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Acquaye‐Mallory A, Vera E, Choi A, Wall K, Gilbert MR, Armstrong TS. Identifying associations between sample characteristics, symptoms, and self-efficacy differences in adult patients with rare tumors of the central nervous system who participated in a novel web-based natural history study. Cancer Med 2024; 13:e70017. [PMID: 39101481 PMCID: PMC11299073 DOI: 10.1002/cam4.70017] [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: 04/12/2024] [Revised: 06/28/2024] [Accepted: 07/05/2024] [Indexed: 08/06/2024] Open
Abstract
OBJECTIVE High self-efficacy is associated with improved self-care and reduced symptoms in cancer patients but has not been fully interrogated in adults with central nervous system (CNS) cancers. We aimed to identify the relationship between self-efficacy levels in managing emotions (SEMEM) and social interactions (SEMSI) by examining sample characteristics and symptom burden. METHODS Sample characteristics and patient-reported outcome (PRO) measures addressing self-efficacy (PROMIS SEMEM & SEMSI) and symptom burden (MDASI BT or SP) were collected in a novel web-based study of 158 adult patients diagnosed with rare CNS tumors. RESULTS The sample was predominantly female (73%), diagnosed with an ependymoma (66%), and had a median age of 45 (19-75). Low SEMEM was associated with a longer duration of symptoms before surgery (r = -0.26) and female gender (92%) among brain tumor (BT) participants and in spinal cord tumors (SCT), those with lower education (r = 0.29). Reporting low SEMSI was associated with being married (42%), lower education (r = 0.22), and a prolonged time with symptoms before surgery (r = 0.29) in those with BTs, with no associations identified in SCT. More severe mood-related interference (including mood, enjoyment of life, and relationship with others) was associated with lower SEMEM among both locations (r = -0.61 brain, r = -0.28 spine) and SEMSI in BT participants (r = -0.54). CONCLUSIONS Low self-efficacy was linked to a prolonged time between symptom onset and initial surgery, education, gender, and marital status and was associated with higher mood-related interference. Understanding characteristics associated with low self-efficacy underscores a need for future studies to tailor interventions that enhance self-efficacy.
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Affiliation(s)
- Alvina Acquaye‐Mallory
- Neuro‐Oncology Branch, Center for Cancer ResearchNational Cancer Institute, National Institutes of HealthBethesdaMarylandUSA
| | - Elizabeth Vera
- Neuro‐Oncology Branch, Center for Cancer ResearchNational Cancer Institute, National Institutes of HealthBethesdaMarylandUSA
| | - Anna Choi
- Neuro‐Oncology Branch, Center for Cancer ResearchNational Cancer Institute, National Institutes of HealthBethesdaMarylandUSA
| | - Kathleen Wall
- Neuro‐Oncology Branch, Center for Cancer ResearchNational Cancer Institute, National Institutes of HealthBethesdaMarylandUSA
| | - Mark R. Gilbert
- Neuro‐Oncology Branch, Center for Cancer ResearchNational Cancer Institute, National Institutes of HealthBethesdaMarylandUSA
| | - Terri S. Armstrong
- Neuro‐Oncology Branch, Center for Cancer ResearchNational Cancer Institute, National Institutes of HealthBethesdaMarylandUSA
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Saldivia-Siracusa C, Dos Santos ES, González-Arriagada WA, Prado-Ribeiro AC, Brandão TB, Owosho A, Lopes MA, Epstein JB, Santos-Silva AR. Conspiracy of Silence in Head and Neck Cancer Diagnosis: A Scoping Review. Dent J (Basel) 2024; 12:214. [PMID: 39057001 PMCID: PMC11276277 DOI: 10.3390/dj12070214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 06/30/2024] [Accepted: 07/09/2024] [Indexed: 07/28/2024] Open
Abstract
Cancer disclosure represents a complex healthcare dynamic. Physicians or caregivers may be prompted to withhold diagnosis information from patients. This study aims to comprehensively map and synthesize available evidence about diagnosis nondisclosure regarding head and neck cancer (HNC) patients. Following the Joanna Briggs Institute guidelines, a scoping review was conducted across major databases without period restriction, yielding 9238 publications. After screening and selection, a descriptive synthesis was conducted. Sixteen studies were included, primarily conducted in academic settings (75%) from Europe and Asia, with a total population of 662 patients predominantly diagnosed with brain, oral, pharyngeal, or laryngeal tumors. Remarkably, 22.51% of patients were unaware of their diagnosis. Although physicians were the main source of diagnostic information (35%), they reported to often use vague terms to convey malignancy. Additionally, 13.29% of patients were aware of their diagnosis from sources other than doctors or caregivers. Caregivers (55%) supported diagnosis concealment, and physicians tended to respect family wishes. A high diagnosis-to-death interval, education, and age significantly influenced diagnosis disclosure. HNC patients expressed a desire for personalized open communication. Multiple factors influenced the decision on diagnosis disclosure. Current evidence on this topic varies significantly, and there is limited research on the consequences of nondisclosure. These findings reflect the underestimation of the patients' outlook in the diagnosis process and highlight the need for further research, aiming to establish open communication and patient autonomy during the oncological journey.
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Affiliation(s)
- Cristina Saldivia-Siracusa
- Departamento de Diagnóstico Oral, Faculdade de Odontologia de Piracicaba (FOP), Universidade Estadual de Campinas (UNICAMP), São Paulo 13414-903, Brazil; (C.S.-S.); (E.S.D.S.); (A.C.P.-R.); (M.A.L.)
| | - Erison Santana Dos Santos
- Departamento de Diagnóstico Oral, Faculdade de Odontologia de Piracicaba (FOP), Universidade Estadual de Campinas (UNICAMP), São Paulo 13414-903, Brazil; (C.S.-S.); (E.S.D.S.); (A.C.P.-R.); (M.A.L.)
| | | | - Ana Carolina Prado-Ribeiro
- Departamento de Diagnóstico Oral, Faculdade de Odontologia de Piracicaba (FOP), Universidade Estadual de Campinas (UNICAMP), São Paulo 13414-903, Brazil; (C.S.-S.); (E.S.D.S.); (A.C.P.-R.); (M.A.L.)
- Oral Medicine Service, Sírio Libanês Hospital, São Paulo 01308-050, Brazil
| | - Thaís Bianca Brandão
- Dental Oncology Service, São Paulo State Cancer Institute (ICESP-FMUSP), São Paulo 01246-903, Brazil;
| | - Adepitan Owosho
- Departments of Diagnostic Sciences, Department of Otolaryngology—Head & Neck Surgery and Bioscience Research, College of Dentistry, The University of Tennessee Health Science Center, Memphis, TN 38163, USA;
| | - Marcio Ajudarte Lopes
- Departamento de Diagnóstico Oral, Faculdade de Odontologia de Piracicaba (FOP), Universidade Estadual de Campinas (UNICAMP), São Paulo 13414-903, Brazil; (C.S.-S.); (E.S.D.S.); (A.C.P.-R.); (M.A.L.)
| | - Joel B. Epstein
- City of Hope Comprehensive Cancer Center, Duarte, CA 91010, USA;
- Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Alan Roger Santos-Silva
- Departamento de Diagnóstico Oral, Faculdade de Odontologia de Piracicaba (FOP), Universidade Estadual de Campinas (UNICAMP), São Paulo 13414-903, Brazil; (C.S.-S.); (E.S.D.S.); (A.C.P.-R.); (M.A.L.)
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Rimmer B, Finch T, Balla M, Dutton L, Williams S, Lewis J, Gallagher P, Burns R, Araújo‐Soares V, Menger F, Sharp L. Understanding supported self-management for people living with a lower-grade glioma: Implementation considerations through the lens of normalisation process theory. Health Expect 2024; 27:e14073. [PMID: 38733245 PMCID: PMC11087884 DOI: 10.1111/hex.14073] [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] [Received: 12/22/2023] [Revised: 02/16/2024] [Accepted: 05/02/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND Supported self-management can improve clinical and psychosocial outcomes in people with cancer; the considerations required to implement self-management support (SMS) for people living with a lower-grade glioma (LGG)-who often have complex support needs-are not known. We aimed to identify and understand these implementation considerations through the lens of normalisation process theory (NPT), from the perspectives of healthcare professionals (HCP) and people with LGG. METHODS We conducted semistructured interviews with HCPs who support adults with brain tumours (n = 25; 12 different healthcare professions), and people with LGG who had completed primary treatment (n = 28; male n = 16, mean age 54.6 years, mean time since diagnosis 8.7 years), from across the United Kingdom. Interviews were transcribed and inductive open coding conducted, before deductively mapping to constructs of NPT. We first mapped HCP data, then integrated data from people with LGG to explore alignment in experiences and perspectives. RESULTS We generated supporting evidence for all four NPT constructs and related subconstructs, namely: 'Coherence', 'Cognitive participation', 'Collective action' and 'Reflexive monitoring'. Data from HCPs and people with LGG clearly demonstrated that effective SMS constitutes a collective activity. Key implementation considerations included: ensuring awareness of, and access to, support; building strong HCP-support recipient relationships; and careful inclusion of close family and friends. We identified pertinent challenges, such as identifying support needs (influenced by the extent to which those with LGG engage in help-seeking), resistance to support (e.g., technology literacy), training for HCPs and HCP cooperation. CONCLUSIONS This study demonstrates the collective nature of, and provides insight into the individual roles within, supported self-management. We outline considerations to operationalise, sustain and appraise the implementation of SMS for people with LGG. PATIENT OR PUBLIC CONTRIBUTION People with brain tumours, and informal caregivers, were involved in the development of information materials and topic guides to ensure accessibility and pertinence. They also had opportunities to comment on interview findings.
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Affiliation(s)
- Ben Rimmer
- Population Health Sciences Institute, Newcastle University Centre for CancerNewcastle UniversityNewcastle upon TyneUK
| | - Tracy Finch
- Department of Nursing, Midwifery and HealthNorthumbria UniversityNewcastle upon TyneUK
| | - Michelle Balla
- Faculty of Medical SciencesNewcastle UniversityNewcastle upon TyneUK
| | - Lizzie Dutton
- Population Health Sciences Institute, Newcastle University Centre for CancerNewcastle UniversityNewcastle upon TyneUK
| | - Sophie Williams
- Newcastle upon Tyne Hospitals NHS Foundation TrustNewcastle upon TyneUK
| | - Joanne Lewis
- Newcastle upon Tyne Hospitals NHS Foundation TrustNewcastle upon TyneUK
| | | | - Richéal Burns
- Faculty of ScienceAtlantic Technological UniversitySligoIreland
- Health and Biomedical Strategic Research CentreAtlantic Technological UniversitySligoIreland
| | - Vera Araújo‐Soares
- Population Health Sciences Institute, Newcastle University Centre for CancerNewcastle UniversityNewcastle upon TyneUK
- Department for Prevention of Cardiovascular and Metabolic Disease, Centre for Preventive Medicine and Digital Health, Medical Faculty MannheimHeidelberg UniversityHeidelbergGermany
| | - Fiona Menger
- School of Education, Communication and Language SciencesNewcastle UniversityNewcastle upon TyneUK
| | - Linda Sharp
- Population Health Sciences Institute, Newcastle University Centre for CancerNewcastle UniversityNewcastle upon TyneUK
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Haydon HM, Blackler A, Nowak AK, Langbecker D, Collier J, Halkett G. Exploratory multi-methods evaluation of an online intervention for carers of people with high-grade glioma. Neurooncol Pract 2023; 10:544-554. [PMID: 38026580 PMCID: PMC10666811 DOI: 10.1093/nop/npad032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023] Open
Abstract
Background Inadequate knowledge and skills and a lack of confidence to provide care have been identified as major unmet needs for carers of people with brain cancer. An online intervention was developed to address the unmet needs of carers of people with high-grade glioma. Methods Ten carers evaluated the intervention through multiple methods. Acceptability and usability were measured through online data analytics (unique page views, time on page), surveys, and interviews. Questionnaires measured potential impacts on distress (Distress Thermometer), depression, anxiety (Hospital Anxiety and Depression Scale), carer competence (Carer Competence Scale), carer preparedness (Caregiving Preparedness Scale), unmet needs (Supportive Care Needs Scale - Brain Tumor Specific for carers), usability and acceptability (USE). Results Results suggested the intervention had high levels of usability (usability scales' means range = 5.1 to 6.7 out of 7) and acceptability (M = 76.3/100). Correlations indicated the potential to impact depression. Qualitative findings highlighted benefits of the intervention as a comprehensive reliable resource that could validate and normalize carer experiences. Interview findings guided further improvements (eg, additional carer videos, content organization). Conclusions The study indicated high acceptability and usability of an online intervention for carers of people with high-grade glioma. This exploratory study also provided preliminary indications of a potential to decrease depression. However, a more robust, potentially longitudinal, investigation is needed with a larger and broader sample. Informed by this study, the intervention has been amended and a randomized controlled trial will further evaluate the enhanced intervention.
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Affiliation(s)
- Helen M Haydon
- Centre for Online Health, The University of Queensland, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
- Centre for Health Services Research, The University of Queensland, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Alethea Blackler
- School of Design, Queensland University of Technology, Brisbane City, Queensland, Australia
| | - Anna K Nowak
- School of Medicine, University of Western Australia, Perth, Western Australia, Australia
| | - Danette Langbecker
- Centre for Online Health, The University of Queensland, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
- Centre for Health Services Research, The University of Queensland, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Justin Collier
- Centre for Online Health, The University of Queensland, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
- Centre for Health Services Research, The University of Queensland, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Georgia Halkett
- School of Nursing, Curtin University, Bently Western Australia, Australia
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Rimmer B, Balla M, Dutton L, Lewis J, Brown MC, Burns R, Gallagher P, Williams S, Araújo-Soares V, Finch T, Menger F, Sharp L. Identifying and understanding how people living with a lower-grade glioma engage in self-management. J Cancer Surviv 2023:10.1007/s11764-023-01425-x. [PMID: 37450254 DOI: 10.1007/s11764-023-01425-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 06/23/2023] [Indexed: 07/18/2023]
Abstract
PURPOSE Lower-grade gliomas (LGG) are mostly diagnosed in working-aged adults and rarely cured. LGG patients may face chronic impairments (e.g. fatigue, cognitive deficits). Self-management can improve clinical and psychosocial outcomes, yet how LGG patients self-manage the consequences of their tumour and its treatment is not fully understood. This study, therefore, aimed to identify and understand how LGG patients engage in the self-management of their condition. METHODS A diverse group of 28 LGG patients (age range 22-69 years; male n = 16, female n = 12; mean time since diagnosis = 8.7 years) who had completed primary treatment, were recruited from across the United Kingdom. Semi-structured interviews were conducted. Informed by a self-management strategy framework developed in cancer, directed content analysis identified and categorised self-management types and strategies used by patients. RESULTS Overall, 20 self-management strategy types, comprising 123 self-management strategies were reported; each participant detailed extensive engagement in self-management. The most used strategy types were 'using support' (n = 28), 'creating a healthy environment' (n = 28), 'meaning making' (n = 27), and 'self-monitoring' (n = 27). The most used strategies were 'accepting the tumour and its consequences' (n = 26), 'receiving support from friends (n = 24) and family' (n = 24), and 'reinterpreting negative consequences' (n = 24). CONCLUSIONS This study provides a comprehensive understanding of the strategies used by LGG patients to self-manage their health and wellbeing, with a diverse, and substantial number of self-management strategies reported. IMPLICATIONS FOR CANCER SURVIVORS The findings will inform the development of a supported self-management intervention for LGG patients, which will be novel for this patient group.
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Affiliation(s)
- Ben Rimmer
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle Upon Tyne, England.
| | - Michelle Balla
- Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, England
| | - Lizzie Dutton
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle Upon Tyne, England
| | - Joanne Lewis
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, England
| | - Morven C Brown
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle Upon Tyne, England
| | - Richéal Burns
- Faculty of Science, Atlantic Technological University, Sligo, Ireland
- Health and Biomedical Strategic Research Centre, Atlantic Technological University, Sligo, Ireland
| | | | - Sophie Williams
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, England
| | - Vera Araújo-Soares
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle Upon Tyne, England
- Centre for Preventive Medicine and Digital Health, Department for Prevention of Cardiovascular and Metabolic Disease, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Tracy Finch
- Department of Nursing, Midwifery and Health, Northumbria University, Newcastle Upon Tyne, England
| | - Fiona Menger
- School of Education, Communication and Language Sciences, Newcastle University, Newcastle Upon Tyne, England
| | - Linda Sharp
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle Upon Tyne, England
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Amanda R, Rana K, Saunders P, Tracy M, Bridges N, Poudel P, Arora A. Evaluation of the usability, content, readability and cultural appropriateness of online alcohol and other drugs resources for Aboriginal and Torres Strait Islander Peoples in New South Wales, Australia. BMJ Open 2023; 13:e069756. [PMID: 37164458 PMCID: PMC10174040 DOI: 10.1136/bmjopen-2022-069756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/12/2023] Open
Abstract
OBJECTIVES This study aimed to analyse the usability, content, readability and cultural appropriateness of alcohol and other drugs (AODs) resources for Aboriginal and Torres Strait Islander Peoples in New South Wales (NSW), Australia. OUTCOME MEASURES The content of 30 AOD resources for Aboriginal and Torres Strait Islander Peoples was analysed according to the following criteria: general characteristics; elements of graphical design and written communication; thoroughness and content; readability (Flesch-Kincaid grade level (FKGL), Gunning Fog index (Fog), Simplified Measure of Gobbledygook and Flesch Reading Ease); and cultural appropriateness. RESULTS Most resources displayed good usability, depicted by the use of headings and subheadings (n=27), superior writing style (n=19), relevant visuals (n=19) and use of colour support (n=30). However, some resources used at least one professional jargon (n=13), and many did not provide any peer-reviewed references (n=22). During content analysis, 12 resources were categorised into the alcohol group and 18 resources in the other drugs group. Impact of alcohol during pregnancy and breast feeding (n=12) was the most common included topics in the resources related to alcohol, while the physical impact of drugs (n=15) was the most discussed topics among the other drugs group. Based on the FKGL readability score, 83% of resources met the recommended reading grade level of 6-8 by NSW Health. Many resources (n=21) met at least half of the cultural appropriateness elements of interest. However, less than one-third were developed in collaboration with the local community (n=9), used local terms (n=5), targeted the local community (n=3), included an Aboriginal voice (n=2) and addressed the underlying cause (n=1). CONCLUSIONS Many AOD resources are developed specifically for Aboriginal and Torres Strait Islander Peoples, but their usability, content and readability differed, and they were not culturally appropriate for all communities. Development of a standardised protocol for resource development is suggested.
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Affiliation(s)
- Rebecca Amanda
- School of Health Sciences, Western Sydney University, Penrith, NSW, Australia
- Health Equity Laboratory, Campbelltown, NSW, Australia
| | - Kritika Rana
- School of Health Sciences, Western Sydney University, Penrith, NSW, Australia
- Health Equity Laboratory, Campbelltown, NSW, Australia
- Translational Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - Paul Saunders
- Translational Health Research Institute, Western Sydney University, Penrith, NSW, Australia
- School of Medicine, Western Sydney University, Penrith, NSW, Australia
| | - Marguerite Tracy
- General Practice Clinical School, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
- Drug Health Services, Cumberland Hospital, Western Sydney Local Health District, North Parramatta, NSW, Australia
| | - Nicole Bridges
- School of Humanities and Communication Arts, Western Sydney University, Kingswood, NSW, Australia
| | - Prakash Poudel
- Office of Research and Education, Canberra Hospital, Canberra Health Services, ACT Government, Canberra, ACT, Australia
| | - Amit Arora
- School of Health Sciences, Western Sydney University, Penrith, NSW, Australia
- Health Equity Laboratory, Campbelltown, NSW, Australia
- Translational Health Research Institute, Western Sydney University, Penrith, NSW, Australia
- Discipline of Child and Adoloscent Health, Sydney Medical School, The University of Sydney, Westmead, NSW, Australia
- Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, Surry Hills, NSW, Australia
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Halkett GKB, Lobb EA, Phillips JL, McDougall E, Clarke J, Campbell R, Dhillon HM, McGeechan K, Hudson P, King A, Wheeler H, Kastelan M, Long A, Nowak AK. Carer preparedness improved by providing a supportive educational intervention for carers of patients with high-grade glioma: RCT results. J Neurooncol 2023; 161:501-513. [PMID: 36658381 PMCID: PMC9992082 DOI: 10.1007/s11060-023-04239-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 12/24/2022] [Indexed: 01/21/2023]
Abstract
BACKGROUND High-grade glioma (HGG) is a rapidly progressing and debilitating disease. Family carers take on multiple responsibilities and experience high levels of distress. We aimed to deliver a nurse-led intervention (Care-IS) to carers to improve their preparedness to care and reduce distress. METHODS We conducted a randomised controlled trial (ACTRN:12612001147875). Carers of HGG patients were recruited during patients' combined chemoradiation treatment. The complex intervention comprised four components: (1) initial telephone assessment of carer unmet needs; (2) tailored hard-copy resource folder; (3) home visit; and, (4) monthly telephone support for up to 12 months. Primary outcomes included preparedness for caregiving and distress at 2, 4, 6 and 12 months. Intervention effects were estimated using linear mixed models which included a time by group interaction. Secondary outcomes included anxiety, depression, quality of life, carer competence and strain. RESULTS We randomised 188 carers (n = 98 intervention, n = 90 control). The intervention group reported significantly higher preparedness for caregiving at 4 months (model β = 2.85, 95% CI 0.76-4.93) and all follow-up timepoints including 12 months (model β = 4.35, 95% CI 2.08-6.62), compared to the control group. However, there was no difference between groups in carer distress or any secondary outcomes. CONCLUSIONS This intervention was effective in improving carer preparedness. However, carer distress was not reduced, potentially due to the debilitating/progressive nature of HGG and ongoing caring responsibilities. Future research must explore whether carer interventions can improve carer adjustment, self-efficacy and coping and how we support carers after bereavement. Additionally, research is needed to determine how to implement carer support into practice.
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Affiliation(s)
- Georgia K B Halkett
- Curtin School of Nursing/Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, GPO Box U1987, Bentley, Perth, WA, 6005, Australia.
| | - Elizabeth A Lobb
- Calvary Health Care Kogarah, Sydney, NSW, Australia.,School of Medicine, The University of Notre Dame, Sydney, NSW, Australia.,Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Jane L Phillips
- Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia.,School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Emma McDougall
- Curtin School of Nursing/Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, GPO Box U1987, Bentley, Perth, WA, 6005, Australia
| | - Jenny Clarke
- Curtin School of Nursing/Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, GPO Box U1987, Bentley, Perth, WA, 6005, Australia
| | - Rachel Campbell
- Psycho-Oncology Cooperative Research Group, School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia
| | - Haryana M Dhillon
- Psycho-Oncology Cooperative Research Group, School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia.,Centre for Medical Psychology & Evidence-Based Decision-Making, University of Sydney, Sydney, NSW, Australia
| | - Kevin McGeechan
- School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Peter Hudson
- Centre for Palliative Care St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia.,Department of Nursing, University of Melbourne, Melbourne, VIC, Australia.,Vrije University Brussels, Brussels, Belgium
| | - Anne King
- Cancer Network Western Australia, North Metropolitan Health Service, Perth, WA, Australia
| | - Helen Wheeler
- Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Marina Kastelan
- Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards, NSW, Australia.,The Brain Cancer Group, North Shore Private Hospital, St Leonards, NSW, Australia
| | - Anne Long
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - Anna K Nowak
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia.,Medical School, University of Western Australia, Nedlands, WA, Australia
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Özistanbullu D, Weber R, Kleemann J, Jäger M, Kippenberger S, Kaufmann R, Meissner M. Exploring the Most Visible Websites on Cutaneous T‐cell Lymphoma–Revealing Limited Quality of Patient Health Information on the Internet. J Eur Acad Dermatol Venereol 2022; 36:2008-2015. [DOI: 10.1111/jdv.18439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 06/15/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Deniz Özistanbullu
- Department of Dermatology, Venereology and Allergology University Hospital Frankfurt Goethe University Frankfurt Germany
| | - Ronja Weber
- Department of Dermatology, Venereology and Allergology University Hospital Frankfurt Goethe University Frankfurt Germany
| | - Johannes Kleemann
- Department of Dermatology, Venereology and Allergology University Hospital Frankfurt Goethe University Frankfurt Germany
| | - Manuel Jäger
- Department of Dermatology Städtisches Klinikum Karlsruhe Germany
| | - Stefan Kippenberger
- Department of Dermatology, Venereology and Allergology University Hospital Frankfurt Goethe University Frankfurt Germany
| | - Roland Kaufmann
- Department of Dermatology, Venereology and Allergology University Hospital Frankfurt Goethe University Frankfurt Germany
| | - Markus Meissner
- Department of Dermatology, Venereology and Allergology University Hospital Frankfurt Goethe University Frankfurt Germany
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9
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Tripathi SD, Parker PD, Prabhu AV, Thomas K, Rodriguez A. An Examination of Patients and Caregivers on Reddit Navigating Brain Cancer: Content Analysis of the Brain Tumor Subreddit. JMIR Cancer 2022; 8:e35324. [PMID: 35731559 PMCID: PMC9260533 DOI: 10.2196/35324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 05/03/2022] [Accepted: 05/27/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Occurring in up to 40% of all patients with cancer, the incidence of brain tumors has caused limited survival, a high psychosocial burden, and an increase in the loss of decision-making capability for the unique population. Although specific symptoms depend on the type of brain tumor, a clinical team of physicians, nurses, and other individuals commonly assist patients and their caregivers with how to tackle the upcoming challenges of their diagnosis. Despite the support from clinical team members, many patients and caregivers may still seek outside support through social media to process their emotions and seek comfort outside of the clinical setting. Specifically, online resources such as Reddit are used where users are provided with the anonymity they need to show their true behavior without fear of judgment. In this study, we aimed to examine trends from Reddit discussion threads on brain tumors to identify areas of need in patient care. OBJECTIVE Our primary aims were to determine the type of Reddit user posting, classify the specific brain tumors that were the subject of the posts, and examine the content of the original posts. METHODS We used a qualitative descriptive design to understand patients' and caregivers' unmet and met needs. We selected posts from the top-rated 100 posts from the r/braincancer subreddit from February 2017 to June 2020 to identify common themes using content analysis. RESULTS The qualitative content analysis revealed how Reddit users primarily used the forum as a method to understand and process the emotions surrounding a brain tumor diagnosis. Three major topic areas from content analysis emerged as prominent themes, including (1) harnessing hope, (2) moving through the grief process, and (3) expressing gratitude toward other Reddit users. Most of the authors of the posts were patients with brain tumors (32/88, 36%) who used Reddit as a reflective journaling tool to process the associated emotions of a challenging diagnosis. CONCLUSIONS This study shows the potential of Reddit to serve as a unique group therapy platform for patients affected by brain tumors. Our results highlight the support provided by the Reddit community members as a unique mechanism to assist cancer survivors and caregivers with the emotional processing of living with brain tumors. Additionally, the results highlight the importance of recommending Reddit as a therapeutic virtual community and the need for implementing online resources as a part of a health care professional's repertoire to understand the level of support they can give their patients.
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Affiliation(s)
- Sanidhya D Tripathi
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, AR, United States
| | - Pearman D Parker
- College of Nursing, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Arpan V Prabhu
- Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Kevin Thomas
- Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Analiz Rodriguez
- Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, AR, United States
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Halkett GKB, Berg MN, Daudu D, Dhillon HM, Koh ES, Ownsworth T, Lobb E, Phillips J, Langbecker D, Agar M, Hovey E, Moorin R, Nowak AK. Supportive care of patients diagnosed with high grade glioma and their carers in Australia. J Neurooncol 2022; 157:475-485. [PMID: 35397081 PMCID: PMC8994178 DOI: 10.1007/s11060-022-03991-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 03/18/2022] [Indexed: 11/30/2022]
Abstract
Purpose This study aimed to: determine the supportive care available for Australian patients with High Grade Glioma (HGG) and their carers; identify service gaps; and inform changes needed to implement guidelines and Optimal Care Pathways. Methods This cross-sectional online survey recruited multidisciplinary health professionals (HPs) who were members of the Cooperative Trials Group for Neuro-Oncology involved in management of patients diagnosed with HGG in Australian hospitals. Descriptive statistics were calculated. Fisher's exact test was used to explore differences between groups. Results 42 complete responses were received. A majority of MDT meetings were attended by a: neurosurgeon, radiation oncologist, medical oncologist, radiologist, and care coordinator. Less than 10% reported attendance by a palliative care nurse; physiotherapist; neuropsychologist; or speech therapist. Most could access referral pathways to a cancer care coordinator (76%), neuropsychologist (78%), radiation oncology nurse (77%), or psycho-oncologist (73%), palliative care (93–100%) and mental health professionals (60–85%). However, few routinely referred to an exercise physiologist (10%), rehabilitation physician (22%), dietitian (22%) or speech therapist (28%). Similarly, routine referrals to specialist mental health services were not standard practice. Nearly all HPs (94%) reported HGG patients were advised to present to their GP for pre-existing conditions/comorbidities; however, most HPs took responsibility (≤ 36% referred to GP) for social issues, mental health, symptoms, cancer complications, and treatment side-effects. Conclusions While certain services are accessible to HGG patients nationally, improvements are needed. Psychosocial support, specialist allied health, and primary care providers are not yet routinely integrated into the care of HGG patients and their carers despite these services being considered essential in clinical practice guidelines and optimal care pathways. Supplementary Information The online version contains supplementary material available at 10.1007/s11060-022-03991-z.
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Affiliation(s)
- Georgia K B Halkett
- Faculty of Health Sciences, Curtin School of Nursing, Curtin University, GPO Box U1987, Bentley, WA, 6005, Australia.
| | - Melissa N Berg
- Faculty of Health Sciences, Curtin School of Nursing, Curtin University, GPO Box U1987, Bentley, WA, 6005, Australia.,School of Nursing and Midwifery, The University of Notre Dame Australia, Fremantle, WA, Australia
| | - Davina Daudu
- Faculty of Health Sciences, Curtin School of Nursing, Curtin University, GPO Box U1987, Bentley, WA, 6005, Australia.,Medical School, University of Western Australia, Nedlands, WA, Australia
| | - Haryana M Dhillon
- Psycho-Oncology Cooperative Research Group, School of Psychology, Faculty of Science, University of Sydney, Camperdown, NSW, Australia.,Centre for Medical Psychology & Evidence-Based Decision-Making, School of Psychology, Faculty of Science, University of Sydney, Camperdown, NSW, Australia
| | - Eng-Siew Koh
- South West Sydney Clinical School, UNSW Medicine, University of New South Wales, Liverpool, NSW, Australia.,Liverpool and Macarthur Cancer Therapy Centres, Liverpool, Australia.,Ingham Institute for Applied Medical Research, Liverpool, Australia
| | - Tamara Ownsworth
- School of Applied Psychology & The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
| | - Elizabeth Lobb
- Calvary Health Care Kogarah, Sydney, NSW, Australia.,School of Medicine, The University of Notre Dame, Sydney, NSW, Australia.,Faculty of Health, University of Technology, Ultimo, NSW, Australia
| | - Jane Phillips
- Faculty of Health, School of Nursing, Queensland University of Technology, Brisbane, Australia
| | - Danette Langbecker
- Centre for Online Health and Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | - Meera Agar
- Faculty of Health, University of Technology, Ultimo, NSW, Australia
| | - Elizabeth Hovey
- South West Sydney Clinical School, UNSW Medicine, University of New South Wales, Liverpool, NSW, Australia.,Prince of Wales Clinical School, UNSW Medicine, University of New South Wales, Randwick, Australia.,Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, Australia
| | - Rachael Moorin
- Faculty of Health Sciences, Curtin School of Population Health, Curtin University, Bentley, WA, Australia.,School of Population and Global Health, University of Western Australia, Nedlands, WA, Australia
| | - Anna K Nowak
- Medical School, University of Western Australia, Nedlands, WA, Australia.,Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
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