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Manne SL, Hudson SV, O'Malley D, Devine KA, Matasar M, Peram J, Solleder J, Handorf E, Evens AM. Survivorship preparedness and activation among survivors of lymphoma. J Cancer Surviv 2024:10.1007/s11764-024-01664-6. [PMID: 39190132 DOI: 10.1007/s11764-024-01664-6] [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: 04/24/2024] [Accepted: 08/15/2024] [Indexed: 08/28/2024]
Abstract
OBJECTIVES Taking an active role in managing post-treatment care has emerged as a key aspect of promoting a successful transition into survivorship and is associated with better patient outcomes. In this study, we focus on two key aspects of active self-management, activation and preparedness. Activation was defined as understanding one's role in the care process and having the knowledge, skill, and confidence to take on a role in managing self-care. Preparedness was defined as the extent to which individuals perceived they had sufficient information about what to expect after cancer treatments are completed. The study goal was to characterize survivorship preparedness and activation among lymphoma survivors within 5 years of treatment completion in New Jersey and examine the association of sociodemographic, medical, care transition experiences, practical concerns, and psychosocial factors with activation and preparedness. METHODS One hundred and one Hodgkin lymphoma or non-Hodgkin lymphoma survivors who had completed treatment within 5 years completed a survey of survivorship care experiences (response rate = 34.12%). RESULTS Approximately 60% of survivors reported high activation, with similar percentages for higher preparedness. Less activated survivors were significantly (p < .05) younger, married, resided in a more deprived geographic area, and reported more fatigue and information needs. Less activated survivors reported recalling that their providers were significantly (p < .05) less likely to discuss long-term side effects, psychosocial needs, risk-reducing lifestyle recommendations, and how to manage other medical concerns. Fewer care transition practices were most strongly associated with lower preparedness. CONCLUSIONS A significant proportion were not activated for survivorship, and both activation and preparedness were strongly associated with providers' survivorship transition practices. IMPLICATIONS FOR CANCER SURVIVORS Implementing programs to foster more activation and preparedness for lymphoma survivorship care would benefit from education about recommended follow-up care and healthy lifestyle practices. Providers should routinely ask about their patients' confidence and preparedness for survivorship and provide referrals for appropriate care as needed.
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Affiliation(s)
- Sharon L Manne
- Rutgers Cancer Institute of New Jersey, 120 Albany Street, Tower 2 Floor 8, New Brunswick, NJ, 08901, USA.
| | - Shawna V Hudson
- Dept Family Medicine and Community Health, Rutgers RWJ Medical School, 303 George Street, Rm 309, New Brunswick, NJ, 08901, USA
| | - Dena O'Malley
- Dept Family Medicine and Community Health, Rutgers RWJ Medical School, 303 George Street, Rm 309, New Brunswick, NJ, 08901, USA
| | - Katie A Devine
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08901, USA
| | - Matthew Matasar
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08901, USA
| | - Jacintha Peram
- Rutgers Cancer Institute of New Jersey, 120 Albany Street, Tower 2 Floor 8, New Brunswick, NJ, 08901, USA
| | - Justin Solleder
- Rutgers Cancer Institute of New Jersey, 120 Albany Street, Tower 2 Floor 8, New Brunswick, NJ, 08901, USA
| | - Elizabeth Handorf
- Rutgers School of Public Health, 120 Albany Street, Tower 2 Floor 5, New Brunswick, NJ, 08901, USA
| | - Andrew M Evens
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08901, USA
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Kelly BC, Hanson HA, Utz RL, Hollingshaus MS, Meeks H, Tay DL, Ellington L, Stephens CE, Ornstein KA, Smith KR. Disparities and determinants of place of death: Insights from the Utah Population Database. DEATH STUDIES 2023; 48:663-675. [PMID: 37676820 PMCID: PMC11119959 DOI: 10.1080/07481187.2023.2255864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
To better understand determinants and potential disparities in end of life, we model decedents' place of death with explanatory variables describing familial, social, and economic resources. A retrospective cohort of 204,041 decedents and their family members are drawn from the Utah Population Database family caregiving dataset. Using multinomial regression, we model place of death, categorized as at home, in a hospital, in another location, or unknown. The model includes family relationship variables, sex, race and ethnicity, and a socioeconomic status score, with control variables for age at death and death year. We identified the effect of a family network of multiple caregivers, with 3+ daughters decreasing odds of a hospital death by 17 percent (OR: 0.83 [0.79, 0.87], p < 0.001). Place of death also varies significantly by race and ethnicity, with most nonwhite groups more likely to die in a hospital. These determinants may contribute to disparities in end of life.
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Affiliation(s)
- Brenna C Kelly
- Department of Geography, University of Utah, Salt Lake City, Utah, USA
- Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Heidi A Hanson
- Computational Sciences and Engineering Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee, USA
- Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Rebecca L Utz
- Department of Sociology, University of Utah, Salt Lake City, Utah, USA
| | - Mike S Hollingshaus
- Kem C. Gardner Policy Institute, David Eccles School of Business, University of Utah, Salt Lake City, Utah, USA
| | - Huong Meeks
- Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Djin L Tay
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
| | - Lee Ellington
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
| | | | | | - Ken R Smith
- Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, Utah, USA
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Contributions of cancer treatment, comorbidities, and obesity to aging-related disease risks among non-Hodgkin lymphoma survivors. Cancer Causes Control 2023; 34:171-180. [PMID: 36414860 DOI: 10.1007/s10552-022-01652-0] [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: 03/14/2022] [Accepted: 11/01/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE It is unknown whether cancer treatment contributes more to long-term disease risk than lifestyle factors and comorbidities among B-cell non-Hodgkin lymphoma (B-NHL) survivors. METHODS B-NHL survivors were identified in the Utah Cancer Registry from 1997 to 2015. Population attributable fractions (PAF) were calculated to assess the role of clinical and lifestyle factors for six cardiovascular, pulmonary, and renal diseases. RESULTS Cancer treatment contributed to 11% of heart and pulmonary conditions and 14.1% of chronic kidney disease. Charlson Comorbidity Index (CCI) at baseline contributed to all six diseases with a range of 9.9% of heart disease to 26.5% of chronic kidney disease. High BMI at baseline contributed to 18.4% of congestive heart failure and 7.9% of pneumonia, while smoking contributed to 4.8% of COPD risk. CONCLUSION Cancer treatment contributed more to heart disease, COPD, and chronic kidney disease than lifestyle factors and comorbidities among B-NHL survivors. High BMI at baseline contributed more to congestive heart failure and pneumonia than cancer treatment, whereas smoking at baseline was not a major contributor in this B-NHL survivor cohort. Baseline comorbidities consistently demonstrated high attributable risks for these diseases, demonstrating a strong association between preexisting comorbidities and aging-related disease risks.
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