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Liu Q, Jiang L, Ho KY, Lam KKW, Lam W, Yang F, Mao T, Sun M, Shen B, Ho JM, Liu PK, Chiu SY, Wong FKY. Spiritual Interventions Among Pediatric Patients With Cancer: A Systematic Review And Meta-Analysis. J Pain Symptom Manage 2024; 68:e8-e20. [PMID: 38518833 DOI: 10.1016/j.jpainsymman.2024.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 03/11/2024] [Accepted: 03/13/2024] [Indexed: 03/24/2024]
Abstract
CONTEXT Although spiritual intervention is crucial in the care of childhood cancer patients (CCPs), its effectiveness has not yet been systematically evaluated. OBJECTIVES To determine the effectiveness of existing spiritual interventions on psychological, spiritual outcomes, and quality of life (QoL) in CCPs. METHODS We searched eight databases to identify relevant randomized controlled trials and quasi-experimental studies. Risk of bias was assessed using the Cochrane risk-of-bias tool for randomized trials. Results were either synthesized in a systematic narrative synthesis or a meta-analysis using a random effects model, where appropriate. The pooled treatment effect was estimated using the standardized mean difference (SMD) and 95% confidence interval (CI). RESULTS Twelve studies with 576 CCPs were included. Eight studies showed a high risk of bias. The overall effect of existing spiritual interventions on QoL (Z = 1.05, SMD = 0.64, 95%CI = -0.15 to 1.83, P = 0.29), anxiety (Z = 1.11, SMD = -0.83, 95%CI = -2.30 to 0.64, P = 0.28) and depressive symptoms (Z = 1.06, SMD = -0.49, 95%CI = -1.40 to 0.42, P = 0.12) were statistically nonsignificant. The nonsignificant findings could be attributed to the high heterogeneity among the included studies (QoL: I2 = 85%; anxiety: I2 = 90%; depressive symptoms: I2 = 58%). CONCLUSION Evidence to support the positive effects of existing spiritual interventions on psychological and spiritual outcomes and QoL in CCPs is insufficient. Future studies should adopt a more rigorous design and unify the outcome measures to reduce the risk of bias and heterogeneity, respectively.
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Affiliation(s)
- Qi Liu
- School of Nursing (Q.L., L.J., K.Y.H., K.K.W.L., W.L., F.Y., T.M., J.M.C.H., F.K.Y.W.), Hong Kong Polytechnic University, Hung Hom, Kowloon, HKSAR
| | - Ling Jiang
- School of Nursing (Q.L., L.J., K.Y.H., K.K.W.L., W.L., F.Y., T.M., J.M.C.H., F.K.Y.W.), Hong Kong Polytechnic University, Hung Hom, Kowloon, HKSAR
| | - Ka Yan Ho
- School of Nursing (Q.L., L.J., K.Y.H., K.K.W.L., W.L., F.Y., T.M., J.M.C.H., F.K.Y.W.), Hong Kong Polytechnic University, Hung Hom, Kowloon, HKSAR.
| | - Katherine K W Lam
- School of Nursing (Q.L., L.J., K.Y.H., K.K.W.L., W.L., F.Y., T.M., J.M.C.H., F.K.Y.W.), Hong Kong Polytechnic University, Hung Hom, Kowloon, HKSAR
| | - Winsome Lam
- School of Nursing (Q.L., L.J., K.Y.H., K.K.W.L., W.L., F.Y., T.M., J.M.C.H., F.K.Y.W.), Hong Kong Polytechnic University, Hung Hom, Kowloon, HKSAR
| | - Funa Yang
- School of Nursing (Q.L., L.J., K.Y.H., K.K.W.L., W.L., F.Y., T.M., J.M.C.H., F.K.Y.W.), Hong Kong Polytechnic University, Hung Hom, Kowloon, HKSAR
| | - Ting Mao
- School of Nursing (Q.L., L.J., K.Y.H., K.K.W.L., W.L., F.Y., T.M., J.M.C.H., F.K.Y.W.), Hong Kong Polytechnic University, Hung Hom, Kowloon, HKSAR
| | - Mei Sun
- Xiangya School of Nursing (M.S.), Central South University, China
| | - Biyu Shen
- Department of Nursing (B.S.), Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, China
| | - Jacqueline Mc Ho
- School of Nursing (Q.L., L.J., K.Y.H., K.K.W.L., W.L., F.Y., T.M., J.M.C.H., F.K.Y.W.), Hong Kong Polytechnic University, Hung Hom, Kowloon, HKSAR
| | - P K Liu
- Hong Kong Children's Hospital (P.K.L.), Shing Cheong Road, Kowloon Bay, HKSAR
| | - S Y Chiu
- Department of Adolescent Medicine (S.Y.C.), Queen Mary Hospital, 102 Pokfulam Road, HKSAR
| | - Frances-Kam-Yuet Wong
- School of Nursing (Q.L., L.J., K.Y.H., K.K.W.L., W.L., F.Y., T.M., J.M.C.H., F.K.Y.W.), Hong Kong Polytechnic University, Hung Hom, Kowloon, HKSAR
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Çaksen H. Spiritual needs of children and adolescents with cancer at the end of life. Pediatr Blood Cancer 2024:e31063. [PMID: 38733130 DOI: 10.1002/pbc.31063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Accepted: 04/26/2024] [Indexed: 05/13/2024]
Affiliation(s)
- Hüseyin Çaksen
- Divisions of Pediatric Neurology and Genetics and Behavioral-Developmental Pediatrics, Department of Pediatrics, Faculty of Medicine, Necmettin Erbakan University, Meram, Konya, Türkiye
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Liu Q, Ho KY, Lam KKW, Ho JMC, Lam W, Ma P, Abu-Odah H, Belay GM, Ling DL, Ching SSY, Wong FKY. Effectiveness of spiritual interventions on psychological outcomes and quality of life among paediatric patients with cancer: a study protocol for a systematic review. BMJ Open 2023; 13:e070810. [PMID: 36882254 PMCID: PMC10008432 DOI: 10.1136/bmjopen-2022-070810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
INTRODUCTION Cancer and its treatment affect children's physical, psychological and social well-being throughout the disease trajectory. Spiritual well-being is a fundamental dimension of people's overall health and is considered a source of strength to motivate patients to cope with and adapt to their disease. Appropriate spiritual interventions are important to mitigate the psychological impact of cancer on children, with an ultimate goal of improving their quality of life (QoL) throughout the treatment course. However, the overall effectiveness of spiritual interventions for paediatric patients with cancer remains unclear. This paper describes a protocol to systematically summarise the characteristics of studies related to existing spiritual interventions and synthesise their effectiveness on psychological outcomes and QoL among children with cancer. METHODS AND ANALYSIS Ten databases will be searched to identify appropriate literature: MEDLINE, the Cochrane Central Register of Controlled Trials, EMBASE, CINAHL, PsycINFO, LILACS, OpenSIGLE, the Chinese Biomedical Literature Database, the Chinese Medical Current Contents and the Chinese National Knowledge Infrastructure. All randomised controlled trials that meet our inclusion criteria will be included. The primary outcome will be QoL as evaluated by self-reported measures. The secondary outcomes will be self-reported or objectively measured psychological outcomes, including anxiety and depression. Review Manager V.5.3 will be used to synthesise the data, calculate treatment effects, perform any subgroup analyses and assess the risk of bias in included studies. ETHICAL AND DISSEMINATION The results will be presented at international conferences and published in peer-reviewed journals. As no individual data will be involved in this review, ethical approval is not required.
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Affiliation(s)
- Qi Liu
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Ka Yan Ho
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | | | | | - Winsome Lam
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Polly Ma
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Hammoda Abu-Odah
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | | | - Dong-Lan Ling
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
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Liu Q, Ho KY, Lam KKW, Lam WYY, Cheng EHL, Ching SSY, Wong FKY. A Descriptive and Phenomenological Exploration of the Spiritual Needs of Chinese Children Hospitalized with Cancer. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192013217. [PMID: 36293795 PMCID: PMC9602965 DOI: 10.3390/ijerph192013217] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/10/2022] [Accepted: 10/11/2022] [Indexed: 05/12/2023]
Abstract
Spiritual well-being is the fourth dimension of health, as equally important as physical, mental, and social well-being. The shadow of death associated with cancer triggers children to explore their personal values, meanings, and life goals throughout the illness trajectory, enabling them to identify their unique spiritual needs. Chinese children are generally non-religious, unlike Western children, which affects their spiritual needs. To address the literature gaps, we applied a qualitative, descriptive, phenomenological approach for exploring the spiritual needs of Chinese children hospitalized with cancer. Purposive sampling was conducted in two public hospitals with special wards for pediatric oncology patients in Hunan Province, China. Consequently, 22 children, hospitalized with cancer, were recruited and individually interviewed using a semi-structured interview format. We conducted a thematic analysis of the interview transcripts. Four important themes were identified: the need for self-exploration, inner needs, need for a connection with others, and need for a connection with gods, supernatural powers, and fictional characters. We found that culture significantly influenced the spiritual needs of Chinese children with cancer. Hope was a key factor motivating the children to continue cancer treatment. To address their unique spiritual needs, culturally specific interventions should be developed and incorporated into their care to enhance their spiritual well-being.
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Affiliation(s)
| | - Ka-Yan Ho
- Correspondence: ; Tel.: +852-27666417
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5
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Rossato L, Ullán AM, Scorsolini-Comin F. Religious and Spiritual Practices Used by Children and Adolescents to Cope with Cancer. JOURNAL OF RELIGION AND HEALTH 2021; 60:4167-4183. [PMID: 33871781 DOI: 10.1007/s10943-021-01256-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/07/2021] [Indexed: 06/12/2023]
Abstract
This study consists of an integrative review of the scientific literature that aimed to know the religious and spiritual practices used by children and adolescents to cope with cancer. From searches in the databases/libraries CINAHL, PsycINFO, PubMed, SciELO and Lilacs (2009-2019), the final sample consisted of 20 articles. Prayers were the most widely used practices, followed by sacred books and objects, going to sacred places and the use of music. Improvements in well-being, physical and emotional health have been reported. It is concluded that such practices should be recognized as important resources in coping with cancer illness in this population.
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Affiliation(s)
- Lucas Rossato
- Department of Psychiatric Nursing and Human Sciences, University of São Paulo At Ribeirão Preto College of Nursing, Av. Bandeirantes, 3900 - Vila Monte Alegre, Ribeirão Preto, SP, 14040-902, Brazil.
| | - Ana M Ullán
- Advanced Research Unit in Pediatric Psychology, Department of Social Psychology and Anthropology, University of Salamanca, Salamanca, Spain
| | - Fabio Scorsolini-Comin
- Department of Psychiatric Nursing and Human Sciences, University of São Paulo At Ribeirão Preto College of Nursing, Av. Bandeirantes, 3900 - Vila Monte Alegre, Ribeirão Preto, SP, 14040-902, Brazil
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Religious–spiritual experiences of family members and caregivers of children and adolescents with cancer. Palliat Support Care 2021; 20:711-719. [DOI: 10.1017/s1478951521001590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
This integrative literature review aimed to identify the religious and spiritual experiences of family members and caregivers of children and adolescents with cancer. Through systematized searches in the databases/libraries CINAHL, PsycINFO, Pubmed, SciELO, and Lilacs, 69 articles produced between 2010 and 2020 were retrieved. There was a predominance of studies with parents developed in hospital facilities. The caregivers’ religious and spiritual experiences helped them to cope with childhood cancer, especially in maintaining hope, reducing stress and anxiety symptoms, as well as in providing psychological and social support. Negative outcomes such as questioning faith, the feeling of punishment, and disruption with the religious and spiritual group were also perceived. It is recommended to include religiosity and spirituality for the provision of more humanized and comprehensive care, as well as further investigation of the negative experiences regarding religiosity and spirituality in this public.
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Proserpio T, Pagani Bagliacca E, Sironi G, Clerici CA, Veneroni L, Massimino M, Ferrari A. Spirituality and Sustaining Hope in Adolescents with Cancer: The Patients' View. J Adolesc Young Adult Oncol 2020; 9:36-40. [DOI: 10.1089/jayao.2019.0058] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Tullio Proserpio
- Pastoral Care Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Giovanna Sironi
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Carlo Alfredo Clerici
- Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
- SSD Clinical Psychology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Laura Veneroni
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Maura Massimino
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
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Ferrari A, Veneroni L, Signoroni S, Silva M, Gaggiotti P, Casanova M, Chiaravalli S, Clerici CA, Proserpio T, Massimino M. Loop: there's no going back: A Graphic Novel by Adolescent Cancer Patients on the Youth Project in Milan. THE JOURNAL OF MEDICAL HUMANITIES 2019; 40:505-511. [PMID: 31165370 DOI: 10.1007/s10912-019-09561-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The present paper describes the story of the development of a graphic novel-a story about superheroes-written by adolescent cancer patients on the Youth Project at the Istituto Nazionale Tumori in Milan (Italy). Nineteen patients from fifteen to twenty-five years old (fifteen receiving treatment for their cancer, four who had recently completed their treatments) participated in a four month creative writing laboratory managed by a professional teacher. The output from the writing laboratory was a written text that was used as the script for a graphic novel drawn by professional cartoonists and working together with the patients. Through their story, adolescent patients succeeded in voicing their dreams and fears. It was the adolescent patients themselves who explained how they had each tried to bring out the superhero inside them. This project describes the amazing powers of adolescents with cancer and opens a precious window on their inner world, enabling us to gain a better understanding of what they are really thinking and feeling through their own words.
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Affiliation(s)
- Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - Laura Veneroni
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Stefano Signoroni
- Unit for Hereditary Digestive Tract Tumors, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Matteo Silva
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Paola Gaggiotti
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Michela Casanova
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Stefano Chiaravalli
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Carlo Alfredo Clerici
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- Department of Biomolecular Sciences and Biotechnology, Psychology Section, Faculty of Medicine, University of Milan, Milan, Italy
| | - Tullio Proserpio
- Pastoral Care Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Maura Massimino
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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9
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Robert R, Stavinoha P, Jones BL, Robinson J, Larson K, Hicklen R, Smith B, Perko K, Koch K, Findley S, Weaver MS. Comment on: Spiritual support: A model of care not to forget. Pediatr Blood Cancer 2019; 66:e27866. [PMID: 31309697 DOI: 10.1002/pbc.27866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 05/15/2019] [Indexed: 11/08/2022]
Affiliation(s)
- Rhonda Robert
- Department of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Pete Stavinoha
- Department of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Barbara L Jones
- Steve Hicks School of Social Work and Dell Medical School, University of Texas at Austin, Austin, Texas
| | - Jacob Robinson
- Division of Pediatric Palliative Care, Children's Hospital and Medical Center, Omaha, Nebraska
| | - Kara Larson
- Division of Spiritual Ministry and Chaplaincy, Children's Hospital Medical Center, Omaha, Nebraska
| | - Rachel Hicklen
- The Research Medical Library, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Blake Smith
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, Texas
| | - Kathleen Perko
- Bridges Palliative Care Program, Doernbecher, Children's Hospital, Oregon Health and Science University, Portland, Oregon
| | - Kendra Koch
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, Texas
| | - Stephen Findley
- Department of Spiritual Care and Education, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Meaghann S Weaver
- Division of Pediatric Palliative Care, Children's Hospital and Medical Center, Omaha, Nebraska
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Proserpio T, Ferrari A, Clerici CA, Massimino M. Spiritual support: A model of care not to forget. Pediatr Blood Cancer 2019; 66:e27818. [PMID: 31087623 DOI: 10.1002/pbc.27818] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 05/06/2019] [Indexed: 12/28/2022]
Affiliation(s)
- Tullio Proserpio
- Pastoral Care Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Carlo Alfredo Clerici
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy.,Department of Biomolecular Sciences and Biotechnology, Psychology Section, Faculty of Medicine, University of Milan, Milan, Italy
| | - Maura Massimino
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
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Abstract
Adolescents and young adults (AYAs) with cancer constitute a particular group of patients with unique features, whose needs during and after treatment are poorly met. A standardized model of care for them has yet to be established, as neither the pediatric nor the adult oncology systems seamlessly fit their needs. Regardless of the setting in which they are treated, their health care providers should be aware of the impact that the disease and its treatments have on these especially vulnerable patients. Simple ways of improving the AYA experience should be considered: reducing isolation through connections with peers, adapting the staff's approach to the emotional and developmental needs of this age group, and modifying the hospital environment making it more age appropriate. Commitment of national governments is valuable; building and sharing international experience will accelerate advances in clinical care, education, and research. Further progress in the care of AYA cancer patients is still needed to improve their outcomes.
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Kaye EC, Snaman JM, Johnson L, Levine D, Powell B, Love A, Smith J, Ehrentraut JH, Lyman J, Cunningham M, Baker JN. Communication with Children with Cancer and Their Families Throughout the Illness Journey and at the End of Life. PALLIATIVE CARE IN PEDIATRIC ONCOLOGY 2018. [DOI: 10.1007/978-3-319-61391-8_4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Cancer in adolescence - the girlfriend's story. TUMORI JOURNAL 2017; 104:NP1-NP2. [PMID: 29048707 DOI: 10.5301/tj.5000686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Ferrari A, Gaggiotti P, Silva M, Veneroni L, Magni C, Signoroni S, Casanova M, Luksch R, Terenziani M, Spreafico F, Meazza C, Clerici CA, Massimino M. Searching for Happiness. J Clin Oncol 2017; 35:2209-2212. [DOI: 10.1200/jco.2017.72.8733] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Andrea Ferrari
- Andrea Ferrari, Paola Gaggiotti, Matteo Silva, Laura Veneroni, Chiara Magni, Stefano Signoroni, Michela Casanova, Roberto Luksch, Monica Terenziani, Filippo Spreafico, Cristina Meazza, Carlo Alfredo Clerici and Maura Massimino, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori; and Carlo Alfredo Clerici, University of Milan, Milan, Italy
| | - Paola Gaggiotti
- Andrea Ferrari, Paola Gaggiotti, Matteo Silva, Laura Veneroni, Chiara Magni, Stefano Signoroni, Michela Casanova, Roberto Luksch, Monica Terenziani, Filippo Spreafico, Cristina Meazza, Carlo Alfredo Clerici and Maura Massimino, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori; and Carlo Alfredo Clerici, University of Milan, Milan, Italy
| | - Matteo Silva
- Andrea Ferrari, Paola Gaggiotti, Matteo Silva, Laura Veneroni, Chiara Magni, Stefano Signoroni, Michela Casanova, Roberto Luksch, Monica Terenziani, Filippo Spreafico, Cristina Meazza, Carlo Alfredo Clerici and Maura Massimino, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori; and Carlo Alfredo Clerici, University of Milan, Milan, Italy
| | - Laura Veneroni
- Andrea Ferrari, Paola Gaggiotti, Matteo Silva, Laura Veneroni, Chiara Magni, Stefano Signoroni, Michela Casanova, Roberto Luksch, Monica Terenziani, Filippo Spreafico, Cristina Meazza, Carlo Alfredo Clerici and Maura Massimino, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori; and Carlo Alfredo Clerici, University of Milan, Milan, Italy
| | - Chiara Magni
- Andrea Ferrari, Paola Gaggiotti, Matteo Silva, Laura Veneroni, Chiara Magni, Stefano Signoroni, Michela Casanova, Roberto Luksch, Monica Terenziani, Filippo Spreafico, Cristina Meazza, Carlo Alfredo Clerici and Maura Massimino, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori; and Carlo Alfredo Clerici, University of Milan, Milan, Italy
| | - Stefano Signoroni
- Andrea Ferrari, Paola Gaggiotti, Matteo Silva, Laura Veneroni, Chiara Magni, Stefano Signoroni, Michela Casanova, Roberto Luksch, Monica Terenziani, Filippo Spreafico, Cristina Meazza, Carlo Alfredo Clerici and Maura Massimino, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori; and Carlo Alfredo Clerici, University of Milan, Milan, Italy
| | - Michela Casanova
- Andrea Ferrari, Paola Gaggiotti, Matteo Silva, Laura Veneroni, Chiara Magni, Stefano Signoroni, Michela Casanova, Roberto Luksch, Monica Terenziani, Filippo Spreafico, Cristina Meazza, Carlo Alfredo Clerici and Maura Massimino, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori; and Carlo Alfredo Clerici, University of Milan, Milan, Italy
| | - Roberto Luksch
- Andrea Ferrari, Paola Gaggiotti, Matteo Silva, Laura Veneroni, Chiara Magni, Stefano Signoroni, Michela Casanova, Roberto Luksch, Monica Terenziani, Filippo Spreafico, Cristina Meazza, Carlo Alfredo Clerici and Maura Massimino, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori; and Carlo Alfredo Clerici, University of Milan, Milan, Italy
| | - Monica Terenziani
- Andrea Ferrari, Paola Gaggiotti, Matteo Silva, Laura Veneroni, Chiara Magni, Stefano Signoroni, Michela Casanova, Roberto Luksch, Monica Terenziani, Filippo Spreafico, Cristina Meazza, Carlo Alfredo Clerici and Maura Massimino, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori; and Carlo Alfredo Clerici, University of Milan, Milan, Italy
| | - Filippo Spreafico
- Andrea Ferrari, Paola Gaggiotti, Matteo Silva, Laura Veneroni, Chiara Magni, Stefano Signoroni, Michela Casanova, Roberto Luksch, Monica Terenziani, Filippo Spreafico, Cristina Meazza, Carlo Alfredo Clerici and Maura Massimino, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori; and Carlo Alfredo Clerici, University of Milan, Milan, Italy
| | - Cristina Meazza
- Andrea Ferrari, Paola Gaggiotti, Matteo Silva, Laura Veneroni, Chiara Magni, Stefano Signoroni, Michela Casanova, Roberto Luksch, Monica Terenziani, Filippo Spreafico, Cristina Meazza, Carlo Alfredo Clerici and Maura Massimino, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori; and Carlo Alfredo Clerici, University of Milan, Milan, Italy
| | - Carlo Alfredo Clerici
- Andrea Ferrari, Paola Gaggiotti, Matteo Silva, Laura Veneroni, Chiara Magni, Stefano Signoroni, Michela Casanova, Roberto Luksch, Monica Terenziani, Filippo Spreafico, Cristina Meazza, Carlo Alfredo Clerici and Maura Massimino, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori; and Carlo Alfredo Clerici, University of Milan, Milan, Italy
| | - Maura Massimino
- Andrea Ferrari, Paola Gaggiotti, Matteo Silva, Laura Veneroni, Chiara Magni, Stefano Signoroni, Michela Casanova, Roberto Luksch, Monica Terenziani, Filippo Spreafico, Cristina Meazza, Carlo Alfredo Clerici and Maura Massimino, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori; and Carlo Alfredo Clerici, University of Milan, Milan, Italy
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15
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Ferrari A, Silva M, Veneroni L, Magni C, Clerici CA, Meazza C, Terenziani M, Spreafico F, Chiaravalli S, Casanova M, Luksch R, Catania S, Schiavello E, Biassoni V, Podda M, Bergamaschi L, Puma N, Indini A, Proserpio T, Massimino M. Measuring the efficacy of a project for adolescents and young adults with cancer: A study from the Milan Youth Project. Pediatr Blood Cancer 2016; 63:2197-2204. [PMID: 27554940 DOI: 10.1002/pbc.26172] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 06/08/2016] [Accepted: 06/28/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND Various projects dedicated specifically to adolescents and young adults (AYA) with cancer have been developed in recent years. A critical aspect of such programs is the ability to demonstrate its value, and therefore how to measure desired outcomes. METHODS A list of metrics to consider for demonstrating the advantages of an AYA program was identified and used to assess the activity of the Youth Project operating at the Pediatric Oncology Unit of the Istituto Nazionale Tumori in Milan. RESULTS The number of newly diagnosed AYA patients seen at the Unit has increased since the formal launch of the Youth Project, from 65 to 81.2 cases/year. Concerning the 78 AYA patients presenting with malignant neoplasms in 2015, 82% were included in clinical trials (the other 18% in prospective observational studies). Fertility preservation measures were implemented for 59% of AYA patients considered at risk, and specific psychological support was provided in 70.6% of cases; 72.5% of patients actively participated in support activities. Other parameters considered were a preliminary satisfaction questionnaire administered to patients and the program's scientific recognition and acknowledgment by the community. CONCLUSIONS The study proposed a number of potentially reproducible, practical parameters to consider in assessing the value of a program dedicated to AYA. These metrics were examined in terms of the activities of our Youth Project, and confirmed its efficacy. To be sustainable over time, AYA projects have to be accepted as a standard of care at the community and government levels.
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Affiliation(s)
- Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy.
| | - Matteo Silva
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Laura Veneroni
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Chiara Magni
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Carlo Alfredo Clerici
- Clinical Biology, Oncology and Hemato-Oncology Department, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Cristina Meazza
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Monica Terenziani
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Filippo Spreafico
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Stefano Chiaravalli
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Michela Casanova
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Roberto Luksch
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Serena Catania
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Elisabetta Schiavello
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Veronica Biassoni
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Marta Podda
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Luca Bergamaschi
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Nadia Puma
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Alice Indini
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Tullio Proserpio
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Maura Massimino
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
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