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Adriaans DJM, Rosendaal M, Nieuwenhuijzen GAP, Heesakkers FBM, Notenboom L, Teijink JAW, Laarhoven HWMV, Dierick-van Daele ATM. Expectations and needs of patients with esophageal cancer during curative treatment regarding self-management, self-management support and eHealth: a qualitative study. Eur J Oncol Nurs 2024; 71:102638. [PMID: 38943774 DOI: 10.1016/j.ejon.2024.102638] [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: 11/09/2023] [Revised: 06/03/2024] [Accepted: 06/06/2024] [Indexed: 07/01/2024]
Abstract
PURPOSE Self-management is an essential component of the curative treatment trajectory of esophageal cancer patients. The aims of this study were to explore expectations and needs of esophageal cancer patients during curative treatment regarding self-management, relevant aspects of self-management in which they need additional support, and to explore their willingness to use eHealth. METHODS Semi-structured interviews were conducted with esophageal cancer patients, who had been treated with neoadjuvant chemo(radio)therapy followed by surgery, maximally 1 year after surgery. Based on the general model of self-management, the following themes were discussed: experience-based knowledge, contribution to care, living with the condition, and organization of care and support. A stepwise systematic text condensation guided the data analysis. RESULTS All four domains of the general model of self-management were identified. All participants described a remarkable difference between the pre-operative pathway, when it felt like they were taken by the hand, and the postoperative pathway, when it felt like they were thrown into the deep end. They adjusted to their new life situation by learning new experiences, while dealing with their diminished confidence in their bodies. Patients expressed the need for support from different sources, and were open to the idea of using eHealth in addition to usual care. (digital) Self-management support should be easily accessible, person-centered, confidential, and include personal contact. CONCLUSION Differences were found among esophageal cancer patients regarding self-management, self-management support and eHealth for self-management purposes, indicating there is no one approach that will meet the needs of all patients at all times.
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Affiliation(s)
- Daniëlle J M Adriaans
- Fontys University of Applied Sciences, Ds Th Fliednerstraat 2, Eindhoven, 5631, BN, the Netherlands; Department of Surgery, Catharina Hospital, Eindhoven, Michelangelolaan 2, Eindhoven, 5602, ZA, the Netherlands; CAPHRI School for Public Health and Primary Care, Maastricht University, 6200, MD, Maastricht, the Netherlands.
| | - Mariëlle Rosendaal
- Fontys School of HRM and Psychology, Fontys University of Applied Science, P.O. Box 347, 5600, AH, Eindhoven, the Netherlands
| | - Grard A P Nieuwenhuijzen
- Department of Surgery, Catharina Hospital, Eindhoven, Michelangelolaan 2, Eindhoven, 5602, ZA, the Netherlands
| | - Fanny B M Heesakkers
- Department of Surgery, Catharina Hospital, Eindhoven, Michelangelolaan 2, Eindhoven, 5602, ZA, the Netherlands
| | - Loes Notenboom
- Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands
| | - Joep A W Teijink
- Department of Surgery, Catharina Hospital, Eindhoven, Michelangelolaan 2, Eindhoven, 5602, ZA, the Netherlands; CAPHRI School for Public Health and Primary Care, Maastricht University, 6200, MD, Maastricht, the Netherlands
| | - Hanneke W M van Laarhoven
- Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands; Amsterdam UMC, University of Amsterdam, Department of Medical Oncology, Meibergdreef 9, Amsterdam, the Netherlands
| | - Angelique T M Dierick-van Daele
- Fontys University of Applied Sciences, Ds Th Fliednerstraat 2, Eindhoven, 5631, BN, the Netherlands; Department of Education and Research, Catharina Hospital, Eindhoven, Michelangelolaan 2, Eindhoven, 5602, ZA, the Netherlands; Fontys School of People and Health Studies, Ds Th Fliednerstraat 2, Eindhoven, 5631, BN, the Netherlands
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van Maaren MC, van Hoeve JC, Korevaar JC, van Hezewijk M, Siemerink EJM, Zeillemaker AM, Klaassen-Dekker A, van Uden DJP, Volders JH, Drossaert CHC, Siesling S. The effectiveness of personalised surveillance and aftercare in breast cancer follow-up: a systematic review. Support Care Cancer 2024; 32:323. [PMID: 38695938 PMCID: PMC11065941 DOI: 10.1007/s00520-024-08530-2] [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: 11/17/2023] [Accepted: 04/27/2024] [Indexed: 05/05/2024]
Abstract
PURPOSE Breast cancer follow-up (surveillance and aftercare) varies from one-size-fits-all to more personalised approaches. A systematic review was performed to get insight in existing evidence on (cost-)effectiveness of personalised follow-up. METHODS PubMed, Scopus and Cochrane were searched between 01-01-2010 and 10-10-2022 (review registered in PROSPERO:CRD42022375770). The inclusion population comprised nonmetastatic breast cancer patients ≥ 18 years, after completing curative treatment. All intervention-control studies studying personalised surveillance and/or aftercare designed for use during the entire follow-up period were included. All review processes including risk of bias assessment were performed by two reviewers. Characteristics of included studies were described. RESULTS Overall, 3708 publications were identified, 64 full-text publications were read and 16 were included for data extraction. One study evaluated personalised surveillance. Various personalised aftercare interventions and outcomes were studied. Most common elements included in personalised aftercare plans were treatment summaries (75%), follow-up guidelines (56%), lists of available supportive care resources (38%) and PROs (25%). Control conditions mostly comprised usual care. Four out of seven (57%) studies reported improvements in quality of life following personalisation. Six studies (38%) found no personalisation effect, for multiple outcomes assessed (e.g. distress, satisfaction). One (6.3%) study was judged as low, four (25%) as high risk of bias and 11 (68.8%) as with concerns. CONCLUSION The included studies varied in interventions, measurement instruments and outcomes, making it impossible to draw conclusions on the effectiveness of personalised follow-up. There is a need for a definition of both personalised surveillance and aftercare, whereafter outcomes can be measured according to uniform standards.
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Affiliation(s)
- Marissa C van Maaren
- Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, P.O. Box 217, 7500 AE, Enschede, the Netherlands.
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands.
| | - Jolanda C van Hoeve
- Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, P.O. Box 217, 7500 AE, Enschede, the Netherlands
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands
| | - Joke C Korevaar
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, the Netherlands
- The Hague University of Applied Sciences, The Hague, the Netherlands
| | | | | | | | - Anneleen Klaassen-Dekker
- Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, P.O. Box 217, 7500 AE, Enschede, the Netherlands
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands
| | | | - José H Volders
- Department of Surgery, Diakonessenhuis, Utrecht, the Netherlands
| | - Constance H C Drossaert
- Department of Psychology, Health & Technology, University of Twente, Enschede, the Netherlands
| | - Sabine Siesling
- Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, P.O. Box 217, 7500 AE, Enschede, the Netherlands
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands
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Momennasab M, Ghorbani F, Yektatalab S, Magharei M, Tehranineshat B. The Effect of Spiritual Group Therapy on the Quality of Life and Empowerment of Women with Breast Cancer: A Randomized Clinical Trial in Iran. JOURNAL OF RELIGION AND HEALTH 2024; 63:1504-1522. [PMID: 38489131 DOI: 10.1007/s10943-024-02009-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/29/2024] [Indexed: 03/17/2024]
Abstract
This randomized clinical trial was carried out on 74 women with breast cancer between May 2015 and April 2016 in the south of Iran. The patients were selected using a simple sampling method and randomly divided into an intervention (n = 30) and a control (n = 37) group. Five spiritual therapy sessions were conducted for the intervention group. Each session lasted one hour. The quality of life and empowerment of the patients were measured before and one month after the intervention. To collect data, four instruments were used, including a demographic information form, the European Organization for Research and Treatment of Cancer QOL questionnaire Cancer-30 (EORTC QLQ C-30), EORTC QLQ Breast-23 (EORTC QLQ-BR23), and the Cancer Empowerment Questionnaire (CEQ). After the intervention, a difference was observed between the groups concerning the mean score of general health (P = 0.016) and emotional function (P = 0.029), but there was no significant difference between the groups concerning the mean score of empowerment (P = 0.62). Thus, it appears that spiritual group therapy can improve the quality of life of this group of patients.IRCT registration number: IRCT 2014050417546N2.
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Affiliation(s)
- Marzieh Momennasab
- Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Ghorbani
- Student Research Committee, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shahrzad Yektatalab
- Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahboobeh Magharei
- Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Banafsheh Tehranineshat
- Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
- Department of Nursing, Faculty of Nursing and Midwifery, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
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Bahrami MA, Tabari S, Tahmasebi S, Zangouri V, Ravangard R. Strategies to Promote Empowerment Status of Breast Cancer Women. Int J Breast Cancer 2024; 2024:3305399. [PMID: 38348180 PMCID: PMC10861285 DOI: 10.1155/2024/3305399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 01/01/2024] [Accepted: 01/25/2024] [Indexed: 02/15/2024] Open
Abstract
Background As the second leading cause of death in women in the world, breast cancer has several physical and psychological effects. Nowadays, nonclinical approaches such as patient empowerment have been considered by physicians along with clinical care. Given the increasing number of breast cancer women worldwide, promoting the empowerment of these patients is one of the key factors affecting their survival and quality of life. Therefore, because of no comprehensive research on the empowerment needs and related improvement strategies, this study is aimed at determining the empowerment status of breast cancer patients referred to the Shahid Motahari Breast Cancer Clinic in Iran, Shiraz, and at providing strategies to improve their empowerment in 2021. Methods This applied study was conducted in two phases. In the quantitative phase, 310 Cancer-Related Patient Empowerment Scale questionnaires (Persian format) were distributed among the studied patients selected through the random sampling method in the clinic, and the items with "unacceptable status" became the basis for determining the empowerment strategies through the scoping review and semistructured interviews with 22 medical staff and patients through the thematic analysis. The collected data were analyzed using the SPSS 20.0 and MAXQDA10 software. Results The mean score of the participants' empowerment strategies was 3.58. The results showed that trust in the physician, family support, and spiritual beliefs could affect the empowerment of the studied patients. Moreover, the participants needed empowerment strategies in 11 scale items with unacceptable status, for which 46 strategies were determined in the scoping review and interview phase. Conclusion The results of this study provided useful strategies for empowering breast cancer patients, the most important of which were classified into five categories of financial support, informational support, interaction with the physician, occupational support, and complementary therapies, the use of which by the stakeholders could help to improve the patients' quality of life while improving their empowerment.
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Affiliation(s)
- Mohammad Amin Bahrami
- Health Human Resources Research Center, Department of Health Services Management, School of Management and Medical Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shahrzad Tabari
- Student Research Committee, Department of Health Services Management, School of Management and Medical Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sedigheh Tahmasebi
- Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Vahid Zangouri
- Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ramin Ravangard
- Health Human Resources Research Center, Department of Health Services Management, School of Management and Medical Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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Chen X, Xiao X, Huang X, Wang R, Yang J, Yang L, Wang Y, Zhou C. Empowerment and quality of life: the mediating role of self-efficacy and health literacy among spousal caregivers in China. Health Promot Int 2023; 38:daad133. [PMID: 37874985 DOI: 10.1093/heapro/daad133] [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: 10/26/2023] Open
Abstract
The aim of this study was to explore the chain mediation model of self-efficacy and health literacy between empowerment and quality of life among spousal caregivers of disabled elderly based on 'Marriage Binding'. From December 2020 to June 2022, the cross-sectional study was conducted in hospitals and communities, in Guangdong, Fujian, Sichuan, Hunan, Jiangxi, Guangxi and Yunnan provinces, China. Descriptive statistics were used to describe the demographic data and four main variables, including empowerment, self-efficacy, health literacy and quality of life. Spearman correlation analysis was used to analyze the correlation between the four main research variables. Multiple Linear Regression and bootstrap analysis were used to analyze the direct and indirect effects among them. Any two variables of spousal caregivers were correlated among empowerment, self-efficacy, health literacy and quality of life. Self-efficacy and health literacy can separately and sequentially mediate the relationship between empowerment and quality of life. To improve the quality of life of spousal caregivers of disabled elderly, the mediating role of self-efficacy, the mediating role of health literacy and the chain mediating role of self-efficacy and health literacy should take effect. In the future, some intervention studies should be taken to enhance the effects of those variables that may be beneficial for improving quality of life of spousal caregivers of disabled elderly.
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Affiliation(s)
- Xuan Chen
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, PR China
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, 510515, PR China
| | - Xiuying Xiao
- Department of Nursing, Zhuhai Fifth People's Hospital, Zhuhai, Guangdong, 519090, PR China
| | - Xiu'e Huang
- Department of Nursing, Long Gang Districy People's Hospital of Shen Zhen, ShenZhen, Guangdong, 518172, PR China
| | - Run Wang
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, PR China
| | - Jing Yang
- Department of Nursing, Long Gang Districy People's Hospital of Shen Zhen, ShenZhen, Guangdong, 518172, PR China
| | - Lingli Yang
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, PR China
| | - Yiling Wang
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, PR China
| | - Chunlan Zhou
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, PR China
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Kim SH, Choe YH, Choi J, Park JY, Yi E. Factors Associated With Quality of Life Among Posttreatment Cancer Survivors in Korea: A Meta-analysis. Cancer Nurs 2023:00002820-990000000-00162. [PMID: 37523733 DOI: 10.1097/ncc.0000000000001273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
BACKGROUND Identification of factors associated with quality of life (QOL) among cancer survivors is crucial for identifying potential targets for intervention. OBJECTIVES We aimed to provide evidence of factors associated with the QOL among posttreatment cancer survivors in Korea. METHODS We performed a systematic literature search from January 2000 to September 2022 using PubMed, EMBASE, CINAHL, PsycINFO, and Korean databases (RISS, SCIENCEON). We evaluated study quality using the Joanna Briggs Institute Quality Appraisal Checklists for Analytical Cross-sectional Studies and performed statistical analysis using the R 3.0 software (R Foundation for Statistical Computing, Vienna, Austria) package. We analyzed the pooled effect sizes of potential QOL correlates by the random-effects model. RESULTS This meta-analysis included 31 studies with 8934 participants. The pooled estimates were significantly large for economic status (r = -0.53); significantly medium for fatigue (r = -0.39), anxiety (r = -0.29), depression (r = -0.42), self-efficacy (r = 0.37), and social support (r = 0.30); and significantly small for education level (r = -0.18), job status (r = -0.09), cancer stage (r = -0.20), and time since diagnosis (r = -0.26). CONCLUSIONS Low education level, having no job, low economic status, advanced cancer stage, short disease period, fatigue, anxiety, and depression were significantly associated with worse QOL, whereas self-efficacy and social support were significantly associated with better QOL. IMPLICATIONS FOR PRACTICE The findings have potential implications for identifying "at-risk survivors" of deteriorated QOL and for suggesting powerful strategies (eg, enhancing self-efficacy or social support) for improving QOL.
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Affiliation(s)
- Soo Hyun Kim
- Author Affiliations: Department of Nursing, Inha University, Incheon, South Korea
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Ahn J, Lee KE. Experiences of peer support activities and the need for a metaverse-based program in young women with breast cancer: A qualitative study. Asia Pac J Oncol Nurs 2023; 10:100253. [PMID: 37448532 PMCID: PMC10336407 DOI: 10.1016/j.apjon.2023.100253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 05/25/2023] [Indexed: 07/15/2023] Open
Abstract
Objective This study aimed to explore young breast cancer survivors' experiences of peer support activities and their need for a metaverse-based peer support program. Methods This qualitative content analysis study involved 15 young women with breast cancer under the age of 40. Participants with diverse experiences in peer support activities were purposefully selected. Data were collected in March 2023 through three focus group interviews and three additional individual interviews. Saturation was reached when no new themes emerged from the interviews. The interviews were transcribed verbatim and analyzed using conventional content analysis. This study ensured the trustworthiness of the data based on criteria including truth value, applicability, consistency, and neutrality. Results Four categories emerged: advantages, disadvantages, preferences for peer support activities, and the need for metaverse-based peer support programs. Participants valued peer support activities for exchanging information, nurturing empathy, and encouraging healthy behaviors. Challenges included information confusion, peer conflict, isolation, and stigma. Preferences for group composition, size, and medium varied; however, all participants agreed on the importance of operational guidelines. Participants expected a metaverse-based peer support program to provide safe and enjoyable experiences despite concerns about unfamiliar platforms. Conclusions This study highlights the unique needs and preferences of young breast cancer survivors regarding peer support activities. Well-organized and tailored peer support can significantly enhance their quality of life. These findings provide valuable insights for developing effective metaverse-based peer support programs to meet the needs of young women with breast cancer.
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Affiliation(s)
- Jeonghee Ahn
- Department of Medicine, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Kyoung-Eun Lee
- Department of Nursing Science, SunMoon University, 70, Sunmoon-ro 221beon-gil, Tangjeong-myeon, Asan-si, Chungcheongnam-do, Republic of Korea
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Tawfik E, Ghallab E, Moustafa A. A nurse versus a chatbot ‒ the effect of an empowerment program on chemotherapy-related side effects and the self-care behaviors of women living with breast Cancer: a randomized controlled trial. BMC Nurs 2023; 22:102. [PMID: 37024875 PMCID: PMC10077642 DOI: 10.1186/s12912-023-01243-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 03/10/2023] [Indexed: 04/08/2023] Open
Abstract
BACKGROUND The high levels of unmet needs in relation to provision of self-care information reported by women living with breast cancer suggests that pre-chemotherapy education is suboptimal. Chatbots are emerging as a promising platform to provide education to patients helping them self-manage their symptoms at home. However, evidence from empirical studies on the effect of chatbots education on women living with breast cancer self-care behaviors and symptoms management are scarce. METHODS This three-arm randomized controlled trial was performed in a chemotherapy day care center within an oncology center in Egypt. A total of 150 women living with breast cancer were randomly selected and randomized into three groups: the ChemoFreeBot group (n = 50), the nurse-led education group (n = 50), and the routine care group (n = 50). In the ChemoFreeBot group, women were given a link to interact with ChemoFreeBot and ask questions about their symptoms and self-care interventions by typing questions or keywords at any time. On the same day as their first day of chemotherapy, the nurse-led education group received face to face teaching sessions from the researcher (nurse) about side effects and self-care interventions. The routine care group received general knowledge during their chemotherapy session about self-care interventions. The self-care behaviors effectiveness and the frequency, severity and distress of chemotherapy side effects were measured at baseline and postintervention for the three groups. The ChemoFreeBot's usability was assessed. RESULTS The mixed design repeated measures ANOVA analyses revealed a statistically significant both group effect and interaction effect of group*time, indicating a significant difference between the three groups in terms of the physical symptoms frequency (F = 76.075, p < .001, F = 147, p < .001, respectively), severity (F = 96.440, p < .001, F = 220.462, p < .001), and distress (F = 77.171, p < .001, F = 189.680, p < .001); the psychological symptoms frequency (F = 63.198, p < .001, F = 137.908, p < .001), severity (F = 62.137, p < .001), (F = 136.740, p < .001), and distress (F = 43.003, p < .001, F = 168.057, p < .001), and the effectiveness of self-care behaviors (F = 20.134, p < .001, F = 24.252, p < .001, respectively). The Post hoc analysis with Bonferroni adjustment in showed that women in the ChemoFreeBot group experienced a statistically significant less frequent, less severe and less distressing physical and psychological symptoms and higher effective self-care behaviors than those in the nurse-led education and routine care groups (p > .001). CONCLUSION ChemoFreeBot was a useful and cost-effective tool to improve increase self-care behavior and reduce chemotherapy side effects in women living with breast cancer through the provision of personalized education and the improvement of the accessibility to real-time and high-quality information compared to "one size fits all" approach used by nurses to provide the information. ChemoFreeBot can be an empowering tool to assist nurses to educate women with breast cancer and allow women to take an active role in managing their symptom. TRIAL REGISTRATION This study was retrospectively registered in the University hospital Medical Information Network (UMIN) Center, Clinical Trials Registry on 26/09/2022; Registration No:R000055389,Trial ID:UMIN000048955.
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Affiliation(s)
- Elham Tawfik
- Community Health Nursing Department, Faculty of Nursing, Damanhour University, Damanhour, Egypt
- Community Health Nursing Department, Faculty of Nursing, The British University in Egypt, Cairo, Egypt
| | - Eman Ghallab
- Nursing Education Department, Faculty of Nursing, Alexandria University, Alexandria, Egypt.
- Medical Surgical Nursing Department, Faculty of Nursing, Galala University, Suez, Egypt.
| | - Amel Moustafa
- Community Health Nursing Department, Faculty of Nursing, Damanhour University, Damanhour, Egypt
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The longitudinal association between patient empowerment and patient-reported outcomes: What is the direction of effect? PLoS One 2022; 17:e0277267. [DOI: 10.1371/journal.pone.0277267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 10/21/2022] [Indexed: 11/12/2022] Open
Abstract
Background
Theoretical literature and cross-sectional studies suggest empowerment is associated with other patient-reported outcomes (PROs). However, it is not known if patient empowerment is leading to improvements in other PROs or vice versa.
Aims
The present study aimed to examine the direction of effects between patient empowerment and PROs in young persons with congenital heart disease (CHD).
Methods
As part of the STEPSTONES-CHD trial, adolescents with CHD from seven pediatric cardiology centers in Sweden were included in a longitudinal observational study (n = 132). Data were collected when patients were 16 (T0), 17 (T1) and 18 ½ years old (T2). The Gothenburg Young Persons Empowerment Scale (GYPES) was used to measure patient empowerment. Random intercepts cross-lagged panel models between patient empowerment and PROs (communication skills; patient-reported health; quality of life; and transition readiness) were undertaken.
Results
We found a significant cross-lagged effect of transition readiness over patient empowerment between T1 and T2, signifying that a higher level of transition readiness predicted a higher level of patient empowerment. No other significant cross-lagged relationships were found.
Conclusion
Feeling confident before the transition to adult care is necessary before young persons with CHD can feel in control to manage their health and their lives. Clinicians interested in improving patient empowerment during the transitional period should consider targeting transition readiness.
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Experiences and perspectives of ethnocultural breast cancer survivors in the interior region of British Columbia: A descriptive cross-sectional approach. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2022. [DOI: 10.1016/j.cegh.2022.101095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Toma G, Carolan A, Buckner-Petty S, Vargas L, Wolter C, Khan A. The role of in-person focus groups in the management of urinary incontinence in women from a mixed-methods, randomized pilot study. Arch Gynecol Obstet 2022; 306:1539-1545. [PMID: 35652933 DOI: 10.1007/s00404-022-06633-x] [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: 02/21/2022] [Accepted: 05/14/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE To assess the quantitative and qualitative components of in-person focus groups as a potential intervention for female patients with urinary incontinence. METHODS Women over the age of 18 seeking treatment for UI were randomized to standard care with focus group participation or to standard care alone. All participants completed validated questionnaires: MESA, UDI-6, OAB-SAT-q, PGI-S, PGI-I, SQoL-F, PHQ-9, IPAQ at the beginning and conclusion of the study. Questionnaires were analyzed with repeated measures of ANOVA models in an intention-to-treat manner. Three moderated focus group sessions were held and audio recorded. Recordings were transcribed and categorized by frequency into themes using grounded theory methodology. RESULTS A total of ten control and eight intervention participants agreed to participate. Seven women attended all three focus group sessions and were included in the final analysis. Transcripts from focus group sessions observed women identified most with (1) urinary incontinence (UI) as a chronic disease, (2) shame managing UI, and (3) social constraints of toileting. Participants self-reported appreciation of focus group participation and desire for on-going sessions. Analysis of the questionnaires did not demonstrate statistically significant differences. CONCLUSION Data ascertained from questionnaires were unable to demonstrate a meaningful effect in improved treatment outcomes for control and intervention participants. Grounded theory analysis of transcripts identified four primary themes: (1) appreciation of the focus group, (2) UI as a gendered issue, (3) lack of public awareness, and (4) history of negative provider interactions. All focus group participants self-reported interest in attending future focus group sessions.
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Affiliation(s)
- Gina Toma
- Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, Arizona, 85054, USA.
- Arizona State University, Phoenix, Arizona, USA.
| | | | - Skye Buckner-Petty
- Department of Research Administration, Mayo Clinic Arizona, Phoenix, Arizona, USA
| | - Laura Vargas
- Department of Research Administration, Mayo Clinic Arizona, Phoenix, Arizona, USA
| | | | - Aqsa Khan
- Division of Urology, Mayo Clinic, Phoenix, Arizona, USA
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Lubis NL, Hasnida H, Novitarum L. Develop Webinar-Based Empowerment to Increase Optimism of Breast Cancer Survivors. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.10108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND: Breast cancer patients must undergo a series of therapies that take a long time with painful side effects. Fellow breast cancer sufferers are people who can provide psychological support to patients. Cancer patients need to get support from others to always motivate, encourage, motivate, control, and assist cancer patients.
OBJECTIVE: This study aims to develop a model of webinar-based empowerment to increase optimism of breast cancer survivors in Medan.
METHODS: The type of research used is action research with 78 participants. There are two types of instruments for data collection, the focus group discussion (FGD) question guide and the Revised Life Orientation Test (LOT-R) instrument. Six people were used for in-depth interviews and 72 people for the implementation of optimism socialization through webinars.
RESULTS: The results of the optimism assessment showed that 83% of participants had positive optimism after the webinar activity on tips and tricks “Successful controlling emotions with Optimism.” Based on the results of the paired t test, p < 0.0001 was obtained. This shows that webinars can affect the optimism of breast cancer survivors.
CONCLUSIONS: Fellow breast cancer patients are needed to motivate each other and share experiences in dealing with breast cancer treatment and how to prevent complications or metastases. The role of fellow breast cancer sufferers is currently very easy to do with webinar-based empowerment. Webinars have the effect of increasing optimism.
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Ziegler E, Hill J, Lieske B, Klein J, dem OV, Kofahl C. Empowerment in cancer patients: Does peer support make a difference? A systematic review. Psychooncology 2022; 31:683-704. [PMID: 34981594 DOI: 10.1002/pon.5869] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 12/16/2021] [Accepted: 12/20/2021] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Empowerment is critical for cancer patients to make informed choices, to manage medication, and to navigate through the oncological care system. Cancer peer support provides patients with information, emotional relief and may promote empowerment. This paper provides a systematic review of the literature examining the impact of cancer peer support interventions on psychological empowerment. METHODS PubMed, Web of Science, CINAHL, Cochrane Library, PsycINFO and PSYNDEX databases were systematically searched from inception until December 2020. We included quantitative studies, published in English or German, which examined peer-led cancer support interventions and their impact on the three components of psychological empowerment (intrapersonal, interactional and behavioural) among participating cancer patients. RESULTS Database searches and screening of relevant reference lists identified 2336 potentially relevant articles. A total of 29 studies were included in the review. Active coping, self-efficacy and knowledge were the most prominent dimensions of empowerment in these studies. The majority of studies revealed that peer support led to a small to medium, significant increase in psychological empowerment, and was associated with further patient-reported benefits. CONCLUSIONS The existing evidence suggests a weak to moderate, positive association between cancer peer support and the three components of psychological empowerment among cancer patients. Peer support groups should be seen as an important element in cancer care and clinical practice and, thus, be more systematically involved in cancer care.
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Affiliation(s)
- Elâ Ziegler
- Center for Psychosocial Medicine, Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Josephine Hill
- Center for Psychosocial Medicine, Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Berit Lieske
- Center for Psychosocial Medicine, Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jens Klein
- Center for Psychosocial Medicine, Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Olaf von dem
- Center for Psychosocial Medicine, Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christopher Kofahl
- Center for Psychosocial Medicine, Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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14
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The Effectiveness of e-Health Interventions on Caregiver Burden, Depression, and Quality of Life in Informal Caregivers of Patients with cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Int J Nurs Stud 2022; 127:104179. [DOI: 10.1016/j.ijnurstu.2022.104179] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 01/07/2022] [Accepted: 01/11/2022] [Indexed: 01/19/2023]
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Scholz S, Teetz L. Smart health via mHealth? Potentials of mobile health apps for improving prevention and adherence of breast cancer patients. Digit Health 2022; 8:20552076221074127. [PMID: 35096411 PMCID: PMC8796094 DOI: 10.1177/20552076221074127] [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: 09/24/2021] [Accepted: 12/27/2021] [Indexed: 11/15/2022] Open
Abstract
Objective Today there are several health and medical apps (mHealth) in app stores. Germany is the world's first country that introduced apps paid by the regular health insurance service. Even though breast cancer is the most common cancer in women, mHealth for breast cancer has been largely unexplored. Methods A total of 33 apps from two major mobile application marketplaces (Google Play Store/Android; App Store/iOS) have been selected for analysis. Results The app analysis shows that there are currently only 10 mHealth apps in German, which are specifically dedicated to breast cancer patients. The features of these apps fall into two categories: improvement of health literacy and indirect intervention. These apps can be used for all phases of the patient journey starting with the diagnosis. Conclusions mHealth apps have the potential to support the adherence of breast cancer patients. In order to exploit this future potential, the app quality, as well as the information about the available apps, must be urgently improved. Currently, it is very difficult both for laypersons and for doctors/other therapists to identify high-quality apps. Guidance from independent or governmental institutions would be helpful to further the digitalization in health care.
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Affiliation(s)
- Stefanie Scholz
- SRH Fuerth University of Applied Sciences, Fuerth, Bayern, Germany
| | - Laura Teetz
- Sanacorp Pharmahandel GmbH (former: Bamberg University), Bamberg, Bayern, Germany
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Peterson NA, Lardier DT, Powell KG, Mankopf E, Rashid M, Morton CM, Borys S. Psychometric properties of a Recovery Empowerment Scale: Testing emotional, cognitive, behavioral, and relational domains. JOURNAL OF COMMUNITY PSYCHOLOGY 2021; 49:2874-2891. [PMID: 33963772 DOI: 10.1002/jcop.22592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 04/13/2021] [Indexed: 06/12/2023]
Abstract
Psychological empowerment (PE) is a multidimensional construct comprised of emotional, cognitive, behavioral, and relational domains. Although context-specific measures of PE exist, no study to date has introduced and tested a measure of the construct that captures all four domains for both women and men in recovery from substance misuse. Furthermore, research has largely neglected the relational dimension, particularly in studies involving people in recovery. In this study, we tested a measure of PE among a diverse sample (n = 200) of people in recovery who participated in a program designed to expand access to medications for opioid use disorder in the northeastern United States. Factor analysis results supported the hypothesized four-factor structure of the scale, and dimensions of PE were found to be associated in expected ways with measures of quality of life, self-reported health, and depression. Implications of the study are described and directions for future research discussed.
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Affiliation(s)
- N Andrew Peterson
- Center for Prevention Science, Northeast & Caribbean Technology Transfer Center, School of Social Work, Rutgers University, New Brunswick, New Jersey, USA
| | - David T Lardier
- Family and Child Studies, University of New Mexico, Albuquerque, New Mexico, USA
| | - Kristen G Powell
- Center for Prevention Science, Northeast & Caribbean Technology Transfer Center, School of Social Work, Rutgers University, New Brunswick, New Jersey, USA
| | - Emilie Mankopf
- Center for Prevention Science, Northeast & Caribbean Technology Transfer Center, School of Social Work, Rutgers University, New Brunswick, New Jersey, USA
| | - Mariam Rashid
- Center for Tobacco Studies, Biomedical Health Sciences, Rutgers University, New Brunswick, New Jersey, USA
| | - Cory M Morton
- Center for Prevention Science, Northeast & Caribbean Technology Transfer Center, School of Social Work, Rutgers University, New Brunswick, New Jersey, USA
| | - Suzanne Borys
- New Jersey Division of Mental Health & Addiction Services, Trenton, New Jersey, USA
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Perspectives of oncology nurses on peer support for patients with cancer. Eur J Oncol Nurs 2021; 51:101925. [PMID: 33647543 DOI: 10.1016/j.ejon.2021.101925] [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: 09/15/2020] [Revised: 02/12/2021] [Accepted: 02/14/2021] [Indexed: 11/22/2022]
Abstract
PURPOSE To understand the perspectives of oncology nurses on peer support for patients with cancer and the role of oncology nurses in its provision. METHOD Thematic semi-structured interviews of 10 oncology nurses working in a single university hospital were conducted. The data were analysed using content analysis. RESULTS Oncology nurses thought that peer support promotes the psychosocial wellbeing of patients with cancer by increasing their social contact and strengthening their emotional resources. In their daily work, oncology nurses engaged in several activities that promote the interactions between patients with cancer and informal forms of peer support. However, directing patients with cancer to formal peer support services outside specialised health care was not an established practice. Oncology nurses expressed several concerns about the availability of support and the coping ability of peer supporters and expressed scepticism about the reliability of information shared in peer support groups. CONCLUSIONS The awareness of oncology nurses regarding formal peer support services appears rather limited. This knowledge gap should be reduced, such as through closer collaboration between hospitals and third sector cancer organisations, which does not appear effective at present based on the results. In addition, patients with cancer should be systematically informed about peer support.
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Asadi M, Tabari F, Haghani S, Heidari ME. The impact of empowerment model-based education on quality of life of transgender people under hormone therapy: A randomized clinical trial. J Family Med Prim Care 2020; 9:2794-2800. [PMID: 32984128 PMCID: PMC7491847 DOI: 10.4103/jfmpc.jfmpc_1201_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 01/26/2020] [Accepted: 03/02/2020] [Indexed: 11/30/2022] Open
Abstract
Introduction: Gender identity disorder is a complex psychological problem and people with this disorder are at risk of many problems, including reduced quality of life. Empowerment intervention is one of the methods that can be used to improve the quality of life of people. The present study aimed to investigate the effect of empowerment model-based training on the quality of life of transgender people undergoing hormone therapy. Methods: The present study is a randomized clinical trial that was conducted in 2012 on 81 transgender people at Tehran Welfare Center. The study samples were randomly assigned into two groups of intervention and control. The intervention group received training based on the empowerment model (threat perception, problem-solving, educational participation, and evaluation) and the control group received routine treatment. Results: According to the findings, after the intervention, a statistically significant difference was found between the two groups in terms of the mean level of overt anxiety (P = 0.045) and aspects of emotional health (P = 0.030), the general perception of health (P = 0.007), mental health (P = 0.008), and overall quality of life (P = 0.005). Also, although there was a statistically significant difference in the aspect emotional well-being in the intervention group before and after the intervention (P = 0.034), this difference was not significant between the two groups (P = 0.274). Conclusion: The results showed that the empowerment-based training program had a significant relationship with the improvement in aspects of emotional health, the overall perception of health, mental health, emotional well-being and overall quality of life.
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Affiliation(s)
- Maryam Asadi
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Fariba Tabari
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Shima Haghani
- Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Eghbal Heidari
- Student's Scientific Research Center, Nursing and Midwifery University, Tehran University Medical Science, Tehran, Iran
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Empowering caregivers in the radiotherapy process: the results of a randomized controlled trial. Support Care Cancer 2020; 29:2395-2404. [PMID: 32918607 DOI: 10.1007/s00520-020-05743-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 09/04/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE The present study aims to evaluate the effectiveness of a mobile-assisted empowerment program developed specifically for caregivers of cancer patients undergoing radiotherapy. METHODS In this study, seventy-four individuals who gave care for cancer patients that received radiotherapy between September 2019 and May 2020 were randomized to receive a mobile-assisted empowerment program or standard care. The mobile-assisted empowerment program comprised of education and information related to the radiotherapy process, videos, activities, and question-and-answer modules to support caregivers during the radiotherapy process. Outcome measures were collected at baseline (day 1 of radiotherapy) and on day 21 and included caregiver demographics, distress, quality of life, and coping style using validated questionnaires. RESULTS Compared with baseline, individuals' mean scores of distress were lower in the empowerment group than the control group (p < 0.001). General quality of life and sub-dimension mean scores were higher in the empowerment group than the control group (p ≤ 0.05). There was no difference in the coping style average scores (p ≥ 0.05) between the two groups. CONCLUSIONS This study supports the findings that a mobile-supported empowerment program reduced the level of caregiver distress and increased quality of life during their loved one's treatment with radiotherapy.
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A standardized patient education class as a vehicle to improving shared decision-making and increasing access to breast reconstruction. J Plast Reconstr Aesthet Surg 2020; 73:1534-1539. [PMID: 32241738 DOI: 10.1016/j.bjps.2020.02.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 12/25/2019] [Accepted: 02/11/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND Shared decision-making is a key component of patient-centered care and has been shown to improve patient satisfaction and quality of life. Herein, we study the impact of a standardized patient education class for prospective breast reconstruction patients on clinic efficiency, access to care, and perception on shared decision-making. METHODS The number of new patient consultations per clinic, as well as average duration of the first individual clinic encounter, was compared before and after the introduction of a standardized education class given by the senior author to all new breast reconstruction patients. To evaluate patients' perception of shared decision-making, the 9-item Shared Decision-Making Questionnaire (SDM-Q9) and the Satisfaction with Information scale of the BREAST-Q Reconstruction Module were electronically distributed among the patients and compared between the two groups. RESULTS Introduction of the patient education class was associated with a significant reduction in the duration of new patient encounters compared to historic controls (31.8 min vs. 53.5 min, p < 0.01) along with permitting a 43% increase in new patient visits. No differences in self-perceived patient education and autonomy were seen between class participants and historic controls in the SDM-Q9 scores (p = 0.58) and BREAST-Q scores (p = 0.14). CONCLUSION The introducing a standardized patient education class translated into a significant reduction in the duration of individual new patient encounters, thereby increasing patient access to care, while maintaining high-quality standards of self-perceived patient education and shared decision-making.
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Cherian R, Le G, Whall J, Gomez S, Sarkar U. Content shared on social media for national cancer survivors day 2018. PLoS One 2020; 15:e0226194. [PMID: 31940384 PMCID: PMC6961846 DOI: 10.1371/journal.pone.0226194] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 11/18/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Studies estimate that the number of cancer survivors will double by 2050 due to improvements in diagnostic accuracy and treatment efficacy. Despite the growing population of cancer survivors, there is a paucity of research regarding how these individuals experience the transition from active treatment to long-term surveillance. While research has explored this transition from more organized venues, such as support groups for cancer survivors, this paper explores the discourses surrounding cancer survivorship on social media, paying particular attention to how individuals who identify as cancer survivors represent their experience. METHODS We identified social media posts relating to cancer survivorship on Twitter and Instagram in early June 2018, in order to coincide with National Cancer Survivorship Day on June 3, 2018. We used nine pre-selected hashtags to identify content. For each hashtag, we manually collected the 150 most recent posts from Twitter and the 100 most recent plus the top 9 posts from Instagram. Our preliminary sample included 1172 posts; after eliminating posts from one hashtag due to irrelevance, we were left with 1063 posts. We randomly sampled 200 of these to create a subset for analysis; after review for irrelevant posts, 193 posts remained for analysis (118 from Instagram and 75 from Twitter). We utilized a grounded theory approach to analyze the posts, first open-coding a subset to develop a codebook, then applying the codebook to the rest of the sample and finally memo writing to develop themes. RESULTS Overall, there is substantial difference in the tone and thematic content between Instagram and Twitter posts, Instagram takes on a more narrative form that represents journeys through cancer treatment and subsequent survivorship, whereas Twitter is more factual, leaning towards advocacy, awareness and fundraising. In terms of content type, 120 posts (62%) of the sample were images, of which 42 (35%) were images of the individual posting and 28 (23%) were images of patients posted by family or friends. Of the remaining images, 14 (12%) were of support groups and 7 (6%) were of family or friends. We identified four salient themes through analysis of the social media posts from Twitter and Instagram: social support, celebrating milestones and honoring survivors, expressing identity, and renewal vs. rebirth. DISCUSSION We observed a marked relationship between physical appearance, functional status and survivorship. Additionally, our findings suggest the importance of social support for cancer patients and survivors as well as the role social media can pay in identity formation. CONCLUSION Our findings suggest that individuals who identify as survivors on social media define their identity fluidly, incorporating elements of physical, emotional and psychological health as well as autonomy.
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Affiliation(s)
- Roy Cherian
- Department of Medicine, Division of General Internal Medicine University of California, San Francisco, Zuckerberg San Francisco General Hospital, San Francisco, California, United States of America
| | - Gem Le
- Department of Medicine, Division of General Internal Medicine University of California, San Francisco, Zuckerberg San Francisco General Hospital, San Francisco, California, United States of America
| | - James Whall
- California Northstate University College of Medicine, Elk Grove, California, United States of America
| | - Scarlett Gomez
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, United States of America
| | - Urmimala Sarkar
- Department of Medicine, Division of General Internal Medicine University of California, San Francisco, Zuckerberg San Francisco General Hospital, San Francisco, California, United States of America
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Abstract
Purpose
The purpose of this paper is to develop a research framework for exploring and improving patient empowerment through the analysis of the effects produced by a satisfying physician relationship on patient involvement in the healthcare process.
Design/methodology/approach
The authors begin with a literature review of patient empowerment in healthcare, useful to highlight the importance of relational aspects. Then, the authors tested the hypotheses of the research through the analysis of 450 questionnaires. The results are analyzed through covariance-based structural equation modeling.
Findings
This paper highlights how empowerment is a more complex phenomenon, needing many dimensions to be investigated. The hypotheses were tested, and correlations computed, highlighting a medium-strong positive correlation between physician relationship and patient involvement determining satisfying patient empowerment.
Research limitations/implications
The considerations conducted in the paper are restricted to physician relationship and needs further research aimed to analyze and evaluate the changes in the patient behaviors influenced by empowerment.
Practical implications
The research points offer new insight into patient empowerment and allow the healthcare provider to create new opportunities for promoting patient empowerment through the development of quality relationship for effective patient involvement.
Originality/value
The study developed contributes new insight about patient empowerment in the healthcare management literature, proving the key role of satisfying physician relationship useful for future researches.
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Abstract
OBJECTIVE To summarise the evidence on determinants of health-related quality of life (HRQL) in Asian patients with breast cancer. DESIGN Systematic review conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations and registered with PROSPERO (CRD42015032468). METHODS According to the PRISMA guidelines, databases of MEDLINE (PubMed), Embase and PsycINFO were systematically searched using the following terms and synonyms: breast cancer, quality of life and Asia. Articles reporting on HRQL using EORTC-QLQ-C30, EORTC-QLQ-BR23, FACT-G and FACT-B questionnaires in Asian patients with breast cancer were eligible for inclusion. The methodological quality of each article was assessed using the quality assessment scale for cross-sectional studies or the Newcastle-Ottawa Quality Assessment Scale for cohort studies. RESULTS Fifty-seven articles were selected for this qualitative synthesis, of which 43 (75%) were cross-sectional and 14 (25%) were longitudinal studies. Over 75 different determinants of HRQL were studied with either the EORTC or FACT questionnaires. Patients with comorbidities, treated with chemotherapy, with less social support and with more unmet needs have poorer HRQL. HRQL improves over time. Discordant results in studies were found in the association of age, marital status, household income, type of surgery, radiotherapy and hormone therapy and unmet sexuality needs with poor global health status or overall well-being. CONCLUSIONS In Asia, patients with breast cancer, in particular those with other comorbidities and those treated with chemotherapy, with less social support and with more unmet needs, have poorer HRQL. Appropriate social support and meeting the needs of patients may improve patients' HRQL.
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Affiliation(s)
- Peh Joo Ho
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Sofie A M Gernaat
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Mikael Hartman
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
- Department of Surgery, National University of Singapore, Singapore
| | - Helena M Verkooijen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Imaging Division, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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