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Ma X, Wang Q, Chan DNS. Women's Experience and Management of Cancer-Related Fatigue and Psychological Distress During Treatment for Gynaecological Cancer: A Qualitative Study. J Adv Nurs 2024. [PMID: 39382348 DOI: 10.1111/jan.16527] [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: 05/26/2024] [Revised: 09/18/2024] [Accepted: 09/27/2024] [Indexed: 10/10/2024]
Abstract
AIM To explore women's experience and management of cancer-related fatigue and psychological distress during treatment for gynaecological cancer. DESIGN Qualitative descriptive study. METHODS Face-to-face semistructured individual interviews were conducted with 23 women in mainland China undergoing treatment for gynaecological cancer between July and October 2023. Data were analysed using content analysis. RESULTS Three categories were identified: overwhelming experience of cancer-related fatigue, diverse experiences of psychological distress and strategies for managing cancer-related fatigue and psychological distress. Participants reported physical exhaustion and emotional fatigue, disrupting their normal lives. Psychological distress included distress due to cancer treatment, psychological burden associated with social relationships, frustration with being ill and worries about disease progression and recurrence. Strategies for managing symptoms were mainly nonpharmacological, with some unable to find suitable methods. CONCLUSION This study found that participants had a complex experience of cancer-related fatigue and psychological distress, influenced by social expectations regarding women's roles and treatment impacts on reproductive health and femininity. These findings underscore the need for comprehensive interventions involving family members or fellow patients to reduce both symptoms. IMPLICATIONS FOR PATIENT CARE Nurses should focus on addressing cancer-related fatigue and psychological distress in women receiving treatment for gynaecological cancer, particularly in adolescents and young adults. It is essential to provide comprehensive care to improve their physical and psychological well-being. IMPACT This study explored how women with gynaecological cancer experience and manage cancer-related fatigue and psychological distress. The findings highlight the need for holistic care that addresses physical and psychological symptoms. Nurses should consider the impact of reproductive health and femininity on symptom experiences and management. Furthermore, the findings could inform the development of evidence-based interventions to improve the physical and psychological well-being of women with gynaecological cancer. REPORTING METHOD Standards for Reporting Qualitative Research checklist. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Xing Ma
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Qian Wang
- Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Dorothy Ngo Sheung Chan
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
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Price J, Brunet J. A single-subject research design evaluating a co-created yoga program for adults with gynecologic cancer: feasibility study protocol. Pilot Feasibility Stud 2024; 10:8. [PMID: 38229143 PMCID: PMC10790429 DOI: 10.1186/s40814-023-01435-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 12/20/2023] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Worldwide, > 1.3 million adults are diagnosed with a gynecologic cancer each year, affecting their wellbeing and quality of life. This manuscript describes the protocol for a study that sought to assess the feasibility, acceptability, and fidelity of a community-based co-created yoga program and proposed evaluative methods, and estimate program effects on self-reported outcomes. METHODS Using a multiple baseline single-subject research design with a follow-up phase (ABA), quantitative and qualitative data were collected from program participants and the instructor. Participants were randomly assigned to varying baseline lengths and completed weekly surveys for 3-5 weeks pre-program. Then, participants engaged in a bi-modal 12-week hatha yoga program consisting of 2 60-min group classes a week, with optional supplemental features (January-April, 2023). Participants completed surveys after classes 1, 12, and 24. All yoga classes were audio- and video-recorded. Post-program, participants completed surveys 1, 4, and 8 weeks after the last class and took part in a semi-structured interview 1 week after to discuss program acceptability, suitability, relevance, and potential benefits. Feasibility outcomes (i.e., recruitment, retention, and program adherence rates, engagement with optional program features) were tracked by the instructor assistant and study team during the study. The yoga instructor was interviewed about their experience delivering the program 2 weeks after the last class. PLANNED ANALYSIS Feasibility outcomes will be analyzed using descriptive statistics. Interview transcripts will be coded using reflexive thematic analysis. Class recordings will be coded using duration and frequency coding. Survey responses for self-reported outcomes will be analyzed visually and using multilevel modeling. EXPECTED OUTCOMES Data will help determine refinements, if any, required to the program and instructor guidebook, implementation approach, and proposed evaluation methods before scale-up projects and definitive trials are started. TRIAL REGISTRATION ClinicalTrials.gov NCT05610982. November 3, 2022.
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Affiliation(s)
- Jenson Price
- School of Human Kinetics, University of Ottawa, 125 University Private, Montpetit Hall, Room 339, Ottawa, ON, K1N 6N5, Canada
| | - Jennifer Brunet
- School of Human Kinetics, University of Ottawa, 125 University Private, Montpetit Hall, Room 339, Ottawa, ON, K1N 6N5, Canada.
- Cancer Therapeutic Program, Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, Canada.
- Institut du Savoir Montfort, Hôpital Montfort, Ottawa, ON, Canada.
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McCloy K, Hughes C, Dunwoody L, Marley J, Cleland I, Cruciani F, Saunders C, Gracey J. Evaluating the effectiveness of mindfulness alone compared to exercise and mindfulness on fatigue in women with gynaecology cancer (GEMS): Protocol for a randomised feasibility trial. PLoS One 2023; 18:e0278252. [PMID: 37883461 PMCID: PMC10602305 DOI: 10.1371/journal.pone.0278252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 05/30/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND In 2020 Globocan reported nearly 1.4 million new cases of gynaecology cancer worldwide. Cancer related fatigue has been identified as a symptom that can be present for gynaecology cancer patients many years after treatment. The current evidence around the management of this symptom suggests that exercise has the most positive outcome. However, some ambiguity remains around the evidence and whether it can address all areas of fatigue effectively. More recently, other interventions such as mindfulness have begun to show a favourable response to the management of symptoms for cancer patients. To date there has been little research that explores the feasibility of using both these interventions together in a gynaecology cancer population. This study aims to explore the feasibility of delivering an intervention that involves mindfulness and mindfulness and exercise and will explore the effect of this on fatigue, sleep, mood and quality of life. METHODS/DESIGN This randomised control trial will assess the interventions outcomes using a pre and post design and will also include a qualitative process evaluation. Participants will be randomised into one of 2 groups. One group will undertake mindfulness only and the other group will complete exercise and mindfulness. Both groups will use a mobile application to complete these interventions over 8 weeks. The mobile app will be tailored to reflect the group the participants have drawn during randomisation. Self-reported questionnaire data will be assessed at baseline prior to commencing intervention and at post intervention. Feasibility will be assessed through recruitment, adherence, retention and attrition. Acceptability and participant perspective of participation (process evaluation), will be explored using focus groups. DISCUSSION This trial will hope to evidence and demonstrate that combination of two interventions such as mindfulness and exercise will further improve outcomes of fatigue and wellbeing in gynaecology cancer. The results of this study will be used to assess (i) the feasibility to deliver this type of intervention to this population of cancer patients using a digital platform; (ii) assist this group of women diagnosed with cancer to manage fatigue and other symptoms of sleep, mood and impact their quality of life. TRIAL REGISTRATION NCT05561413.
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Affiliation(s)
- Kairen McCloy
- Institute of Nursing and Health Research, Ulster University, Newtownabbey, United Kingdom
| | - Ciara Hughes
- Institute of Nursing and Health Research, Ulster University, Newtownabbey, United Kingdom
| | - Lynn Dunwoody
- Psychology Research Institute, Ulster University, Coleraine, United Kingdom
| | - Joanne Marley
- Institute of Nursing and Health Research, Ulster University, Newtownabbey, United Kingdom
| | - Ian Cleland
- School of Computing, Ulster University, Newtownabbey, United Kingdom
| | - Federico Cruciani
- School of Computing, Ulster University, Newtownabbey, United Kingdom
| | | | - Jackie Gracey
- Institute of Nursing and Health Research, Ulster University, Newtownabbey, United Kingdom
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Barandouzi ZA, Eng T, Shelton J, Khanna N, Scott I, Meador R, Bruner DW. Associations of the gut microbiome with psychoneurological symptom cluster in women with gynecologic cancers: a longitudinal study. Support Care Cancer 2023; 31:626. [PMID: 37819383 DOI: 10.1007/s00520-023-08058-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: 05/05/2023] [Accepted: 09/20/2023] [Indexed: 10/13/2023]
Abstract
PURPOSE The present study aimed to evaluate the associations between the gut microbiome and psychoneurological symptoms (PNS) cluster in women with gynecologic cancers over time. METHODS In this secondary data analysis, 19 women with cervical and endometrial cancers treated with radiotherapy were followed at pre-treatment, 6-8 weeks, and 6 months post-treatment. To measure symptoms, Functional Assessment of Cancer Therapy-General (FACT-G) and Patient Health Questionnaire-9 (PHQ-9) were used. An average Z score of at least three out of five symptoms was computed as the PNS cluster total score. Rectal swabs were also collected at the same time points and sequenced using 16S rRNA V4 regions. The Kruskal-Wallis and permutational multivariable analysis of variance tests were used to compare α- and β-diversity between patients with high and low PNS cluster. The linear discriminant analysis effect size (LEfSe) tested taxa differences between study groups. Also, the linear mixed-effect model was used to evaluate the association of the gut microbiome and the PNS cluster over cancer treatment. RESULTS The patients' mean age was 58 years, 47% Black, 52% single/divorced, and 66% had college or above education. Among the participants, 63% had endometrial cancer with stage I disease. There was a different taxonomy profile between patients with high and low PNS. Patients with high PNS had a lower α-diversity than those with low PNS (Shannon, p = 0.03, evenness, p = 0.03). The mixed effects model results showed that low α-diversity and abundance of Fusicatenibacter and Ruminococcus were associated with high PNS cluster over cancer treatment. CONCLUSION The association between the gut microbiome and PNS cluster suggest that the gut microbiota plays a role in developing the PNS cluster. Future larger studies are required to shed light on the gut microbiota role in symptom development in gynecologic cancer patients.
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Affiliation(s)
- Zahra Amirkhanzadeh Barandouzi
- School of Nursing, Emory University, 1520 Clifton Road NE, Atlanta, GA, 30322, USA
- Winship Cancer Institute, Emory University, Atlanta, GA, 30322, USA
| | - Tony Eng
- Winship Cancer Institute, Emory University, Atlanta, GA, 30322, USA
- School of Medicine, Emory University, 201 Dowman Dr, Atlanta, GA, 30322, USA
| | - Joseph Shelton
- Winship Cancer Institute, Emory University, Atlanta, GA, 30322, USA
- School of Medicine, Emory University, 201 Dowman Dr, Atlanta, GA, 30322, USA
| | - Namita Khanna
- Winship Cancer Institute, Emory University, Atlanta, GA, 30322, USA
- School of Medicine, Emory University, 201 Dowman Dr, Atlanta, GA, 30322, USA
| | - Isabelle Scott
- School of Nursing, Emory University, 1520 Clifton Road NE, Atlanta, GA, 30322, USA
| | - Rebecca Meador
- School of Nursing, Emory University, 1520 Clifton Road NE, Atlanta, GA, 30322, USA
| | - Deborah Watkins Bruner
- School of Nursing, Emory University, 1520 Clifton Road NE, Atlanta, GA, 30322, USA.
- Winship Cancer Institute, Emory University, Atlanta, GA, 30322, USA.
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Jónsdóttir B, Wikman A, Sundström Poromaa I, Stålberg K. Advanced gynecological cancer: Quality of life one year after diagnosis. PLoS One 2023; 18:e0287562. [PMID: 37352193 PMCID: PMC10289468 DOI: 10.1371/journal.pone.0287562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 06/07/2023] [Indexed: 06/25/2023] Open
Abstract
OBJECTIVE Gynaecological cancer treatment impacts women's physical and psychological health. Our objective was to examine quality of life (QoL) in women with advanced gynaecological cancer at diagnosis and one year later, and to identify sociodemographic and clinical characteristics associated with QoL. METHODS Women with endometrial, ovarian or cervical cancer treated in Uppsala, Sweden 2012-2019 were included. FIGO stage ≥II was considered advanced gynaecological cancer, whereas women in FIGO stage I were used as a control group. QoL was assessed with SF-36. We obtained information on sociodemographic and clinical characteristics from medical records and health questionnaires. Differences in QoL domains were tested with t-tests, a mixed model ANOVA and multiple linear regression analyses. RESULTS The study population (n = 372) included 150 (40.3%) women with advanced gynaecological cancer. At diagnosis, women with advanced cancer reported lower physical (71.6 vs 81.8 (mean) p<0.05) and role functioning/physical scores (62.6 vs 77.2 (mean) p<0.05) than women in FIGO stage I. One year later, women with advanced cancer reported higher scores in the mental health domain (78.3 vs 73.2 (mean) p<0.05) than women in FIGO stage I. However, no difference was found in the QoL scores of women with advanced disease one year after diagnoses when stratified by diagnosis. Women with a history of psychiatric illness and higher BMI reported poorer physical and mental QoL at follow-up, while advanced stage, level of education and smoking were not associated with QoL. CONCLUSION Women with advanced gynaecological cancer have equally good QoL one year after diagnosis as women with limited disease. Women with previous psychiatric illness and high BMI, are at risk of impaired physical and mental health.
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Affiliation(s)
- Björg Jónsdóttir
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Anna Wikman
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | | | - Karin Stålberg
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
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Wang YW, Ou YC, Lin H, Huang KS, Fu HC, Wu CH, Chen YY, Huang SW, Tu HP, Tsai CC. Characteristics of Cancer-Related Fatigue and an Efficient Model to Identify Patients with Gynecological Cancer Seeking Fatigue-Related Management. Cancers (Basel) 2023; 15:cancers15072181. [PMID: 37046843 PMCID: PMC10093098 DOI: 10.3390/cancers15072181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 03/26/2023] [Accepted: 04/01/2023] [Indexed: 04/09/2023] Open
Abstract
Cancer-related fatigue (CRF) is the most common somatic discomfort in patients with gynecological cancers. CRF is often overlooked; however, it can impair the patients’ quality of life considerably. This cross-sectional study aimed to identify the clinical characteristics of CRF in gynecological cancer patients. Questionnaires and the International Classification of Diseases 10th Revision (ICD-10) criteria were used to identify CRF. The enrolled patients were further categorized according to the amount of fatigue-related management received. Of the enrolled 190 patients, 40.0% had endometrial cancer, 28.9% had cervical cancer, and 31.1% had ovarian cancer. On the basis of the ICD-10 diagnostic criteria, 42.6% had non-cancer-related fatigue, 10% had CRF, and 51% had BFI-T questionnaire-based fatigue. Moreover, 77.9% of the study cohort had ever received fatigue-related management. Further analysis showed that patients with endometrial/cervical cancer, International Federation of Gynecology and Obstetrics stage >1, Eastern Cooperative Oncology Group performance status score ≥1, inadequate cancer treatment response, and receiving cancer treatment in the past week had a higher probability of receiving more fatigue-related management. The five-item predictive model developed from these factors may help physicians recognize patients seeking more fatigue-related management more efficiently. This is important as they may suffer from a more profound CRF.
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Affiliation(s)
- Ying-Wen Wang
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 833, Taiwan
| | - Yu-Che Ou
- Department of Obstetrics and Gynecology, Chia-Yi Chang Gung Memorial Hospital, Chiayi 613, Taiwan
| | - Hao Lin
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 833, Taiwan
| | - Kun-Siang Huang
- Department of Family Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 833, Taiwan
| | - Hung-Chun Fu
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 833, Taiwan
| | - Chen-Hsuan Wu
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 833, Taiwan
| | - Ying-Yi Chen
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 833, Taiwan
| | - Szu-Wei Huang
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 833, Taiwan
| | - Hung-Pin Tu
- Department of Public Health and Environmental Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Ching-Chou Tsai
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 833, Taiwan
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Demirci PY, Tunuğ Ş, Vurgeç BA, Sürücü ŞG. Relationship between supportive care needs with coronavirus anxiety and death anxiety of women with gynecologic cancer during the COVID-19 pandemic. J Obstet Gynaecol Res 2023; 49:1019-1027. [PMID: 36604851 DOI: 10.1111/jog.15537] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 12/19/2022] [Indexed: 01/07/2023]
Abstract
AIM The study aimed to determine the relationship between supportive care needs with coronavirus anxiety and death anxiety of women with gynecologic cancer during COVID-19. METHODS The population of the study was women with gynecologic cancer who received chemotherapy in a university hospital. The study sample was calculated using G*Power 3.1.9.4 analysis program and completed with 64 patients who agreed to participate and met the research criteria. The personal information form, supportive care needs survey-short form (SCNS-SF29Tr ), coronavirus anxiety scale (CAS), and death anxiety scale (DAS) were used for data collection. RESULTS The participants' SCNS-SF29Tr mean score was 105.7 ± 17.26, CAS mean score was 11.19 ± 3.96, and DAS mean score was 40.13 ± 15.5. There was a positive, very high-level correlation between the health system and information and psychological needs subscales of SCNS-SF29Tr and CAS (r = 0.809, r = 0.878, respectively; p < 0.05). In addition, a high-level relationship was found between the daily life subscale of SCNS-SF29Tr and CAS (r = 0.674; p < 0.001). A positive low-level relationship was determined between the health system and information, daily life, and psychological needs (except for the sexuality) subscales of SCNS-SF29Tr and DAS (r = 0.357, r = 0.252, r = 0.353 respectively; p < 0.05). CONCLUSION Gynecologic cancer participants had unmet supportive care needs in all subscales except for the sexuality. The participants had higher supportive care needs, high-level coronavirus anxiety, and medium-level death anxiety. In addition, the participants' all supportive care needs have increased as their coronavirus anxiety levels have increased. The participants' supportive care needs have increased, except for sexuality, as their death anxiety levels have increased.
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Affiliation(s)
- Pınar Y Demirci
- Nursing Department, Faculty of Health Sciences, Cukurova University, Adana, Turkey
| | - Şule Tunuğ
- Gyne-Oncology Service, Cukurova University Faculty of Medicine Balcalı Hospital, Adana, Turkey
| | - Burcu A Vurgeç
- Midwifery Department, Faculty of Health Sciences, Cukurova University, Adana, Turkey
| | - Şule G Sürücü
- Midwifery Department, Faculty of Health Sciences, Cukurova University, Adana, Turkey
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McCloy K, Hughes C, Dunwoody L, Marley J, Gracey J. Effects of mindfulness-based interventions on fatigue and psychological wellbeing in women with cancer: A systematic review and meta-analysis of randomised control trials. Psychooncology 2022; 31:1821-1834. [PMID: 36221152 PMCID: PMC9828570 DOI: 10.1002/pon.6046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 09/01/2022] [Accepted: 09/27/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND Cancer diagnosis and treatment can cause fatigue, stress and anxiety which can have a detrimental effect on patients, families and the wider community. Mindfulness-based interventions appear to have positive effects on managing these cancer-related symptoms. OBJECTIVE To investigate the efficacy of mindfulness on cancer related fatigue (CRF) and psychological well-being in female cancer patients. METHODS Five databases (CINHAL, Ovid Medline, Ovid Psych Info, Scopus, and Cochrane), and two trial registers (WHO and Clinicaltrials.gov) were searched for randomised control trials from inception to April 2021 and updated in August 2022. Meta-analysis was performed using Review Manager 5.4. The standardised mean difference (SMD) and 95% confidence intervals (CI) were used to determine the intervention effect. Subgroup analysis was performed for adaptation to types of mindfulness, length of intervention and types of comparator used. RESULTS Twenty-one studies with a total of 2326 participants were identified. Mindfulness significantly improved CRF (SMD -0.81, 95% CI -1.17 to -0.44), depression (SMD-0.74, 95% CI -1.08 to -0.39) and anxiety (SMD -0.92, 95% CI -1.50 to -0.33). No effect was observed for quality of life (SMD 0.32, 95% CI -0.13-0.87) and sleep (SMD -0.65, 95% CI -1.34-0.04). Subgroup analysis revealed that there was little difference in SMD for adapted type of mindfulness (p = 0.42), wait list control compared to active comparator (p = 0.05) or length of intervention (p = 0.29). CONCLUSION Mindfulness appears to be effective in reducing CRF and other cancer related symptoms in women. Adaptations to mindfulness delivery did not have negative impact on results which may aid delivery in the clinical settings.
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Liu Y, Liu Q, Jiang X. Bibliometric analysis of hotspots and frontiers in cancer-related fatigue among ovarian cancer survivors. PLoS One 2022; 17:e0274802. [PMID: 36137125 PMCID: PMC9499248 DOI: 10.1371/journal.pone.0274802] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 09/03/2022] [Indexed: 11/19/2022] Open
Abstract
Objectives To explore and analyze research hotspots and frontiers in CRF in ovarian cancer patients to provide an evidence-based basis for scholars and policymakers. Background Ovarian cancer is one of the most common and lethal gynecological malignancies. Cancer-related fatigue (CRF) is an annoying and pervasive side-effect that seriously affects the activities of daily living and decreases the quality of life (QoL) of cancer survivors. Methods The literature was retrieved from the Web of Science Core Collection (WOSCC) from inception to 2021-12-31. CiteSpace was used to discuss research countries, institutions, authors, and keywords. Results This study ultimately included 755 valid publications, and the number of publications showed a gradual upward trend. The countries, institutions, authors, and journals that have published the most articles and cited the most frequently were the United States, the University of Texas MD Anderson Cancer Center, Michael Friedlander and Amit M Oza, Gynecologic Oncology, and Journal of Clinical Oncology. The top three high-frequency keywords were Ovarian cancer, chemotherapy, and clinical trial. The top three keywords with the strongest citation bursts were cyclophosphamide, double-blind, and open-label. Conclusions Conducting multi-center, large-sample, randomized controlled clinical trials to determine whether chemotherapeutic agents have severe adverse effects and to discuss the relationship between CRF and QoL and overall survival in cancer survivors are hotspots in this field. The new trends may be applying double-blind, randomized controlled trials to clarify the causes of CRF and open-label, randomized trials to determine the efficacy, safety, and tolerability of chemotherapeutic agents.
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Affiliation(s)
- Yuanxia Liu
- West China School of Nursing, Sichuan University/ West China Hospital, Sichuan University, Sichuan, China
| | - Qianxia Liu
- Department of Laboratory, Linxia Hui Autonomous Prefecture Center for Disease Control and Prevention, Gansu, China
| | - Xiaolian Jiang
- West China School of Nursing, Sichuan University/ West China Hospital, Sichuan University, Sichuan, China
- * E-mail:
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10
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Haryani, Hsu YY, Wang ST. Symptom clusters change over time among patients with gynecological cancer receiving chemotherapy. Eur J Oncol Nurs 2022; 60:102193. [PMID: 36030751 DOI: 10.1016/j.ejon.2022.102193] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 08/04/2022] [Accepted: 08/10/2022] [Indexed: 11/04/2022]
Abstract
PURPOSE This study aimed to explore symptom clusters at different time points among patients with gynecological cancer undergoing chemotherapy. METHODS A longitudinal design was used to explore the patterns of symptom clusters four times: during prechemotherapy (T0), first (T1), second (T2), and third (T3) cycles of chemotherapy. The Memorial Symptom Assessment Scale was used to assess the dimension of symptoms. The study was conducted in Indonesia. Exploratory factor analysis was used to analyze the structures of symptom clusters across time. RESULTS A total of 120 subjects provided baseline data, and 82 were retained at T3. Before chemotherapy, the most prevalent symptoms were pain and difficulty in sleeping. However, after starting chemotherapy, the patients suffered from chemotherapy-related side effects, including nausea, change in taste, lack of appetite, hair loss, fatigue, and feeling of "I don't look like myself." Six symptom clusters were identified in patients with gynecological cancer across four time points during chemotherapy: pain-related, nutritional, emotional, hormonal-related, fatigue-related, and body-image symptom clusters. Nutrition and emotion symptom clusters occurred consistently from T0 to T3, fatigue-related clusters appeared after chemotherapy at T1 and T2, and body-image symptom clusters emerged at late T2 and T3. CONCLUSION The structures of symptom clusters in this study were dynamic and various. The nutrition and emotional-related symptoms constituted a cluster during chemotherapy. Oncology nurses should provide physical and psychosocial interventions to relieve these symptoms in patients with gynecological cancer undergoing chemotherapy.
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Affiliation(s)
- Haryani
- Department of Medical Surgical Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Indonesia
| | - Yu-Yun Hsu
- Department of Nursing, College of Medicine, National Cheng Kung University, Taiwan.
| | - Shan-Tair Wang
- Professor & Deputy Superintendent Ditmanson Medical Foundation, Chiayi Christian Hospital
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11
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Hare CJ, Crangle C, McGarragle K, Ferguson SE, Hart TL. Change in cancer-related fatigue over time predict health-related quality of life in ovarian cancer patients. Gynecol Oncol 2022; 166:487-493. [PMID: 35835613 DOI: 10.1016/j.ygyno.2022.07.001] [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: 03/23/2022] [Revised: 06/30/2022] [Accepted: 07/04/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE There is limited research examining how change in cancer-related fatigue (CRF) over time predicts change in health-related quality of life (HRQOL), and no studies have examined this relationship in ovarian cancer patients, specifically. The purpose of this study was to explore the prevalence and trajectory of CRF over time and examine how change in CRF over time predicts change in HRQOL in ovarian cancer patients. METHODS Ovarian cancer patients (N = 202) were recruited from Princess Margaret Cancer Centre in Toronto, Canada. Consenting participants completed measures at baseline (beginning of study) and again three months later. Data were analyzed using a longitudinal multilevel mixed model design. RESULTS Four groups of CRF trajectories emerged. Fifty-four percent reported CRF as always present, 16% reported CRF subsided, 21% reported CRF developed, and 9% reported CRF as never present. As CRF developed, functional and physical wellbeing decreased. As CRF subsided, functional, physical, and emotional wellbeing improved. CRF trajectory was not associated with change in social wellbeing over time. CONCLUSIONS Our findings suggest CRF negatively impacts all domains of HRQOL except for social wellbeing in ovarian cancer patients. Among patients who reported that CRF improved over time, all HRQOL domains impacted by CRF showed recovery to normal endorsement rates. Among patients who reported development of CRF, impacted HRQOL domains significantly declined over time. Implications from this research indicate that fatigue management should be prioritized during and after cancer treatment to ensure optimal physical, functional, and emotional wellbeing.
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Affiliation(s)
- Crystal J Hare
- Toronto Metropolitan University, Toronto, Ontario, Canada
| | | | | | - Sarah E Ferguson
- Division of Gynecologic Oncology, Princess Margaret Cancer Centre/University Health Network/Sinai Health Systems, Toronto, Ontario, Canada; Department of Obstetrics and Gynaecology, University of Toronto, Toronto, Ontario, Canada
| | - Tae L Hart
- Toronto Metropolitan University, Toronto, Ontario, Canada.
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12
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Galica J, Saunders S, Romkey-Sinasac C, Silva A, Ethier JL, Giroux J, Jull J, Maheu C, Ross-White A, Stark D, Robb K. The needs of gynecological cancer survivors at the end of primary treatment: A scoping review and proposed model to guide clinical discussions. PATIENT EDUCATION AND COUNSELING 2022; 105:1761-1782. [PMID: 34865888 DOI: 10.1016/j.pec.2021.11.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 11/19/2021] [Accepted: 11/20/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Gynecological cancer (GC) survivors have unmet needs when they complete primary cancer treatment. Despite this, no known research has summarized these needs and survivors' suggestions to address them. We conducted a scoping review to fill these gaps and develop a model useful to guide clinical discussions and/or interventions. METHODS English, full length, and accessible primary studies describing the needs of GC survivors were included. No restrictions on date nor country of publication were applied. Two reviewers screened and extracted data, which was verified by a third reviewer. RESULTS Seventy-one studies met the inclusion criteria for data extraction. Results were thematically grouped into seven dimensions: physical needs, sexuality-related concerns, altered self-image, psychological wellbeing, social support needs, supporting the return to work, and healthcare challenges and preferences. After consulting with a stakeholder group (a GC survivor, clinicians, and researchers), the dimensions were summarized into a proposed model to guide clinical assessments and/or interventions. CONCLUSION Results illuminate the diverse needs of GC survivors as they complete primary cancer treatment and their recommendations for care to meet these needs. PRACTICE IMPLICATIONS The resulting model can be used to guide assessments, discussions and/or interventions to optimally prepare GC survivors for transition out of primary cancer treatment.
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Affiliation(s)
- Jacqueline Galica
- Queen's University School of Nursing, Kingston, Ontario, Canada; Queen's Cancer Research Institute, Division of Cancer Care and Epidemiology, Kingston, Ontario, Canada.
| | | | | | - Amina Silva
- Queen's University School of Nursing, Kingston, Ontario, Canada
| | - Josée-Lyne Ethier
- Queen's Cancer Research Institute, Division of Cancer Care and Epidemiology, Kingston, Ontario, Canada; Queen's University Department of Oncology; Kingston, Ontario, Canada
| | - Janet Giroux
- Queen's University School of Nursing, Kingston, Ontario, Canada; Kingston Health Sciences Centre, Kingston General Hospital Site and the Cancer Centre of Southeastern Ontario, Kingston, Ontario, Canada; Queen's University, Department of Obstetrics and Gynecology, Kingston, Ontario, Canada
| | - Janet Jull
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
| | - Christine Maheu
- Ingram School of Nursing, McGill University, Montréal, Québec, Canada
| | | | - Debora Stark
- Kingston Health Sciences Centre, Kingston General Hospital Site and the Cancer Centre of Southeastern Ontario, Kingston, Ontario, Canada
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Onyedibe MC, Ifeagwazi CM, Charles S U. The efficacy of group cognitive behavioural therapy in improving adaptive cognitive emotion regulation in Nigerian breast cancer patients. COUNSELLING & PSYCHOTHERAPY RESEARCH 2021. [DOI: 10.1002/capr.12429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | | | - Umeh Charles S
- Department of Psychiatry College of Medicine University of Lagos Lagos Nigeria
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Lan J, Cai Y, Liu C, Xie K. Relationship between muscular fitness and quality of life as well as psychological distress in radiotherapy patients with cervical cancer. ZHONG NAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF CENTRAL SOUTH UNIVERSITY. MEDICAL SCIENCES 2021; 46:1260-1266. [PMID: 34911861 PMCID: PMC10929858 DOI: 10.11817/j.issn.1672-7347.2021.210317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Patients with cervical cancer who have received radiotherapy often suffer from systemic muscle volume reduction and quality of life decline due to systemic effects of tumor and side effects of radiotherapy. The purpose of this study was to investigate the status of muscle fitness, quality of life, and psychological pain in patients with cervical cancer who received radiotherapy, and to explore the correlation between muscle fitness, quality of life, and psychological pain. METHODS A total of 202 cervical cancer patients aged 19-71, who received radiotherapy in Hunan Cancer Hospital from July 2020 to February 2021, were selected by convenience sampling method. Functional Assessment of Cancer Therapy Cervix (FACT-CX) and Distress Thermometer (DT) were used for the survey. The patient's grip strength was assessed by a handgrip meter and compared with that of healthy Chinese women of the same age. The correlation between muscle fitness and quality of life and psychological pain was analyzed. RESULTS The grip strength of cervical cancer patients receiving radiotherapy was significantly lower than that of healthy Chinese women at the same age (P<0.05). Multiple linear regression analysis showed that there were 4 factors affecting grip strength, including emotional thermometer score, social and family status score, cervical cancer related function score and tumor metastasis (all P<0.05). CONCLUSIONS The grip strength of patients with cervical cancer undergoing radiotherapy is generally decreased, which is affected by many factors, and is closely related to the quality of life and psychological pain of patients. In the future, dynamic attention should be paid to the changes of grip strength and related functions in patients receiving radiotherapy for cervical cancer, the potential risks in the treatment should be identified early, and targeted intervention should be taken.
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Affiliation(s)
- Jing Lan
- Second Department of Gynecology, Central South University Cancer Hospital/Hunan Cancer Hospital, Changsha 410013.
| | - Ying Cai
- Department of Rehabilitation Medicine, Xiangya Hospital, Central South University, Changsha 410008
| | - Chaoxia Liu
- Fifth Department of Gynecology, Central South University Cancer Hospital/ Hunan Cancer Hospital, Changsha 410013, China
| | - Kangling Xie
- Department of Rehabilitation Medicine, Xiangya Hospital, Central South University, Changsha 410008.
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15
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Karawekpanyawong N, Kaewkitikul K, Maneeton B, Maneeton N, Siriaree S. The prevalence of depressive disorder and its association in Thai cervical cancer patients. PLoS One 2021; 16:e0252779. [PMID: 34153051 PMCID: PMC8216533 DOI: 10.1371/journal.pone.0252779] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 05/23/2021] [Indexed: 11/17/2022] Open
Abstract
PURPOSE The purpose of this study is to examine the prevalence, associated factors and quality of life associated with depressive disorder in cervical cancer patients. PATIENTS AND METHODS This cross-sectional study was carried out in a gynecologic oncology clinic of a university hospital in Northern Thailand from October 2018 to August 2019. Two-hundred cervical cancer patients were screened for depressive disorder using the nine-item Patient Health Questionnaire (PHQ-9), and psychiatrists interviewed eligible patients to confirm diagnoses. We measured the quality of life using questionnaires from the European Organisation for the Research and Treatment of Cancer: Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and Cervical Cancer Module 24 (EORTC QLQ-Cx24). Associated factors, including comorbidity, fatigue, and pain, were collected using the Charlson Comorbidity Index (CCI), the eleven-item Chalder Fatigue Scale (CFQ 11), and the visual analog scale (VAS) for pain, respectively. RESULTS Twenty-seven (13.5%) cervical cancer patients were diagnosed with depressive disorder by psychiatrists according to the DSM-5. Depressive disorder was related to a worse quality of life in these patients. A binary logistic regression analysis revealed that depressive disorder among these patients was linked with these factors: high fatigue score (aOR: 1.35; CI: 1.18-1.53), high pain score (aOR: 1.25; CI: 1.02-1.54), no perception of social support, (aOR: 3.12; CI: 1.11-8.81), and no previous surgical treatment for cervical cancer (aOR: 2.99; CI: 1.08-8.29). CONCLUSION The depressive disorder prevalence was 13.5% in Northern Thai cervical cancer patients. In this demographic, cervical cancer patients-who reported high fatigue or pain scores, did not perceive social support, or had no previous cervical cancer surgery- were more likely to have depressive disorder.
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Affiliation(s)
| | - Kewalee Kaewkitikul
- Faculty of Medicine, Department of Psychiatry, Chiang Mai University, Chiang Mai, Thailand
| | - Benchalak Maneeton
- Faculty of Medicine, Department of Psychiatry, Chiang Mai University, Chiang Mai, Thailand
| | - Narong Maneeton
- Faculty of Medicine, Department of Psychiatry, Chiang Mai University, Chiang Mai, Thailand
| | - Sitthicha Siriaree
- Faculty of Medicine, Department of Obstetrics and Gynecology, Chiang Mai University, Chiang Mai, Thailand
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16
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Zick SM, Kruger G, Harte S, Sen A, Harris RE, Pearce CL. Acupressure for Cancer-fatigue in Ovarian Cancer Survivor (AcuOva) Study: A community-based clinical trial study protocol examining the impact of self-acupressure on persistent cancer-related fatigue in ovarian cancer survivors. Contemp Clin Trials 2021; 107:106477. [PMID: 34119716 DOI: 10.1016/j.cct.2021.106477] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 06/04/2021] [Accepted: 06/08/2021] [Indexed: 11/26/2022]
Abstract
Background Persistent cancer-related fatigue is one of the most common and burdensome symptoms experienced by ovarian cancer survivors. Despite the high burden of fatigue in ovarian cancer survivors, there are few available treatments. Previous research has shown self-acupressure to be a safe method for improving persistent fatigue, sleep, and quality of life among fatigued breast cancer survivors, yet there are no studies examining self-acupressure for fatigue in ovarian cancer survivors. Methods A three group parallel, randomized controlled trial will be conducted to evaluate the efficacy of self-acupressure taught and delivered via a patient-designed, custom-built mobile app ("MeTime") and accompanying hand-held device ("AcuWand") to help guide correct pressure application. A sample of 165 ovarian cancer survivors, who have completed primary cancer treatment will be recruited from tumor registries in Michigan and Los Angeles. Participants will be mailed a tablet preloaded with the app and a device, and all visits will be conducted remotely. Participants will be randomized to 6-weeks of daily self-acupressure via the app and device, or a sham app and device, or no care group. Self-report measures will be completed at baseline, 6-weeks (post-intervention), 3-, and 6-months. Primary outcome is the Brief Fatigue Inventory; secondary outcomes are sleep, quality of life, and symptoms commonly associated with persistent fatigue. Discussion An app based self-acupressure treatment may be an easily-accessible and inexpensive treatment to reduce fatigue in ovarian cancer survivors. The results of the study will provide information on the possible benefits of app-based self-acupressure for fatigue in ovarian cancer survivors. Trial registration: This study is registered at ClinicalTrials.gov Identifier: NCT03763838, date registered on December 4, 2018.
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Affiliation(s)
- Suzanna Maria Zick
- Department of Family Medicine, University of Michigan, 24 Frank Lloyd Wright Drive, Ann Arbor, MI 48105, USA; Department of Nutritional Sciences, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, USA.
| | - Grant Kruger
- Department of Mechanical Engineering, University of Michigan, 1043 H H Dow Bldg, Ann Arbor, MI 48109-2136, USA; Department of Anesthesiology, University of Michigan, 1043 H H Dow Bldg, Ann Arbor, MI 48109-2136, USA.
| | - Steven Harte
- Department of Anesthesiology, University of Michigan, Domino's Farms/Lobby M, Ann Arbor, MI 48106, USA; Department of Rheumatology, University of Michigan, Domino's Farms/Lobby M, Ann Arbor, MI 48106, USA.
| | - Ananda Sen
- Department of Family Medicine, University of Michigan, 1018 Fuller Street, Ann Arbor, MI 48104-1213, USA; Department of Biostatistics, University of Michigan, 1018 Fuller Street, Ann Arbor, MI 48104-1213, USA.
| | - Richard Edmund Harris
- Department of Anesthesiology, University of Michigan, 24 Frank Lloyd Wright Drive, Ann Arbor, MI 48105, USA.
| | - Celeste Leigh Pearce
- Department of Epidemiology, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109-2029, USA.
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17
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Cirillo Sanchez C, Czuber-Dochan W, Cox S, Murrells T, Christine N, Ann M. Dietary Habits of Women with Gynecological Cancer before, during and after Treatment: A Long-Term Prospective Cohort Study. Nutr Cancer 2020; 73:2643-2653. [PMID: 33305602 DOI: 10.1080/01635581.2020.1856386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND AND AIM Over 21,000 new cases of gynecological cancer are diagnosed annually in the United Kingdom. There is evidence of cancer patients altering their eating habits before and during treatment. Some women with gynecological cancer make conscious decisions to change their diet as self-management for their cancer symptoms and to adopt a healthier lifestyle. Little is known about the impact of treatment on dietary habits. This study aimed to identify and describe the dietary habits of women with gynecological cancer before, during and after treatment. METHODS This was a longitudinal prospective cohort study using seven-day food diaries to collect dietary intake data before treatment and up to two years after gynecological cancer treatment. Nutritics© software was used for analysis of the diaries. A general linear mixed model was used for the statistical analysis, adjusted for multiple comparisons. RESULTS 15 women with gynecological cancer participated; 69 food diaries were analyzed. There were no statistically significant changes in dietary habits or weight for this cohort during the two-year follow-up, except for caffeine intake which increased at 2 years (p < 0.05). CONCLUSIONS Despite the importance of maintaining a healthy dietary intake and weight after cancer treatment, participants' diets did not change.
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Affiliation(s)
- Claudia Cirillo Sanchez
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Wladzia Czuber-Dochan
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Selena Cox
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Trevor Murrells
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Norton Christine
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Muls Ann
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK.,Gastrointestinal and Nutrition Team, Cancer Services, The Royal Marsden NHS Foundation Trust, London, UK
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18
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Prevalence and risk factors of cancer-related fatigue: A systematic review and meta-analysis. Int J Nurs Stud 2020; 111:103707. [DOI: 10.1016/j.ijnurstu.2020.103707] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 06/02/2020] [Accepted: 06/25/2020] [Indexed: 12/14/2022]
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19
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Morrison KS, Paterson C, Coltman CE, Toohey K. What are the Barriers and Enablers to Physical Activity Participation in Women with Ovarian Cancer? A Rapid Review of the Literature. Semin Oncol Nurs 2020; 36:151069. [PMID: 33012610 DOI: 10.1016/j.soncn.2020.151069] [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: 10/23/2022]
Abstract
BACKGROUND Engagement in regular physical activity is recommended for women diagnosed with ovarian cancer due to aggressive treatment approaches, an increased risk of disease recurrence and low survival rates. OBJECTIVES To synthesize the current available evidence identifying barriers and enablers to participation in physical activity among women diagnosed with ovarian cancer. DATA SOURCES Peer-reviewed articles in electronic databases including CINAHL, Cochrane, Medline, Psych INFO and Scopus and key studies' reference lists. CONCLUSION Although evidence pertaining to the study population was limited, the findings of this review suggest women with ovarian cancer experience similar barriers and enablers to the general population and other cancer cohorts. The primary barriers to physical activity participation reported by this population were treatment or disease related side effects, fear of injury or falling and the absence of physical activity counselling. Key enablers reported to facilitate physical activity participation were the implementation of individualized interventions with targeted goals in addition to support from health and medical professionals. Future research on ovarian cancer populations is warranted to further explore perceived barriers and enablers. IMPLICATIONS FOR NURSING PRACTICE Nurses working within the oncology field are well positioned clinically to facilitate physical activity engagement and identify and overcome barriers to participation within a population that experiences high mortality rates and disease recurrence.
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Affiliation(s)
- Kittani S Morrison
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia.
| | - Catherine Paterson
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia; Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce, Australian Capital Territory, Australia; School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, Australian Capital Territory, Australia; Canberra Health Services & ACT Health, SYNERGY Nursing & Midwifery Research Centre, Canberra Hospital, Garran, Australian Capital Territory, Australia; School of Nursing, Midwifery & Paramedic Practice, Robert Gordon University, Garthdee, Aberdeen, UK
| | - Celeste E Coltman
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia; University of Canberra Research Institute for Sport and Exercise, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - Kellie Toohey
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia; Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce, Australian Capital Territory, Australia
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20
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Persistence of Late Substantial Patient-Reported Symptoms (LAPERS) After Radiochemotherapy Including Image Guided Adaptive Brachytherapy for Locally Advanced Cervical Cancer: A Report From the EMBRACE Study. Int J Radiat Oncol Biol Phys 2020; 109:161-173. [PMID: 32853710 DOI: 10.1016/j.ijrobp.2020.08.044] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 08/19/2020] [Indexed: 12/26/2022]
Abstract
PURPOSE This report describes the persistence of late substantial treatment-related patient-reported symptoms (LAPERS) in the multi-institutional EMBRACE study on magnetic resonance image guided adaptive brachytherapy in locally advanced cervical cancer (LACC). METHODS AND MATERIALS Patient-reported symptoms (European Organization for Research and Treatment of Cancer [EORTC]-C30/CX24) and physician-assessed morbidity (Common Terminology Criteria for Adverse Events [CTCAE], version 3.0) were assessed at baseline and regular timepoints during follow-up. Patients with sufficient EORTC follow-up (baseline and ≥3 late follow-up visits) were analyzed. LAPERS events were defined as the presence of substantial EORTC symptoms (quite a bit/very much) for at least half of the assessments (persistence) and progression beyond baseline condition (treatment-related). For each EORTC symptom, the ratio between LAPERS rates and crude incidence rates of substantial symptoms was calculated to represent the proportion of symptomatic patients with persisting symptoms. For 9 symptoms with a corresponding EORTC/CTCAE assessment, the overlap of LAPERS and severe morbidity events (grades 3-5) was evaluated. RESULTS Of 1047 patients with EORTC available, 741 had sufficient follow-up for the LAPERS analyses. The median follow-up was 59 months (interquartile range, 42-70 months). Across all symptoms, the proportion of patients with LAPERS events (LAPERS rates) was in median 4.6% (range, 0.0% vaginal bleeding to 20.4% tiredness). Urinary frequency, neuropathy, fatigue, insomnia, and menopausal symptoms revealed LAPERS rates of >10%. Vomiting, blood in stool, urinary pain/burning, and abnormal vaginal bleeding displayed LAPERS rates of <1%. A median of 19% of symptomatic patients (interquartile range, 8.0%-28.5%) showed persistent long-term symptoms (LAPERS events). In symptoms with a corresponding EORTC/CTCAE assessment, 12% of LAPERS events were accompanied by a severe CTCAE event. CONCLUSIONS Within this large cohort of survivors of LACC, a subgroup of patients with persistent symptoms (LAPERS events) was identified. For symptoms with a corresponding EORTC/CTCAE assessment, the vast majority of LAPERS events occurred in patients without corresponding severe physician-assessed morbidity. These findings emphasize the importance of distinguishing between transient and persisting symptoms in the aftercare of LACC survivors.
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21
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Effects of a laughter programme with entrainment music on stress, depression, and health-related quality of life among gynaecological cancer patients. Complement Ther Clin Pract 2020; 39:101118. [DOI: 10.1016/j.ctcp.2020.101118] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 02/04/2020] [Accepted: 02/10/2020] [Indexed: 12/26/2022]
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22
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Yu CH, Wang TJ, Chang CL, Liang SY, Wu SF, Liu CY, Lu YY. Healthy life styles, sleep and fatigue in endometrial cancer survivors: A cross-sectional study. J Clin Nurs 2020; 29:1372-1380. [PMID: 31970842 DOI: 10.1111/jocn.15189] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 12/10/2019] [Accepted: 01/10/2020] [Indexed: 12/24/2022]
Abstract
AIMS AND OBJECTIVES The primary aim of this study is to explore the influence of obesity, healthy lifestyle and sleep quality of endometrial cancer survivors on their fatigue level. BACKGROUND As many as 30% of endometrial cancer survivors still suffer from fatigue 5 years after completing therapy. Fatigue may hinder cancer survivors from participating in daily activities or returning to their original roles and functions, thus affecting their health-related quality of life. DESIGN This study adopted a cross-sectional correlational research design. The STROBE checklist for cross-sectional studies was used as a reference for reporting the study. METHODS A consecutive sample of 134 endometrial cancer survivors was recruited from the outpatient clinics of a medical centre in Taipei, Taiwan. Data were collected using structured questionnaires. RESULTS Study subjects scored 44 points (SD = 7.09) on average for the fatigue levels. Results of linear regression showed that sleep quality (ß = -0.38), comorbidity index (ß = -0.024) and age (ß = 0.20) were important predictors of fatigue. However, differences in obesity, vegetable and fruit intake, physical activity did not lead to significant differences in fatigue level. CONCLUSIONS Survivors who had poorer sleep quality, higher comorbidity index and younger age reported higher fatigue. RELEVANCE TO CLINICAL PRACTICE The study findings are relevant for assessing and preventing fatigue in endometrial cancer survivors. Those with poorer sleep quality, higher comorbidity index and younger age are at a greater risk for fatigue and deserve further attention. Although the study results failed to support the link between obesity, vegetable and fruit intake, physical activity and fatigue, the ratio of survivors who comply with recommended healthy lifestyles was low. Hence, it is of urgent necessity that this population receives the help to maintain a healthy lifestyle.
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Affiliation(s)
- Chia-Hui Yu
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan, ROC
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan, ROC
| | - Tsae-Jyy Wang
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan, ROC
| | - Chih-Long Chang
- Department of Medical Research, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan, ROC
| | - Shu-Yuan Liang
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan, ROC
| | - Shu-Fang Wu
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan, ROC
| | - Chieh-Yu Liu
- Department of Speech Language Pathology and Audiology, National Taipei University of Nursing and Health Science, Taipei, Taiwan, ROC
| | - Yu Ying Lu
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan, ROC
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Puppo C, Dentand L, Tredan O, Ahmed-Lecheheb D, Joly F, Préau M. The quality of life of long-term remission patients in the Vivrovaire study: The impact of ovarian cancer on patient trajectory. J Psychosoc Oncol 2020; 38:481-500. [PMID: 31989874 DOI: 10.1080/07347332.2019.1710656] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Objectives: In this study, we explored how ovarian cancer (OC) survivors give meaning to their cancer experience and how the latter has an impact on their quality of life (QOL).Participants: The sample comprised 16 OC patients participating in the French study Vivrovaire in Lyon who were in long-term remission.Methods: We employed a qualitative approach, based on semi-structured interviews. Using ATLAS.ti software, we performed a thematic analysis of the collected data.Findings: Three main OC-related themes emerged: body and physical issues; social life evolutions; participant retrospective perception of OC experience.Interpretation: Our results underline the need to take into account the various dimensions of patient identity when studying OC survivors' QOL and to consider intra-individual QOL evolutions from a temporal perspective.Implications for Psychosocial Providers: Helping patients acquire a sound understanding of their illness experience is an enormous challenge for OC healthcare.
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Affiliation(s)
| | | | - Olivier Tredan
- Departement of Medical Oncology, Centre Léon Bérard, Lyon, France
| | - Djihane Ahmed-Lecheheb
- Centre François Baclesse, Clinical Research Departement, av. General Harris, UNICANCER, Caen, France.,INSERM, Caen, France
| | - Florence Joly
- Centre François Baclesse, Clinical Research Departement, av. General Harris, UNICANCER, Caen, France.,INSERM, Caen, France.,Université de Caen Basse-Normandie, Caen, France.,Department of Oncology, CHU de Caen, Caen, France
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24
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Liu X, Moore C, Wanstall K, Armeson K, Kelechi T. Hematology and Depression Levels: Examining Correlated Factors Among Hospitalized Patients. Clin J Oncol Nurs 2019; 23:423-429. [PMID: 31322620 DOI: 10.1188/19.cjon.423-429] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Depression in patients with cancer negatively influences physical symptoms, treatment success, coping, and quality of life (QOL), and is associated with increased mortality. OBJECTIVES This study investigated the prevalence of depression and explored fatigue, QOL, and pain that is associated with depression in patients on first admission to a hematologic oncology unit. METHODS This descriptive study measured depression, QOL, and fatigue with the Patient Health Questionnaire-9, the Functional Assessment of Cancer Therapy (FACT)-General, and the FACT-Anemia scale, respectively. Pain levels were examined with a numeric rating scale. FINDINGS 58 patients participated; 17 reported moderate to severe depression, which highly correlated with fatigue, QOL, and pain. Among all factors, multivariate analysis showed that fatigue, particularly the physical domain of fatigue, has the strongest reverse correlation with depression.
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Affiliation(s)
- Xiang Liu
- Medical University of South Carolina
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25
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Lopes AC, Bacalhau R, Santos M, Pereira M, Pereira MG. Contribution of Sociodemographic, Clinical, and Psychological Variables to Quality of Life in Women with Cervical Cancer in the Follow-Up Phase. J Clin Psychol Med Settings 2019; 27:603-614. [PMID: 31292805 DOI: 10.1007/s10880-019-09644-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
This study evaluates the contribution of sociodemographic, clinical, and psychological variables to quality of life (QoL) of women with cervical cancer in the follow-up phase. This cross-sectional study, conducted at the Portuguese Oncology Institute of Lisbon, included 200 women with cervical cancer during follow-up. Patients were assessed on QoL (EORTC QLQ-C30), body image and specific symptoms (EORTC QLQ-CX24), psychological morbidity (HADS), social support (SSSS), emotional expression (CECS), and spirituality (SpREUK). Education and social support contributed positively to QoL, whereas body image and symptoms contributed negatively. Body image played a moderating role in the relationship between depression and QoL, but not between anxiety and QoL. Spirituality and emotional expression did not moderate the relationship between anxiety/depression and QoL. Health professionals should reference and monitor women with cervical cancer, providing support at the diagnosis and follow-up phase since physical and psychological symptoms, resulting from the disease, remain after the end of treatment and contribute negatively to their QoL. Interventions should focus on these particular outcomes to promote patients' QoL.
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Affiliation(s)
- Ana Clara Lopes
- School of Psychology, University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal
| | - Rosário Bacalhau
- School of Psychology, University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal
| | - Martim Santos
- School of Psychology, University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal
| | - Marta Pereira
- School of Psychology, University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal
| | - M Graça Pereira
- School of Psychology, University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal.
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Labeled as lucky: contradictions between what women and healthcare professionals experience regarding the need for help after the early stages of gynecological cancer. Support Care Cancer 2019; 28:907-916. [DOI: 10.1007/s00520-019-04882-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 05/21/2019] [Indexed: 02/07/2023]
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Joly F, Ahmed-Lecheheb D, Kalbacher E, Heutte N, Clarisse B, Grellard JM, Gernier F, Berton-Rigaud D, Tredan O, Fabbro M, Savoye AM, Kurtz JE, Alexandre J, Follana P, Delecroix V, Dohollou N, Roemer-Becuwe C, De Rauglaudre G, Lortholary A, Prulhiere K, Lesoin A, Zannetti A, N'Guyen S, Trager-Maury S, Chauvenet L, Abadie Lacourtoisie S, Gompel A, Lhommé C, Floquet A, Pautier P. Long-term fatigue and quality of life among epithelial ovarian cancer survivors: a GINECO case/control VIVROVAIRE I study. Ann Oncol 2019; 30:845-852. [PMID: 30851097 DOI: 10.1093/annonc/mdz074] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Few data are available on long-term fatigue (LTF) and quality of life (QoL) among epithelial ovarian cancer survivors (EOCS). In this case-control study, we compared LTF, symptoms and several QoL domains in EOCS relapse-free ≥3 years after first-line treatment and age-matched healthy women. PATIENTS AND METHODS EOCS were recruited from 25 cooperative GINECO centers in France. Controls were randomly selected from the electoral rolls. All participants completed validated self-reported questionnaires: fatigue (FACIT-F), QoL (FACT-G/O), neurotoxicity (FACT-Ntx), anxiety/depression (HADS), sleep disturbance (ISI), and physical activity (IPAQ). Severe LTF (SLTF) was defined as a FACIT-F score <37/52. Univariate and multivariate logistic regressions were conducted to analyze SLTF and its influencing factors in EOCS. RESULTS A total of 318 EOCS and 318 controls were included. EOCS were 63-year-old on average, with FIGO stage I/II (50%), III/IV (48%); 99% had received platinum and taxane chemotherapy, with an average 6-year follow-up. There were no differences between the two groups in socio-demographic characteristics and global QoL. EOCS had poorer FACIT-F scores (40 versus 45, P < 0.0001), lower functional well-being scores (18 versus 20, P = 0.0002), poorer FACT-O scores (31 versus 34 P < 0.0001), and poorer FACT-Ntx scores (35 versus 39, P < 0.0001). They also reported more SLTF (26% versus 13%, P = 0.0004), poorer sleep quality (63% versus 47%, P = 0.0003), and more depression (22% versus 13%, P = 0.01). Fewer than 20% of EOCS and controls exercised regularly. In multivariate analyses, EOCS with high levels of depression, neurotoxicity, and sleep disturbance had an increased risk of developing SLTF (P < 0.01). CONCLUSION Compared with controls, EOCS presented similar QoL but persistent LTF, EOC-related symptoms, neurotoxicity, depression, and sleep disturbance. Depression, neuropathy, and sleep disturbance are the main conditions associated with severe LTF.
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Affiliation(s)
- F Joly
- Department of Oncology, Centre François Baclesse, Caen; INSERM, U1086, Caen; UMR-S1077, University of Caen Basse-Normandie, Caen; Department of Oncology, CHU de Caen, Caen.
| | - D Ahmed-Lecheheb
- Department of Oncology, Centre François Baclesse, Caen; INSERM, U1086, Caen
| | - E Kalbacher
- Department of Oncology, CHU Jean Minjoz, Besançon
| | - N Heutte
- Department of Clinical Research, Centre François Baclesse, Caen
| | - B Clarisse
- Department of Clinical Research, Centre François Baclesse, Caen
| | - J M Grellard
- Department of Clinical Research, Centre François Baclesse, Caen
| | - F Gernier
- INSERM, U1086, Caen; Department of Clinical Research, Centre François Baclesse, Caen
| | - D Berton-Rigaud
- Department of Oncology, Institut de Cancérologie de l'Ouest, Site René Gauducheau, Saint Herblain
| | - O Tredan
- Department of Oncology, Centre Léon Bérard, Lyon
| | - M Fabbro
- Department of Oncology, Institut Régional du Cancer, Montpellier
| | - A M Savoye
- Department of Oncology, Institut Jean Godinot, Reims
| | - J E Kurtz
- Department of Oncology, Hôpitaux Universitaires de Strasbourg, Strasbourg
| | - J Alexandre
- Department of Oncology, Hôpital Cochin, Paris
| | - P Follana
- Department of Oncology, Centre Antoine Lacassagne, Nice
| | - V Delecroix
- Department of Oncology, Clinique Mutualiste de l'Estuaire, Saint-Nazaire
| | - N Dohollou
- Department of Oncology, Polyclinique Bordeaux Nord Aquitaine, Bordeaux
| | - C Roemer-Becuwe
- Department of Oncology, Centre d'Oncologie de Gentilly, Nancy
| | | | - A Lortholary
- Department of Oncology, Centre Catherine de Sienne, Nantes
| | - K Prulhiere
- Department of Oncology, Institut du Cancer Courlancy, Reims
| | - A Lesoin
- Department of Oncology, Centre Oscar Lambret, Lille
| | - A Zannetti
- Department of Oncology, Centre Hospitalier de Cholet, Cholet
| | | | | | - L Chauvenet
- Department of Oncology, Centre Hospitalier de Sens, Sens
| | - S Abadie Lacourtoisie
- Department of Oncology, Institut de Cancérologie de l'Ouest, Site Paul Papin, Angers
| | - A Gompel
- Department of Oncology, Hôpitaux Universitaires Cochin Hôtel-Dieu Broca, Paris
| | - C Lhommé
- Department of Oncology, Gustave Roussy, Villejuif
| | - A Floquet
- Department of Oncology, Institut Bergonié, Bordeaux, France
| | - P Pautier
- Department of Oncology, Gustave Roussy, Villejuif
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Sekse RJT, Dunberger G, Olesen ML, Østerbye M, Seibaek L. Lived experiences and quality of life after gynaecological cancer-An integrative review. J Clin Nurs 2019; 28:1393-1421. [PMID: 30461101 PMCID: PMC7328793 DOI: 10.1111/jocn.14721] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 09/07/2018] [Accepted: 11/03/2018] [Indexed: 01/09/2023]
Abstract
Aim and objectives To review the literature on Nordic women's lived experiences and quality of life (QoL) after gynaecological cancer treatment. Background While incidence and survival are increasing in all groups of gynaecological cancers in the Nordic countries, inpatient hospitalisation has become shorter in relation to treatment. This has increased the need for follow‐up and rehabilitation. Design Integrative literature review using the Equator PRISMA guidelines. Methods The review was selected, allowing inclusion of both experimental and nonexperimental research. The search included peer‐reviewed articles published 1995–2017. To frame the search strategy, we applied the concept of rehabilitation, which holds a holistic perspective on health. Results Fifty‐five articles were included and were contextualised within three themes. Physicalwell-being in a changed body encompasses bodily changes comprising menopausal symptoms, a changed sexual life, complications in bowels, urinary tract, lymphoedema and pain, bodily‐based preparedness and fear of recurrence. Mental well-being as a woman deals with questioned womanliness, the experience of revitalised values in life, and challenges of how to come to terms with oneself after cancer treatment. Psychosocial well-being and interaction deals with the importance of having a partner or close person in the process of coming to terms with oneself after cancer. Furthermore, the women needed conversations with health professionals around the process of coping with changes and late effects, including intimate and sensitive issues. Conclusion Years after gynaecological cancer, women have to deal with fundamental changes and challenges concerning their physical, mental and psychosocial well‐being. Future research should focus on how follow‐up programmes can be organised to target the multidimensional aspects of women's QoL. Research collaboration across Nordic countries on rehabilitation needs and intervention is timely and welcomed. Relevance to clinical practice To ensure that all aspects of cancer rehabilitation are being addressed, we suggest that the individual woman is offered an active role in her follow‐up.
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Affiliation(s)
- Ragnhild Johanne Tveit Sekse
- Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Sciences, University of Bergen, Bergen, Norway
| | - Gail Dunberger
- Department of Health Care Science, Ersta Sköndal Bräcke University College, Stockholm, Sweden
| | - Mette Linnet Olesen
- Research Unit Womens and Childrens Health Department, Copenhagen, Denmark.,Department of Gynaecology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Maria Østerbye
- AU Library, Health Sciences Aarhus University, Aarhus C, Denmark
| | - Lene Seibaek
- Department of Gynecology and Obstetrics, Aarhus University Hospital, Aarhus N, Denmark
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Oliveira PFD, Iunes DH, Alves RS, Carvalho JMD, Menezes FDS, Carvalho LC. Effects of Exergaming in Cancer Related Fatigue in the Quality of Life and Electromyography of the Middle Deltoid of People with Cancer in Treatment: A Controlled Trial. Asian Pac J Cancer Prev 2018; 19:2591-2597. [PMID: 30256065 PMCID: PMC6249443 DOI: 10.22034/apjcp.2018.19.9.2591] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Objective: In the present study, we aimed to evaluate the effects an exergaming protocol for cancer patients who undergo or have already undergone cancer treatment. We sought to evaluate changes in cancer-related fatigue, function, and ability to perform daily activities, in addition to changes in the electromyographic pattern of the middle deltoid muscle. Methods: We conducted a controlled trial. Nineteen volunteers in the cancer group (aged 61 ± 9 years; body mass index28 ± 5) and 19 in the control group (aged 58 ± 8 years); body mass index 28 ± 4) participated in the study. They were evaluated by means of a sociodemographic and clinical questionnaire, the Functional Assessment of Chronic Therapy-Fatigue (FACIT-F) questionnaire, and surface electromyography in the deltoid muscle at three moments: before the beginning of the exergaming protocol, after 10 training sessions, and after 20 sessions. The protocol consisted of practicing exergaming using Xbox 360® (Microsoft, Redmond, USA) with Kinect®. The game “Your Shape Fitness Evolved” (Ubisoft, Rennes, France) was used. Results: Total FACIT-F scores, fatigue subscale scores, and median frequency values observed in the cancer group were lower than those in the control group. These values improved in relation to the initial evaluation in the cancer group after the practice of the exergaming protocol. Conclusion: The exergaming protocol used in this study was effective for reducing reported symptoms of fatigue, increasing perceived quality of life, and improving the pattern of deltoid muscle contraction in cancer patients.
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Affiliation(s)
- Paulo Furtado de Oliveira
- Motricity Science Institute, Federal University of Alfenas, 2600 Jovino Fernandes Sales Ave, Alfenas, Minas Gerais, Brazil.,Bioscience Program, Federal University of Alfenas, 2600 Jovino Fernandes Sales Ave, Alfenas, Minas Gerais, Brazil.
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Smet S, Pötter R, Haie-Meder C, Lindegaard JC, Schulz-Juergenliemk I, Mahantshetty U, Segedin B, Bruheim K, Hoskin P, Rai B, Huang F, Cooper R, van Limbergen E, Tanderup K, Kirchheiner K. Fatigue, insomnia and hot flashes after definitive radiochemotherapy and image-guided adaptive brachytherapy for locally advanced cervical cancer: An analysis from the EMBRACE study. Radiother Oncol 2018; 127:440-448. [DOI: 10.1016/j.radonc.2018.03.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Revised: 03/11/2018] [Accepted: 03/13/2018] [Indexed: 11/25/2022]
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Combined aerobic and resistance training improves physical capacity in women treated for gynecological cancer. Support Care Cancer 2018; 26:3389-3396. [DOI: 10.1007/s00520-018-4185-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 03/28/2018] [Indexed: 01/25/2023]
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Chow KM, So WKW, Choi KC, Chan CWH. Sexual function, psychosocial adjustment to illness, and quality of life among Chinese gynaecological cancer survivors. Psychooncology 2018; 27:1257-1263. [DOI: 10.1002/pon.4663] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 01/22/2018] [Accepted: 01/28/2018] [Indexed: 11/08/2022]
Affiliation(s)
- Ka Ming Chow
- The Nethersole School of Nursing; The Chinese University of Hong Kong; Hong Kong SAR China
| | - Winnie Kwok Wei So
- The Nethersole School of Nursing; The Chinese University of Hong Kong; Hong Kong SAR China
| | - Kai Chow Choi
- The Nethersole School of Nursing; The Chinese University of Hong Kong; Hong Kong SAR China
| | - Carmen Wing Han Chan
- The Nethersole School of Nursing; The Chinese University of Hong Kong; Hong Kong SAR China
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Kobleder A, Mayer H, Gehrig L, Senn B. “Promoting continuity of care”-Specialist nurses’ role experiences in gynaecological oncology: A qualitative study. J Clin Nurs 2017; 26:4890-4898. [DOI: 10.1111/jocn.13966] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2017] [Indexed: 12/19/2022]
Affiliation(s)
- Andrea Kobleder
- Institute of Applied Nursing Sciences IPW-FHS; FHS St. Gallen, University of Applied Sciences; St. Gallen Switzerland
- Department of Nursing Science; University of Vienna; Vienna Austria
| | - Hanna Mayer
- Department of Nursing Science; University of Vienna; Vienna Austria
| | | | - Beate Senn
- Institute of Applied Nursing Sciences IPW-FHS; FHS St. Gallen, University of Applied Sciences; St. Gallen Switzerland
- Sydney Nursing School; University of Sydney; Sydney NSW Australia
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Cook O, McIntyre M, Recoche K, Lee S. Experiences of gynecological cancer patients receiving care from specialist nurses: a qualitative systematic review. JBI DATABASE OF SYSTEMATIC REVIEWS AND IMPLEMENTATION REPORTS 2017; 15:2087-2112. [PMID: 28800057 DOI: 10.11124/jbisrir-2016-003126] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND The care needs of women with gynecological cancer are complex and change over the course of their cancer journey. Specialist nurses are well positioned to play a role in meeting the needs of women with gynecological cancer although their role and scope of practice have not been well defined. As patients are a key stakeholder, understanding their experience of care is an important step in better defining the role and scope of practice of specialist nurses in gynecological oncology in Australia and New Zealand. OBJECTIVES This review sought to consider gynecological cancer patients' experiences of specialist nursing care. Exploring the patient's experience of care by a specialist nurse is one step in the process of better defining the role and scope of practice of specialist gynecological-oncology nurses in Australia and New Zealand. INCLUSION CRITERIA TYPES OF PARTICIPANTS This review included studies with a focus on women with gynecological cancer who had been cared for by a specialist nurse. Studies of women with gynecological cancer at any point on the continuum of care from pre-diagnosis to survivorship or end of life, including those with a recurrence of the disease, were included, with no limit to the duration of care received for inclusion in the review. PHENOMENA OF INTEREST Studies that explored how women with gynecological cancer experience the care and interventions of specialist nurses were included. TYPES OF STUDIES Qualitative studies including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research and feminist research were considered for review. This review also considered the qualitative components of mixed method studies. CONTEXT Research conducted in any country was considered for inclusion in this review providing that the study was reported in English. Studies conducted in any setting including, but not limited to, acute hospitals, outpatient/ambulatory clinics, chemotherapy or radiotherapy units, support groups, palliative care units or the patient's home were included. SEARCH STRATEGY A three-step search strategy was utilized in this review. An initial limited search of MEDLINE and CINAHL was undertaken followed by a comprehensive search using all identified keywords and index terms across all included databases. The reference lists of all identified reports and articles were hand searched for additional studies. METHODOLOGICAL QUALITY Each paper was independently assessed by two independent reviewers for methodological validity prior to inclusion in the review using the standardized critical appraisal instrument from the Joanna Briggs Institute the Qualitative Assessment and Review Instrument. When disagreement arose between the reviewers, the given paper was independently appraised by a third reviewer. DATA EXTRACTION Data were extracted from papers included in the review using the standardized data extraction tool from Joanna Briggs Institute the Qualitative Assessment and Review Instrument. Data extraction was completed independently by two reviewers. DATA SYNTHESIS Extracted findings from seven included papers were grouped according to similarity in meaning from which 11 categories were developed. These categories were then subjected to a meta-synthesis that produced a set of three synthesized findings. RESULTS Key findings were extracted from six included papers and classified as unequivocal (U) or credible (C). A total of 30 findings were extracted and aggregated into 11 categories based on similarity in meaning. From the 11 categories, three synthesized findings were developed: i) Tailored care: specialist nurses play a role in understanding and meeting the individual needs of women with gynecological cancer; ii) Accessible care: specialist nurses guide women with gynecological cancer along the continuum of care and are an easily accessed source of knowledge and support; iii) Dependable expertise: women with gynecological cancer express trust and reassurance in the experience and expertise of the specialist nurse. CONCLUSIONS This systematic review synthesized the findings of seven studies that captured the experiences of women with gynecological cancer who received care from a specialist nurse. The specialist nurse offers tailored, accessible and expert care to women with gynecological cancer. From the synthesis it is recommended that women with gynecological cancer have access to the services of a specialist nurse at key points on the continuum of care, that specialist nurses provide information to patients on their disease and treatment in the form preferred by the patient and ensure that this information has been understood, and that specialist nurses are afforded time to spend with patients to enable greater exploration and identification of patient needs and the provision of personalized care. Further study that considers other key stakeholders in the specialist nurse role in gynecological oncology is recommended in order to gain a full understanding of specialist nurses' contribution to the care of women with gynecological cancer. Additionally, it is recommended that further studies be conducted to seek the perspectives of women with gynecological cancer from culturally and linguistically diverse backgrounds and Indigenous populations on specialist nursing care as they appear to be under-represented in current research.
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Affiliation(s)
- Olivia Cook
- 1School of Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia 2The Centre for Chronic Disease Management: a Joanna Briggs Institute Centre of Excellence, Melbourne, Australia
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Chen Y, Ding S, Tao X, Feng X, Lu S, Shen Y, Wu Y, An X. The quality of life of patients developed delirium after coronary artery bypass grafting is determined by cognitive function after discharge: A cross-sectional study. Int J Nurs Pract 2017; 23. [PMID: 28752905 DOI: 10.1111/ijn.12563] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 03/21/2017] [Accepted: 04/30/2017] [Indexed: 12/14/2022]
Abstract
AIMS Postoperative delirium (POD) and declined cognitive function were common in patients (especially elderly patients) who underwent coronary artery bypass grafting (CABG), which may affect quality of life (QoL). The aim of this study was to determine the relationships among age, POD, declined cognitive function, and QoL in patients who underwent CABG. METHODS Consecutive patients who underwent first time elective CABG and assessed for POD using Confusion Assessment Method for intensive care unit for 5 postoperative days from November 2013 to March 2015 were recruited. A cross-sectional study was conducted during April 2015 to assess their cognitive function and QoL, using the Telephone Interview for Cognitive Status Scale and Medical Outcomes Study 36-Item Short Form Health Survey. The relationships among age, POD, declined cognitive function, and QoL were tested using path analysis. RESULTS Declined cognitive function was associated with poorer QoL. POD was associated with declined cognitive function but was not associated with poorer QoL. Ageing was not associated with QoL but was associated with POD and declined cognitive function. CONCLUSION The QoL of patients developed delirium after CABG is determined by cognitive function after discharge. Necessary strategies should be implemented to prevent POD and declined cognitive function, especially in elderly patients.
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Affiliation(s)
- Yuling Chen
- School of Nursing, Capital Medical University, Beijing, China
| | - Shu Ding
- School of Nursing, Capital Medical University, Beijing, China
| | - Xiangjun Tao
- School of Nursing, Capital Medical University, Beijing, China
| | - Xinwei Feng
- School of Nursing, Capital Medical University, Beijing, China
| | - Sai Lu
- School of Nursing and Midwifery College of Health and Biomedicine, Victoria University, Melbourne, VIC, Australia
| | - Yuzhi Shen
- Department of Heart Center, Beijing Chao-Yang Hospital, Beijing, China
| | - Ying Wu
- School of Nursing, Capital Medical University, Beijing, China
| | - Xiangguang An
- Department of Heart Center, Beijing Chao-Yang Hospital, Beijing, China
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Symptom Burden and Functional Dependencies Among Cancer Patients in Botswana Suggest a Need for Palliative Care Nursing. Cancer Nurs 2017; 39:E29-38. [PMID: 25881812 DOI: 10.1097/ncc.0000000000000249] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Palliative care and cancer nursing in sub-Saharan Africa is hampered by inadequate clinical resources and evidence base but is central to symptom management amid the growing cancer burden. OBJECTIVE The aim of this study is to describe symptom burden and functional dependencies of cancer patients in Botswana using the Memorial Symptom Assessment Scale-Short Form (MSAS-SF) and Enforced Social Dependency Scale (ESDS). METHODS A cross-sectional multisite study was conducted in Gaborone, Botswana, from June to August 2013 using MSAS-SF, ESDS, and Eastern Cooperative Oncology Group (ECOG) performance status at 1 time point. Descriptive statistics, tests of association, correlation, and scale validity were used. RESULTS Among the 100 cancer patients, 65 were women, 21 were inpatients, 48 were human immunodeficiency virus-positive, 23 had gynecological malignancies, 34 had stage 4 disease, and 54 received chemotherapy only. Sixty-four reported pain; 54, neuropathies; 51, weight loss; and 51, hunger. Most distressing symptoms were weight loss, body image, skin changes, and pain. Recreational/social role was most affected by cancer. Cronbach's α for both the MSAS-SF and ESDS was .91. Variations in means for MSAS-SF and ESDS were associated with ECOG grade 2 (P < .05); the ECOG moderately correlated (0.35) with MSAS-SF (P < .01). No associations with human immunodeficiency virus status were found. CONCLUSIONS Patients reported distressing levels of cancer pain, weight loss, hunger, and dependency in recreational/social activities. The Setswana translations of the MSAS-SF and ESDS were found reliable to assess cancer patients' symptoms and function. IMPLICATIONS FOR PRACTICE Nurses trained in palliative care are needed to meet cancer patients' pain and symptom management care needs.
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Quality of life among survivors of early-stage cervical cancer in Taiwan: an exploration of treatment modality differences. Qual Life Res 2017; 26:2773-2782. [PMID: 28608151 DOI: 10.1007/s11136-017-1619-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2017] [Indexed: 11/12/2022]
Abstract
PURPOSE Women with early-stage cervical cancer may experience changes in their quality of life (QoL) due to treatment or to the effects of the cancer. In this study, we examined differences in QoL by treatment modality between women who underwent surgery only and those treated with concurrent chemoradiation (CCRT). METHODS The sample of 290 women had been diagnosed with stage I-II cervical cancer. Data were collected on these women's demographic and disease characteristics, general QoL, and cancer-specific QoL using an author-designed demographic-disease survey, the European Organization for Research and Treatment of Cancer QoL questionnaire, and the Taiwanese-version Cervical Cancer Module 24 questionnaire, respectively. Data were analyzed by descriptive statistics and analysis of covariance. RESULTS Women with cervical cancer who underwent surgery only had significantly worse constipation and body image than those treated with CCRT. Women who underwent CCRT had worse physical and role functioning than those who underwent surgery only. Women who had CCRT also reported worse symptoms, such as fatigue, appetite loss, diarrhea, financial difficulties, sexual enjoyment, and sexual/vaginal functioning, than those who had only surgery. CONCLUSIONS Our results add knowledge about QoL in women with early-stage cervical cancer who receive different treatment modalities. When suggesting treatment modalities for women with cervical cancer, health professionals should also consider changes in women's QoL after cancer treatment. To improve women's QoL after treatment, professionals should also offer timely and individualized interventions based on women's cervical cancer treatment.
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Steen R, Dahl AA, Hess SL, Kiserud CE. A study of chronic fatigue in Norwegian cervical cancer survivors. Gynecol Oncol 2017; 146:630-635. [PMID: 28552254 DOI: 10.1016/j.ygyno.2017.05.028] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 05/19/2017] [Accepted: 05/21/2017] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Chronic fatigue after treatment is a common adverse event in cancer patients, but there are few studies in long-term survivors of cervical cancer. The aim of this investigation was to explore the prevalence of chronic fatigue and its association with various clinical and treatment-related factors in a population-based cohort of Norwegian cervical cancer survivors treated by any modality. METHODS All patients, treated for cervical cancer from 2000 through 2007 in the Health Region of South-Eastern Norway, cancer-free, alive and aged ≤75years by the end 2013 (n=822) received a questionnaire covering chronic fatigue and other clinical variables. RESULTS 461 of 822 survivors (56%) completed the questionnaire and 382 entered the analyses. Chronic fatigue was reported by 23% (95% confidence interval 19%-27%) with a median age of 52years (range 32-75) at survey, 11years (range 7-15) after diagnosis. Among survivors treated by minimal invasive- or radical surgery, 19% had chronic fatigue, while the prevalence was 28% in those treated with radiation and concomitant chemotherapy (chemoradiation). The chronic fatigue group reported significantly more cardiovascular disease, obesity, less physical activity, more treatment-related symptom experience, more menopausal symptoms, higher levels of anxiety and depressive symptoms, and poorer quality of life than the non-fatigued group. In multivariate analysis only increased level of depression and poorer global quality of life were significantly associated with chronic fatigue. CONCLUSIONS Chronic fatigue was reported by 23% of long-term survivors after cervical cancer at a mean of 11years after treatment. Some of the associated factors are amenable to prevention and/or treatment and should be subjects of attention at follow-up.
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Affiliation(s)
- Rita Steen
- Department of Gynaecologic Oncology, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, Norway; National Advisory Unit on Late Effects After Cancer Treatment, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, Norway
| | - Alv A Dahl
- National Advisory Unit on Late Effects After Cancer Treatment, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Siri Lothe Hess
- National Advisory Unit on Late Effects After Cancer Treatment, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, Norway
| | - Cecilie E Kiserud
- National Advisory Unit on Late Effects After Cancer Treatment, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, Norway.
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Lin KY, Frawley H, Denehy L, Feil D, Granger C. Exercise interventions for patients with gynaecological cancer: a systematic review and meta-analysis. Physiotherapy 2016; 102:309-319. [DOI: 10.1016/j.physio.2016.02.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 02/16/2016] [Indexed: 02/09/2023]
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Li CC, Tsai YF, Chang TC, Chen L. Associations among menopausal symptoms, sleep and fatigue in Taiwanese women with endometrial cancer. Eur J Cancer Care (Engl) 2016; 26. [DOI: 10.1111/ecc.12559] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2016] [Indexed: 12/22/2022]
Affiliation(s)
- Chia-Chun Li
- School of Nursing; College of Medicine; Chang Gung University; Tao-Yuan Taiwan
| | - Yun-Fang Tsai
- School of Nursing; College of Medicine; Chang Gung University; Tao-Yuan Taiwan
| | - Ting-Chang Chang
- Department of Obstetrics and Gynecology; College of Medicine; Chang Gung University; Tao-Yuan Taiwan
- Department of Obstetrics and Gynecology; Chang Gung Memorial Hospital; Tao-Yuan Taiwan
| | - Lynn Chen
- School of Nursing; University of Maryland at Baltimore; Baltimore MD USA
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Manne SL, Myers-Virtue S, Kissane D, Ozga ML, Kashy DA, Rubin SC, Rosenblum NG, Heckman CJ. Group-based trajectory modeling of fear of disease recurrence among women recently diagnosed with gynecological cancers. Psychooncology 2016; 26:1799-1809. [PMID: 27421919 DOI: 10.1002/pon.4223] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 06/21/2016] [Accepted: 07/10/2016] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Fear of cancer recurrence is an important clinical phenomenon and is associated with decrements in life domains. The study goals were to characterize patterns of global fear of recurrence (FOR) and 4 domains of fear (health, role, womanhood, and death worry) over time in women who were diagnosed with gynecological cancer and to identify demographic, medical, and psychological predictors of FOR. METHOD One hundred eighteen women participating in the usual care arm of a randomized trial completed the Concerns about Recurrence scale as well as measures of depressive symptoms, cancer-specific distress, coping, coping efficacy, and social network responses at 4 time points. The majority of the sample was diagnosed with stage 3 ovarian cancer. RESULTS Group-based trajectory modeling identified subgroups of women with high-stable (49.1%), high-decreasing (25.3%), and low-stable (25.5%) trajectories for global FOR. For role worries, 3 similar group trajectories were identified. For health worries, modeling identified subgroups with high-decreasing (19.1%) and low-increasing (80.9%) trajectories. For womanhood worries, modeling identified subgroups with high-increasing (15.7%) and low-decreasing (84.2%) trajectories. Young age, metastatic cancer, depression, cancer distress, holding back, and lower coping efficacy were associated with the high-stable global FOR and at least 1 domain of FOR. CONCLUSION Almost half of the women recently diagnosed with gynecological cancer evidence persistently elevated FOR over the 6-month period postdiagnosis. Psychological interventions to reduce FOR may be more effective if they focus on teaching patients coping skills, as well as greater comfort expressing cancer-specific concerns to others.
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Affiliation(s)
- Sharon L Manne
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Shannon Myers-Virtue
- Temple University Maurice H. Kornberg School of Dentistry, Philadelphia, Pennsylvania, USA
| | - David Kissane
- Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Monash University, Clayton, Victoria, Australia
| | - Melissa L Ozga
- Memorial Sloan Kettering Cancer Center, New York, New York, USA
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Health-related quality of life in ovarian cancer survivors: Results from the American Cancer Society's Study of Cancer Survivors - I. Gynecol Oncol 2016; 141:543-549. [PMID: 27072805 DOI: 10.1016/j.ygyno.2016.04.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 03/28/2016] [Accepted: 04/03/2016] [Indexed: 12/31/2022]
Abstract
OBJECTIVE There are limited data on outcomes and predictors of health-related quality of life (HRQOL) of ovarian cancer survivors. Therefore, we examined the trajectory and predictors of HRQOL one- and two-years post-diagnosis in this population. METHODS 365 ovarian cancer survivors, a subset of participants in the longitudinal American Cancer Society's Study of Cancer Survivors-I, completed questionnaires at one-year post-diagnosis on sociodemographics, clinical factors, and HRQOL (SF-36). 284 women had HRQOL data at two-years post-diagnosis. In this secondary data analysis, we examined HRQOL at both time points, changes in HRQOL and predictors of HRQOL with univariate and multivariate linear regression. RESULTS Mean mental and physical HRQOL scores one-year post-diagnosis were 49.37 (SD±11.59) and 45.96 (SD±10.89), respectively. Older age, lower income, higher disease stage, more comorbidities and greater symptom burden were associated with poorer physical functioning one year post-diagnosis. Younger age, higher stage, having an existing mental health issue, greater symptom burden, and not receiving chemotherapy were associated with poorer mental functioning. Disease recurrence between one- and two-years post-diagnosis and greater symptom burden were predictors of declining physical functioning from one- to two-years post-diagnosis. Mental functioning did not change significantly between assessments. CONCLUSIONS Overall mental and physical functioning of these ovarian cancer survivors was similar to the general population. However, lower HRQOL was associated with a number of variables, including disease recurrence, treatment status, symptom burden, age, and number of comorbidities. These findings can help health care providers identify survivors who may benefit from relevant interventions.
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Heckler CE, Garland SN, Peoples AR, Perlis ML, Shayne M, Morrow GR, Kamen C, Hoefler J, Roscoe JA. Cognitive behavioral therapy for insomnia, but not armodafinil, improves fatigue in cancer survivors with insomnia: a randomized placebo-controlled trial. Support Care Cancer 2015; 24:2059-2066. [PMID: 26542272 DOI: 10.1007/s00520-015-2996-y] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 10/26/2015] [Indexed: 11/30/2022]
Abstract
PURPOSE Fatigue is a prevalent, distressing side effect of cancer and cancer treatment which commonly coexists with insomnia. Cognitive behavioral therapy for insomnia (CBT-I) has been shown to improve insomnia in cancer patients, but less is known about its ability to impact fatigue. This work is the analysis for a secondary aim of a four-arm randomized controlled trial (RCT) study assessing the combined and comparative effect of CBT-I and a wakefulness-promoting agent, armodafinil (A), to improve sleep and daytime functioning in cancer survivors. Herein, we examine the effect of CBT-I, with and without A, on fatigue in cancer survivors. PATIENTS AND METHODS This study was a four-arm factorial study with CBTI-I (yes/no) versus A (yes/no). It consisted of 96 cancer survivors (average age 56 years; 88 % female; 68 % breast cancer). Fatigue was assessed by the brief fatigue inventory (BFI) and the FACIT-Fatigue scale. The analysis assessed the additive effects of CBT-I and A and possible non-additive effects where the effect of CBT-I changes depending on the presence or absence of A. RESULTS Analyses adjusting for baseline differences showed that CBT-I improved fatigue as measured by two separate scales (BFI: P = 0.002, Std. error = 0.32, effect size (ES) = 0.46; FACIT-Fatigue: P < 0.001, Std. error = 1.74, ES = 0.64). Armodafinil alone did not show a statistically significant effect on fatigue levels (all Ps > 0.40) nor did the drug influence the efficacy of CBT-I. Structural equation analysis revealed that reductions in insomnia severity were directly responsible for improving cancer-related fatigue. CONCLUSIONS CBT-I with and without armodafinil resulted in a clinically and statistically significant reduction of subjective daytime fatigue in cancer survivors with chronic insomnia. Armodafinil did not improve cancer-related fatigue (CRF) and did not change the efficacy of CBT-I. Patients reporting CRF should be screened and, if indicated, treated for insomnia as part of a comprehensive fatigue management program.
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Affiliation(s)
- Charles E Heckler
- Department of Surgery, University of Rochester James P. Wilmot Cancer Center, 265 Crittenden Blvd. CU 420658, Rochester, NY, 14642, USA.
| | - Sheila N Garland
- Department of Psychology, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Anita R Peoples
- Department of Surgery, University of Rochester James P. Wilmot Cancer Center, 265 Crittenden Blvd. CU 420658, Rochester, NY, 14642, USA
| | - Michael L Perlis
- Department of Psychiatry, University of Pennsylvania, 3535 Market Street, Suite 670, Philadelphia, PA, 19104, USA
| | - Michelle Shayne
- Department of Surgery, University of Rochester James P. Wilmot Cancer Center, 265 Crittenden Blvd. CU 420658, Rochester, NY, 14642, USA
| | - Gary R Morrow
- Department of Surgery, University of Rochester James P. Wilmot Cancer Center, 265 Crittenden Blvd. CU 420658, Rochester, NY, 14642, USA
| | - Charles Kamen
- Department of Surgery, University of Rochester James P. Wilmot Cancer Center, 265 Crittenden Blvd. CU 420658, Rochester, NY, 14642, USA
| | - Jenine Hoefler
- Department of Surgery, University of Rochester James P. Wilmot Cancer Center, 265 Crittenden Blvd. CU 420658, Rochester, NY, 14642, USA
| | - Joseph A Roscoe
- Department of Surgery, University of Rochester James P. Wilmot Cancer Center, 265 Crittenden Blvd. CU 420658, Rochester, NY, 14642, USA
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Pfaendler KS, Wenzel L, Mechanic MB, Penner KR. Cervical cancer survivorship: long-term quality of life and social support. Clin Ther 2015; 37:39-48. [PMID: 25592090 PMCID: PMC4404405 DOI: 10.1016/j.clinthera.2014.11.013] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 11/25/2014] [Accepted: 11/25/2014] [Indexed: 11/12/2022]
Abstract
PURPOSE Surgery, radiotherapy, and chemotherapy are the mainstays of cervical cancer treatment. Many patients receive multiple treatment modalities, each with its own long-term effects. Given the high 5-year survival rate for cervical cancer patients, evaluation and improvement of long-term quality of life are essential. METHODS Pertinent articles were identified through searches of PubMed for literature published from 1993 to 2014. We summarize quality of life data from long-term follow-up studies of cervical cancer patients. We additionally summarize small group interviews of Hispanic and non-Hispanic cervical cancer survivors regarding social support and coping. FINDINGS Data are varied in terms of the long-term impact of treatment on quality of life, but consistent in suggesting that patients who receive radiotherapy as part of their treatment have the highest risk of increased long-term dysfunction of bladder and bowel, as well as sexual dysfunction and psychosocial consequences. Rigorous investigations regarding long-term consequences of treatment modalities are lacking. IMPLICATIONS Continued work to improve treatment outcomes and survival should also include a focus on reducing adverse long-term side effects. Providing supportive care during treatment and evaluating the effects of supportive care can reduce the prevalence and magnitude of long-term sequelae of cervical cancer, which will in turn improve quality of life and quality of care.
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Affiliation(s)
- Krista S Pfaendler
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of California at Irvine Medical Center, Orange, California
| | - Lari Wenzel
- Program in Public Health, University of California, Irvine, Irvine, California; Department of Medicine and Program in Public Health, Chao Family Comprehensive Cancer Center, University of California, Irvine, Irvine, California
| | - Mindy B Mechanic
- Department of Psychology, California State University, Fullerton, Fullerton, California
| | - Kristine R Penner
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of California at Irvine Medical Center, Orange, California.
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