. BMC Psychol 2022; 10:175. [PMID: 35843954 PMCID: PMC9288676 DOI: 10.1186/s40359-022-00878-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 06/28/2022] [Indexed: 01/06/2023] Open
Abstract
Background As the number of cancer survivors is growing, valid instruments for assessing cancer survivors' needs are required. Thus, the aim of this study was to translate and validate the Cancer Survivors Unmet Needs (CaSUN) scale. Methods Cancer survivors were recruited from 30 family medicine practices and separated into two samples (sample 1, n = 147; sample 2, n = 148). Factor structure was explored with an exploratory analysis in sample 1 and determined with a confirmatory analysis in sample 2. Psychometric properties were assessed with internal consistency, test–retest reliability and construct validity. Results A translation and cultural adaptation of the CaSUN scale resulted in 34 items being included in the final version. The factor structure confirmed the five-factors solution of the CaSUN-SL. Cronbach’s alpha was 0.94 for the CaSUN-SL and ranged from 0.71–0.88 for specific domains. Test–retest reliability showed moderate-high stability over time. The CaSUN-SL significantly and positively correlated with anxiety (r = 0.49), depression (r = 0.44), health-related quality of life (r = 0.36), and negatively with self-perceived health (r = − 0.36) and resilience (r = − 0.47), which confirms the construct validity. In addition, we found a significant correlation between unmet needs and age (r = − 0.29), gender (r = 0.14), cancer stage (r = 0.20), cancer type (r = 0.19), and time since treatment (r = − 0.20). Conclusions Results indicate that CaSUN-SL is a valid and reliable measure to assess the Slovenian cancer survivors’ unmet, met and total needs and can be used for further prospective studies. Trial Registration: No. 0120-25/2019/6.
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26
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Chen M, Li R, Chen Y, Ding G, Song J, Hu X, Jin C. Unmet supportive care needs and associated factors: Evidence from 4195 cancer survivors in Shanghai, China. Front Oncol 2022; 12:1054885. [PMID: 36530993 PMCID: PMC9748420 DOI: 10.3389/fonc.2022.1054885] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 11/10/2022] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Cancer survivors at different stages of life often have different needs that make it challenging for services to provide satisfactory care. Few studies have considered whether services are truly meeting the needs of cancer patients by exploring and identifying their perspectives on unmet needs. OBJECTIVE The aim of this study was to identify the unmet needs of cancer survivors and to further determine the potential impact of socio-demographic factors. METHODS A cross-sectional study that included 4195 cancer patients was conducted in Shanghai, China. Using Maslow's hierarchy of needs theory as a conceptual framework, the questionnaire included five dimensions: information, life and finances, continuing care, emotions, and self-actualization. Correlation analysis and ordered logistic regression analysis was used to explore the relationship between demographic sociological factors and unmet needs for supportive care. RESULTS The most common unmet supportive care needs include information needs (2.91 ± 1.32), self-actualization needs (2.69 ± 1.32) and continuing care needs (2.59 ± 1.30). Unmet needs for life and finances were more pronounced among cancer participants in the 45-69 age group. After adjusting for confounders, we found that each 6-month increase in the time since diagnosis was associated with a 0.8% (OR: 0.992, 95% CI: 0.985-0.998) reduction in high need for continuing care and a 0.9% (OR:0.991, 95% CI: 0.983-0.999) reduction in high need for self-actualization, respectively. CONCLUSIONS Information needs are the most important concern among the diverse unmet needs of cancer survivors. Time since diagnosis is associated with unmet supportive care needs of cancer survivors. The findings highlight the large gap between actual health services and patients' unmet need for supportive care, which will provide the basis for a patient-centered supportive care system for cancer survivors.
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Affiliation(s)
- Minxing Chen
- Shanghai Health Development Research Center, Shanghai Medical Information Center, Shanghai, China
| | - Ruijia Li
- Shanghai Health Development Research Center, Shanghai Medical Information Center, Shanghai, China
| | - Yujie Chen
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Gang Ding
- Oncology Department, Shanghai International Medical Center, Shanghai, China
| | - Jie Song
- Shanghai Health Development Research Center, Shanghai Medical Information Center, Shanghai, China
| | - Xiaojing Hu
- Shanghai Health Development Research Center, Shanghai Medical Information Center, Shanghai, China
| | - Chunlin Jin
- Shanghai Health Development Research Center, Shanghai Medical Information Center, Shanghai, China
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27
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Deuning-Smit E, Kolsteren EEM, Kwakkenbos L, Custers JAE, Hermens RPMG, Prins JB. Barriers and facilitators for implementation of the SWORD evidence-based psychological intervention for fear of cancer recurrence in three different healthcare settings. J Cancer Surviv 2022:10.1007/s11764-022-01285-x. [DOI: 10.1007/s11764-022-01285-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022]
Abstract
Abstract
Purpose
Fear of cancer recurrence (FCR) interventions are effective, but few are implemented. This study aimed to identify barriers and facilitators for implementing the evidence-based blended SWORD intervention in routine psycho-oncological care.
Methods
Semi-structured interviews with 19 cancer survivors and 18 professionals from three healthcare settings assessed barriers and facilitators in six domains as described by the determinant frameworks of Grol and Flottorp: (1) innovation, (2) professionals, (3) patients, (4) social context, (5) organization, and (6) economic and political context.
Results
In the innovation domain, there were few barriers. Facilitators included high reliability, accessibility, and relevance of SWORD. In the professional domain, physicians and nurses barriers were lack of self-efficacy, knowledge, and skills to address FCR whereas psychologists had sufficient knowledge and skills, but some were critical towards protocolized treatments, cognitive behavioral therapy, or eHealth. Patient domain barriers included lack of FCR awareness, negative expectations of psychotherapy, and unwillingness/inability to actively engage in treatment. A social context domain barrier was poor communication between different healthcare professionals. Organization domain barriers included inadequate referral structures to psychological services, limited capacity, and complex legal procedures. Economic and political context domain barriers included lack of a national implementation structure for evidence-based psycho-oncological interventions and eHealth platform costs.
Conclusions
Implementation strategies should be targeted at patient, professional, organizational and economic and political domains. Identified barriers and facilitators are relevant to other researchers in psycho-oncology that aim to bridge the research-practice gap.
Implications for cancer survivors
This study contributes to the implementation of evidence-based psychological interventions for cancer survivors, who can benefit from these services.
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28
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Paterson C, Toohey K, Bacon R, Kavanagh PS, Roberts C. What Are the Unmet Supportive Care Needs of People Affected by Cancer: An Umbrella Systematic Review. Semin Oncol Nurs 2022:151353. [DOI: 10.1016/j.soncn.2022.151353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 09/16/2022] [Accepted: 10/12/2022] [Indexed: 11/24/2022]
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29
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Kemp EB, Geerse OP, Knowles R, Woodman R, Mohammadi L, Nekhlyudov L, Koczwara B. Mapping Systematic Reviews of Breast Cancer Survivorship Interventions: A Network Analysis. J Clin Oncol 2022; 40:2083-2093. [PMID: 35171707 PMCID: PMC9242404 DOI: 10.1200/jco.21.02015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
PURPOSE Despite a large volume of research, breast cancer survivors continue to experience high levels of unmet need. To better understand the breadth of evidence, we mapped systematic review-level evidence across cancer survivorship domains and outcomes and conducted network analyses of breast cancer survivorship care interventions. METHODS Umbrella review methodology was used to identify published systematic reviews reporting on survivorship care interventions for breast cancer survivors. Included reviews were mapped against domains and health care outcomes as specified by the Cancer Survivorship Quality Framework, and network analyses were conducted to determine the extent of clustering of reviews, and connectivity across domains and outcomes. RESULTS Of 323 included reviews, most focused on management of physical (71.5%) or psychologic (65.3%) effects, health-related quality of life (55.1%), and physical activity (45.2%). Few focused on financial/employment effects, chronic conditions, health care delivery domains, or health service use or cost outcomes. Network analysis indicated 38.6% of reviews were connected to a single domain, 35.0% to two domains, and 16.5% to three domains, indicating a relatively siloed nature of research, with greater community clustering between health care delivery domains but limited connection between these and the other domains. Reviews published between 2011 and 2021 were more likely to examine financial toxicity and chronic conditions, but these domains remained under-represented compared with physical and psychologic effects. CONCLUSION Despite vast volume of breast cancer survivorship intervention research, systematic review-level research is unevenly distributed, siloed, and with significant gaps in key domains and outcomes. Assessment of evidence gaps in primary research and strategic planning of future research, in consultation with survivors, is needed.
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Affiliation(s)
- Emma B Kemp
- Flinders Health and Medical Research Institute, Flinders University, South Australia, Australia
| | - Olaf P Geerse
- Department of Pulmonary Disease, Amsterdam University Medical Centre, Amsterdam, the Netherlands
| | - Reegan Knowles
- Flinders Health and Medical Research Institute, Flinders University, South Australia, Australia
| | - Richard Woodman
- Flinders Health and Medical Research Institute, Flinders University, South Australia, Australia
| | - Leila Mohammadi
- Flinders Health and Medical Research Institute, Flinders University, South Australia, Australia
| | | | - Bogda Koczwara
- Flinders Health and Medical Research Institute, Flinders University, South Australia, Australia
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30
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Al-Kaylani HM, Loeffler BT, Mott SL, Curry M, Phadke S, van der Plas E. Characterizing Early Changes in Quality of Life in Young Women With Breast Cancer. Front Psychol 2022; 13:871194. [PMID: 35645920 PMCID: PMC9132041 DOI: 10.3389/fpsyg.2022.871194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 03/22/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Younger age at diagnosis is a risk factor for poor health-related quality of life (HRQOL) in long-term breast cancer survivors. However, few studies have specifically addressed HRQOL in young adults with breast cancer (i.e., diagnosed prior to age 40), nor have early changes in HRQOL been fully characterized. Methods Eligible female patients with breast cancer were identified through our local cancer center. To establish HRQOL, patients completed the Functional Assessment of Cancer Therapy-Breast (FACT-B) around diagnosis and 12 months later. Sociodemographic factors, genetic susceptibility to cancer, tumor- and treatment-related factors, and comorbidities (e.g., depression/anxiety) were abstracted from medical records and the local oncology registry. Mixed-effects models were used to identify changes in FACT-B scores during the first year of treatment and to determine whether any demographic/treatment-related factors modulated changes in scores. Results Health-related quality of life in young patients with breast cancer was within normal limits at baseline, with a FACT-B overall well-being score of 108.5 (95% confidence limits [CI] = 103.7, 113.3). Participants reported slight improvements over a 12-month period: FACT-B overall well-being scores increased 6.6 points (95% CI = 2.1, 11.1, p < 0.01), functional well-being improved 3.0 points (95% CI = 2.0, 4.1, p < 0.01), emotional well-being improved 1.9 points (95% CI = 0.9, 2.8, p < 0.01), and physical well-being improved 1.5 points (95% CI = 0.2, 2.8, p = 0.03), on average. Participants with anxiety/depression at baseline reported greater improvements in FACT-B overall well-being (change: 12.9, 95% CI = 6.4, 9.5) and functional well-being (change: 5.2, 95% CI = 3.5, 6.9) than participants who did not have anxiety/depression at baseline (change in FACT-B overall well-being: 4.9, 95% CI = 0.2, 9.7; change in functional well-being: 2.3, 95% CI = 1.1, 3.4). Marital status, reconstructive surgery, and baseline clinical staging were also significantly associated with changes in aspects of HRQOL, although their impact on change was relatively minimal. Conclusion Young women with breast cancer do not report HRQOL concerns during the first year of treatment. Improvements in HRQOL during the first year of treatment may be attributable to a sense of relief that the cancer is being treated, which, in the short run, may outweigh the negative late effects of treatment.
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Affiliation(s)
- Hend M Al-Kaylani
- Department of Psychiatry, University of Iowa Hospital and Clinics, Iowa City, IA, United States
| | - Bradley T Loeffler
- Holden Comprehensive Cancer Center, University of Iowa Hospital and Clinics, Iowa City, IA, United States
| | - Sarah L Mott
- Holden Comprehensive Cancer Center, University of Iowa Hospital and Clinics, Iowa City, IA, United States
| | - Melissa Curry
- Holden Comprehensive Cancer Center, University of Iowa Hospital and Clinics, Iowa City, IA, United States
| | - Sneha Phadke
- Division of Hematology, Oncology, and Blood and Marrow Transplantation, Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA, United States
| | - Ellen van der Plas
- Department of Psychiatry, University of Iowa Hospital and Clinics, Iowa City, IA, United States
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31
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Hart NH, Crawford-Williams F, Crichton M, Yee J, Smith TJ, Koczwara B, Fitch MI, Crawford GB, Mukhopadhyay S, Mahony J, Cheah C, Townsend J, Cook O, Agar MR, Chan RJ. Unmet supportive care needs of people with advanced cancer and their caregivers: a systematic scoping review. Crit Rev Oncol Hematol 2022; 176:103728. [PMID: 35662585 DOI: 10.1016/j.critrevonc.2022.103728] [Citation(s) in RCA: 67] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 05/24/2022] [Accepted: 05/26/2022] [Indexed: 01/11/2023] Open
Abstract
Examining and addressing unmet care needs is integral to improving the provision and quality of cancer services. This review explored the prevalence of unmet supportive care needs, and factors associated with unmet need, in adults with advanced cancers (solid and hematological malignancies) and their caregivers. Electronic databases (PubMed, CINAHL, EMBASE) were searched, producing 85 papers representing 81 included studies. People with advanced cancer reported the highest unmet needs in financial, health system and information, psychological, and physical and daily living domains, whereas caregivers reported the highest unmet needs in psychological, and patient care and support domains. Distress, depression, and anxiety were associated with higher unmet needs across all unmet need domains for people with advanced cancer and their caregivers. Substantial heterogeneity in study populations and methods was observed. Findings from this review can inform targeted strategies and interventions to address these unmet needs in people with advanced cancer.
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Affiliation(s)
- Nicolas H Hart
- Caring Futures Institute, College of Nursing and Health Science, Flinders University, SA, Australia; Exercise Medicine Research Institute, School of Medical and Health Sciences, Edith Cowan University, WA, Australia; Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, QLD, Australia; Institute for Health Research, University of Notre Dame Australia, WA, Australia.
| | - Fiona Crawford-Williams
- Caring Futures Institute, College of Nursing and Health Science, Flinders University, SA, Australia; Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, QLD, Australia
| | - Megan Crichton
- Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, QLD, Australia; Nutrition and Dietetics Research Group, Bond University, QLD, Australia
| | - Jasmine Yee
- Centre for Medical Psychology and Evidence-Based Decision-Making, Faculty of Medicine and Health, University of Sydney, NSW, Australia
| | - Thomas J Smith
- Division of General Internal Medicine, John Hopkins Medical Institutions, Baltimore, MD, USA
| | - Bogda Koczwara
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, SA, Australia; Flinders Cancer and Innovation Centre, Flinders Medical Centre, SA, Australia
| | - Margaret I Fitch
- School of Graduate Studies, Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Gregory B Crawford
- Discipline of Medicine, University of Adelaide, SA, Australia; Northern Adelaide Local Health Network, SA, Australia
| | - Sandip Mukhopadhyay
- Burdwan Medical College, West Bengal, Kolkata, India; Indian Council of Medical Research, National Institute of Cholera and Enteric Diseases, Kolkata, India
| | | | - Chan Cheah
- Internal Medicine, UWA Medical School, University of Western Australia, WA, Australia; Department of Haematology, Sir Charles Gairdner Hospital, WA, Australia; Department of Haematology, Hollywood Private Hospital, WA, Australia
| | | | - Olivia Cook
- McGrath Foundation, NSW, Australia; School of Nursing and Midwifery, Monash University, VIC, Australia
| | - Meera R Agar
- IMPACCT Centre, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Raymond J Chan
- Caring Futures Institute, College of Nursing and Health Science, Flinders University, SA, Australia; Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, QLD, Australia
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32
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Coutts-Bain D, Sharpe L, Pradhan P, Russell H, Heathcote LC, Costa D. Are Fear of Cancer Recurrence and Fear of Progression Equivalent Constructs? Psychooncology 2022; 31:1381-1389. [PMID: 35470502 PMCID: PMC9545421 DOI: 10.1002/pon.5944] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 04/03/2022] [Accepted: 04/10/2022] [Indexed: 11/25/2022]
Abstract
Background The predominant definition of fear of cancer recurrence (FCR) conflates FCR with fear of progression (FOP). However, this assumption has never been tested. Importantly, if FCR and FOP are distinct and have different predictors, existing interventions for FCR may not be equally effective for survivors who fear progression rather than recurrence of their disease. The present study aimed to determine whether FCR and FOP are empirically equivalent; and whether they are predicted by the same theoretically derived variables. Methods Three hundred and eleven adults with a history of breast or ovarian cancer were analysed (n = 209, 67% in remission). Exploratory factor analysis was conducted on the items of the FCR Inventory severity subscale and short‐form FOP Questionnaire together. Structural equation modelling was conducted to predict FCR and FOP and determine whether theoretical models accounted equally well for both constructs, and whether models were equally relevant to those with and without current disease. Findings The factor analysis demonstrated that the FCR Inventory severity subscale and the short‐form FOP Questionnaire loaded onto distinct, but related, factors which represented FCR and FOP. Structural modelling indicated that risk perception and bodily threat monitoring were more strongly associated with FCR than FOP. However, both FCR and FOP were associated with metacognitions and intrusions. Interpretation These findings suggest that whilst FCR and FOP are related with some overlapping predictors, they are not the same construct. Hence, it is necessary to ensure that in clinical practice and research these constructs are considered separately.
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Affiliation(s)
| | - Louise Sharpe
- The School of Psychology, University of Sydney, Sydney, NSW, Australia
| | - Poorva Pradhan
- The School of Psychology, University of Sydney, Sydney, NSW, Australia
| | | | - Lauren C Heathcote
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Daniel Costa
- The School of Psychology, University of Sydney, Sydney, NSW, Australia.,Pain Management Research Institute, Royal North Shore Hospital, St Leonards, NSW, Australia
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33
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Trajectories of Anxiety and Depression Symptoms over Five Years since Breast Cancer Diagnosis: Results of the NEON-BC Prospective Study. Healthcare (Basel) 2022; 10:healthcare10040661. [PMID: 35455838 PMCID: PMC9026220 DOI: 10.3390/healthcare10040661] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/23/2022] [Accepted: 03/29/2022] [Indexed: 02/01/2023] Open
Abstract
Anxiety and depression symptoms are frequent among patients with breast cancer (BCa) and may last after initial treatments. We aimed to identify five-year trajectories of anxiety and depression symptoms among women with BCa. Neuro-oncological complications of BCa (NEON-BC) cohort included 506 patients admitted at the Portuguese Institute of Oncology of Porto in 2012, who were evaluated with the Hospital Anxiety and Depression Scale before cancer treatment and after one, three, and five years (7.9% attrition rate). Mixed-effect models were used to model anxiety and depression scores over time and model-based clustering to identify the different trajectories. Three trajectories of anxiety symptoms were identified: (1) high scores at baseline and increasing over time (21.7%); (2) consistently low scores over time (63.6%); (3) mid-range scores at baseline, decreasing over time (14.6%). Three trajectories were identified for depression symptoms: (1) high scores at baseline and increasing over time (21.1%); (2) mid-range scores at baseline, which decreased afterward (58.7%); (3) consistently low levels over time (20.2%). Age, education, baseline, and one-year anxiety/depression status predicted the worst five-year trajectories. These results show that assessing anxiety and depression symptoms before treatment and after one year may contribute to identifying the patients who could benefit the most from psychological support.
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Crawford-Williams F, Koczwara B, Chan RJ, Vardy J, Lisy K, Morris J, Iddawela M, Mackay G, Jefford M. Defining research and infrastructure priorities for cancer survivorship in Australia: a modified Delphi study. Support Care Cancer 2022; 30:3805-3815. [PMID: 35031828 DOI: 10.1007/s00520-021-06744-2] [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: 07/18/2021] [Accepted: 12/06/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE The aim of this study was to establish research and infrastructure priorities for cancer survivorship. METHODS A two-round modified online Delphi study was completed by Australian experts in cancer survivorship. Initial priorities were generated from the literature and organized into four research categories: physiological outcomes, psychosocial outcomes, population groups, and health services; and one research infrastructure category. In round 1 (R1), panelists ranked the importance of 77 items on a five-point scale (not at all important to very important). In round 2 (R2), panelists ranked their top 5 priorities within each category. Panelists also specified the type of research needed, such as biological, exploratory, intervention development, or implementation, for the items within each research category. RESULTS Response rates were 76% (63/82) and 82% (68/82) respectively. After R1, 12 items were added, and 16 items combined or reworded. In R2, the highest prioritized research topics and the preferred type of research in each category were: biological research in cancer progression and recurrence; implementation and dissemination research for fear of recurrence; exploratory research for rare cancer types; and implementation research for quality of care topics. Data availability was listed as the most important priority for research infrastructure. CONCLUSIONS This study has defined priorities that can be used to support coordinated action between researchers, funding bodies, and other key stakeholders. Designing future research which addresses these priorities will expand our ability to meet survivors' diverse needs and lead to improved outcomes.
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Affiliation(s)
- Fiona Crawford-Williams
- Cancer and Palliative Care Outcomes Centre and School of Nursing, Queensland University of Technology, Brisbane, QLD, Australia. .,Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia.
| | - Bogda Koczwara
- Flinders Centre for Innovation in Cancer, Flinders University, Bedford Park, SA, Australia.,Department of Medical Oncology, Flinders Medical Centre, Bedford Park, SA, Australia
| | - Raymond J Chan
- Cancer and Palliative Care Outcomes Centre and School of Nursing, Queensland University of Technology, Brisbane, QLD, Australia.,Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia.,Department of Cancer Services, Princess Alexandra Hospital, Woolloongabba, QLD, Australia
| | - Janette Vardy
- Concord Cancer Centre, Concord Repatriation General Hospital, Sydney, NSW, Australia.,Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Karolina Lisy
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia
| | - Julia Morris
- Cancer Council SA, Adelaide, SA, Australia.,School of Psychology Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia
| | - Mahesh Iddawela
- Latrobe Regional Hospital, Traralgon, VIC, Australia.,Alfred Health, Melbourne, VIC, Australia
| | - Gillian Mackay
- Clinical Oncology Society of Australia (COSA), Sydney, NSW, Australia
| | - Michael Jefford
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia
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Heß V, Meng K, Schulte T, Neuderth S, Bengel J, Faller H, Schuler M. Decreased mental health, quality of life, and utilization of professional help in cancer patients with unexpressed needs: A longitudinal analysis. Psychooncology 2021; 31:725-734. [PMID: 34841641 DOI: 10.1002/pon.5856] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 10/21/2021] [Accepted: 10/21/2021] [Indexed: 11/12/2022]
Abstract
BACKGROUND Cancer patients' mental health and quality of life can be improved through professional support according to their needs. In previous analyses of the UNSAID study, we showed that a relevant proportion of cancer patients did not express their needs during the admission interview of inpatient rehabilitation. We now examine trajectories of mental health, quality of life, and utilization of professional help in cancer patients with unexpressed needs. METHODS We enrolled 449 patients with breast, prostate, and colon cancer at beginning (T0) and end (T1) of a 3-week inpatient rehabilitation and 3 (T2) and 9 (T3) months after discharge. We explored depression (PHQ-2), anxiety (GAD-2), emotional functioning (EORTC QLQ-C30), fear of progression (FoP-Q-SF), and global quality of life (EORTC QLQ-C30) using structuring equation models. Furthermore, we evaluated self-reports about expressing needs and utilization of professional help at follow-up. RESULTS Patients with unexpressed needs (24.3%, n = 107) showed decreased mental health compared to other patients (e.g., depression: d T0 = 0.32, d T1-T3 = 0.39). They showed a significant decline in global quality of life at discharge and follow-up (d = 0.28). Furthermore, they had a higher need for support (Cramer's V T2 = 0.10, T3 = 0.15), talked less about their needs (Cramer's V T2 = 0.18), and made less use of different health care services at follow-up. CONCLUSION Unexpressed needs in cancer patients may be a risk factor for decreased mental health, quality of life, and non-utilization of professional help in the long term. Further research should clarify causal relationships and focus on this specific group of patients to improve cancer care.
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Affiliation(s)
- Verena Heß
- University of Würzburg, Würzburg, Bayern, Germany
| | - Karin Meng
- University of Würzburg, Würzburg, Bayern, Germany
| | | | - Silke Neuderth
- University of Applied Sciences Würzburg-Schweinfurt, Würzburg, Bayern, Germany
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Jung A, Kay SS, Robinson JL, Sheppard BB, Mayer DK. Large-scale North American cancer survivorship surveys: 2011-2019 update. J Cancer Surviv 2021; 16:1236-1267. [PMID: 34734367 DOI: 10.1007/s11764-021-01111-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 09/07/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE There are gaps in our knowledge to provide quality cancer care to the growing numbers of survivors. Leveraging existing data to answer survivorship research questions is one approach to address these gaps. Therefore, the purpose of this paper is to replicate and expand a previous report of existing cancer survivorship survey data. METHODS We conducted a trifold search strategy for relevant surveys and data sets to (1) determine the extent to which cancer survivors are being surveyed, (2) determine the topics being covered in these surveys, and (3) create a compendium of information about these surveys and data sets, so researchers can conduct additional analyses. RESULTS Thirty-five surveys were identified and included in this report; most were longitudinal studies (71%) in adult cancer survivors (91%). The domains addressed in these surveys were general medical characteristics, medical conditions, costs, employment, symptoms and/or side effects, psychosocial factors and coping, perceived quality of care, and health behaviors. CONCLUSIONS Existing data are available for researchers to explore new knowledge to enhance cancer survivorship quality care. This is an opportunity to fully utilize existing data to answer survivorship questions in a cost effective manner. IMPLICATIONS FOR CANCER SURVIVORS Survivors should be encouraged to participate in research studies as these data can close the gap in our knowledge and care of this growing population.
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Affiliation(s)
- Ahrang Jung
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599-7460, USA
| | | | - Jennifer L Robinson
- Department of Behavioral and Community Health, University of Maryland at College Park, College Park, MD, 20742-2611, USA
| | | | - Deborah K Mayer
- School of Nursing, UNC Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599-7460, USA.
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Ciria-Suarez L, Jiménez-Fonseca P, Palacín-Lois M, Antoñanzas-Basa M, Fernández-Montes A, Manzano-Fernández A, Castelo B, Asensio-Martínez E, Hernando-Polo S, Calderon C. Breast cancer patient experiences through a journey map: A qualitative study. PLoS One 2021; 16:e0257680. [PMID: 34550996 PMCID: PMC8457460 DOI: 10.1371/journal.pone.0257680] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 09/03/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Breast cancer is one of the most prevalent diseases in women. Prevention and treatments have lowered mortality; nevertheless, the impact of the diagnosis and treatment continue to impact all aspects of patients' lives (physical, emotional, cognitive, social, and spiritual). OBJECTIVE This study seeks to explore the experiences of the different stages women with breast cancer go through by means of a patient journey. METHODS This is a qualitative study in which 21 women with breast cancer or survivors were interviewed. Participants were recruited at 9 large hospitals in Spain and intentional sampling methods were applied. Data were collected using a semi-structured interview that was elaborated with the help of medical oncologists, nurses, and psycho-oncologists. Data were processed by adopting a thematic analysis approach. RESULTS The diagnosis and treatment of breast cancer entails a radical change in patients' day-to-day that linger in the mid-term. Seven stages have been defined that correspond to the different medical processes: diagnosis/unmasking stage, surgery/cleaning out, chemotherapy/loss of identity, radiotherapy/transition to normality, follow-up care/the "new" day-to-day, relapse/starting over, and metastatic/time-limited chronic breast cancer. The most relevant aspects of each are highlighted, as are the various cross-sectional aspects that manifest throughout the entire patient journey. CONCLUSIONS Comprehending patients' experiences in depth facilitates the detection of situations of risk and helps to identify key moments when more precise information should be offered. Similarly, preparing the women for the process they must confront and for the sequelae of medical treatments would contribute to decreasing their uncertainty and concern, and to improving their quality-of-life.
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Affiliation(s)
- Laura Ciria-Suarez
- Clinical Psychology and Psychobiology Department, Faculty of Psychology, University of Barcelona, Barcelona, Spain
| | - Paula Jiménez-Fonseca
- Medical Oncology Department Hospital Universitario Central of Asturias, Oviedo, Spain
| | - María Palacín-Lois
- Social Psychology and Quantitative Psychology Department, Faculty of Psychology, University of Barcelona, Barcelona, Spain
| | | | - Ana Fernández-Montes
- Medical Oncology Department, Complexo Hospitalario Universitario de Ourense, Ourense, Spain
| | | | - Beatriz Castelo
- Medical Oncology Department, Hospital Universitario La Paz, Madrid, Spain
| | | | - Susana Hernando-Polo
- Medical Oncology Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Caterina Calderon
- Clinical Psychology and Psychobiology Department, Faculty of Psychology, University of Barcelona, Barcelona, Spain
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Song Y, Li J, Feng Y, Li S, Hong J. Actual needs and perceived supply of nursing supportive care among patients with cancer in mainland China: A cross-sectional study. Jpn J Nurs Sci 2021; 19:e12449. [PMID: 34498402 DOI: 10.1111/jjns.12449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 07/06/2021] [Accepted: 07/14/2021] [Indexed: 01/14/2023]
Abstract
AIM Nurses are considered a major source of professional support for patients. However, little is known about what cancer patients need from nurses regarding professional support and the provision of services in China. The purpose of this study is to investigate professional nursing supportive care needs, perceived supply, and the possible gaps between the two for patients with cancer in mainland China. METHODS A total of 390 inpatients with different types of cancer were recruited. The professional nursing supportive care scale was used to assess the needs for and perceived supply of various types of support. RESULTS The information aspect was one of the most critical needs for supportive care, and the technical aspect was the one with the highest perceived level of supply. Significant mismatches between actual needs and perceived supply were identified. CONCLUSIONS Significant gaps existed between actual needs and perceived supply. Nurses should pay more attention to the higher actual needs and lower perceived levels of supply regarding supportive care for cancer patients.
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Affiliation(s)
- Yongxia Song
- School of Nursing, Anhui Medical University, Hefei, China
| | - Jingru Li
- School of Nursing, Anhui Medical University, Hefei, China
| | - Yuan Feng
- School of Nursing, Anhui Medical University, Hefei, China
| | - Shuwen Li
- School of Nursing, Anhui Medical University, Hefei, China
| | - Jingfang Hong
- School of Nursing, Anhui Medical University, Hefei, China.,Anhui Provincial Nursing International Research Center, Hefei, China
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de Heus E, van der Zwan JM, Husson O, Frissen AR, van Herpen CML, Merkx MAW, Duijts SFA. Unmet supportive care needs of patients with rare cancer: A systematic review. Eur J Cancer Care (Engl) 2021; 30:e13502. [PMID: 34409667 DOI: 10.1111/ecc.13502] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 06/04/2021] [Accepted: 07/27/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Patients with rare cancers may experience different unmet needs than those with common cancer. The objective of this systematic review was to (1) investigate unmet supportive care needs of rare cancer patients throughout the disease trajectory and (2) identify predictive factors for these unmet needs. METHODS PubMed, PsycINFO and CINAHL were searched for publications (January 2011 to March 2021) focusing on unmet needs of patients with rare cancer. Two reviewers independently selected studies, extracted data and performed quality assessment. Findings were synthesised. RESULTS The search yielded 4,598 articles, of which 59 articles met eligibility criteria and 57 were of medium or high quality. Rare cancer patients most frequently reported unmet needs in the healthcare system and information domain (up to 95%), followed by the psychological domain (up to 93%) and the physical and daily living domain (up to 80%). Unmet needs were mainly reported in the posttreatment phase. The most frequently identified predictors were higher anxiety, younger age and higher neuroticism. CONCLUSION Patients with rare cancer have unmet needs throughout their disease trajectory. Supportive care needs of rare cancer patients should be addressed individually, depending on the rare cancer subdomain and phase of disease and from diagnosis onwards.
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Affiliation(s)
- Eline de Heus
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jan Maarten van der Zwan
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Olga Husson
- Division of Psychosocial Research and Epidemiology and Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Anne-Roos Frissen
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Carla M L van Herpen
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Matthias A W Merkx
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,IQ Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Saskia F A Duijts
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Balakrishnan A, Idicula SM, Jones J. Deep learning based analysis of sentiment dynamics in online cancer community forums: An experience. Health Informatics J 2021; 27:14604582211007537. [PMID: 33832380 DOI: 10.1177/14604582211007537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Online health communities (OHC) provide various opportunities for patients with chronic or life-threatening illnesses, especially for cancer patients and survivors. A better understanding of the sentiment dynamics of patients in OHCs can help in the precise formulation of the needs during their treatment. The current study investigated the sentiment dynamics in patients' narratives in a Breast Cancer community group (Breastcancer.org) to identify the changes in emotions, thoughts, stress, and coping mechanisms while undergoing treatment options, particularly chemotherapy, radiation, and surgery. Sentiment dynamics of users' posts was performed using a deep learning model. A sentiment change analysis was performed to measure change in the satisfaction level of the users. The deep learning model BiLSTM with sentiment embedding features provided a better F1-score of 91.9%. Sentiment dynamics can assess the difference in satisfaction level the users acquire by interacting with other users in the forum. A comparison of the proposed model with existing models revealed the effectiveness of this methodology.
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Meghani SH, Levoy K, Magan KC, Starr LT, Yocavitch L, Barg FK. "I'm Dealing With That": Illness Concerns of African American and White Cancer Patients While Undergoing Active Cancer Treatments. Am J Hosp Palliat Care 2021; 38:830-841. [PMID: 33107324 PMCID: PMC8424597 DOI: 10.1177/1049909120969121] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND National oncology guidelines recommend early integration of palliative care for patients with cancer. However, drivers for this integration remain understudied. Understanding illness concerns at the time of cancer treatment may help facilitate integration earlier in the cancer illness trajectory. OBJECTIVE To describe cancer patients' concerns while undergoing cancer treatment, and determine if concerns differ among African Americans and Whites. METHODS A 1-time, semi-structured qualitative interview was conducted with a purposive subsample of cancer patients participating in a larger study of illness concerns. Eligible patients were undergoing cancer treatments and had self-reported moderate-to-severe pain in the last week. Analysis encompassed a qualitative descriptive approach with inductive thematic analysis. RESULTS Participants (16 African American, 16 White) had a median age of 53 and were predominantly females (72%) with stage III/IV cancer (53%). Illness concerns were largely consistent across participants and converged on 3 themes: symptom experience (pain, options to manage pain), cancer care delivery (communication, care coordination and care transitions), and practical concerns (access to community and health system resources, financial toxicity). CONCLUSIONS The findings extend the scope of factors that could be utilized to integrate palliative care earlier in the cancer illness trajectory, moving beyond the symptoms- and prognosis-based triggers that typify current referrals to also consider diverse logistical concerns. Using this larger set of concerns aids anticipatory risk mitigation and planning (e.g. care transitions, financial toxicity), helps patients receive a larger complement of support services, and builds cancer patients' capacity toward a more patient-centered treatment and care experience.
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Affiliation(s)
- Salimah H. Meghani
- Department of Biobehavioral Health Sciences, NewCourtland Center for Transitions and Health, University of Pennsylvania School of Nursing; Philadelphia, Pennsylvania
| | - Kristin Levoy
- Department of Biobehavioral Health Sciences, NewCourtland Center for Transitions and Health, University of Pennsylvania School of Nursing; Philadelphia, Pennsylvania
| | | | - Lauren T. Starr
- Department of Biobehavioral Health Sciences, NewCourtland Center for Transitions and Health, University of Pennsylvania School of Nursing; Philadelphia, Pennsylvania
| | | | - Frances K. Barg
- Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania; Philadelphia, Pennsylvania
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Li J, Liu Y, Jiang J, Peng X, Hu X. Effect of telehealth interventions on quality of life in cancer survivors: A systematic review and meta-analysis of randomized controlled trials. Int J Nurs Stud 2021; 122:103970. [PMID: 34303269 DOI: 10.1016/j.ijnurstu.2021.103970] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 04/20/2021] [Accepted: 04/24/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND With advances in cancer disease diagnosis and treatment, the trends of cancer survival continue to increase, but cancer survivors usually experience disease- or treatment-related problems (including both physiological and psychological problems) and poorer quality of life. Various types of telehealth interventions have been widespread in the field of medical care and have been shown to be cost-effective, to have high levels of patient satisfaction, and to have high acceptability among health professionals. Currently, there is no definite conclusion about the effectiveness of telehealth interventions on cancer survivors' quality of life. OBJECTIVES To evaluate the effects of telehealth interventions on cancer survivors' quality of life and compare the effectiveness of different types. DESIGN A systematic review and meta-analysis. METHODS A systematic literature search was conducted in six databases (MEDLINE, Embase, the Cochrane Central Register of Controlled trials, CINAHL, PsycINFO, and Web of Science) to identify relevant studies from inception to 14 April 2021. Two reviewers independently screened studies and extracted the data. The Cochrane risk-of-bias tool was used to evaluate the quality of the included studies. Data synthesis was conducted in Review Manager (Version 5.3), and the quality of life scores were calculated by using the standard mean difference (SMD) and 95% confidence intervals (CIs). Sensitivity analysis and subgroup analysis were also conducted. RESULTS Twenty-eight randomized controlled trials (RCTs) published from 2002 to 2020 were included. Meta-analysis revealed significant effects of telehealth interventions on cancer survivors' quality of life (SMD = 0.24, 95% CI: 0.14-0.34, P < 0.00001). Subgroup analysis showed that the most effective method was application-based intervention (SMD = 0.41, 95% CI: 0.17-0.66) and the short-term telehealth intervention was more effective than other durations of intervention (SMD = 0.28, 95% CI: 0.06-0.50). The effects on breast cancer survivors' quality of life were greater than those on the other types of cancer survivors (SMD = 0.30, 95% CI: 0.10-0.51). Sensitivity analysis indicated that the pooled results were robust and reliable. CONCLUSION Telehealth interventions are effective and alternative methods for improving quality of life among cancer survivors. The most effective approach was application-based intervention, the most common approach was website-based intervention, and in terms of intervention durations, the short-term telehealth intervention was the most effective. Most telehealth interventions included breast cancer survivors. More large, well-designed RCTs are needed to confirm the effects of telehealth interventions on quality of life in cancer survivors.
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Affiliation(s)
- Juejin Li
- West China School of Nursing, West China Hospital, Sichuan University, No 37 Guo-xue-xiang Lane, Wuhou District, Chengdu, Sichuan, PR China
| | - Yong Liu
- Department of Burn and Plastic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Jianjun Jiang
- Department of Palliative Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Xingchen Peng
- Department of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Xiaolin Hu
- West China School of Nursing, West China Hospital, Sichuan University, No 37 Guo-xue-xiang Lane, Wuhou District, Chengdu, Sichuan, PR China.
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Turon H, Hill D, Watson R, Hobden B, Millar J, Sanson-Fisher R. A patient-centred approach to determine optimal supportive care across the cancer trajectory: a cross-sectional study. Eur J Cancer Care (Engl) 2021; 30:e13455. [PMID: 33881182 DOI: 10.1111/ecc.13455] [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: 10/10/2020] [Revised: 02/04/2021] [Accepted: 04/05/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Supportive care is recognised as an integral component of cancer care. To comprehensively improve supportive care and to inform policy, it is essential to examine consumer's views of health services. This study aimed to develop and test a patient-centred approach by measuring consumer perspectives on the importance of aspects of supportive care to determine what patients consider highest quality or 'optimal' care. METHODS A cross-sectional survey was conducted in oncology outpatient clinics. Eligible patients were invited to complete the optimal care survey on an iPad. The survey consisted of 69 items assessing 14 care domains across five phases of the care trajectory. RESULTS A total of 359 participants completed the survey. Items in the 'preparation for treatment' and 'follow-up and end-of-life care' phases were endorsed as very important/essential to optimal care by most participants (79-97% and 80-100%, respectively). Items in the 'preparation for first appointment' (48-84%), 'first appointment' (51-97%) and 'receiving treatment' (32-93%) phases showed greater variation in endorsement. CONCLUSION This study provides a patient-centred tool for quantifying optimal supportive care for people with cancer across the treatment trajectory. This tool could be used by healthcare providers to evaluate existing care quality, develop policies and guide clinical service improvements.
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Affiliation(s)
- Heidi Turon
- Health Behaviour Research Collaborative, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia
| | - David Hill
- Health Behaviour Research Collaborative, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.,Cancer Council Victoria, Melbourne, VIC, Australia.,School of Population & Global Health, University of Melbourne, Parkville, VIC, Australia
| | - Rochelle Watson
- Health Behaviour Research Collaborative, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia
| | - Breanne Hobden
- Health Behaviour Research Collaborative, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia
| | - Jeremy Millar
- Cancer Council Victoria, Melbourne, VIC, Australia.,Alfred Health Radiation Oncology Services, Melbourne, VIC, Australia.,Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Rob Sanson-Fisher
- Health Behaviour Research Collaborative, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia
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Santoso AMM, Jansen F, Lissenberg-Witte BI, Baatenburg de Jong RJ, Langendijk JA, Leemans CR, Smit JH, Takes RP, Terhaard CHJ, van Straten A, Verdonck-de Leeuw IM. Poor sleep quality among newly diagnosed head and neck cancer patients: prevalence and associated factors. Support Care Cancer 2021; 29:1035-1045. [PMID: 32566997 PMCID: PMC7767896 DOI: 10.1007/s00520-020-05577-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 06/11/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Head and neck cancer (HNC) patients often suffer from distress attributed to their cancer diagnosis which may disturb their sleep. However, there is lack of research about poor sleep quality among newly diagnosed HNC patients. Therefore, our aim was to investigate the prevalence and the associated factors of poor sleep quality among HNC patients before starting treatment. MATERIALS AND METHODS A cross-sectional study was conducted using the baseline data from NET-QUBIC study, an ongoing multi-center cohort of HNC patients in the Netherlands. Poor sleep quality was defined as a Pittsburgh Sleep Quality Index (PSQI) total score of > 5. Risk factors examined were sociodemographic factors (age, sex, education level, living situation), clinical characteristics (HNC subsite, tumor stage, comorbidity, performance status), lifestyle factors, coping styles, and HNC symptoms. RESULTS Among 560 HNC patients, 246 (44%) had poor sleep quality before start of treatment. Several factors were found to be significantly associated with poor sleep: younger age (odds ratio [OR] for each additional year 0.98, 95% CI 0.96-1.00), being female (OR 2.6, 95% CI 1.7-4.1), higher passive coping style (OR 1.18, 95% CI 1.09-1.28), more oral pain (OR 1.10, 95% CI 1.01-1.19), and less sexual interest and enjoyment (OR 1.13, 95% CI 1.06-1.20). CONCLUSION Poor sleep quality is highly prevalent among HNC patients before start of treatment. Early evaluation and tailored intervention to improve sleep quality are necessary to prepare these patients for HNC treatment and its consequences.
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Affiliation(s)
- Angelina M M Santoso
- Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioural and Movement Sciences & Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
- Cancer Center Amsterdam Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Femke Jansen
- Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioural and Movement Sciences & Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
- Cancer Center Amsterdam Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Otolaryngology - Head and Neck Surgery, Amsterdam UMC, Vrije Universiteit Amsterdam, PO Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Birgit I Lissenberg-Witte
- Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Robert J Baatenburg de Jong
- Department of Otolaryngology and Head and Neck Surgery, Erasmus Cancer Institute, Erasmus MC, Rotterdam, The Netherlands
| | - Johannes A Langendijk
- Department of Radiation Oncology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - C René Leemans
- Department of Otolaryngology - Head and Neck Surgery, Amsterdam UMC, Vrije Universiteit Amsterdam, PO Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Johannes H Smit
- Department of Psychiatry, Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Robert P Takes
- Department of Otorhinolaryngology and Head and Neck Surgery, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Chris H J Terhaard
- Department of Radiotherapy, University Medical Center, Utrecht, The Netherlands
| | - Annemieke van Straten
- Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioural and Movement Sciences & Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - Irma M Verdonck-de Leeuw
- Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioural and Movement Sciences & Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
- Cancer Center Amsterdam Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
- Department of Otolaryngology - Head and Neck Surgery, Amsterdam UMC, Vrije Universiteit Amsterdam, PO Box 7057, 1007 MB, Amsterdam, The Netherlands.
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Tsatsou I, Konstantinidis T, Kalemikerakis I, Adamakidou T, Vlachou E, Govina O. Unmet Supportive Care Needs of Patients with Hematological Malignancies: A Systematic Review. Asia Pac J Oncol Nurs 2021; 8:5-17. [PMID: 33426184 PMCID: PMC7785074 DOI: 10.4103/apjon.apjon_41_20] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 06/27/2020] [Indexed: 12/12/2022] Open
Abstract
Hematological malignancies require intensive and long-term treatment, which brings a significant burden on patients, leading to unmet supportive care needs. The purpose of this review was to investigate the unmet supportive care needs of patients with hematological malignancies during and after active treatment as well as the factors that affect them. A systematic bibliographic search was carried out in the PubMed database for English articles published between 2009 and 2020 according to the Preferred Reporting Items for Systematic Reviews guidelines and under the terms: "unmet needs", "supportive care", "hematological malignancy" and "hematological cancer." Twenty studies were evaluated and reviewed. Hierarchical frequently reported unmet supportive care needs were informational, emotional, physical, daily living/practical (accessibility, transportation, and financial problems), and family life/relational needs. In particular, patients with multiple myeloma most frequently reported unmet needs at the informational, physical, emotional, and daily living/practical domain. Patients with myelodysplastic syndromes reported physical, emotional, practical, and relational needs. Patients with leukemia and lymphoma rated their needs as informational, physical, psychological, daily living, and sexual. Sexual and spiritual unmet needs were reported at a low level. Predictive indicators for increased unmet supportive care needs were the type of the hematological malignancy, younger age, marital status, female gender, monthly income, coexistence of anxiety and depression, and altered quality of life. To conclude with, the literature reports a significant number of unmet supportive care needs in patients with hematological malignancies, whose frequency and intensity were influenced by a variety of factors. However, the large heterogeneity of studies (design, sample, and needs assessment tools) makes the generalization of the results difficult.
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Affiliation(s)
- Ioanna Tsatsou
- Oncology-Hematology Department, Hellenic Airforce General Hospital, Heraklion, Greece
| | | | | | | | - Eugenia Vlachou
- Department of Nursing, University of West Attica, Athens, Greece
| | - Ourania Govina
- Department of Nursing, University of West Attica, Athens, Greece
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Ciria-Suarez L, Jiménez-Fonseca P, Palacín-Lois M, Antoñanzas-Basa M, Férnández-Montes A, Manzano-Fernández A, Castelo B, Asensio-Martínez E, Hernando-Polo S, Calderon C. Ascertaining breast cancer patient experiences through a journey map: A qualitative study protocol. PLoS One 2020; 15:e0244355. [PMID: 33347475 PMCID: PMC7751958 DOI: 10.1371/journal.pone.0244355] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 12/08/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The current cancer care system must be improved if we are to have in-depth knowledge about breast cancer patients' experiences throughout all the stages of their disease. AIM This study seeks to describe breast cancer patients' experience over the course of the various stages of illness by means of a journey model. METHODS This is a qualitative descriptive study. Individual, semi-structured interviews will be administered to women with breast cancer and breast cancer survivors. Patients will be recruited from nine large hospitals in Spain and intentional sampling will be used. Data will be collected by means of a semi-structured interview that was elaborated with the help of medical oncologists, nurses, and psycho-oncologists. Data will be processed adopting a thematic analysis approach. DISCUSSION The outcomes of this study will afford new insights into breast cancer patients' experiences, providing guidance to improve the care given to these individuals. This protocol aims to describe the journey of patients with breast cancer through the healthcare system to establish baseline data that will serve as the basis for the development and implementation of a patient-centered, evidence-based clinical pathway.
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Affiliation(s)
- Laura Ciria-Suarez
- Clinical Psychology and Psychobiology Department, Faculty of Psychology, University of Barcelona, Barcelona, Spain
| | - Paula Jiménez-Fonseca
- Medical Oncology Department, Hospital Universitario Central of Asturias, Oviedo, Spain
| | - María Palacín-Lois
- Social Psychology and Quantitative Psychology Department, Faculty of Psychology, University of Barcelona, Barcelona, Spain
| | | | - Ana Férnández-Montes
- Medical Oncology Department, Complejo Hospitalario Universitario de Orense, Orense, Spain
| | | | - Beatriz Castelo
- Medical Oncology Department, Hospital Universitario La Paz, Madrid, Spain
| | | | - Susana Hernando-Polo
- Medical Oncology Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Caterina Calderon
- Clinical Psychology and Psychobiology Department, Faculty of Psychology, University of Barcelona, Barcelona, Spain
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Ciria-Suarez L, Jimenez-Fonseca P, Hernández R, Rogado J, Calderon C. Estimation of Risk of Recurrence and Toxicity Among Oncologists and Patients With Resected Breast Cancer: A Quantitative Study. Front Psychol 2020; 11:540083. [PMID: 33192784 PMCID: PMC7653019 DOI: 10.3389/fpsyg.2020.540083] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 10/05/2020] [Indexed: 12/20/2022] Open
Abstract
Shared decision-making regarding adjuvant systemic therapy in breast cancer is based on both properly conveying information about the prognosis of the disease and the benefits and risks of adjuvant treatment, as well as the patient's ability to understand this information. This work proposed to analyze oncologists' and patients' perceptions of the risk of recurrence with and without chemotherapy and toxicity, and the factors influencing said impressions. This was a prospective, cross-sectional, multicenter study that involved 281 breast cancer patients and 23 oncologists. Prognosis (risk of recurrence with and without chemotherapy and risk of severe toxicity with chemotherapy) and shared decision making (SDM) questionnaires were completed by all participants; breast cancer patients also filled out the 18-item Brief Symptom Inventory (BSI-18). Oncologists' prediction of risk of relapse without and with chemotherapy (30.4 and 13.3%) and risk of severe toxicity (9.8%) were more optimistic than those of breast cancer patients (78.6, 29.6, and 61%, respectively). The greater the severity, the higher the risk of relapse according to the oncologists (p = 0.001); not so for the patients. Older physicians and more experienced ones predicted lower risk of relapse with and without chemotherapy and less severe toxicity than younger doctors and those with less experience (p < 0.001). Oncologists' SDM and their prediction of risk of relapsing with chemotherapy correlated negatively with patients' SDM and their prediction of risk of severe toxicity (p < 0.01). There is a positive correlation between psychological distress (BSI-18) and prognosis of risk of recurrence with chemotherapy in breast cancer patients (p < 0.001). These results stress the importance of improving doctor-patient communication in SDM. In breast cancer patients undergoing treatment with curative intent, expectations of being cured would increase and treatment-related anxiety would decrease by enhancing doctor-patient communication to coincide more with respect to risk of relapse and toxicity, thereby enhancing patients' quality of life.
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Affiliation(s)
- Laura Ciria-Suarez
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona, Spain
| | - Paula Jimenez-Fonseca
- Department of Medical Oncology, Central University Hospital of Asturias, Oviedo, Spain
| | - Raquel Hernández
- Department of Medical Oncology, Canary University Hospital, Santa Cruz de Tenerife, Spain
| | - Jacobo Rogado
- Department of Medical Oncology, Infanta Leonor University Hospital, Madrid, Spain
| | - Caterina Calderon
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona, Spain
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Fitch MI, Nicoll I, Lockwood G, Newton L, Strohschein FJ. Improving survivorship care: Perspectives of cancer survivors 75 years and older. J Geriatr Oncol 2020; 12:453-460. [PMID: 32962951 DOI: 10.1016/j.jgo.2020.09.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 09/08/2020] [Accepted: 09/10/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE This work describes perspectives of older adult cancer survivors about improvements that should be considered during the early period of survivorship. Findings will be useful in program development of age-appropriate services following completion of cancer treatment for older adults. METHODS A national survey was conducted across ten Canadian provinces to understand follow-up experiences of cancer survivors one to three years post-treatment. The survey included open-ended questions enabling respondents to offer insight into their experiences. This publication presents analysis of responses from older adults (75+ years) about suggestions for improving survivorship care. RESULTS In total, 3274 older adults (75+ years) responded to the survey and 1424 responded to the question about improvements. Fifty-five percent of the older adults were male, 28% had experienced metastatic disease and 75% reported comorbid conditions. A total of 640 respondents offered 932 suggestions in the areas of service delivery (n = 763, 81.9%), support (n = 108, 11.6%), and practical assistance (n = 61, 6.5%). Improvements in information/communication (n = 291) and follow-up care (n = 180) accounted for the highest number of suggestions regarding service delivery. Thematic analysis revealed three key messages about improvement: 'offer me needed support', 'make access easy for me', and 'show me you care'. CONCLUSION Suggestions for improvement in survivorship care by older adults treated for cancer emphasize need for changes in the approaches taken by health care providers in interactions and organization of care delivery. Proactive provision of information, detailed schedules for follow-up care, and ease of access to post-treatment care are needed.
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Affiliation(s)
- Margaret I Fitch
- Bloomberg Faculty of Nursing, University of Toronto, 207 Chisholm Ave, Toronto, Ontario M4C 4V9, Canada.
| | | | | | - Lorelei Newton
- School of Nursing, University of Victoria, PO Box 1700 STN CSC, Victoria, BC V8W 2Y2, Canada.
| | - Fay J Strohschein
- Oncology and Aging Program, Jewish General Hospital, Wainwright, Montreal, Alberta, Canada.
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49
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Heß V, Meng K, Schulte T, Neuderth S, Bengel J, Faller H, Schuler M. Prevalence and predictors of cancer patients' unexpressed needs in the admission interview of inpatient rehabilitation. Psychooncology 2020; 29:1549-1556. [DOI: 10.1002/pon.5450] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 06/12/2020] [Accepted: 06/15/2020] [Indexed: 12/17/2022]
Affiliation(s)
- Verena Heß
- Institute of Clinical Epidemiology and Biometry, University of Würzburg Würzburg Germany
| | - Karin Meng
- Institute of Clinical Epidemiology and Biometry, University of Würzburg Würzburg Germany
| | | | - Silke Neuderth
- Faculty of Applied Social Sciences, University of Applied Sciences Würzburg‐ Schweinfurt Würzburg Germany
| | - Jürgen Bengel
- Department of Rehabilitation Psychology and Psychotherapy University of Freiburg Freiburg im Breisgau Germany
| | - Hermann Faller
- Institute of Clinical Epidemiology and Biometry, University of Würzburg Würzburg Germany
| | - Michael Schuler
- Institute of Clinical Epidemiology and Biometry, University of Würzburg Würzburg Germany
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50
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Lo-Fo-Wong DNN, de Haes HCJM, Aaronson NK, van Abbema DL, den Boer MD, van Hezewijk M, Immink M, Kaptein AA, Menke-Pluijmers MBE, Reyners AKL, Russell NS, Schriek M, Sijtsema S, van Tienhoven G, Verdam MGE, Sprangers MAG. Risk factors of unmet needs among women with breast cancer in the post-treatment phase. Psychooncology 2019; 29:539-549. [PMID: 31785043 PMCID: PMC7065096 DOI: 10.1002/pon.5299] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 10/30/2019] [Accepted: 11/18/2019] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Unmet health care needs require additional care resources to achieve optimal patient well-being. In this nationwide study we examined associations between a number of risk factors and unmet needs after treatment among women with breast cancer, while taking into account their health care practices. We expected that more care use would be associated with lower levels of unmet needs. METHODS A multicenter, prospective, observational design was employed. Women with primary breast cancer completed questionnaires 6 and 15 months post-diagnosis. Medical data were retrieved from medical records. Direct and indirect associations between sociodemographic and clinical risk factors, distress, care use, and unmet needs were investigated with structural equation modeling. RESULTS Seven hundred forty-six participants completed both questionnaires (response rate 73.7%). The care services received were not negatively associated with the reported levels of unmet needs after treatment. Comorbidity was associated with higher physical and daily living needs. Higher age was associated with higher health system-related and informational needs. Having had chemotherapy and a mastectomy were associated with higher sexuality needs and breast cancer-specific issues, respectively. A higher level of distress was associated with higher levels of unmet need in all domains. CONCLUSIONS Clinicians may use these results to timely identify which women are at risk of developing specific unmet needs after treatment. Evidence-based, cost-effective (online) interventions that target distress, the most influential risk factor, should be further implemented and disseminated among patients and clinicians.
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Affiliation(s)
- Deborah N N Lo-Fo-Wong
- Academic Medical Center, Cancer Center Amsterdam, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Hanneke C J M de Haes
- Academic Medical Center, Cancer Center Amsterdam, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Neil K Aaronson
- Antoni van Leeuwenhoek Hospital, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Doris L van Abbema
- GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | | | | | | | - Ad A Kaptein
- Leiden University Medical Center, Leiden, The Netherlands
| | | | - Anna K L Reyners
- University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Nicola S Russell
- Antoni van Leeuwenhoek Hospital, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | - Sieta Sijtsema
- University Medical Center Utrecht, Utrecht, The Netherlands
| | - Geertjan van Tienhoven
- Academic Medical Center, Cancer Center Amsterdam, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Mathilde G E Verdam
- Academic Medical Center, Cancer Center Amsterdam, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Mirjam A G Sprangers
- Academic Medical Center, Cancer Center Amsterdam, Amsterdam University Medical Centers, Amsterdam, The Netherlands
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