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Maras AF, Penedo FJ, Ramirez AG, Worch SM, Ortiz MS, Yanez B, Munoz E, Lad T, Hollowell C, Medina HN, Moreno PI. Cardiometabolic comorbidities in Hispanic/Latino cancer survivors: prevalence and impact on health-related quality of life and supportive care needs. Support Care Cancer 2023; 31:711. [PMID: 37982906 DOI: 10.1007/s00520-023-08181-9] [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: 03/28/2023] [Accepted: 11/10/2023] [Indexed: 11/21/2023]
Abstract
PURPOSE The aim of this study was to characterize the prevalence of cardiometabolic comorbidities (i.e., diabetes, peripheral vascular disease, myocardial infarction, congestive heart failure, cerebrovascular disease) among Hispanic/Latino cancer survivors and examine the impact of cardiometabolic comorbidities on health-related quality of life (HRQoL), unmet supportive care needs, patient-provider communication self-efficacy, satisfaction with cancer care, and increases in healthy behaviors. METHODS Hispanics/Latinos diagnosed with breast, prostate, or colorectal cancer (N = 288) were assessed within 15 months of primary treatment completion. RESULTS One-quarter (24.7%) of survivors were diagnosed with diabetes and one-fifth (20.8%) were diagnosed with peripheral vascular disease. Survivors with at least one cardiometabolic comoribidity were older (t(278) = -.3.622, p < .001) and more likely to have a household income of less than $25,000 (X2 = 8.369, p = .004). When adjusting for sociodemographic and medical covariates, survivors with cardiometabolic comorbidities demonstrated worse overall HRQoL (B = -4.792, p = .050), emotional (B = -1.479, p = .018) and physical (B = -2.228, p = .005) wellbeing, a higher odds of unmet psychological (OR = 2.095, p = .027) and sexuality (OR = 2.898, p = .004) needs, and greater patient-provider communication self-efficacy (B = .179, p = .045). There were no differences in healthy behavior changes or satisfaction with cancer care. CONCLUSIONS Cardiometabolic comorbidities may be highly prevalent among Hispanic/Latino cancer survivors and increase the risk of worse HRQoL and unmet supportive care needs. Targeted interventions are needed to optimize health among Hispanic/Latino cancer survivors with cardiometabolic comorbidities.
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Affiliation(s)
- Ashley F Maras
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Frank J Penedo
- Department of Psychology, University of Miami, Miami, FL, USA
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
- Sylvester Comprehensive Cancer Center, Cancer Control Research Program, University of Miami, Miami, FL, USA
| | - Amelie G Ramirez
- Institute for Health Promotion Research, UT Health San Antonio, San Antonio, TX, USA
- Department of Population Health Sciences, UT Health San Antonio Long School of Medicine, San Antonio, TX, USA
| | - Sarah M Worch
- Department of Psychology, University of Miami, Miami, FL, USA
| | - Manuel S Ortiz
- Department of Psychology, Universidad de La Frontera, Temuco, Chile
| | - Betina Yanez
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Edgar Munoz
- Institute for Health Promotion Research, UT Health San Antonio, San Antonio, TX, USA
| | - Thomas Lad
- Division of Hematology/Oncology, Cook County Health, Chicago, IL, USA
| | | | - Heidy N Medina
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Patricia I Moreno
- Sylvester Comprehensive Cancer Center, Cancer Control Research Program, University of Miami, Miami, FL, USA.
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.
- University of Miami Don Soffer Clinical Research Center, 1120 NW 14Th Street, Miami, FL, 33136, USA.
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Yoon J, Lee H, Son H. Effects of an interactive coaching intervention on quality of life and psychological factors for colorectal cancer survivors: A single group pre and posttest design. Eur J Oncol Nurs 2023; 66:102413. [PMID: 37776600 DOI: 10.1016/j.ejon.2023.102413] [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: 05/23/2023] [Revised: 07/25/2023] [Accepted: 09/07/2023] [Indexed: 10/02/2023]
Abstract
OBJECTIVE To develop and evaluate the effects of an interactive coaching intervention, using a self-management mobile application, on quality of life and physical and psychological factors for colorectal cancer survivors. METHODS We developed a self-management mobile application providing social support services for post-treatment CRC survivors and evaluated its effects through baseline and post-intervention surveys. Using the biopsychosocial holistic model as the theoretical framework, automated interactive coaching technology was applied for six weeks to provide supportive services tailored for each user. To evaluate the effects of the application, self-efficacy, health practice index, depression, fear of cancer recurrence, and quality of life measures were administered to participants. A total of 34 men and 5 women were included in the analysis. RESULTS Participants' mean age were 54.10 years and 78% of them had been diagnosed within the last five years. There were significant increases in self-efficacy (z = 2.09, p = .04), health practice index (t = 2.35, p = .02), and quality of life (t = 2.03, p = .05). More specifically, the emotional functional score increased (z = 2.23, p = .03) while both of the total symptom score (t = 2.10, p = .04) and the fatigue symptom score (z = 2.54, p = .01) decreased after six weeks of using the mobile application. CONCLUSIONS Interventions supporting colorectal cancer survivors' self-management are critical for addressing the challenges they face after treatment and improving their quality of life. Providing social support through mobile applications could be a good strategy in terms of usability and effectiveness.
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Affiliation(s)
- Jaehee Yoon
- Wolchon Elementary School, 132, Mokdongjungang-ro, Yangcheon-gu, Seoul, 07989, South Korea.
| | - HyunHae Lee
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, 06974, South Korea
| | - Heesook Son
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, 06974, South Korea.
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3
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Welch WA, Solk P, Auster-Gussman L, Whitaker M, Siddique J, Fanning J, Mishory A, Khan S, Santa-Maria C, Kulkarni S, Phillips SM. Longitudinal Sedentary Time and Symptoms in Breast Cancer Patients during Chemotherapy Using Ecological Momentary Assessment. Med Sci Sports Exerc 2023; 55:966-974. [PMID: 36574735 PMCID: PMC10106380 DOI: 10.1249/mss.0000000000003115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
PURPOSE To examine the relationship between daily fluctuations in symptoms and sedentary behavior (SB) during chemotherapy (CT) for breast cancer. METHODS Breast cancer patients ( N = 68, M age = 48.5 ± 10.4 yr) undergoing CT wore an activity monitor on their hip to assess daily SB and completed prompts assessing symptoms (affect, anxiety, depression, fatigue, pain, and physical and cognitive functioning) for 10 consecutive days (3 d pre-CT, day of, and 6 d post-CT) at the beginning, middle and end cycles of CT. Mixed models assessed the bidirectional between-person (BP) and within-person (WP) associations of current day symptoms with minutes of SB measured on 1) the same day and 2) the next day, controlling for relevant covariates. RESULTS Within person same-day results revealed a significant association between affect, anxiety, fatigue, physical functioning, pain, and cognitive functioning and same-day SB. Worse than average symptom ratings on a given day were associated with more SB that day. There was a significant WP relationship between previous-day anxiety, depression, and physical function and next-day SB (i.e., worse than average symptom ratings the previous day were associated with more SB the next day). Within person same-day results revealed a significant association between same-day SB and affect, anxiety, fatigue, pain, physical functioning, and cognitive functioning. The WP relationships were significant for previous-day SB and next-day affect and pain (i.e., higher than average SB associated with lower ratings). Relationships persisted when controlling for moderate-to-vigorous physical activity. There were no significant BP results. CONCLUSIONS Higher symptom ratings were associated with increased SB and higher SB was associated with worse symptoms. Future work should identify SB reduction intervention approaches tailoring to daily symptom burden during CT for breast cancer.
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Affiliation(s)
- Whitney A. Welch
- Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Payton Solk
- Northwestern University Feinberg School of Medicine, Chicago, IL
| | | | - Madelyn Whitaker
- Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Juned Siddique
- Northwestern University Feinberg School of Medicine, Chicago, IL
| | | | - Abby Mishory
- Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Seema Khan
- Northwestern University Feinberg School of Medicine, Chicago, IL
| | | | - Swati Kulkarni
- Northwestern University Feinberg School of Medicine, Chicago, IL
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4
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Joseph R, Hart NH, Bradford N, Wallen MP, Han CY, Pinkham EP, Hanley B, Lock G, Wyld D, Wishart L, Koczwara B, Chan A, Agbejule OA, Crichton M, Teleni L, Holland JJ, Edmiston K, Naumann L, Brown T, Chan RJ. Essential elements of optimal dietary and exercise referral practices for cancer survivors: expert consensus for medical and nursing health professionals. Support Care Cancer 2023; 31:46. [DOI: 10.1007/s00520-022-07509-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 11/04/2022] [Indexed: 12/23/2022]
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5
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The development and validation of scales to measure the presence of a teachable moment following a cardiovascular disease event. Prev Med Rep 2022; 28:101876. [PMID: 35801000 PMCID: PMC9254119 DOI: 10.1016/j.pmedr.2022.101876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 06/07/2022] [Accepted: 06/24/2022] [Indexed: 11/22/2022] Open
Abstract
Investigating cardiac events as teachable moments is a promising venture. Validated measures to conduct research on teachable moments are lacking. We developed scales that demonstrate validity and reliability. The scales could be employed in research on teachable moments and behavior change. Clinicians could use the scales to foster conversation around lifestyle.
Better conceptually-driven research is necessary to learn more about 1) the characteristics of life events as teachable moments (TMs) and 2) the potential of life events to evoke lifestyle change intention (LCI). This study aimed to develop and validate two scales for the purposes of TM research in the context of cardiovascular disease (CVD): the CardiacTM and CardiacLCI-scales. After the initial development of items based on a theoretical framework and literature search, six experts rated the content validity of both scales as sufficient. The item list was further adjusted after think-aloud sessions with two CVD patients. The resulting scales were presented online in a cross-sectional survey, which yielded 625 responses of Dutch CVD patients (June 2020). To test construct validity, we conducted Exploratory Factor Analysis (EFA) with Varimax rotation on a random split-half of the sample (n = 300) and evaluated the factor structure with Confirmatory Factor Analysis (CFA) on the holdout sample (n = 325). EFA and CFA on the CardiacTM-scale (α = 0.88) revealed a 28-item six-factor structure explaining 61.0% of the variance, with adequate goodness-of-fit statistics (CFI = 0.87; TLI = 0.85; SRMR = 0.07) and internally reliable factors (Affective impact, Risk CVD, Changed self-concept, CVD group identity, Risk non-communicable disease, Anticipated regret). The CardiacLCI-scale (α = 0.81) revealed an 11-item two-factor structure explaining 51.5% of the variance, with adequate model fit (CFI = 0.92; TLI = 0.90; SRMR = 0.08) and internally reliable factors (Event-related lifestyle change and General healthy lifestyle). The scales may be used to expand knowledge around life events as TMs and to support conversation regarding lifestyle after cardiac and other life events.
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6
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Ezenwankwo EF, Nnate DA, Usoro GD, Onyeso CP, Anieto IB, Ibeneme SC, Albertus Y, Lambert VE, Ezeukwu AO, Abaraogu UO, Shamley D. A scoping review examining the integration of exercise services in clinical oncology settings. BMC Health Serv Res 2022; 22:236. [PMID: 35189864 PMCID: PMC8859567 DOI: 10.1186/s12913-022-07598-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 02/04/2022] [Indexed: 12/11/2022] Open
Abstract
Background Addressing questions surrounding the feasibility of embedding exercise service units in clinical oncology settings is imperative for developing a sustainable exercise-oncology clinical pathway. We examined available literature and offered practical recommendations to support evidence-based practice, policymaking, and further investigations. Methods Four thousand eight hundred sixty-three unique records identified in Embase, CINAHL, MEDLINE, Web of Science Core Collection, and ProQuest (Health and Medicine) were screened for studies that recruited cancer patients, assessed the co-location of exercise service and cancer treatment units, and reported findings on service implementation. Evidence from six studies providing data from over 30 programs was integrated using narrative synthesis. Results Service implementation was relatively modest across the included studies. Exercise services were delivered by physiotherapists, exercise physiologists, and kinesiologists and funded mainly through grants and private donations, with staff salaries accruing as the major expense. Service penetration, adoption, and acceptability were generally low. However, studies recorded high clinician/patient satisfaction. Major barriers to service integration were limited funding, lack of detailed implementation plan, and low organizational buy-in. Common reasons for non-utilization, missed sessions, and dropouts were lack of interest, unwellness, hospital readmission, disease progression, and adverse skeletal events. Conclusion Implementing exercise services in clinical oncology settings seems an effective approach for increasing access to exercise-based rehabilitation for individuals on cancer treatment. While this model appears feasible for patients/clinicians, efforts are required to optimize service integration both in the short and long term. Key priorities include seeking [local] actions to address issues relating to funding and organizational buy-in. Important considerations may include developing an implementation plan to guide the implementation process, expanding the patient core management team to include staff from the exercise rehabilitation unit, and exploring the role of patient feedback in increasing clinician participation (e.g., treating oncologists and nurses) in the referral process. Future research should consider effective strategies to promote patients’ sense of self-efficacy and behavioral control and, further, the place of audit and feedback in improving exercise service delivery and overall service implementation. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07598-y.
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Affiliation(s)
- Elochukwu F Ezenwankwo
- Centre for Health Through Physical Activity, Lifestyle and Sports (HPALS), Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa. .,Cancer Research Initiative, Faculty of Health Sciences, University of Cape Town, Anzio Road, ObservatoryCape Town, 7925, South Africa.
| | - Daniel A Nnate
- Department of Nursing and Community Health, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK.,Countess of Chester Hospital NHS Foundation Trust, Health Park, Liverpool Road, Chester, CH2 1UL, UK
| | - Godspower D Usoro
- Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria
| | - Chimdimma P Onyeso
- Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria
| | - Ijeoma B Anieto
- Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria
| | - Sam C Ibeneme
- Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria.,Department of Physiotherapy, Faculty of Health Sciences, School of Therapeuitc Studies, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, 2193, South Africa.,Department of Physiotherapy, Faculty of Health Sciences and Technology, King David University of Medical Sciences, Ebonyi State, Uburu, Nigeria
| | - Yumna Albertus
- Centre for Health Through Physical Activity, Lifestyle and Sports (HPALS), Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Victoria E Lambert
- Centre for Health Through Physical Activity, Lifestyle and Sports (HPALS), Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Antoninus O Ezeukwu
- Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria
| | - Ukachukwu O Abaraogu
- Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria.,Department of Physiotherapy and Paramedicine, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Delva Shamley
- Centre for Health Through Physical Activity, Lifestyle and Sports (HPALS), Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.,Clinical Research Centre, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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van Eckert S, Seidel N, Stölzel F, Wolff M, Glausch M, Spallek J. „Aktiv leben mit Krebs – Tipps für einen
gesunden Lebensstil“ – Bedarfserfassung und Entwicklung einer
multimedialen Patienteninformation. DAS GESUNDHEITSWESEN 2022; 85:227-233. [PMID: 35073593 DOI: 10.1055/a-1709-0939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
ZusammenfassungDie positive Wirkung eines gesunden Lebensstils auf die ganzheitliche Verfassung
und Lebensqualität für Krebspatient*innen (Cancer
Survivors) ist wissenschaftlich belegt. Gemäß den National
Comprehensive Cancer Network (NCCN) Guidelines for Survivorship ist
Unterstützung in diesem Bereich ausdrücklich gefordert. Bei
hohem Unterstützungsbedarf für die Entwicklung und Umsetzung
eines gesunden Lebensstils gibt es jedoch, vor allem in ländlichen
Regionen, einen Mangel an spezialisierten Angeboten für
Krebspatient*innen. Nach Erfassung der Bedürfnisse war es unser
Ziel, eine leicht zugängliche, multimediale Patienteninformation auf der
Basis des sozial-kognitiven Prozessmodells des Gesundheitsverhaltens (Health
Action Process Approach – HAPA), zu konzipieren. Die Anhebung der
Gesundheitskompetenz steht u. a. als Basis für informierte
Entscheidungen, und ist damit eine wichtige Ressource für die
Krebsnachsorge. Weiterführende Erhebungen zur Akzeptanz, Nutzung und
Auswirkung der Patienteninformation hinsichtlich einer angestrebten,
längerfristigen Änderung des Gesundheitsverhaltens sind
empfohlen.
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Affiliation(s)
- Sandra van Eckert
- Gesundheitswissenschaften, Brandenburgische Technische
Universität Cottbus-Senftenberg Fakultät 4 Soziale Arbeit
Gesundheit und Musik, Senftenberg, Germany
| | - Nadja Seidel
- Nationales Centrum für Tumorerkrankungen Dresden
(NCT/UCC), Präventionszentrum, Universitätsklinikum Carl
Gustav Carus, Dresden, Germany
| | - Friederike Stölzel
- Nationales Centrum für Tumorerkrankungen Dresden
(NCT/UCC), Präventionszentrum, Universitätsklinikum Carl
Gustav Carus, Dresden, Germany
| | - Michaela Wolff
- Nationales Centrum für Tumorerkrankungen Dresden
(NCT/UCC), Präventionszentrum, Universitätsklinikum Carl
Gustav Carus, Dresden, Germany
| | - Melanie Glausch
- Nationales Centrum für Tumorerkrankungen Dresden
(NCT/UCC), Präventionszentrum, Universitätsklinikum Carl
Gustav Carus, Dresden, Germany
| | - Jacob Spallek
- Gesundheitswissenschaften, Brandenburgische Technische
Universität Cottbus-Senftenberg Fakultät 4 Soziale Arbeit
Gesundheit und Musik, Senftenberg, Germany
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Randomised controlled trial of intermittent vs continuous energy restriction during chemotherapy for early breast cancer. Br J Cancer 2021; 126:1157-1167. [PMID: 34912072 PMCID: PMC9023522 DOI: 10.1038/s41416-021-01650-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 10/18/2021] [Accepted: 11/22/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Excess adiposity at diagnosis and weight gain during chemotherapy is associated with tumour recurrence and chemotherapy toxicity. We assessed the efficacy of intermittent energy restriction (IER) vs continuous energy restriction (CER) for weight control and toxicity reduction during chemotherapy. METHODS One hundred and seventy-two women were randomised to follow IER or CER throughout adjuvant/neoadjuvant chemotherapy. Primary endpoints were weight and body fat change. Secondary endpoints included chemotherapy toxicity, cardiovascular risk markers, and correlative markers of metabolism, inflammation and oxidative stress. RESULTS Primary analyses showed non-significant reductions in weight (-1.1 (-2.4 to +0.2) kg, p = 0.11) and body fat (-1.0 (-2.1 to +0.1) kg, p = 0.086) in IER compared with CER. Predefined secondary analyses adjusted for body water showed significantly greater reductions in weight (-1.4 (-2.5 to -0.2) kg, p = 0.024) and body fat (-1.1 (-2.1 to -0.2) kg, p = 0.046) in IER compared with CER. Incidence of grade 3/4 toxicities were comparable overall (IER 31.0 vs CER 36.5%, p = 0.45) with a trend to fewer grade 3/4 toxicities with IER (18%) vs CER (31%) during cycles 4-6 of primarily taxane therapy (p = 0.063). CONCLUSIONS IER is feasible during chemotherapy. The potential efficacy for weight control and reducing toxicity needs to be tested in future larger trials. CLINICAL TRIAL REGISTRATION ISRCTN04156504.
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Huybrechts I, Kliemann N, Perol O, Cattey-Javouhey A, Benech N, Maire A, Lignini T, Carretier J, Saurin JC, Fervers B, Gunter MJ. Feasibility Study to Assess the Impact of a Lifestyle Intervention during Colorectal Cancer Screening in France. Nutrients 2021; 13:3685. [PMID: 34835941 PMCID: PMC8621980 DOI: 10.3390/nu13113685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 10/15/2021] [Accepted: 10/16/2021] [Indexed: 11/21/2022] Open
Abstract
Current evidence suggests that 30-50% of cancers are attributable to established lifestyle risk factors. Cancer-screening has been identified as an opportunity for delivering advice on lifestyle behaviour change for cancer prevention. This study aimed to evaluate the feasibility and acceptance of promoting advice on the latest evidence-based lifestyle recommendations for cancer prevention at the time of colorectal cancer screening at two hospitals in Lyon, France. This feasibility study included 49 patients (20 men and 29 women) who were invited for colonoscopy. Patients received a leaflet with lifestyle recommendations for cancer prevention, accompanied with a logbook to plan and monitor their behavioural changes. Feedback from patients, hospital staff, and researchers was received via evaluation questionnaires (n = 26) completed after testing the educational material for at least two weeks and via two focus group discussions (n = 7 and n = 9 respectively) organized at the end of the study. All interviewed patients were interested in lowering their cancer risk, and the majority felt ready to change their lifestyle (88%), although most did not know how to decrease their risk of cancer (61%). All patients found the educational material easy to understand and sufficiently attractive and 50% of the patients reported having achieved at least one of the healthy behaviours recommended within the two weeks following the intervention. All hospital staff and almost all patients (92%) involved found that the screening program and the visits planned for colonoscopy was an appropriate moment to provide them with the educational material. This feasibility study has shown that the content, paper-based format, and time of delivery of the intervention were adequate. Health professionals seem to be willing to provide lifestyle recommendations, and patients appear interested in receiving advice for lowering their cancer risk during screening visits.
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Affiliation(s)
- Inge Huybrechts
- International Agency for Research on Cancer, CEDEX 08, 69372 Lyon, France; (N.K.); (T.L.); (M.J.G.)
| | - Nathalie Kliemann
- International Agency for Research on Cancer, CEDEX 08, 69372 Lyon, France; (N.K.); (T.L.); (M.J.G.)
| | - Olivia Perol
- Centre Léon Bérard, 69008 Lyon, France; (O.P.); (A.C.-J.); (A.M.); (J.C.); (B.F.)
| | - Anne Cattey-Javouhey
- Centre Léon Bérard, 69008 Lyon, France; (O.P.); (A.C.-J.); (A.M.); (J.C.); (B.F.)
| | - Nicolas Benech
- Service d’Hépato-Gastroentérologie, Hôpital Edouard Herriot, Hospices Civils de Lyon, 69003 Lyon, France; (N.B.); (J.-C.S.)
| | - Aurelia Maire
- Centre Léon Bérard, 69008 Lyon, France; (O.P.); (A.C.-J.); (A.M.); (J.C.); (B.F.)
| | - Tracy Lignini
- International Agency for Research on Cancer, CEDEX 08, 69372 Lyon, France; (N.K.); (T.L.); (M.J.G.)
| | - Julien Carretier
- Centre Léon Bérard, 69008 Lyon, France; (O.P.); (A.C.-J.); (A.M.); (J.C.); (B.F.)
| | - Jean-Christophe Saurin
- Service d’Hépato-Gastroentérologie, Hôpital Edouard Herriot, Hospices Civils de Lyon, 69003 Lyon, France; (N.B.); (J.-C.S.)
| | - Beatrice Fervers
- Centre Léon Bérard, 69008 Lyon, France; (O.P.); (A.C.-J.); (A.M.); (J.C.); (B.F.)
| | - Marc J. Gunter
- International Agency for Research on Cancer, CEDEX 08, 69372 Lyon, France; (N.K.); (T.L.); (M.J.G.)
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10
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Puleo GE, Borger T, Bowling WR, Burris JL. The State of the Science on Cancer Diagnosis as a "Teachable Moment" for Smoking Cessation: A Scoping Review. Nicotine Tob Res 2021; 24:160-168. [PMID: 34212198 DOI: 10.1093/ntr/ntab139] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 06/30/2021] [Indexed: 12/28/2022]
Abstract
Theoretically, cancer diagnosis has potential to spur health behavior changes in physical activity, diet, substance use, medication adherence and the like. The Teachable Moment heuristic is a parsimonious, transtheoretical framework for understanding the conditions under which behavior change might occur, with constructs that include affective, cognitive, and social factors. Application of the Teachable Moment to smoking cessation after cancer diagnosis might aid selection of predictors in observational studies and inform how to optimally design interventions to promote quit attempts and sustain abstinence, as many smoking cessation interventions for cancer survivors do not yield positive outcomes. This scoping review of 47 studies that span nearly 20 years of literature examines measurement of the Teachable Moment constructs and what empirical support they have in explaining cancer survivors' smoking behavior. From this review, it appears the construct of affective response is more widely explored than risk perceptions, social role, and self-concept. Strong, negative affective responses (e.g., anxiety, general distress) may be a powerful contributor to continued smoking after cancer diagnosis. Risk perceptions may also play a role in smoking behavior, such that never and former smokers espouse stronger perceptions of smoking-related risks than current smokers. Finally, due to a paucity of studies, the role of cancer survivors' self-concept (e.g., identity as a "cancer survivor") and changes in their social role (e.g., employee, athlete) are unclear contributors to their smoking behavior. In summary, the Teachable Moment holds promise in its application to smoking cessation after cancer diagnosis, though more direct research is needed.
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Affiliation(s)
| | - Tia Borger
- Department of Psychology, University of Kentucky
| | | | - Jessica L Burris
- Department of Psychology, University of Kentucky.,Markey Cancer Center, University of Kentucky
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11
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Hashem F, Stephensen D, Bates A, Pellatt-Higgins T, Hobbs RNP, Hopkins M, Woodward H, Stavropoulou C, Swaine IL, Ali H. Acceptability and Feasibility of an Isometric Resistance Exercise Program for Abdominal Cancer Surgery: An Embedded Qualitative Study. Cancer Control 2020; 27:1073274820950855. [PMID: 33035075 PMCID: PMC7791474 DOI: 10.1177/1073274820950855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Although it is recognized in the early stages of cancer recovery that changes in
lifestyle including increases in physical activity improves physical function,
there are no clear findings whether low versus moderate intensity activity or
home or gym exercise offer optimal benefit. Isometric-resistance exercises can
be carried out with very little equipment and space and can be performed while
patients are bed-bound in hospital or at home. This embedded qualitative study,
based in an English hospital trust providing specialist cancer care, was
undertaken as a component of a feasibility trial to evaluate the acceptability
and feasibility of an isometric-resistance exercise program and explore the
suitability of functional assessments by drawing from the experiences of
abdominal cancer patients following surgery. Telephone interviews were
undertaken with 7 participants in the intervention group, and 8 interviews with
the usual care group (n = 15). The gender composition consisted of 11 females
and 4 males. Participants’ ages ranged from 27 to 84 (M = 60.07, SD = 15.40).
Interviews were conducted between August 2017 and May 2018, with audio files
digitally recorded and data coded using thematic framework analysis. Our results
show that blinding to intervention or usual care was a challenge, participants
felt the intervention was safe and suitable aided by the assistance of a
research nurse, yet, found the self-completion questionnaire tools hard to
complete. Our study provides an insight of trial processes, participants’
adherence and completion of exercise interventions, and informs the design and
conduct of larger RCTs based on the experiences of abdominal cancer surgery
patients.
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Affiliation(s)
- Ferhana Hashem
- Centre for Health Service Studies, University of Kent, Canterbury, Kent, United Kingdom
| | - David Stephensen
- Physiotherapy Department, East Kent Hospitals University Foundation NHS Trust, Kent and Canterbury Hospital, Canterbury, Kent, United Kingdom.,Haemophilia Centre, Royal London Hospital, United Kingdom
| | - Amanda Bates
- Centre for Health Service Studies, University of Kent, Canterbury, Kent, United Kingdom
| | - Tracy Pellatt-Higgins
- Centre for Health Service Studies, University of Kent, Canterbury, Kent, United Kingdom
| | - Ralph Nobby Peter Hobbs
- Maidstone and Tunbridge Wells NHS Trust, Maidstone, Maidstone Hospital, Hermitage Lane, Maidstone, Kent, United Kingdom
| | - Malcolm Hopkins
- Maidstone and Tunbridge Wells NHS Trust, Maidstone, Maidstone Hospital, Hermitage Lane, Maidstone, Kent, United Kingdom
| | - Hazel Woodward
- Maidstone and Tunbridge Wells NHS Trust, Maidstone, Maidstone Hospital, Hermitage Lane, Maidstone, Kent, United Kingdom
| | | | - Ian L Swaine
- Centre for Science and Medicine in Sport and Exercise, University of Greenwich, Gillingham, Chatham, United Kingdom
| | - Haythem Ali
- Maidstone and Tunbridge Wells NHS Trust, Maidstone, Maidstone Hospital, Hermitage Lane, Maidstone, Kent, United Kingdom
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12
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Sweeney‐Magee M, Moustaqim‐Barrette A, Gotay C, Dummer T. A systematic mixed studies review of health behaviour change interventions in colorectal cancer survivors. J Adv Nurs 2020. [DOI: 10.1111/jan.14389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 03/20/2020] [Accepted: 04/01/2020] [Indexed: 12/12/2022]
Affiliation(s)
- Molly Sweeney‐Magee
- School of Population and Public Health University of British Columbia Vancouver British Columbia Canada
| | - Amina Moustaqim‐Barrette
- School of Population and Public Health University of British Columbia Vancouver British Columbia Canada
| | - Carolyn Gotay
- School of Population and Public Health University of British Columbia Vancouver British Columbia Canada
| | - Trevor Dummer
- School of Population and Public Health University of British Columbia Vancouver British Columbia Canada
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13
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Asvat Y, King AC, Smith LJ, Lin X, Hedeker D, Henderson TO. Substance use behaviors in adolescent and young adult cancer patients: Associations with mental and physical health. Psychooncology 2020; 29:1068-1076. [PMID: 32154963 DOI: 10.1002/pon.5378] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 02/25/2020] [Accepted: 03/03/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Cancer diagnosis in adolescents and young adults (AYAs) coincides with the developmental initiation of substance use and emergence of affective disturbance. We examined substance use behaviors and risk-stratified associations with mental and physical health, as well as objective indicators of tobacco and cannabis use and concordance with self-report and medical records. METHODS AYAs were 15 to 39 years at cancer diagnosis and ≥18 years and ≥6 months postdiagnosis at study enrollment. Risk-stratified groups included nonsmoker/nondrinker, nonsmoker/drinker, smoker/drinker. Assessments included demographics, past year tobacco, alcohol, and cannabis use, depression, anxiety, sleep, and physical activity. Urine analysis provided biochemical verification of tobacco and cannabis use. RESULTS Participants included 100 AYAs (60% male) with primarily hematological cancers (88%). Past year alcohol, tobacco, and cannabis use prevalence rates were 80%, 15%, and 33%, respectively. A minority (non-users) refrained from both alcohol and tobacco (20%), while most were exclusively alcohol users (65%) or alcohol and tobacco co-users (15%). Relative to other sub-groups, co-users reported more depressive and anxious symptoms, while non-users reported more physical activity. More frequent tobacco and cannabis use were associated with more depressive and anxious symptoms, while more frequent alcohol use was associated with lower physical activity. There were no group differences or associations with sleep quality. There was considerable discordance between tobacco use self-report, biochemical verification, and medical record documentation. CONCLUSIONS Substance use among AYAs is common and detrimental to mental and physical health, especially among more frequent users and co-users, highlighting the need for early assessment and intervention.
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Affiliation(s)
- Yasmin Asvat
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Chicago, Illinois, USA
| | - Andrea C King
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Chicago, Illinois, USA
| | - Lia J Smith
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Xiaolei Lin
- School of Data Science, Fudan University, Shanghai, China, USA
| | - Donald Hedeker
- Department of Public Health Sciences and College, University of Chicago, Chicago, Illinois, USA
| | - Tara O Henderson
- Department of Pediatrics, University of Chicago, Chicago, Illinois, USA
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14
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Gray ID, Kross AR, Renfrew ME, Wood P. Precision Medicine in Lifestyle Medicine: The Way of the Future? Am J Lifestyle Med 2020; 14:169-186. [PMID: 32231483 PMCID: PMC7092395 DOI: 10.1177/1559827619834527] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 12/21/2018] [Accepted: 02/08/2019] [Indexed: 02/06/2023] Open
Abstract
Precision medicine has captured the imagination of the medical community with visions of therapies precisely targeted to the specific individual's genetic, biological, social, and environmental profile. However, in practice it has become synonymous with genomic medicine. As such its successes have been limited, with poor predictive or clinical value for the majority of people. It adds little to lifestyle medicine, other than in establishing why a healthy lifestyle is effective in combatting chronic disease. The challenge of lifestyle medicine remains getting people to actually adopt, sustain, and naturalize a healthy lifestyle, and this will require an approach that treats the patient as a person with individual needs and providing them with suitable types of support. The future of lifestyle medicine is holistic and person-centered rather than technological.
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Affiliation(s)
- Ian D. Gray
- Avondale College of Higher Education, Cooranbong,
New South Wales, Australia
| | - Andrea R. Kross
- Avondale College of Higher Education, Cooranbong,
New South Wales, Australia
| | - Melanie E. Renfrew
- Avondale College of Higher Education, Cooranbong,
New South Wales, Australia
| | - Paul Wood
- Avondale College of Higher Education, Cooranbong,
New South Wales, Australia
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15
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Pugh G, Hough R, Gravestock H, Fisher A. The health behaviour status of teenage and young adult cancer patients and survivors in the United Kingdom. Support Care Cancer 2020; 28:767-777. [PMID: 31144171 PMCID: PMC6954124 DOI: 10.1007/s00520-019-04719-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 02/26/2019] [Indexed: 01/21/2023]
Abstract
PURPOSE The primary aim of this study was to investigate the health behaviour status of teenage and young adult (TYA) cancer patients and survivors; the secondary aim was to determine if TYA cancer patients and survivors health behaviour differs to general population controls. METHODS Two hundred sixty-seven young people with cancer (n =83 cancer patients receiving active treatment: n =174 cancer survivors, 57.1% >1 year since treatment completion) and 321 controls completed a health and lifestyle questionnaire which included validated measures of physical activity (PA) (Godin Leisure Time Exercise Questionnaire), diet (Dietary Instrument for Nutrition Education, DINE), smoking status, and alcohol consumption (AUDIT-C). RESULTS General population controls and cancer survivors were more likely to meet current (PA) recommendations (p <0.001) than TYA cancer patients undergoing treatment (54.8% vs 52.3% vs 30.1%, respectively). Less than 40% of young people with cancer and controls met fat intake, sugar intake, fibre intake or current fruit and vegetable recommendations. TYA cancer survivors were more likely to report binge drinking than controls (OR=3.26, 95% CI 2.12-5.02, p <0.001). Very few young people with in the study were current smokers. The majority of TYA cancer patients and survivors reported a desire to make positive changes to their health behaviour. CONCLUSION Consideration should be given to whether existing health behaviour change interventions which have demonstrated positive effects among the general TYA population could be adapted for young people with cancer.
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Affiliation(s)
- G. Pugh
- Centre for Sports & Exercise Medicine, William Harvey Research Institute, Queen Mary University of London, Mile End Hospital, Bancroft Road, London, E1 4DG UK
- Department of Behavioural Science & Health, University College London, 1-19 Torrington Place, London, WC1E 6BT UK
| | - R. Hough
- Department of Haematology, University College London Hospital, London, UK
| | - H. Gravestock
- CLIC Sargent, No.1 Farriers Yard, L77-85 Fulham Palace Road, London, W6 8JA UK
| | - A. Fisher
- Department of Behavioural Science & Health, University College London, 1-19 Torrington Place, London, WC1E 6BT UK
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16
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Harvie M, Pegington M, Bundred N, Campbell A, Belcher J, Howell S, Howell A. Reply to Comment on "The effectiveness of home versus community-based weight control programmes initiated soon after breast cancer diagnosis: a randomised controlled trial". Br J Cancer 2020; 122:925-926. [PMID: 31932752 PMCID: PMC7078211 DOI: 10.1038/s41416-019-0715-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 12/18/2019] [Indexed: 12/03/2022] Open
Affiliation(s)
- Michelle Harvie
- Prevent Breast Cancer Research Unit, The Nightingale Centre, Manchester University NHS Foundation Trust, Manchester, UK. .,Manchester Breast Centre, Manchester Cancer Research Centre, University of Manchester, Manchester, UK.
| | - Mary Pegington
- Prevent Breast Cancer Research Unit, The Nightingale Centre, Manchester University NHS Foundation Trust, Manchester, UK.,Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, M13 9PL, UK
| | - Nigel Bundred
- Manchester Breast Centre, Manchester Cancer Research Centre, University of Manchester, Manchester, UK.,Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, M13 9PL, UK
| | - Anna Campbell
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, UK
| | - John Belcher
- Department of Medical Statistics, Manchester University NHS Foundation Trust, Manchester, UK
| | - Sacha Howell
- Manchester Breast Centre, Manchester Cancer Research Centre, University of Manchester, Manchester, UK.,Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, M13 9PL, UK.,The Christie NHS Foundation Trust, Manchester, UK
| | - Anthony Howell
- Prevent Breast Cancer Research Unit, The Nightingale Centre, Manchester University NHS Foundation Trust, Manchester, UK.,Manchester Breast Centre, Manchester Cancer Research Centre, University of Manchester, Manchester, UK.,Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, M13 9PL, UK
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17
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Patel A, Schofield G, Keogh J. Influences on health-care practitioners' promotion of physical activity to their patients with prostate cancer: a qualitative study. J Prim Health Care 2019; 10:31-38. [PMID: 30068449 DOI: 10.1071/hc17036] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Physical activity is beneficial for the physical and psychological health of patients with prostate cancer (PCa). Health-care practitioners are ideally positioned to promote physical activity to their patients. AIM To identify factors that influenced health care practitioners to either promote or not promote physical activity to their patients with PCa. METHODS Individual interviews were conducted with 16 Auckland-based health-care practitioners, including specialists (oncologists and urologists), physiotherapists and complementary and alternative (acupuncturists) health-care practitioners. Data were analysed using an inductive thematic approach. RESULTS Treatment-related factors (ie counteracting side-effects of hormone suppression treatment), longer life expectancy and risk factors for other conditions appeared to influence the promotion of physical activity to patients. Time constraints of consultations and complex medical issues were barriers to the promotion of physical activity. CONCLUSIONS This study found that a variety of health-care practitioners are providing some degree of physical activity advice to their patients with PCa. Collaborative practice among health-care practitioners to verbally reinforce the benefits of physical activity, coupled with referral to experts in physical activity promotion/rehabilitation (such as physiotherapists), should be encouraged for best practice care.
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Affiliation(s)
- Asmita Patel
- School of Public Health and Psychosocial Studies, Auckland University of Technology, Auckland, New Zealand
| | - Grant Schofield
- Human Potential Centre, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Justin Keogh
- Human Potential Centre, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
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18
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Sabiston CM, Wrosch C, Castonguay AL, Sylvester BD. Changes in physical activity behavior and C-reactive protein in breast cancer patients. Ann Behav Med 2019; 52:545-551. [PMID: 29668832 PMCID: PMC6361285 DOI: 10.1093/abm/kax010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Background C-reactive protein (CRP) concentrations are associated with morbidity and mortality in breast cancer patients and moderate-vigorous physical activity (MVPA) may help regulate CRP levels. Purpose The purpose of this prospective study was to examine intraindividual and interindividual changes in MVPA on changes in CRP levels among early posttreatment breast cancer patients. Methods During five data collections over the first year posttreatment for breast cancer, women (N = 138, Mage = 55.3, standard deviation = 11.1 years) completed a questionnaire, wore an accelerometer for seven consecutive days to measure MVPA, and provided blood samples to measure CRP concentrations. Intraindividual and interindividual associations between MVPA on CRP were tested using hierarchical linear modeling. Results Based on the intraindividual associations, lower concentrations of CRP were evident when participants engaged in more, as compared to their average, MVPA (β = −.02, p < .021). In addition, interindividual analyses showed that women who engaged in more MVPA across the study period had lower concentrations of CRP compared to women who engaged in less MVPA (β = −.24, p = .006). Conclusions MVPA in breast cancer patients is consistently associated with lower CRP concentrations over time. Interventions may target individual MVPA early after diagnosis to mitigate CRP levels in breast cancer patients.
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Affiliation(s)
- Catherine M Sabiston
- Faculty of Kinesiology and Physical Education, The University of Toronto, Toronto, Canada
- Catherine M. Sabiston
| | - Carsten Wrosch
- Department of Psychology, Concordia University, Montreal, Canada
| | | | - Benjamin D Sylvester
- Faculty of Kinesiology and Physical Education, The University of Toronto, Toronto, Canada
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19
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Poole K, Ogden J, Gasson S, Lemanska A, Archer F, Griffin B, Saxton J, Lyons K, Faithfull S. Creating a teachable moment in community pharmacy for men with prostate cancer: A qualitative study of lifestyle changes. Psychooncology 2019; 28:593-599. [DOI: 10.1002/pon.4983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 11/17/2018] [Accepted: 12/29/2018] [Indexed: 11/09/2022]
Affiliation(s)
- Karen Poole
- Faculty of Health and Medical Sciences, School of Health Sciences; University of Surrey; UK
| | - Jane Ogden
- Faculty of Health and Medical Sciences, School of Psychology; University of Surrey; UK
| | - Sophie Gasson
- Faculty of Health and Medical Sciences, School of Health Sciences; University of Surrey; UK
| | - Agnieszka Lemanska
- Faculty of Health and Medical Sciences, School of Health Sciences; University of Surrey; UK
| | - Fiona Archer
- Faculty of Health and Medical Sciences, School of Health Sciences; University of Surrey; UK
| | - Bruce Griffin
- Faculty of Health and Medical Sciences, School of Biosciences and Medicine; University of Surrey; UK
| | - John Saxton
- Newcastle, Department of Sport, Exercise and Rehabilitation; Northumbria University; UK
| | - Karen Lyons
- Boston College Connell School of Nursing; MA USA
| | - Sara Faithfull
- Faculty of Health and Medical Sciences, School of Health Sciences; University of Surrey; UK
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20
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Abstract
This review evaluates evidence on dietary interventions for cancer survivors giving an overview of people's views and preferences for service attributes and provides a narrative review. After cancer, people often want to change their diet and there is a plethora of evidence why dietary optimisation would be beneficial. However, cancer survivors have different preferences about attributes of services including: place, person and communication mode. Randomised control trials have been reviewed to provide a narrative summary of evidence of dietary interventions. Most studies were on survivors of breast cancer, with a few on colorectal, prostate and gynaecological survivors. Telephone interventions were the most frequently reported means of providing advice and dietitians were most likely to communicate advice. Dietary assessment methods used were FFQ, food diaries and 24-h recalls. Dietary interventions were shown to increase intake of fruit and vegetables, dietary fibre, and improve diet quality in some studies but with contradictory findings in others. Telephone advice increased fruit and vegetable intake primarily in women with breast cancer and at some time points in people after colorectal cancer, but findings were inconsistent. Findings from mail interventions were contradictory, although diet quality improved in some studies. Web-based and group sessions had limited benefits. There is some evidence that dietary interventions improve diet quality and some aspects of nutritional intake in cancer survivors. However, due to contradictory findings between studies and cancer sites, short term follow-up and surrogate endpoints it is difficult to decipher the evidence base.
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21
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Promoting opioid overdose prevention and recovery: An exploratory study of an innovative intervention model to address opioid abuse. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2018; 64:21-29. [PMID: 30551002 DOI: 10.1016/j.drugpo.2018.12.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 11/28/2018] [Accepted: 12/04/2018] [Indexed: 11/23/2022]
Abstract
BACKGROUND Fatal opioid overdose is a national public health concern in the United States and a critical problem confronting New Jersey's addiction treatment system. New Jersey developed an innovative program, the Opioid Overdose Recovery Program (OORP), to address the epidemic and the issue of low treatment admissions following a non-fatal overdose. The OORP utilizes an intervention model with peer recovery specialists (RSs) and patient navigators (PNs) to engage individuals within emergency departments (EDs) immediately following an opioid overdose reversal. The purpose of this exploratory s/tudy was to examine the process through which the OORP was implemented in its first year and determine facilitators and barriers to implementation. METHODS Data were collected in 2016-2017, through 17 telephone interviews and focus groups with 39 participants. Participants were OORP staff and stakeholders selected through purposeful, non-random sampling. Standardized, open-ended interview guides were used. Thematic analysis was conducted to identify, analyze, and report overall patterns. RESULTS Participants detailed stories from the field and policymakers illuminated the process of implementation. Findings revealed logistical barriers to treatment including patients' lack of insurance and cell phones, lack of immediately available detox beds, and program ineligibility for some patients due to medical conditions. The model using peers as first responders had a positive impact as their experiences with addiction enabled them to more successfully engage patients. The PNs were critical in addressing high needs for case management and referral and external partners were also important for implementation. CONCLUSIONS Results underscore the effort needed to integrate this important model within EDs as part of a multi-level approach to address opioid misuse. The identified challenges led to statewide strategic planning and areas for further development. OORP is a promising intervention that might increase the number of individuals suffering with opioid disorders linked to peer support, treatment and recovery.
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22
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Webb J, Fife-Schaw C, Ogden J, Foster J. The Effect of the Move More Pack on the Physical Activity of Cancer Survivors: Protocol for a Randomized Waiting List Control Trial with Process Evaluation. JMIR Res Protoc 2017; 6:e220. [PMID: 29122737 PMCID: PMC5701086 DOI: 10.2196/resprot.7755] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Revised: 08/15/2017] [Accepted: 09/20/2017] [Indexed: 12/03/2022] Open
Abstract
Background Physical activity can improve many common side effects of cancer treatment as well as improve physical function and quality of life (QOL). In addition, physical activity can improve survival rate and reduce cancer recurrence. Despite these benefits, only 23% of cancer survivors in England are active to recommended levels. Cancer survivors are interested in lifestyle behavior change. Home-based interventions offer a promising means for changing physical activity behavior. Prediagnosis levels of physical activity and self-efficacy have been reported to be predictors of physical activity behavior change. The Move More Pack, which has undergone revision, is a printed resource with supporting Internet-based tools that aims to increase the physical activity of cancer survivors in the United Kingdom. The revised Move More Pack is underpinned by the theory of planned behavior and the social cognitive theory. Objective The aim of this proposed study was to investigate the effect of the revised Move More Pack, supported by Internet-based tools, on physical activity, self-efficacy, and health-related QOL (HRQOL) of cancer survivors in the United Kingdom. Methods This study is a two-arm waiting list randomized control trial with embedded process evaluation. A sample of 99 participants per arm will be recruited by invitation through an email database of cancer survivors held by UK charity Macmillan Cancer Support and an advert placed on the Macmillan Cancer Support Facebook page. Each participant is randomized to receive brief physical activity information and the UK guidelines for physical activity, or brief physical activity information and the revised Move More Pack with supporting Internet-based tools. The intervention and control arm will be followed up at 12 weeks to identify changes in self-reported physical activity, self-efficacy, and HRQOL based on Web-based questionnaires. The control arm will receive the revised Move More Pack at 12 weeks with follow-up at 24 weeks. The intervention arm is followed up at 24 weeks to determine maintenance of reported changes. Subgroup analyses will be completed based on participants’ prediagnosis level of physical activity and baseline self-efficacy as possible predictors of positive changes. Use of each component of the revised Move More Pack will be assessed using a 4-point Likert scale. Semistructured phone interviews will evaluate the use and perceived usefulness of the revised Move More Pack. Results Participant recruitment started in March 2017. Projected completion of this study is October 2018. Conclusions This study’s findings will identify if the proposed low-cost broad reach intervention improves physical activity, self-efficacy, and the HRQOL of cancer survivors. The process evaluation is designed to contextualize the use and perceived usefulness of the revised Move More Pack, help augment its efficient distribution, and identify potential improvements to its design.
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Affiliation(s)
- Justin Webb
- Centre for Primary Health and Social Care, School of Social Professions, London Metropolitan University, London, United Kingdom
| | - Chris Fife-Schaw
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Surrey, United Kingdom
| | - Jane Ogden
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Surrey, United Kingdom
| | - Jo Foster
- Support and Wellbeing Team, Macmillan Cancer Support, London, United Kingdom
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23
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Shingler E, Hackshaw-McGeagh L, Robles L, Persad R, Koupparis A, Rowe E, Shiridzinomwa C, Bahl A, Martin RM, Lane JA. The feasibility of the Prostate cancer: Evidence of Exercise and Nutrition Trial (PrEvENT) dietary and physical activity modifications: a qualitative study. Trials 2017; 18:106. [PMID: 28264695 PMCID: PMC5340012 DOI: 10.1186/s13063-017-1828-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 02/07/2017] [Indexed: 01/20/2023] Open
Abstract
Background There is increasing evidence that low levels of physical activity and diets low in fruit and vegetables and high in meat and dairy products are risk factors for prostate cancer disease progression. The Prostate cancer: Evidence of Exercise and Nutrition Trial (PrEvENT) aimed to assess a diet and physical activity intervention in men undergoing radical prostatectomy for localized prostate cancer. The trial included a qualitative component to explore the experiences of men participating in the trial in order to understand the acceptability of the intervention and data collection methods. We report the qualitative findings of the trial and consider how these can be used to inform future research. Methods PrEvENT involved randomizing men to either a dietary and/or physical activity intervention. Semi-structured interviews were conducted with a purposive sample of 17 men on completion of the 6 month trial. Interviews took place in clinic or as telephone interviews, if requested by the participant, and were audio recorded, transcribed, and analyzed using the thematic-based framework approach. Analysis was conducted throughout the data collection process to allow emergent themes to be further explored in subsequent interviews. Results Three overarching themes were identified: acceptability of the intervention, acceptability of the data collection methods and trial logistics. Participants were predominantly positive about both the dietary and physical activity interventions and most men found the methods of data collection appropriate. Recommendations for future trials include consideration of alternative physical activity options, such as cycling or gym sessions, increased information on portion sizes, the potential importance of including wives or partners in the dietary change process and the possibility of using the pedometer or other wearable technology as part of the physical activity intervention. Conclusions We provide insight into the opinions and experiences of the acceptability of the PrEvENT diet and physical activity intervention from the participants themselves. The interventions delivered were acceptable to this sample of participants, as were the data collection methods utilized. We also highlight some considerations for further behavioural change interventions in prostate cancer and other similar populations. Trial registration ISRCTN, ISRCTN99048944. Registered on 17 November 2014. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-1828-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | | | | | - Raj Persad
- Bristol Urological Institute, Bristol, UK
| | | | | | | | - Amit Bahl
- Bristol Haematology & Oncology Centre, Bristol, UK
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24
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Weight changes in postmenopausal breast cancer survivors over 2 years of endocrine therapy: a retrospective chart review. Breast Cancer Res Treat 2017; 162:375-388. [DOI: 10.1007/s10549-017-4106-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 01/06/2017] [Indexed: 10/20/2022]
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25
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Webb J, Hall J, Hall K, Fabunmi-Alade R. Increasing the frequency of physical activity very brief advice by nurses to cancer patients. A mixed methods feasibility study of a training intervention. Public Health 2016; 139:121-133. [PMID: 27370700 DOI: 10.1016/j.puhe.2016.05.015] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 05/15/2016] [Accepted: 05/24/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To examine the impact, acceptability, practicability and implementation of a training intervention, designed using the Behaviour Change Wheel, on the delivery of very brief advice on physical activity, by nurses to cancer patients. STUDY DESIGN A mixed methods feasibility study. METHOD A purposeful sample of nurses (n = 62) were recruited across two delivery arms, face-to-face (n = 55) and online (n = 7). Frequency of delivery of physical activity advice was collected at baseline with follow-up at 12 weeks. The 'capability, opportunity and motivation' of nurses to deliver very brief advice was measured via questionnaire. Semi-structured phone interviews (n = 14) were completed and analyzed thematically. A cost consequence analysis was undertaken. RESULTS The intervention improved the 'capability, opportunity and motivation' of nurses resulting in a change in knowledge, attitudes and beliefs towards physical activity. The intervention was both acceptable and practical. Face-to-face was the preferred mode of delivery, however there was also value in the online option. The cost of delivery per participant was £33.87 for face-to-face delivery, and £103.83 for online delivery inflated due to low recruitment numbers. A significant improvement was seen in delivery of very brief advice at 12 weeks (Z = -4.39, P ≤ 0.01). CONCLUSION The intervention is acceptable, practical and improves delivery of very brief advice on physical activity by nurses to cancer patients in the short-term. Both face-to-face and online delivery should be considered.
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Affiliation(s)
- J Webb
- Macmillan Cancer Support, Support and Wellbeing Department, 89 Albert Embankment, London, SE1 7UQ, UK.
| | - J Hall
- Brunel University, Sport, Health & Exercise Sciences, Kingston Lane, Uxbridge, Middlesex, UB8 3PH, UK
| | - K Hall
- University of Bath, Humanities & Social Sciences, Claverton Down Road, Bath, North Somerset, BA2 7AY, UK
| | - R Fabunmi-Alade
- University of Bath, Humanities & Social Sciences, Claverton Down Road, Bath, North Somerset, BA2 7AY, UK
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Weathering the seasons of cancer survivorship: mind-body therapy use and reported reasons and outcomes by stages of cancer survivorship. Support Care Cancer 2016; 24:3783-91. [PMID: 27048456 DOI: 10.1007/s00520-016-3200-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2015] [Accepted: 03/28/2016] [Indexed: 01/10/2023]
Abstract
PURPOSE Mind-body therapies (MBTs), a subset of complementary and alternative medicine (CAM), are used by cancer survivors to manage symptoms related to their cancer experience. MBT use may differ by cancer survivorship stage (i.e., acute, short-term, long-term) because each stage presents varying intensities of medical activities, associated emotions, and treatment effects. We examined the relationship between MBT use and survivorship stage (acute <1 year; short-term 1 to 5 years; long-term >5 years since diagnosis) using the CAM supplement of the 2012 National Health Interview Survey. We also examined reported reasons for and outcomes of MBT use and frequency of MBT types. METHODS The sample included cancer survivors (N = 3076) and non-cancer controls (N = 31,387). Logistic regression tested the relationship of MBT use and survivorship stage. Weighted percentages were calculated by survivorship stage for reported reasons and outcomes of use and frequency of MBT types. RESULTS MBT use varied by cancer survivorship stage (p = 0.02): acute (8.3 %), short-term (15.4 %), long-term (11.7 %) survivorship and non-cancer controls (13.2 %). In the adjusted model, short-term survivors had 35 % greater odds of MBT use than did controls (95 % CI 1.00, 1.83). Reasons for and outcomes of MBT use varied among the survivorship stages, with more acute survivors reporting medical-related reasons and more short-term survivors reporting to manage symptoms. CONCLUSIONS MBT may fulfill different symptom management needs at varying stages of survivorship. These findings can help inform supportive care services of survivors' use of MBT for symptom burden at each stage and the allocation of these services.
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Koutoukidis DA, Beeken RJ, Manchanda R, Burnell M, Knobf MT, Lanceley A. Diet and exercise in uterine cancer survivors (DEUS pilot) - piloting a healthy eating and physical activity program: study protocol for a randomized controlled trial. Trials 2016; 17:130. [PMID: 26965165 PMCID: PMC4785620 DOI: 10.1186/s13063-016-1260-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 02/26/2016] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Endometrial cancer survivors comprise a high-risk group for obesity-related comorbidities. Healthy eating and physical activity can lead to better health and well-being, but this population may experience difficulties adopting healthy lifestyle practices. Personalised behaviour change programmes that are feasible, acceptable and cost-effective are needed. The aim of this trial is to pilot a manualised programme about healthy eating and physical activity. METHODS/DESIGN This is a phase II, individually randomized, parallel, controlled, two-site, pilot clinical trial. Adult endometrial cancer survivors (n = 64) who have been diagnosed with endometrial cancer within the previous 3 years and are not on active treatment will be invited to participate. Participants will be assigned in a 1:1 ratio through minimisation to either an 8-week, group-based, behaviour-change programme with weekly 90-min sessions about healthy eating and physical activity or usual care. The intervention will focus on self-monitoring, goal setting and self-rewards. Follow-up assessments will be conducted at 8 and 24 weeks from the baseline assessment. Primary feasibility outcomes will include rates of recruitment, adherence, and retention. DISCUSSION The study results will inform the development of a definitive randomised controlled trial to test if the programme can improve the health and quality of life of this population. It will also provide guidance on costing the intervention and the health care resource use in this population. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT02433080, 20 April 2015.
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Affiliation(s)
- Dimitrios A. Koutoukidis
- />Department of Women’s Cancer, EGA Institute for Women’s Health, University College London, London, UK
| | - Rebecca J. Beeken
- />Health Behaviour Research Centre, Department of Epidemiology & Public Health, University College London, London, UK
| | - Ranjit Manchanda
- />Department of Women’s Cancer, EGA Institute for Women’s Health, University College London, London, UK
- />Department of Gynaecological Oncology, Barts Health NHS Trust, Royal London Hospital, London, UK
- />Barts Cancer Institute, Queen Mary University of London, London, UK
| | - Matthew Burnell
- />Department of Women’s Cancer, EGA Institute for Women’s Health, University College London, London, UK
| | - M. Tish Knobf
- />Department of Women’s Cancer, EGA Institute for Women’s Health, University College London, London, UK
- />Acute Care/Health Systems Division, Yale University School of Nursing, New Haven, CT USA
| | - Anne Lanceley
- />Department of Women’s Cancer, EGA Institute for Women’s Health, University College London, London, UK
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Park CL, Cho D, Salner AL, Dornelas E. A randomized controlled trial of two mail-based lifestyle interventions for breast cancer survivors. Support Care Cancer 2016; 24:3037-46. [PMID: 26887585 DOI: 10.1007/s00520-016-3129-y] [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: 11/26/2015] [Accepted: 02/09/2016] [Indexed: 11/30/2022]
Abstract
PURPOSE Although breast cancer survivors' lifestyle choices affect their subsequent health, a majority do not engage in healthy behaviors. Because treatment end is a "teachable moment" for potentially altering lifestyle change for breast cancer survivors, we developed and tested two mail-based interventions for women who recently completed primary treatment. METHODS One hundred seventy-three survivors were randomly assigned to (1) Targeting the Teachable Moment (TTMI, n = 57), (2) Standard Lifestyle Management (SLM, n = 58), or (3) usual care (UC, n = 58) control group. Participants who were assigned to TTMI and SLM received relevant treatment materials biweekly for 4 months. Participants were assessed at baseline (T1, before randomization), post-treatment (T2, 4 months), and follow-up (T3, 7 months). Fruit and vegetable (F/V) intake, fat intake, and moderate-to-vigorous physical activity (MVPA) were assessed. RESULTS Results showed promise for these mail-based interventions for changes in health behaviors: Survivors in TTMI (+.47) and SLM (+.45) reported increased F/V intake, whereas those in UC (-.1) reported decreased F/V intake from T1 to T2. Changes in minutes of MVPA from T1 to T2 were higher in SLM than UC and marginally higher in TTMI than UC. However, these differences were due to decreased MVPA in UC rather than increased MVPA in the intervention groups. There were no group differences regarding fat intake. Survivors reported high satisfaction and preference for mail-based interventions, supporting feasibility. CONCLUSIONS Mail-based lifestyle interventions for breast cancer survivors may benefit F/V intake and physical activity. Further testing and optimizing of these interventions is warranted.
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Affiliation(s)
- Crystal L Park
- Department of Psychology, University of Connecticut, 406 Babbidge Rd, Unit 1020, Storrs, CT, 06269-1020, USA.
| | - Dalnim Cho
- Department of Psychology, University of Connecticut, 406 Babbidge Rd, Unit 1020, Storrs, CT, 06269-1020, USA
| | - Andrew L Salner
- Helen & Harry Gray Cancer Center, Hartford Hospital, 85 Retreat Ave, Hartford, CT, 06106, USA
| | - Ellen Dornelas
- Helen & Harry Gray Cancer Center, Hartford Hospital, 85 Retreat Ave, Hartford, CT, 06106, USA
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Webb J, Foster J, Poulter E. Increasing the frequency of physical activity very brief advice for cancer patients. Development of an intervention using the behaviour change wheel. Public Health 2016; 133:45-56. [PMID: 26822162 DOI: 10.1016/j.puhe.2015.12.009] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 11/20/2015] [Accepted: 12/20/2015] [Indexed: 01/20/2023]
Abstract
BACKGROUND Being physically active has multiple benefits for cancer patients. Despite this only 23% are active to the national recommendations and 31% are completely inactive. A cancer diagnosis offers a teachable moment in which patients might be more receptive to lifestyle changes. Nurses are well placed to offer physical activity advice, however, only 9% of UK nurses involved in cancer care talk to all cancer patients about physical activity. A change in the behaviour of nurses is needed to routinely deliver physical activity advice to cancer patients. As recommended by the Medical Research Council, behavioural change interventions should be evidenced-based and use a relevant and coherent theoretical framework to stand the best chance of success. OBJECTIVE This paper presents a case study on the development of an intervention to improve the frequency of delivery of very brief advice (VBA) on physical activity by nurses to cancer patients, using the Behaviour Change Wheel (BCW). METHOD The eight composite steps outlined by the BCW guided the intervention development process. An iterative approach was taken involving key stakeholders (n = 45), with four iterations completed in total. This was not defined a priori but emerged during the development process. RESULTS A 60 min training intervention, delivered in either a face-to-face or online setting, with follow-up at eight weeks, was designed to improve the capability, opportunity and motivation of nurses to deliver VBA on physical activity to people living with cancer. This intervention incorporates seven behaviour change techniques of goal setting coupled with commitment; instructions on how to perform the behaviour; salience of the consequences of delivering VBA; a demonstration on how to give VBA, all delivered via a credible source with objects added to the environment to support behavioural change. CONCLUSION The BCW is a time consuming process, however, it provides a useful and comprehensive framework for intervention development and greater control over intervention replication and evaluation.
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Affiliation(s)
- J Webb
- Macmillan Cancer Support, 89 Albert Embankment, London SE1 7UQ, UK.
| | - J Foster
- Macmillan Cancer Support, 89 Albert Embankment, London SE1 7UQ, UK
| | - E Poulter
- Macmillan Cancer Support, 89 Albert Embankment, London SE1 7UQ, UK
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Sterba KR, Zapka J, LaPelle N, Armeson K, Ford ME. A Formative Study of Colon Cancer Surveillance Care: Implications for Survivor-Centered Interventions. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2015; 30:719-727. [PMID: 25411092 PMCID: PMC5955696 DOI: 10.1007/s13187-014-0756-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Colon cancer is one of the most commonly diagnosed cancers in the United States, and an increasing number of survivors has underscored the need for improved colon cancer surveillance care quality. Post-treatment surveillance includes follow-up care visits and tests as well as psychosocial support and lifestyle counseling. This formative study explored the individual, interpersonal, and organizational-level factors related to adherence to surveillance care guidelines to identify modifiable factors for potential educational intervention strategies. A convenience sample of 22 survivors (12 women and 10 men) from two cancer centers were recruited to participate in focus groups or key informant telephone interviews to explore their experiences with care after completing treatment and complete a brief survey. Content analysis was used to identify themes. Results confirmed that survivors navigated a complex surveillance care schedule and described a strong trust in their health care providers that guided their follow-up care experiences. Participants defined the terms "survivorship" and "follow-up" in a variety of different ways. Individual-level themes critical to survivors' experiences included having a positive attitude, relying on one's faith, and coping with fears. Interpersonal-level themes centered around interactions and communication with family and health care providers in follow-up care. While organizational-level factors were highlighted infrequently, participants rated office reminder systems and communication among their multiple providers as valuable. Educational interventions capitalizing on survivors' connections with their physicians and focusing on preparing survivors for what to expect in the next phase of their cancer experience, could be beneficial at the end of treatment to activate survivors for the transition to the post-treatment period.
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Affiliation(s)
- Katherine Regan Sterba
- Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon Street, Charleston, SC, 29425, USA.
- Hollings Cancer Center, Medical University of South Carolina, 68 President Street, MSC 955, Charleston, SC, 29425, USA.
| | - Jane Zapka
- Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon Street, Charleston, SC, 29425, USA
- Hollings Cancer Center, Medical University of South Carolina, 68 President Street, MSC 955, Charleston, SC, 29425, USA
| | - Nancy LaPelle
- Division of Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worchester, MA, USA
| | - Kent Armeson
- Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon Street, Charleston, SC, 29425, USA
- Hollings Cancer Center, Medical University of South Carolina, 68 President Street, MSC 955, Charleston, SC, 29425, USA
| | - Marvella E Ford
- Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon Street, Charleston, SC, 29425, USA
- Hollings Cancer Center, Medical University of South Carolina, 68 President Street, MSC 955, Charleston, SC, 29425, USA
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Nyrop KA, Deal AM, Williams GR, Guerard EJ, Pergolotti M, Muss HB. Physical activity communication between oncology providers and patients with early-stage breast, colon, or prostate cancer. Cancer 2015; 122:470-6. [PMID: 26566177 DOI: 10.1002/cncr.29786] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 09/18/2015] [Accepted: 10/19/2015] [Indexed: 12/22/2022]
Abstract
BACKGROUND National guidelines recommend that patients with a cancer diagnosis engage in regular physical activity to reduce cancer-related fatigue, maintain quality of life and physical function, and improve overall prognosis and survival. This study investigates oncology provider communications about physical activity during routine clinic visits with patients with early-stage breast, colon, or prostate cancer. METHODS This study used a retrospective chart review for documentation of inquiries or recommendations pertaining to physical activity in clinician notes and after-visit patient summaries. RESULTS In a 1-month period, 55 oncology providers had 361 encounters (clinic visits) with early-stage cancer patients. Thirty-five percent of these encounters included a provider communication about "physical activity," "exercise," or "activity." Encounters with a medical oncologist resulted in a physical activity communication 55% of the time, whereas encounters with other clinician specialties did so 20% of the time (P < .0001). The likelihood of a physical activity communication increased with patient age (P < .001). When the encounter was with a patient who was being seen for surveillance, chemotherapy, or endocrine treatment, the rate of physical activity communications was significantly higher (46%, 37%, and 58%, respectively) than the rate when the visit was during radiation treatment or surgery (6% and 19%, respectively; P < .0001). CONCLUSIONS This study shows that it is feasible for oncology providers to have physical activity communications during routine clinic visits; however, the frequency of physical activity communications varies among providers. Interventions are needed to remind and encourage all oncology providers to encourage their patients with early-stage cancer to be physically active. .
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Affiliation(s)
- Kirsten A Nyrop
- Division of Hematology and Oncology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Allison M Deal
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Grant R Williams
- Division of Hematology and Oncology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Emily J Guerard
- Division of Hematology and Oncology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Mackenzi Pergolotti
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Hyman B Muss
- Division of Hematology and Oncology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Boulton M, Adams E, Horne A, Durrant L, Rose P, Watson E. A qualitative study of cancer survivors’ responses to information on the long-term and late effects of pelvic radiotherapy 1-11 years post treatment. Eur J Cancer Care (Engl) 2015. [DOI: 10.1111/ecc.12356] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- M. Boulton
- Department of Clinical Health Care; Oxford Brookes University; Oxford UK
| | - E. Adams
- School of Psychology; College of Life Sciences; Birmingham University; Birmingham UK
| | - A. Horne
- Oxford University Hospitals NHS Trust; Department of Radiotherapy; Oxford Cancer and Haematology Centre; Churchill Hospital; Oxford UK
| | - L. Durrant
- Oxford University Hospitals NHS Trust; Department of Radiotherapy; Oxford Cancer and Haematology Centre; Churchill Hospital; Oxford UK
| | - P. Rose
- Department of Primary Health Care Sciences; University of Oxford; Oxford UK
| | - E. Watson
- Department of Clinical Health Care; Oxford Brookes University; Oxford UK
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Bluethmann SM, Basen-Engquist K, Vernon SW, Cox M, Gabriel KP, Stansberry SA, Carmack CL, Blalock JA, Demark-Wahnefried W. Grasping the 'teachable moment': time since diagnosis, symptom burden and health behaviors in breast, colorectal and prostate cancer survivors. Psychooncology 2015; 24:1250-1257. [PMID: 26060053 DOI: 10.1002/pon.3857] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Revised: 04/29/2015] [Accepted: 04/30/2015] [Indexed: 01/09/2023]
Abstract
BACKGROUND A cancer diagnosis may provide a 'teachable moment' in cancer recovery. To better understand factors influencing lifestyle choices following diagnosis, we examined associations between time since diagnosis and symptom burden with recommended dietary (e.g., five or more fruit/vegetable servings/day), physical activity (e.g., >150 active min, 3-5 times/week), and smoking behaviors (i.e., eliminate tobacco use) in cancer survivors. METHODS We analyzed cross-sectional survey data collected from breast (n = 528), colorectal (n = 106), and prostate (n = 419) cancer survivors following active treatment at The University of Texas MD Anderson Cancer Center. Four regression models were tested for behaviors of interest. Additionally, we assessed symptom burden as a potential moderator and/or mediator between time since diagnosis and behaviors. RESULTS Respondents were mostly female (55%) and non-Hispanic White (68%) with a mean age of 62.8 ± 11.4 years and mean time since diagnosis of 4.6 ± 3.1 years. In regression models, greater time since diagnosis predicted lower fruit and vegetable consumption (B = -0.05, p = 0.02) and more cigarette smoking (B = 0.06, p = 0.105). Greater symptom burden was a significant negative predictor for physical activity (B = -0.08, p < .001). We did not find evidence that symptom burden moderated or mediated the association between time since diagnosis and health behaviors. CONCLUSION We assessed the prevalence of recommended behaviors in the context of other challenges that survivors face, including time since diagnosis and symptom burden. Our results provide indirect evidence that proximity to a cancer diagnosis may provide a teachable moment to improve dietary and smoking behaviors and that symptom burden may impede physical activity following diagnosis. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Shirley M Bluethmann
- University of Texas School of Public Health, Houston, TX, USA.,University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Sally W Vernon
- University of Texas School of Public Health, Houston, TX, USA
| | - Matthew Cox
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | | | - Cindy L Carmack
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Bluethmann SM, Vernon SW, Gabriel KP, Murphy CC, Bartholomew LK. Taking the next step: a systematic review and meta-analysis of physical activity and behavior change interventions in recent post-treatment breast cancer survivors. Breast Cancer Res Treat 2015; 149:331-42. [PMID: 25555831 DOI: 10.1007/s10549-014-3255-5] [Citation(s) in RCA: 114] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 12/20/2014] [Indexed: 12/18/2022]
Abstract
Research has shown that recent post-treatment breast cancer survivors face significant challenges around physical activity as they transition to recovery. This review examined randomized controlled trials targeting physical activity behavior change in breast cancer survivors <5 years post-treatment and described (1) characteristics of interventions for breast cancer survivors as well as (2) effect size estimates for these studies. A systematic search was conducted following PRISMA guidelines with Medline, PubMed, PsycINFO, CINAHL, and Scopus databases. Data were abstracted for primary intervention strategies and other details (e.g., setting, duration, theory use). A subgroup analysis was conducted to assess intensity of exercise supervision/monitoring and intervention effectiveness. The search produced 14 unique behavior intervention trials from the US and abroad published 2005-2013. The mean sample size was 153 participants per study. All interventions included moderate-intensity activities plus various behavioral change strategies. Most interventions were partially or entirely home based. The overall standardized mean difference was 0.47 (0.23, 0.67) with p < 0.001. Most interventions were effective in producing short-term behavior changes in physical activity, but varied greatly relative to intervention strategies and intensity of supervision/monitoring. Highly structured interventions tended to produce larger behavior change effects overall, but many larger effect sizes came from interventions supported by phone counseling or e-mail. We observed that 'more' may not be better in terms of direct supervision/monitoring in physical activity behavior interventions. This may be important in exploring less resource-intensive options for effective behavior change strategies for recent post-treatment survivors.
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Affiliation(s)
- Shirley M Bluethmann
- Center for Health Promotion and Prevention Research, University of Texas School of Public Health, 7000 Fannin, Suite 2560, Houston, TX, 77030, USA,
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Brunet J, Amireault S, Chaiton M, Sabiston CM. Identification and prediction of physical activity trajectories in women treated for breast cancer. Ann Epidemiol 2014; 24:837-42. [DOI: 10.1016/j.annepidem.2014.07.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Revised: 07/14/2014] [Accepted: 07/22/2014] [Indexed: 11/28/2022]
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Sabiston CM, Brunet J, Vallance JK, Meterissian S. Prospective examination of objectively assessed physical activity and sedentary time after breast cancer treatment: sitting on the crest of the teachable moment. Cancer Epidemiol Biomarkers Prev 2014; 23:1324-30. [PMID: 24753546 DOI: 10.1158/1055-9965.epi-13-1179] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND This study prospectively examined patterns of objectively assessed sedentary time and moderate-to-vigorous physical activity (MVPA) during a 1-year period following completion of primary treatment among breast cancer survivors. The potential moderating effect of weight status on sedentary and MVPA time was also examined. METHODS Breast cancer survivors [n = 177; M(SD)age = 54.9 (11.1) years, 85% White/Caucasian; 82% stage I or II cancer; M(SD)time since treatment = 3.5 (2.4) months] who were recruited into a convenience sample had weight, height, and waist circumference measured and wore Actigraph GT3X accelerometers for 1 week every 3 months for 1 year. Data were analyzed using repeated measures ANOVA. RESULTS Survivors spent nearly 78% of their day sedentary across all time points compared with less than 2% of their day engaged in MVPA. Sedentary time remained fairly stable over 12 months, whereas MVPA levels significantly decreased. Survivors with an overweight body mass index and unhealthy waist-to-height ratio engaged in significantly less MVPA than healthy weight survivors, with significant waist-to-height ratio moderator effects for both sedentary and MVPA. CONCLUSIONS Sedentary time remains high in the first year following treatment for breast cancer, and MVPA decreases. These trends are more pronounced for survivors who are overweight, with stronger effects noted when waist-to-height ratio was examined compared with body mass index. IMPACT These findings suggest that breast cancer survivors may be doing very little to improve their lifestyle behaviors following a cancer diagnosis and treatments.
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Affiliation(s)
- Catherine M Sabiston
- Authors' Affiliations: Faculty of Kinesiology and Physical Education, University of Toronto, Toronto;
| | - Jennifer Brunet
- School of Human Kinetics, University of Ottawa, Ottawa, Ontario
| | - Jeff K Vallance
- Faculty of Health Disciplines, Athabasca University, Athabasca; and
| | - Sarkis Meterissian
- McGill University Health Center, Cedar's Breast Clinic, Montreal, Quebec, Canada
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Williams K, Steptoe A, Wardle J. Is a cancer diagnosis a trigger for health behaviour change? Findings from a prospective, population-based study. Br J Cancer 2013; 108:2407-12. [PMID: 23695026 PMCID: PMC3681023 DOI: 10.1038/bjc.2013.254] [Citation(s) in RCA: 104] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background: A healthy lifestyle following a cancer diagnosis may improve long-term outcomes. No studies have examined health behaviour change among UK cancer survivors, or tracked behaviours over time in survivors and controls. We assessed smoking, alcohol and physical activity at three times (0–2 years before a cancer diagnosis, 0–2 years post-diagnosis and 2–4 years post-diagnosis) and at matched times in a comparison group. Methods: Data were from waves 1–5 of the English Longitudinal Study of Ageing; a cohort of older adults in England. Behavioural measures were taken at each wave. Generalised estimating equations were used to examine differences by group and time, and group-by-time interactions. Results: Of the 5146 adults included in the analyses, 433 (8.4%) were diagnosed with cancer. Those with a cancer diagnosis were less likely to be physically active (P<0.01) and more likely to be sedentary (P<0.001). There were no group differences in alcohol or smoking. Smoking, alcohol and activity reduced over time in the whole group. Group-by-time interactions were not significant for smoking (P=0.17), alcohol (P=0.20), activity (P=0.17) or sedentary behaviour (P=0.86), although there were trends towards a transient improvement from pre-diagnosis to immediately post-diagnosis. Conclusion: We found little evidence that a cancer diagnosis motivates health-protective changes. Given the importance of healthy lifestyles, strategies for effective support for behaviour change in cancer survivors need to be identified.
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Affiliation(s)
- K Williams
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, Gower Street, London WC1E 6BT, UK
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Murphy JL, Girot EA. The importance of nutrition, diet and lifestyle advice for cancer survivors - the role of nursing staff and interprofessional workers. J Clin Nurs 2013; 22:1539-49. [PMID: 23387979 DOI: 10.1111/jocn.12053] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2012] [Indexed: 11/26/2022]
Abstract
AIMS AND OBJECTIVES To examine current guidelines and the evidence base to illustrate the importance of nutrition, diet and lifestyle advice to support people who have survived cancer and help them integrate back into normal life, improve their quality of life and potentially improve their chance of long-term survival. BACKGROUND Cancer survivors need to know about nutrition and other lifestyle behaviour changes to help them recover and potentially reduce the risk of the same cancer recurring or a new cancer developing. From this perspective, frontline registered nurses are in a prime position to support cancer survivors who are in their care. DESIGN Discursive paper. METHODS On the basis of the international research evidence and a critical analysis of recent policy and practice literature, themes emerged, which illustrate the importance of nutrition, diet and lifestyle advice for cancer survivors. This paper discusses the need for more focused education and greater interprofessional working for quality care delivery. CONCLUSION New professional guidance for emerging frontline nurses indicates they should be able to provide appropriate and more consistent advice on nutritional issues, physical activity and weight management, although more research is needed to understand the right mode of nutrition training. Additionally, interprofessional working needs improving as well as encouraging cancer survivors to respond. RELEVANCE TO CLINICAL PRACTICE High-quality nutrition education and training is required for nurses working across both the acute and primary care sectors. They require this to effectively monitor and advise patients and to know when, where and from whom they can access more specialist help. Interprofessional collaborative working across multi-centre settings (National Health Service and non-National Health Service) is key to provide the best effective care and support for cancer survivors.
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Affiliation(s)
- Jane L Murphy
- School of Health and Social Care, Bournemouth University, Bournemouth, Dorset, UK.
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