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George PN, Ganesh MP. Exploring Holistic Cancer Care and Survivorship in India Through the Kerala Model of Palliative Care: Role of Community Nurse and Outpatient Meetings. J Hosp Palliat Nurs 2024; 26:E135-E141. [PMID: 38727212 DOI: 10.1097/njh.0000000000001036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
Support groups and meetings are self-help gatherings that provide a unique sense of community, unconditional acceptance, and information on cancer and its treatment. This cross-sectional study examined 12 outpatient meetings within the Kerala model of palliative care, a community-based service provided to patients irrespective of disease, stage, or prognosis starting from the time of diagnosis. The study focused on the pivotal role of community nurses in facilitating these meetings, with participants including cancer patients and survivors. Using in-depth interviews (n = 52) and participant observations, this research used a qualitative approach and explored the dynamics and outcomes of outpatient meetings. Findings highlight the indispensable contributions of these community nurses serving as linchpins in providing support, guiding discussions, and offering crucial education. Outpatient meetings effectively addressed psychosocial concerns, combatted stigmas associated with cancer, and promoted informed decision making in cancer care. The study emphasizes the need for recognizing the role played by community nurses in improving psychosocial support and diminishing stigma, and ultimately the quality of life of patients and survivors through the palliative cancer care within the Kerala model. We also underscore the need for policy initiatives, resource allocation, and training programs tailored to support these frontline health care providers effectively.
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Tuominen L, Ritmala M, Vahlberg T, Mäkelä S, Nikander P, Leino-Kilpi H. The effect of nurse-led empowering education on nutrition impact side effects in patients with colorectal cancer undergoing chemotherapy: A randomised trial. PATIENT EDUCATION AND COUNSELING 2023; 115:107895. [PMID: 37473602 DOI: 10.1016/j.pec.2023.107895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 06/26/2023] [Accepted: 07/11/2023] [Indexed: 07/22/2023]
Abstract
OBJECTIVE This study assessed the effect of empowering education on patient-reported outcomes and morbidity. METHODS A randomised controlled trial was conducted on adults with colorectal cancer (43 + 40). The intervention consisted of one-hour empowering patient education on nutrition impact side effects. The effect was compared with standard care. The difference between the groups was analysed pre and post intervention. RESULTS The change in malnutrition-related knowledge level was higher in the intervention group compared to control group (median 0.0, IQR 1.00 vs median 0.0, IQR 0.0, p = 0.028). Additional contacts with outpatient clinic were fewer in intervention group (median 0.00, IQR 0.00) compared to control group (median 1.00, IQR 2.00, p < 0.001). We did not find a statistically significant difference in the change in activation level, risk of malnutrition and quality of life between the groups. CONCLUSION Empowering education may affect positively on patients' knowledge level related to malnutrition and reduce the number of additional contacts with health care thus reduce health care costs. PRACTICE IMPLICATIONS Empowering education may be used in patients with colorectal cancer to improve knowledge and reduce additional contacts with health care. Further research is needed on the effect of empowering education in self-care.
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Affiliation(s)
- Leena Tuominen
- Department of Nursing Science, University of Turku, 20014, Finland; Comprehensive Cancer Center, Helsinki University Hospital, Haartmaninkatu 4, PL 180, 00029 Hus, Finland.
| | - Marita Ritmala
- Department of Nursing Science, University of Turku, 20014, Finland; Helsinki University Hospital, Haartmaninkatu 4, 00290 Helsinki, Finland
| | - Tero Vahlberg
- University of Turku, Kiinamyllynkatu 10, 20520 Turku, Finland
| | - Siru Mäkelä
- Comprehensive Cancer Center, Helsinki University Hospital, Haartmaninkatu 4, PL 180, 00029 Hus, Finland; University of Helsinki, Yliopistonkatu 4, 00100 Helsinki, Finland
| | - Pia Nikander
- Helsinki University Hospital, Haartmaninkatu 4, 00290 Helsinki, Finland
| | - Helena Leino-Kilpi
- Department of Nursing Science, University of Turku, 20014, Finland; Turku University Hospital, Kiinamyllynkatu 4-8, PL 52, 20521 Turku, Finland
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Zahid N, Martins RS, Dawood ZS, Zahid W, Azam I, Ikram M, Hassan A, Bhamani SS, Asad N, Jabbar AA, Akhtar S, Siddiqui MI, Awan MS, Ahmad K. Clinical and psychosocial factors associated with quality of life in patients with head and neck cancer: an analytical cross-sectional study from a lower-middle-income country. BMC Psychol 2023; 11:265. [PMID: 37670380 PMCID: PMC10478451 DOI: 10.1186/s40359-023-01264-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 07/26/2023] [Indexed: 09/07/2023] Open
Abstract
INTRODUCTION The disease course of head and neck (H&N) cancer can severely impair patients' quality of life (QoL). In Pakistan, a South Asian lower-middle-income country (LMIC), psychosocial factors may impact QoL. We aimed to assess QoL and associated factors amongst patients with H&N cancer in Pakistan. METHODS An analytical cross-sectional study was conducted amongst adult (≥ 18 years) patients with H&N cancer who were ≥ 4 weeks post-initiation of treatment. The survey assessed QoL (European Organization for Research and Treatment of Cancer Quality of Life Questionnaires), anxiety and depression (Hospital Anxiety and Depression Scale), and social support (Enriched Social Support Instrument). Multivariable linear regression was performed for analysis. RESULTS A total of 250 patients (mean age: 51.6 years) were included. The majority of patients were married (87%) and living with multigenerational/extended family households (53%). On multivariable linear regression, ongoing cancer treatment (beta coefficient: -13.93), having a tracheostomy (-10.02), and receiving adjuvant chemoradiotherapy (-8.17) were significantly associated with poorer global QoL. Additionally, poorer QoL was associated with depression (-24.37) and anxiety (-13.34). However, having more household family members was associated with better global QoL (0.34). CONCLUSION The QoL of patients with H&N cancer in Pakistan is affected by both the nature of cancer treatment as well as sociocultural factors such the number of household family members. Given that poorer QoL is associated with worse mental health outcomes, there is a need to develop and implement psychosocial interventions to improve the QoL of patients with H&N cancer in Pakistan, particularly during active treatment.
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Affiliation(s)
- Nida Zahid
- Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
| | - Russell Seth Martins
- Division of Thoracic Surgery, Department of Surgery, JFK University Medical Center, Hackensack Meridian Health, Edison, NJ, 08820, United States of America.
| | | | - Wajeeha Zahid
- Department of Community Health Sciences, Aga Khan University Hospital, Karachi, Pakistan
| | - Iqbal Azam
- Department of Community Health Sciences, Aga Khan University Hospital, Karachi, Pakistan
| | - Mubasher Ikram
- Department of Psychiatry, Aga Khan University Hospital, Karachi, Pakistan
| | - Aneesa Hassan
- Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
| | | | - Nargis Asad
- Department of Psychiatry, Aga Khan University Hospital, Karachi, Pakistan
| | | | - Shabbir Akhtar
- Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
| | | | | | - Khabir Ahmad
- Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
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Egeler MD, Boomstra E, Rohaan MW, Van den Heuvel NMJ, Fraterman I, Delfos M, van de Poll-Franse LV, Borch TH, Svane IM, Haanen JBAG, Retèl VP, Boekhout AH. "One more chance to survive": the experiences of patients with advanced melanoma and their partners with tumor-infiltrating lymphocyte therapy-a qualitative study and recommendations for future care. J Cancer Surviv 2023:10.1007/s11764-023-01452-8. [PMID: 37606816 DOI: 10.1007/s11764-023-01452-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 08/16/2023] [Indexed: 08/23/2023]
Abstract
PURPOSE Patients with advanced melanoma refractory to first-line treatment have a need for effective second-line treatment options. A recent phase 3 trial showed promising results for adoptive cell therapy with tumor-infiltrating lymphocytes (TILs) as second-line therapy in patients with advanced melanoma. However, it remains unknown how patients and their partners experience TIL therapy, which is key to evaluate and improve the quality of care. METHODS Semi-structured interviews about the experience of TIL therapy were conducted with patients with advanced melanoma and their partners 2-4 weeks post-treatment (short term) and >6 months after treatment (long term). RESULTS In total, 25 interviews were conducted with advanced melanoma patients treated with TIL (n=13) and their partners (n=12), with the majority being short-term interviews (n=17). Overall, patients and partners experienced TIL therapy as intense (uncertainty of successful TIL culture, multiple treatment-related toxicities, and extensive hospitalization). Patients and partners with young children or other caregiving responsibilities encountered the most challenges during TIL therapy. All patients, however, reported a recovery of all treatment-related toxicities within 2-4 weeks (except fatigue). CONCLUSION Clinical data justify the role of TIL therapy in the treatment of advanced melanoma. With the distinct nature of TIL therapy compared to the current standard of care, we have provided patient-centered recommendations that will further enhance the quality of TIL therapy. IMPLICATIONS FOR CANCER SURVIVORS As more patients with advanced melanoma are expected to receive TIL therapy in the future, our findings could be incorporated into survivorship care plans for this novel group of advanced melanoma survivors treated with TIL.
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Affiliation(s)
- M D Egeler
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
| | - E Boomstra
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - M W Rohaan
- Division of Medical Oncology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - N M J Van den Heuvel
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - I Fraterman
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - M Delfos
- Division of Medical Oncology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - L V van de Poll-Franse
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
- Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
- Department of Medical and Clinical Psychology, Center of Research on Psychology in Somatic Diseases (CoRPS), Tilburg University, Tilburg, The Netherlands
| | - T H Borch
- National Center for Cancer Immune Therapy, Department of Oncology, Copenhagen University Hospital, Herlev, Denmark
| | - I M Svane
- National Center for Cancer Immune Therapy, Department of Oncology, Copenhagen University Hospital, Herlev, Denmark
| | - J B A G Haanen
- Division of Medical Oncology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
- Division of Molecular Oncology and Immunology, Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of Clinical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - V P Retèl
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - A H Boekhout
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
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de Santis RB, Wainstein AJA, Machado GCOG, Santos FAV, Melo MRP, Drummond‐Lage AP. Cancer patients admitted in the emergency department: A single‐centre observational study. Eur J Cancer Care (Engl) 2022; 31:e13758. [DOI: 10.1111/ecc.13758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 10/03/2022] [Accepted: 10/09/2022] [Indexed: 12/24/2022]
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Nutrition and physical activity in cancer patients: a survey on their information sources. J Cancer Res Clin Oncol 2022:10.1007/s00432-022-04282-w. [PMID: 35994117 DOI: 10.1007/s00432-022-04282-w] [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: 07/25/2022] [Accepted: 08/11/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND Many cancer patients suffer from problems concerning nutrition and physical activity (PA) during and after their treatment. Forwarding reliable health information could help to alleviate severe symptoms. The present study aimed to examine cancer patients' commonly used information sources on nutrition and PA. METHODS An anonymous questionnaire was developed and distributed to German cancer patients in different settings. In total, 90 questionnaires have been completed between October 2021 and March 2022. For analysis, descriptive statistics were used and associations between information sources and patients' lifestyle behaviour explored utilising Spearman's Rho, Mann-Whitney U, and Pearson's Chi Square tests. RESULTS The cancer patients received information on nutrition and PA most frequently from physicians (70.9%), family and friends (68%) and browsing the internet (61.3%). Half of the patients (51.1%) had questions concerning these topics during the time of their disease. The majority of those patients (81.8%) reported that their questions were answered. The topics were addressed primarily with outpatient oncologists (60.0%) and in rehabilitation clinics (53.3%). Just about half of the patients (55.3%) felt satisfactorily informed on nutrition and PA in their cancer disease, more so if they talked to their oncologist or family physician (Z = - 2.450, p = 0.014 and Z = - 3.425, p = 0.001 resp.). CONCLUSION Cancer patients receive information on nutrition and PA predominantly after their initial treatment. Since they might be missing significant information to alleviate severe symptoms during their treatment, the importance of nutrition and PA should be emphasised by clinicians early on in treatment. TRIAL REGISTRATION Trial Registration Number (May 7, 2021): 2021-2149-Bef.
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Ruiz-Rodríguez I, Hombrados-Mendieta I, Melguizo-Garín A, Martos-Méndez MJ. The Importance of Social Support, Optimism and Resilience on the Quality of Life of Cancer Patients. Front Psychol 2022; 13:833176. [PMID: 35356348 PMCID: PMC8959607 DOI: 10.3389/fpsyg.2022.833176] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 02/03/2022] [Indexed: 01/09/2023] Open
Abstract
Introduction The aim of the present study is to carry out a multidimensional analysis on the relation between satisfaction with social support received, resilience and optimism in cancer patients and their quality of life. Materials and Methods Data were gathered through questionnaires fulfilled by 142 cancer patients. Data relate to sociodemographic, health, quality of life, social support, resilience and optimism. Results Satisfaction with the sources and types of support, resilience and optimism relates positively with quality of life. Predictive models show that informational support from friends is the variable that most increases patients' general health, while emotional support from the partner is the one that best improves how patients cope with the disease. In the same line, emotional support from the partner, together with informational support from family are the ones that most contribute to reduce patients' symptoms. Resilience improves general health and functioning, and reduces symptoms. Patients' optimism and resilience also reduce symptoms. Gender differences were found, with females showing lower quality of life than males, mainly in how they cope with cancer. Patients in the stage of treatment showed lower quality of life and higher symptoms. Such increase was observed in patients who received hormonotherapy or chemotherapy. Discussion Important practical implications can be drawn from results, which could help improve cancer patients' quality of life through intervention strategies aimed at increasing their resilience, optimism and the social support provided by their closer sources.
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Affiliation(s)
- Iván Ruiz-Rodríguez
- Department of Social Psychology, Faculty of Psychology, University of Málaga, Málaga, Spain
| | | | - Anabel Melguizo-Garín
- Department of Social Psychology, Faculty of Psychology, University of Málaga, Málaga, Spain
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Katsaros D, Hawthorne J, Patel J, Pothier K, Aungst T, Franzese C. Optimizing Social Support in Oncology with Digital Platforms (Preprint). JMIR Cancer 2022; 8:e36258. [PMID: 35749161 PMCID: PMC9270705 DOI: 10.2196/36258] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 05/26/2022] [Accepted: 05/31/2022] [Indexed: 11/28/2022] Open
Abstract
Increased cancer prevalence and survival rates coupled with earlier patient discharges from hospitals have created a greater need for social support. Cancer care is both short term and long term, requiring acute treatments, treatments for remission, and long-term screenings and treatment regimens. Health care systems are already overwhelmed and often struggle to provide social support systems for everyone. Caregivers are limited in number, and even when they are available, they often lack necessary information, skills, or resources to meet the needs of patients with cancer. The act of caregiving presents various challenges, and caregivers themselves often need social support as well. Despite these needs, most social support programs are targeted toward patients alone. Given the prevalence of cancer and known needs of these patients and their caregivers, the ability to identify those who need social support is crucial. Further, the scalability and overall availability of social support programs is vital for successful patient care. This paper establishes the benefits of social support for both patients and caregivers coping with cancer treatments, explores innovative ways of identifying patients who may need social support using digital tools, and reviews potential advantages of digital social support programs.
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Affiliation(s)
- Dimos Katsaros
- Matchstick LLC, Boonton, NJ, United States
- College of Pharmacy, University of Rhode Island, Kingston, RI, United States
| | - James Hawthorne
- Matchstick LLC, Boonton, NJ, United States
- College of Pharmacy, University of Rhode Island, Kingston, RI, United States
| | - Jay Patel
- College of Pharmacy, University of Rhode Island, Kingston, RI, United States
| | - Kaitlin Pothier
- College of Pharmacy, University of Rhode Island, Kingston, RI, United States
| | - Timothy Aungst
- Massachusetts College of Pharmacy and Health Sciences, Worcester, MA, United States
| | - Chris Franzese
- Matchstick LLC, Boonton, NJ, United States
- College of Pharmacy, University of Rhode Island, Kingston, RI, United States
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Roy DC, Lun R, Wang TF, Chen Y, Wells P. Life dissatisfaction in Canadians aged 40 and above with cancer and mental health disorders: A cross-sectional study using the Canadian Community Health Survey. Cancer Med 2021; 10:7601-7609. [PMID: 34582119 PMCID: PMC8559453 DOI: 10.1002/cam4.4287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 09/01/2021] [Accepted: 09/02/2021] [Indexed: 12/02/2022] Open
Abstract
Background Life dissatisfaction varies with different factors––particularly in the presence of chronic conditions, such as cancer. The combination of cancer and mental health disorders may increase life dissatisfaction due to lowered resilience against stress. We sought to determine if life dissatisfaction is higher in Canadians aged 40 and above with cancer compared to the cancer‐free population and if there is a synergistic effect between cancer and mental health disorder on life dissatisfaction. Methods We conducted a cross‐sectional study using the 2015–2016 Canadian Community Health Survey. We included 67,294 subjects aged 40+, and evaluated the association between cancer, mental health disorders, and life dissatisfaction using logistic regression and odds ratios (ORs) while adjusting for age, sex, marital status, education level, and chronic conditions. Relative excess risk due to interaction (RERI), attributional proportion due to interaction (AP), and Synergy index (S‐index), were calculated to determine the significance of additive interaction. Results Compared to the cancer‐free population, life dissatisfaction was higher in patients with cancer (OR 2.44, 95% CI: 1.88–3.16) and mental health disorders (OR 5.17, 95% CI: 4.56–5.85). The adjusted ORs for life dissatisfaction were 2.45 (95% CI: 1.74–3.43) and 5.17 (95% CI: 4.55–5.87) for cancer and mental health disorders, respectively, but when both conditions were present, the OR increased to 12.50 (95% CI: 8.40–18.62). The results suggested a synergistic interaction (RERI: 5.89 [95% CI: 0.91–10.87]; AP: 0.47 [95% CI: 0.25–0.69]; and S‐index: 2.05 [95% CI: 1.30–3.23]). Conclusion This study showed higher life dissatisfaction in cancer and mental health disorder patients. A synergistic effect was detected between cancer and mental health disorder on life dissatisfaction. These results suggest cancer patients with mental health disorders require additional support and psychological resources to improve their quality of life.
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Affiliation(s)
- Danielle Carole Roy
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Ronda Lun
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.,Department of Medicine, University of Ottawa, and The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Tzu-Fei Wang
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.,Department of Medicine, University of Ottawa, and The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Yue Chen
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Philip Wells
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.,Department of Medicine, University of Ottawa, and The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
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