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Lond B, Dodd C, Davey Z, Darlison L, McPhelim J, Rawlinson J, Williamson I, Merriman C, Waddington F, Bagnallainslie D, Rajendran B, Usman J, Henshall C. A systematic review of the barriers and facilitators impacting patient enrolment in clinical trials for lung cancer. Eur J Oncol Nurs 2024; 70:102564. [PMID: 38554615 DOI: 10.1016/j.ejon.2024.102564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 03/06/2024] [Accepted: 03/11/2024] [Indexed: 04/02/2024]
Abstract
PURPOSE Clinical research trials are needed to enhance the medical care and treatment for lung cancer, which remains the leading cause of cancer-related deaths worldwide. While clinical trials allow for the development of novel therapies to treat cancer, the recruitment of lung cancer patients to trials is low. This review aimed to identify and synthesise the available literature concerning barriers and facilitators affecting lung cancer patients' decisions to enrol in clinical trials to guide future cancer research efforts. METHODS Four databases were systematically searched: Academic Search Complete, CINHAL, PubMed, and PsycINFO in August 2023. A supplemental grey literature search was also conducted alongside this. Articles were quality appraised using CASP and JMI checklists, and results were narratively synthesised. RESULTS Eighteen articles of varied design met the inclusion criteria, and results were mapped onto the Capability, Opportunity, and Motivation Behaviour (COM-B) Model to help structure and conceptualise review findings. Evidence suggests that the decision to enrol in a trial is multifaceted and informed by: when and how study information is presented, travel and trial eligibility, and altruistic hopes and fears. CONCLUSIONS There is need to address the many different concerns that lung cancer patients have about participating in a clinical trial through the supply of accessible and timely trial information, and via the reduction of travel, expansion of study eligibility criteria, and recognition of a person's altruistic wishes, hopes, fears, and family-oriented concerns. Future research should aim to work alongside lung cancer patients, clinicians, and other stakeholders to increase research accessibility.
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Affiliation(s)
- Benjamin Lond
- Oxford Institute of Applied Health Research, Oxford Brookes University, Oxford, United Kingdom.
| | - Christopher Dodd
- Oxford Institute of Applied Health Research, Oxford Brookes University, Oxford, United Kingdom
| | - Zoe Davey
- Oxford Institute of Applied Health Research, Oxford Brookes University, Oxford, United Kingdom
| | - Liz Darlison
- University Hospitals of Leicester, The Glenfield Hospital, Leicester, United Kingdom
| | - John McPhelim
- University Hospital Hairmyres, NHS Lanarkshire, East Kilbride, United Kingdom
| | - Janette Rawlinson
- Lung Cancer Patient Advisory Group, European Lung Foundation, Sheffield, United Kingdom; British Thoracic Oncology Group Steering Committee, Leicester, United Kingdom
| | - Iain Williamson
- Division of Psychology, De Montfort University, Leicester, United Kingdom
| | - Clair Merriman
- Oxford Institute of Applied Health Research, Oxford Brookes University, Oxford, United Kingdom; Oxford University Hospital Foundation Trust, Oxford, United Kingdom
| | - Francesca Waddington
- Oxford Health NHS Foundation Trust, The Warneford Hospital, Oxford, United Kingdom
| | | | - Balaji Rajendran
- Oxford Health NHS Foundation Trust, The Warneford Hospital, Oxford, United Kingdom
| | - Jesse Usman
- Oxford Health NHS Foundation Trust, The Warneford Hospital, Oxford, United Kingdom
| | - Catherine Henshall
- Oxford Institute of Applied Health Research, Oxford Brookes University, Oxford, United Kingdom; Oxford Health NHS Foundation Trust, The Warneford Hospital, Oxford, United Kingdom
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Erlik M, Timm H, Larsen ATS, Quist M. Reasons for non-participation in cancer rehabilitation: a scoping literature review. Support Care Cancer 2024; 32:346. [PMID: 38743121 PMCID: PMC11093823 DOI: 10.1007/s00520-024-08553-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 05/07/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND Rehabilitation plays an important role in addressing the many challenges of living with cancer, but a large proportion of people with cancer do not participate in available cancer rehabilitation. Hence, reasons for non-participation in cancer rehabilitation need to be explored. OBJECTIVE The present study undertakes a scoping review of research examining reasons for non-participation in cancer rehabilitation among people with cancer. DESIGN A systematic search was conducted in PubMed, Scopus and CINAHL for articles published until July 2023. Included studies were hand searched for relevant references and citations. ELIGIBILITY CRITERIA Method: Studies with qualitative, quantitative or mixed-method design. POPULATION Studies targeting adults (> 18) living with cancer, not participating in rehabilitation. Program type: The review included all studies defining program as rehabilitation but excluded clinical trials. OUTCOME Studies examining reasons for non-participation in available rehabilitation. DATA EXTRACTION The extracted data included author(s)/year of publication, aim, population, information, rehabilitation type and main reasons for non-participation. RESULTS A total of nine studies were included (n = 3 quantitative, n = 2 qualitative, n = 4 mixed methods). Reasons for non-participation included physical, psychosocial and practical aspects. The main reason across studies was 'no need for public support' related to receiving sufficient support from family and friends. All studies focused on individual reasons, and structural conditions were rarely present. CONCLUSION Research within this field is sparse. Future research should explore how individual reasons for non-participation relate to structural conditions, especially among people in socially disadvantaged positions living with cancer.
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Affiliation(s)
- Mikala Erlik
- UCSF-Centre for Health Research, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.
- Department of Public Health, University of Copenhagen, Copenhagen N, Denmark.
| | - Helle Timm
- UCSF-Centre for Health Research, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
- Faculty of Health Science, University of the Faroe Islands, Tórshavn, Faroe Islands
| | | | - Morten Quist
- UCSF-Centre for Health Research, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen N, Denmark
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Naylor J, Killingback C, Green A. An exploration of person-centredness among emergency department physiotherapists: a mixed methods study. Disabil Rehabil 2024:1-14. [PMID: 38329070 DOI: 10.1080/09638288.2024.2310179] [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: 03/31/2023] [Accepted: 01/20/2024] [Indexed: 02/09/2024]
Abstract
PURPOSE There is a growing number of primary contact physiotherapists based in United Kingdom emergency departments (ED) who are expected to deliver person-centred practices. Perceptions of physiotherapists working in these high-pressure environments on person-centredness are currently unknown. A mixed methods exploration of person-centredness among ED physiotherapists targeted this knowledge gap to inform future clinical practice. METHODS Online survey and semi-structured interviews followed a convergent mixed methods design with sequential explanatory features. Data sets were analysed separately using descriptive statistics and thematic analysis, respectively, before merged analysis using joint display. RESULTS Twenty-six surveys and 11 in-depth interviews were completed. The three overarching themes of ED patients, ED physiotherapists, and ED environment were generated. Themes were integrated and analysed alongside quantitative survey findings. This produced three novel contributions that further our understanding of person-centred practices among ED physiotherapists. CONCLUSION ED physiotherapists were mindful of an apparent, yet unspoken struggle between the competing philosophies of biomedicine and person-centredness. The results here support entering a patient's world as a person-centred approach to help navigate the line between what an ED attender wants and the clinical need of their visit.
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Affiliation(s)
- John Naylor
- Department of Physiotherapy, Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom
- Faculty of Health Sciences, University of Hull, Hull, United Kingdom
| | - Clare Killingback
- Faculty of Health Sciences, University of Hull, Hull, United Kingdom
| | - Angela Green
- Department of Physiotherapy, Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom
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Jensen S, Bloch Z, Quist M, Hansen TTD, Johansen C, Pappot H, Suetta C, Skjødt Rafn B. Sarcopenia and loss of muscle mass in patients with lung cancer undergoing chemotherapy treatment: a systematic review and meta-analysis. Acta Oncol 2023; 62:318-328. [PMID: 37051865 DOI: 10.1080/0284186x.2023.2180660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
BACKGROUND In patients with cancer, sarcopenia is associated with treatment related complications, treatment cessation, poor quality of life and reduced overall survival. Despite this, there is limited knowledge about changes in skeletal muscle mass during chemotherapy. The aim of this systematic review and meta-analysis was to investigate the change of skeletal muscle mass and sarcopenia during chemotherapy treatment among patients with lung cancer. METHODS A systematic literature search was conducted in three databases, PubMed, EMBASE and Web of Science. Observational studies with patients with lung cancer were eligible for inclusion if skeletal muscle mass was measured before and after receiving chemotherapy treatment. RESULTS Ten cohort studies with a total of 867 participants met the inclusion criteria. During 5.2 ± 2.9 months of chemotherapy treatment, patients with lung cancer experienced a significant loss of skeletal muscle mass with a standardized mean difference (SMD) of: -0.25 (95% CI -0.47 to -0.03). The pretreatment prevalence of sarcopenia varied across studies from 35% to 74%. Only one study reported prevalence of sarcopenia both before and after chemotherapy treatment with an increase from 35% to 59%. CONCLUSION The present data demonstrate a marked loss of skeletal muscle mass in patients with lung cancer undergoing chemotherapy treatment, as well as a high prevalence of sarcopenia. As sarcopenia is associated with poor clinical outcomes, it seems important to include and use assessments of skeletal muscle mass in clinical practice to identify patients in need for interventions. Moreover, interventional studies to hinder development of sarcopenia are needed.
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Affiliation(s)
- Sandra Jensen
- Cancer Survivorship and Treatment Late Effects, Department of Oncology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Zina Bloch
- Cancer Survivorship and Treatment Late Effects, Department of Oncology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Morten Quist
- University Hospitals, Centre for Health Research Department, University of Copenhagen, Rigshospitalet, Denmark
| | - Tobias Tuse Dunk Hansen
- Cancer Survivorship and Treatment Late Effects, Department of Oncology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Christoffer Johansen
- Cancer Survivorship and Treatment Late Effects, Department of Oncology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Helle Pappot
- Department of Oncology, University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Charlotte Suetta
- Geriatric Research Unit, Department of Medicine, Herlev and Gentofte Hospitals, Herlev, Denmark
- Copenhagen Center for Clinical Age Research, University of Copenhagen, Copenhagen, Denmark
- Geriatric Research Unit, Department of Geriatric and Palliative Medicine, Bispebjerg and Frederiksberg Hospital-Bispebjerg, Copenhagen, Denmark
| | - Bolette Skjødt Rafn
- Cancer Survivorship and Treatment Late Effects, Department of Oncology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark
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Flore J, Kokanović R, Broom A, Heynemann S, Lai-Kwon J, Jefford M. Entanglements and imagined futures: The subject(s) of precision in oncology. Soc Sci Med 2023; 317:115608. [PMID: 36549013 DOI: 10.1016/j.socscimed.2022.115608] [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: 03/24/2022] [Revised: 12/02/2022] [Accepted: 12/09/2022] [Indexed: 12/15/2022]
Abstract
Precision oncology holds an increasingly powerful social function. In the era of precision, how people encounter, live with, and experience cancer, how they imagine their lives, how they navigate treatment regimens, and experience side effects, have been radically transformed. Innovations in oncology - in this case precision-related - are always more-than-clinical; their circulation exceeds the laboratory and the hospital, but what this 'circulation of innovation' produces has been thus far opaque. To begin to comprehend what is emergent at the cancer-precision nexus in people's everyday lives, we draw on qualitative interviews with twenty people diagnosed with metastatic non-small cell lung cancer undergoing immunotherapy and/or targeted therapy and we discuss how precision inflects survivorship, entangles subjects in chronic living, and induces novel temporalities. Through such inflections of survivorship, precision innovation re-shapes expectations and possibilities, and sometimes enacts new, unexpected (or, for some, unwanted) futures. Such illness and survivorship narratives indicate the importance of orientating the social science scholarship toward considerations of temporality and entanglements for comprehending precision innovation in oncology. And in doing so, provide a nuanced account of how innovations unsettle and recast, rather than unravel, the normative scene of cancer.
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Affiliation(s)
- Jacinthe Flore
- Social and Global Studies Centre, School of Global, Urban and Social Studies, RMIT University, Melbourne, Victoria, Australia.
| | - Renata Kokanović
- Social and Global Studies Centre, School of Global, Urban and Social Studies, RMIT University, Melbourne, Victoria, Australia
| | - Alex Broom
- Sydney Centre for Healthy Societies, School of Social and Political Sciences, University of Sydney, Sydney, New South Wales, Australia
| | - Sarah Heynemann
- Department of Medical Oncology, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - Julia Lai-Kwon
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Michael Jefford
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
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Plage S, Olson RE. Surprise Reveals the Affective-Moral Economies in Cancer Illness Narratives. QUALITATIVE HEALTH RESEARCH 2021; 31:2730-2742. [PMID: 34632868 DOI: 10.1177/10497323211044468] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Emotions, like joy and sorrow, feature in illness narratives, dramatizing stories of becoming: sick, well, controlled, in control. However, brief emotions, such as surprise, have received limited analytic attention in cancer illness narratives. Drawing on 20 interviews with 11 participants with diverse cancer diagnoses, along with the 455 photographs they produced for this study, we address the complex interactions between discourse, societal expectations, and perceptions in moral-affective economies. Tracing the emergence, deployment, and silencing of surprise provided an avenue to explore connections between affect, morality, advocacy, and philanthropy. We show how surprise works to deny uncertainties couched in individual risk, and situate cancer causation within the logics of anticipation, (re)producing socio-cultural etiology narratives. Attending to surprise reveals how some cancers are situated as individual responsibilities, with restricted access to compassion and collective resources. Thus, we interrogate the affective-moral economy underpinning cancer illness narratives, and surprise's pivotal role in its analysis.
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Affiliation(s)
- Stefanie Plage
- The University of Queensland, Brisbane, Queensland, Australia
| | - Rebecca E Olson
- The University of Queensland, Brisbane, Queensland, Australia
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