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Meneguin S, Alves IG, Camargo HTF, Pollo CF, Segalla AVZ, de Oliveira C. Comparative Study of the Quality of Life and Coping Strategies in Oncology Patients. Eur J Investig Health Psychol Educ 2024; 14:339-350. [PMID: 38391490 PMCID: PMC10887505 DOI: 10.3390/ejihpe14020023] [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: 10/13/2023] [Revised: 01/26/2024] [Accepted: 01/30/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Despite the current data on morbidity and mortality, a growing number of patients with a diagnosis of cancer survive due to an early diagnosis and advances in treatment modalities. This study aimed to compare the quality of life and coping strategies in three groups of patients with cancer and identify associated clinical and sociodemographic characteristics. METHODS A comparative study was conducted with outpatients at a public hospital in the state of São Paulo, Brazil. The 300 participants were assigned to three groups: patients in palliative care (Group A), patients in post-treatment follow-up with no evidence of disease (Group B), and patients undergoing treatment for cancer (Group C). Data collection involved the use of the McGill Quality of Life Questionnaire and the Ways of Coping Questionnaire. No generic quality-of-life assessment tool was utilized, as it would not be able to appropriately evaluate the impact of the disease on the specific group of patients receiving palliative care. RESULTS Coping strategies were underused. Participants in the palliative care group had poorer quality of life, particularly in the psychological well-being and physical symptom domains. Age, currently undergoing treatment, and level of education were significantly associated with coping scores. Age, gender, income, and the absence of pharmacological pain control were independently associated with quality-of-life scores. Moreover, a positive association was found between coping and quality of life. CONCLUSION Cancer patients in palliative care generally report a lower quality of life. However, male patients, those who did not rely on pharmacological pain control, and those with higher coping scores reported a better perception of their quality of life. This perception tended to decrease with age and income level. Patients currently undergoing treatment for the disease were more likely to use coping strategies. Patients with higher education and quality-of-life scores also had better coping scores. However, the use of coping strategies decreased with age.
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Affiliation(s)
- Silmara Meneguin
- Department of Nursing, Botucatu Medical School, São Paulo State University, São Paulo 18618-970, Brazil
| | - Izadora Gama Alves
- Department of Nursing, Botucatu Medical School, São Paulo State University, São Paulo 18618-970, Brazil
| | | | - Camila Fernandes Pollo
- Department of Nursing, Botucatu Medical School, São Paulo State University, São Paulo 18618-970, Brazil
| | | | - Cesar de Oliveira
- Department of Epidemiology & Public Health, University College London, London WC1E 6BT, UK
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Patel JN, Jandrisevits E, Boselli D, Michalowski T, Parala-Metz A, Walsh D. Opioid Monitoring Using Urine Toxicology Screens in Outpatient Oncology Palliative Medicine. JCO Oncol Pract 2023; 19:990-999. [PMID: 37722086 DOI: 10.1200/op.23.00034] [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: 01/19/2023] [Revised: 07/13/2023] [Accepted: 08/18/2023] [Indexed: 09/20/2023] Open
Abstract
PURPOSE There is a paucity of real-world data on opioid screening and urine toxicology testing in outpatient oncology palliative medicine. METHODS This was a retrospective analysis of adult patients with cancer completing ≥ one outpatient palliative medicine visit and the Edmonton Symptom Assessment Scale (ESAS). Patient demographics, the Screener and Opioid Assessment for Patients with Pain-Short Form (SOAPP-SF), ESAS, medications, and urine toxicology screens (UTSs) were collected at baseline and follow-up visits. The primary end point was the frequency and type(s) of noncompliant UTSs (ie, presence of a nonprescribed substance or absence of a prescribed substance). Secondarily, risk factors for noncompliant UTSs were evaluated using univariate and multivariable logistic regression. RESULTS Of 189 evaluable patients (632 clinic visits), 113 underwent ≥one UTSs, 125 SOAPP-SF, and 75 had both. The median age was 56 (range, 26-80) years, 56% were female, 58% were White, 40% were Black, 48% had stage IV disease, the median baseline pain score was 7, and the median SOAPP-SF was 3. Oxycodone was the most prescribed drug (n = 125). Of 113 patients who underwent UTSs, 54% (n = 61) had ≥one noncompliant result. Thirty-nine percent (n = 44) had a total of 128 noncompliant results for the presence of a nonprescribed substance; 29% (n = 33) had a total of 53 noncompliant results for the absence of a prescribed substance. SOAPP-SF Q4 (use of illegal drugs) (odds ratio [OR], 3.61; 95% CI, 1.81 to 7.19; P < .001) and prescription with nonopioid adjuvant medications (OR, 2.83; 95% CI, 1.12 to 7.19; P = .029) were associated with increased odds of a noncompliant UTS. CONCLUSION More than half of the tested population had noncompliant UTS. Screening and evaluating risk factors for nonmedical opioid use is critical in oncology palliative medicine.
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Affiliation(s)
- Jai N Patel
- Department of Cancer Pharmacology & Pharmacogenomics, Levine Cancer Institute, Atrium Health, Charlotte, NC
| | - Elizabeth Jandrisevits
- Department of Cancer Pharmacology & Pharmacogenomics, Levine Cancer Institute, Atrium Health, Charlotte, NC
| | - Danielle Boselli
- Department of Biostatistics, Levine Cancer Institute, Atrium Health, Charlotte, NC
| | - Tiffany Michalowski
- Department of Pharmacy, Levine Cancer Institute, Atrium Health, Charlotte, NC
- Department of Supportive Oncology, Section of Palliative Medicine, Levine Cancer Institute, Atrium Health, Charlotte, NC
| | - Armida Parala-Metz
- Department of Supportive Oncology, Section of Palliative Medicine, Levine Cancer Institute, Atrium Health, Charlotte, NC
| | - Declan Walsh
- Department of Supportive Oncology, Section of Palliative Medicine, Levine Cancer Institute, Atrium Health, Charlotte, NC
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Update on Prevalence of Pain in Patients with Cancer 2022: A Systematic Literature Review and Meta-Analysis. Cancers (Basel) 2023; 15:cancers15030591. [PMID: 36765547 PMCID: PMC9913127 DOI: 10.3390/cancers15030591] [Citation(s) in RCA: 69] [Impact Index Per Article: 69.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/13/2023] [Accepted: 01/14/2023] [Indexed: 01/20/2023] Open
Abstract
Experiencing pain and insufficient relief can be devastating and negatively affect a patient's quality of life. Developments in oncology such as new treatments and adjusted pain management guidelines may have influenced the prevalence of cancer pain and severity in patients. This review aims to provide an overview of the prevalence and severity of pain in cancer patients in the 2014-2021 literature period. A systematic literature search was performed using the databases PubMed, Embase, CINAHL, and Cochrane. Titles and abstracts were screened, and full texts were evaluated and assessed on methodological quality. A meta-analysis was performed on the pooled prevalence and severity rates. A meta-regression analysis was used to explore differences between treatment groups. We identified 10,637 studies, of which 444 studies were included. The overall prevalence of pain was 44.5%. Moderate to severe pain was experienced by 30.6% of the patients, a lower proportion compared to previous research. Pain experienced by cancer survivors was significantly lower compared to most treatment groups. Our results imply that both the prevalence of pain and pain severity declined in the past decade. Increased attention to the assessment and management of pain might have fostered the decline in the prevalence and severity of pain.
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Karampela M, Isomursu M, Porat T, Maramis C, Mountford N, Giunti G, Chouvarda I, Lehocki F. The Extent and Coverage of Current Knowledge of Connected Health: Systematic Mapping Study. J Med Internet Res 2019; 21:e14394. [PMID: 31573915 PMCID: PMC6785722 DOI: 10.2196/14394] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 07/27/2019] [Accepted: 08/18/2019] [Indexed: 01/09/2023] Open
Abstract
Background This study examines the development of the connected health (CH) research landscape with a view to providing an overview of the existing CH research. The research field of CH has experienced rapid growth coinciding with increasing pressure on health care systems to become more proactive and patient centered. Objective This study aimed to assess the extent and coverage of the current body of knowledge in CH. In doing so, we sought to identify specific topics that have drawn the attention of CH researchers and to identify research gaps, in particular those offering opportunities for further interdisciplinary research. Methods A systematic mapping study that combined scientific contributions from research in the disciplines of medicine, business, computer science, and engineering was used. Overall, seven classification criteria were used to analyze the papers, including publication source, publication year, research type, empirical type, contribution type, research topic, and the medical condition studied. Results The search resulted in 208 papers that were analyzed by a multidisciplinary group of researchers. The results indicated a slow start for CH research but showed a more recent steady upswing since 2013. The majority of papers proposed health care solutions (77/208, 37.0%) or evaluated CH approaches (49/208, 23.5%). Case studies (59/208, 28.3%) and experiments (55/208, 26.4%) were the most popular forms of scientific validation used. Diabetes, cancer, multiple sclerosis, and heart conditions were among the most prevalent medical conditions studied. Conclusions We conclude that CH research has become an established field of research that has grown over the last five years. The results of this study indicate a focus on technology-driven research with a strong contribution from medicine, whereas the business aspects of CH have received less research attention.
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Affiliation(s)
| | | | - Talya Porat
- Imperial College London, London, United Kingdom
| | | | | | | | | | - Fedor Lehocki
- Slovak University of Technology, Bratislava, Slovakia
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Matos TDDS, Meneguin S, Ferreira MDLDS, Miot HA. Quality of life and religious-spiritual coping in palliative cancer care patients. Rev Lat Am Enfermagem 2017; 25:e2910. [PMID: 28699996 PMCID: PMC5511003 DOI: 10.1590/1518-8345.1857.2910] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 04/04/2017] [Indexed: 11/22/2022] Open
Abstract
Objectives: to compare the quality of life and religious-spiritual coping of palliative cancer
care patients with a group of healthy participants; assess whether the perceived
quality of life is associated with the religious-spiritual coping strategies;
identify the clinical and sociodemographic variables related to quality of life
and religious-spiritual coping. Method: cross-sectional study involving 96 palliative outpatient care patient at a public
hospital in the interior of the state of São Paulo and 96 healthy volunteers,
using a sociodemographic questionnaire, the McGill Quality of Life Questionnaire
and the Brief Religious-Spiritual Coping scale. Results: 192 participants were interviewed who presented good quality of life and high use
of Religious-Spiritual Coping. Greater use of negative Religious-Spiritual Coping
was found in Group A, as well as lesser physical and psychological wellbeing and
quality of life. An association was observed between quality of life scores and
Religious-Spiritual Coping (p<0.01) in both groups. Male sex, Catholic religion
and the Brief Religious-Spiritual Coping score independently influenced the
quality of life scores (p<0.01). Conclusion: both groups presented high quality of life and Religious-Spiritual Coping scores.
Male participants who were active Catholics with higher Religious-Spiritual Coping
scores presented a better perceived quality of life, suggesting that this coping
strategy can be stimulated in palliative care patients.
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Affiliation(s)
| | - Silmara Meneguin
- PhD, Assistant Professor, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista Júlio de Mesquita Filho, Botucatu, SP, Brazil
| | - Maria de Lourdes da Silva Ferreira
- PhD, Assistant Professor, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista Júlio de Mesquita Filho, Botucatu, SP, Brazil
| | - Helio Amante Miot
- PhD, Adjunct Professor, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista Júlio de Mesquita Filho, Botucatu, SP, Brazil
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Hui D, Titus A, Curtis T, Ho-Nguyen VT, Frederickson D, Wray C, Granville T, Bruera E, McKee DK, Rieber A. Implementation of the Edmonton Symptom Assessment System for Symptom Distress Screening at a Community Cancer Center: A Pilot Program. Oncologist 2017; 22:995-1001. [PMID: 28476945 PMCID: PMC5553963 DOI: 10.1634/theoncologist.2016-0500] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 03/09/2017] [Indexed: 01/30/2023] Open
Abstract
A better understanding of how the Edmonton Symptom Assessment System (ESAS) can be used for distress screening may facilitate its use to improve patient care. In 2015, the General Medical Oncology Outpatient Clinic at Lyndon B. Johnson Hospital implemented a pilot project with ESAS for distress screening. The impact of ESAS screening on access to psychosocial care before and after program implementation is reported here. Background. Distress screening is mandated by the American College of Surgeons Commission on Cancer; however, there is limited literature on its impact in actual practice. We examined the impact of a pilot distress screening program on access to psychosocial care. Methods. Edmonton Symptom Assessment System (ESAS) screening was routinely conducted at our community‐based medical oncology program. Patients who screened positive for severe distress were sent to a social worker for triage and referred to the appropriate services if indicated. We compared the proportion of patients who had ESAS completed, the proportion of patients who screened positive, and the number of patients who had social work assessment and palliative care consultation over the preimplementation (September 2015), training (October/November 2015), and postimplementation (December 2015) periods. Results. A total of 379, 328, and 465 cancer patients were included in the preimplementation, training, and postimplementation periods, respectively. The proportion of patients who completed ESAS increased over time (83% vs. 91% vs. 96%). Among the patients who had completed ESAS, between 11% and 13% were positive for severe distress, which remained stable over the three periods. We observed a significant increase in social work referrals for psychosocial assessment (21% vs. 71% vs. 79%). There was also a trend towards an increased number of palliative care referrals (12% vs. 20% vs. 28%). Conclusion. Our community‐based cancer center implemented distress screening rapidly in a resource‐limited setting, with a notable increase in symptom documentation and psychosocial referral. Implications for Practice. The American College of Surgeons Commission on Cancer mandates distress screening; however, there is limited literature on how this process should be implemented and its impact on clinical practice. We used the Edmonton Symptom Assessment System for routine symptom distress screening in a community‐based medical oncology program that provides care for an underserved population. Comparing before and after program implementation, we found an increase in the number of documentations of symptom burden and an increase in psychosocial referrals. Findings from this study may inform the implementation of routine symptom distress screening in cancer patients.
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Affiliation(s)
- David Hui
- Department of Palliative Care, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
- Department of General Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | | | | | | | | | - Curtis Wray
- Department of Surgery, University of Texas Medical School at Houston, Houston, Texas, USA
| | | | - Eduardo Bruera
- Department of Palliative Care, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | | | - Alyssa Rieber
- Department of General Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Hui D, Bruera E. The Edmonton Symptom Assessment System 25 Years Later: Past, Present, and Future Developments. J Pain Symptom Manage 2017; 53:630-643. [PMID: 28042071 PMCID: PMC5337174 DOI: 10.1016/j.jpainsymman.2016.10.370] [Citation(s) in RCA: 447] [Impact Index Per Article: 63.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 10/04/2016] [Accepted: 10/12/2016] [Indexed: 12/16/2022]
Abstract
CONTEXT Routine symptom assessment represents the cornerstone of symptom management. Edmonton Symptom Assessment System (ESAS) is one of the first quantitative symptom assessment batteries that allows for simple and rapid documentation of multiple patient-reported symptoms at the same time. OBJECTIVES To discuss the historical development of ESAS, its current uses in different settings, and future developments. METHODS Narrative review. RESULTS Since its development in 1991, ESAS has been psychometrically validated and translated into over 20 languages. We will discuss the variations, advantages, and limitations with ESAS. From the clinical perspective, ESAS is now commonly used for symptom screening and longitudinal monitoring in patients seen by palliative care, oncology, nephrology, and other disciplines in both inpatient and outpatient settings. From the research perspective, ESAS has offered important insights into the nature of symptom trajectory, symptom clusters, and symptom modulators. Furthermore, multiple clinical studies have incorporated ESAS as a study outcome and documented the impact of various interventions on symptom burden. On the horizon, multiple groups are actively investigating further refinements to ESAS, such as incorporating it in electronic health records, using ESAS as a trigger for palliative care referral, and coupling ESAS with personalized symptom goals to optimize symptom response assessment. CONCLUSION ESAS has evolved over the past 25 years to become an important symptom assessment instrument in both clinical practice and research. Future efforts are needed to standardize this tool and explore its full potential to support symptom management.
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Affiliation(s)
- David Hui
- Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
| | - Eduardo Bruera
- Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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