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Ajmera P, Miraj M, Kalra S, Goyal RK, Chorsiya V, Shaik RA, Alzhrani M, Alanazi A, Alqahtani M, Miraj SA, Pawaria S, Mehta V. Impact of telehealth interventions on physiological and psychological outcomes in breast cancer survivors: A meta-analysis of randomised controlled trials. Front Oncol 2023; 12:1017343. [PMID: 36686741 PMCID: PMC9850160 DOI: 10.3389/fonc.2022.1017343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 11/15/2022] [Indexed: 01/07/2023] Open
Abstract
Introduction The use of telehealth interventions has been evaluated in different perspectives in women and also supported with various clinical trials, but its overall efficacy is still ascertained. The objective of the present review is to identify, appraise and analyze randomized controlled trials on breast cancer survivors who have participated in technology-based intervention programs incorporating a wide range of physical and psychological outcome measures. Material and methods We conducted electronic search of the literature during last twenty years i.e., from 2001 till August 10, 2021 through four databases. Standardized mean difference with 95% confidence interval was used. Results A total of 56 records were included in the qualitative and 28 in quantitative analysis. Pooled results show that telehealth interventions were associated with improved quality of life (SMD 0.48, 95% CI 0.03 to 0.92, p=0.04), reduced depression (SMD -1.27, 95% CI =-2.43 to -0.10 p=0.03), low distress and less perceived stress (SMD -0.40, 95% CI =-0.68 to -0.12, p=0.005). However, no significant differences were observed on weight change (SMD -0.27, 95% CI =-2.39 to 1.86, p=0.81) and anxiety scores (SMD -0.09, 95% CI =-0.20 to 0.02, p=0.10) between the two groups. Improvement in health care competence and fitness among participants was also reported. Conclusion Study concludes that telehealth care is a quick, convenient and assuring approach to breast cancer care in women that can reduce treatment burden and subsequent disturbance to the lives of breast cancer survivors.
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Affiliation(s)
- Puneeta Ajmera
- Department of Public Health, School of Allied Health Sciences, Delhi Pharmaceutical Sciences and Research University, New Delhi, India
| | - Mohammad Miraj
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, AlMajmaah, Saudi Arabia,*Correspondence: Mohammad Miraj,
| | - Sheetal Kalra
- School of Physiotherapy, Delhi Pharmaceutical Sciences and Research University, New Delhi, India
| | - Ramesh K. Goyal
- Department of Pharmacology, Delhi Pharmaceutical Sciences and Research University, New Delhi, India
| | - Varsha Chorsiya
- School of Physiotherapy, Delhi Pharmaceutical Sciences and Research University, New Delhi, India
| | - Riyaz Ahamed Shaik
- Department of Family and Community Medicine, College of Medicine, Majmaah University, Al Majmaah, Saudi Arabia
| | - Msaad Alzhrani
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, AlMajmaah, Saudi Arabia
| | - Ahmad Alanazi
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, AlMajmaah, Saudi Arabia
| | - Mazen Alqahtani
- College of Applied Medical Sciences, AlMaarefa University, Dariyah, Riyadh, Saudi Arabia
| | - Shaima Ali Miraj
- Department of Public Health, College of Health Science, Saudi Electronic University, Riyadh, Saudi Arabia
| | - Sonia Pawaria
- Faculty of Physiotherapy, SGT University, Gurugram, India
| | - Vini Mehta
- Department of Public Health Dentistry, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune, India
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Price A, de Bell S, Shaw N, Bethel A, Anderson R, Coon JT. What is the volume, diversity and nature of recent, robust evidence for the use of peer support in health and social care? An evidence and gap map. CAMPBELL SYSTEMATIC REVIEWS 2022; 18:e1264. [PMID: 36909883 PMCID: PMC9316011 DOI: 10.1002/cl2.1264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Background Peer support interventions involve people drawing on shared personal experience to help one another improve their physical or mental health, or reduce social isolation. If effective, they may also lessen the demand on health and social care services, reducing costs. However, the design and delivery of peer support varies greatly, from the targeted problem or need, the setting and mode of delivery, to the number and content of sessions. Robust evidence is essential for policymakers commissioning peer support and practitioners delivering services in health care and community settings. This map draws together evidence on different types of peer support to support the design and delivery of interventions. Objectives The aim of this map was to provide an overview of the volume, diversity and nature of recent, high quality evidence on the effectiveness and cost-effectiveness of the use of peer support in health and social care. Search Methods We searched MEDLINE, seven further bibliographic databases, and Epistemonikos for systematic reviews (in October 2020), randomised controlled trials (in March 2021) and economic evaluations (in May 2021) on the effectiveness of peer support interventions in health and social care. We also conducted searches of Google Scholar, two trial registers, PROSPERO, and completed citation chasing on included studies. Selection Criteria Systematic reviews, randomised controlled trials and economic evaluations were included in the map. Included studies focused on adult populations with a defined health or social care need, were conducted in high-income countries, and published since 2015. Any measure of effectiveness was included, as was any form of peer support providing the peer had shared experience with the participant and a formalised role. Data Collection and Analysis Data were extracted on the type of peer support intervention and outcomes assessed in included studies. Standardised tools were used to assess study quality for all studies: assessing the methodological quality of systematic reviews 2 for systematic reviews; Cochrane risk of bias tool for randomised controlled trials; and consensus health economic criteria list for economic evaluations. Main Results We included 91 studies: 32 systematic reviews; 52 randomised controlled trials; and 7 economic evaluations. Whilst most included systematic reviews and economic evaluations were assessed to be of low or medium quality, the majority of randomised controlled trials were of higher quality. There were concentrations of evidence relating to different types of peer support, including education, psychological support, self-care/self-management and social support. Populations with long-term health conditions were most commonly studied. The majority of studies measured health-related indicators as outcomes; few studies assessed cost-effectiveness. Studies were unevenly distributed geographically, with most being conducted in the USA. Several gaps were evident regarding the delivery of peer support, particularly the integration of peers and professionals in delivering support and interventions of longer duration. Authors' Conclusions Although there is evidence available to inform the commissioning and delivery of peer support in health and social care, there are also clear gaps that need to be addressed to further support provision, particularly regarding cost-effectiveness. The effectiveness of peer support in different countries, with varying health and social care systems, is a priority for future research, as is the integration of peers with professionals in delivering peer support.
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Affiliation(s)
- Anna Price
- Exeter HS&DR Evidence Synthesis CentreUniversity of Exeter Medical School, University of ExeterExeterUK
| | - Siân de Bell
- Exeter HS&DR Evidence Synthesis CentreUniversity of Exeter Medical School, University of ExeterExeterUK
| | - Naomi Shaw
- Exeter HS&DR Evidence Synthesis CentreUniversity of Exeter Medical School, University of ExeterExeterUK
| | - Alison Bethel
- Exeter HS&DR Evidence Synthesis CentreUniversity of Exeter Medical School, University of ExeterExeterUK
| | - Rob Anderson
- Exeter HS&DR Evidence Synthesis CentreUniversity of Exeter Medical School, University of ExeterExeterUK
| | - Jo Thompson Coon
- Exeter HS&DR Evidence Synthesis CentreUniversity of Exeter Medical School, University of ExeterExeterUK
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Yoshikawa E, Fujisawa D, Hisamura K, Murakami Y, Okuyama T, Yoshiuchi K. The potential role of peer support interventions in treating depressive symptoms in cancer patients. J NIPPON MED SCH 2021; 89:16-23. [PMID: 34840208 DOI: 10.1272/jnms.jnms.2022_89-117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Depressive symptoms are prevalent in cancer patients and are one of the most distressing symptoms in this population. Although mental health professionals such as psychiatrists and psychologists are now engaged in cancer care, the management of depressive symptoms in cancer patients needs further improvement. Peer support interventions (PSIs) in cancer care have attracted substantial attention and have several advantages over support by medical professionals, potentially improving depressive symptoms in cancer patients. However, there may be some potential risks. Several strategies using PSIs have been developed to improve depressive symptoms and have been evaluated in randomized controlled trials. The strategies include education on stress management skills, promoting emotional support, counseling on specific topics that are difficult to discuss with others, helping patients navigate the use of resources, and promoting health-related behaviors to decrease depressive symptoms. In this paper, we present recent findings on PSIs in cancer, focusing on randomized controlled trials.
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Affiliation(s)
| | | | - Kazuho Hisamura
- Department of Medical Oncology, School of Medicine, Kanazawa Medical University
| | | | - Toru Okuyama
- Department of Psychiatry, Nagoya City University West Medical Center
| | - Kazuhiro Yoshiuchi
- Department of Stress Sciences and Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo
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Li HW, Scanlon ML, Kisilu N, Litzelman DK. The role of community health workers in the surgical cascade: a scoping review. HUMAN RESOURCES FOR HEALTH 2021; 19:122. [PMID: 34602064 PMCID: PMC8489043 DOI: 10.1186/s12960-021-00659-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 09/15/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Community health workers (CHWs) can increase access to various primary healthcare services; however, their potential for improving surgical care is under-explored. We sought to assess the role of CHWs in the surgical cascade, defined as disease screening, linkage to operative care, and post-operative care. Given the well-described literature on CHWs and screening, we focused on the latter two steps of the surgical cascade. METHODS We conducted a scoping review of the peer-reviewed literature. We searched for studies published in any language from January 1, 2000 to May 1, 2020 using electronic literature databases including Pubmed/MEDLINE, Web of Science, SCOPUS, and Google Scholar. We included articles on CHW involvement in linkage to operative care and/or post-operative surgical care. Narrative and descriptive methods were used to analyze the data. RESULTS The initial search identified 145 articles relevant to steps in the surgical cascade. Ten studies met our inclusion criteria and were included for review. In linkage to care, CHWs helped increase surgical enrollment, provide resources for vulnerable patients, and build trust in healthcare services. Post-operatively, CHWs acted as effective monitors for surgical-site infections and provided socially isolated patients with support and linkage to additional services. The complex and wide-ranging needs of surgical patients illustrated the need to view surgical care as a continuum rather than a singular operative event. CONCLUSION While the current literature is limited, CHWs were able to maneuver complex medical, cultural, and social barriers to surgical care by linking patients to counseling, education, and community resources, as well as post-operative infection prevention services. Future studies would benefit from more rigorous study designs and larger sample sizes to further elucidate the role CHWs can serve in the surgical cascade.
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Affiliation(s)
- Helen W. Li
- Department of Surgery, Washington University School of Medicine in St Louis, St. Louis, MO United States of America
| | - Michael L. Scanlon
- Indiana University Center for Global Health, 702 Rotary Circle, Suite RO 101, Indianapolis, IN 46202 United States of America
| | - Nicholas Kisilu
- Department of General Surgery and Anesthesiology, Moi University School of Medicine, Eldoret, Kenya
| | - Debra K. Litzelman
- William M. Tierney Center for Health Services Research, Regenstrief Institute, Inc. and Indiana University School of Medicine, 1101 West 10th Street, Indianapolis, IN 46202 United States of America
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Informational support for depression and quality of life improvements in older patients with cancer: a systematic review and meta-analysis. Support Care Cancer 2021; 30:1065-1077. [PMID: 34415425 DOI: 10.1007/s00520-021-06494-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 08/07/2021] [Indexed: 01/14/2023]
Abstract
PURPOSE To assess and summarize the effects of informational support on depression and quality of life of older patients with cancer. METHODS PubMed, MEDLINE, and Web of Science were searched to identify articles written in English and published until March 2021. Studies within 10 years period (2010-2021) were included. Randomized controlled trials were included if they evaluated the impact of informational support on depression and quality of life. All analyses were performed with Review Manager 5.3. RESULTS Twelve studies with a total of 2374 participants met the inclusion criteria. Our primary outcomes included depression and quality of life. (1) Depression: results indicated no statistically significant difference and low heterogeneity [SMD = 0.28, 95% CI (- 0.24,0.80), p = 0.45; I2 = 0%], (2) Quality of life: in the subgroup analyses of EORTC QLQ-C30, results indicated a significant effect of informational support on quality of life [SMD = 2.84, 95% CI (0.63, 5.05), p = 0.03; I2 = 79%]; in the subgroup analyses of FACT and SF-36, there were no significance. CONCLUSIONS Informational support could reduce depression and did improve the quality of life in older cancer patients with statistical significance. The findings suggested that informational support was an effective approach to improve depression and quality of life in older patients with cancer.
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Walshe C, Roberts D, Calman L, Appleton L, Croft R, Perez Algorta G, Skevington S, Lloyd-Williams M, Grande G. Peer Mentors for People with Advanced Cancer: Lessons Learnt from Recruiting and Training Peer Mentors for a Feasibility Randomized Controlled Trial. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:710-718. [PMID: 31994006 PMCID: PMC8328854 DOI: 10.1007/s13187-020-01692-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Peer mentors may offer distinctive forms of support to people with advanced cancer. Whilst peer mentor programmes are known, little is understood about recruiting and training peer mentors to support those with advanced cancer. The purpose of this study is to determine the feasibility of recruiting and training peer mentors for a novel peer mentor intervention to promote well-being in people with advanced cancer. Feasibility study testing proactive introduction to a trained peer mentor for 12 weeks in the context of a randomized controlled two-arm trial and nested qualitative process evaluation was used. Peer mentors have/had cancer, recruited via an open call. Two-day training included a new bespoke module on coping with cancer. Descriptive recruitment and training data were captured, supplemented by qualitative interviews, analysed thematically. Forty-eight people expressed interest, mostly female (69%), with breast cancer (32%), and recruited via social media (49%). Twelve people completed training, with attrition often due to availability or mentors' own health; many had advanced cancer themselves. They wanted to 'give something back', but also formed supportive bonds with fellow mentors. It is feasible to recruit and train people with lived experience of cancer to be peer mentors, but those with particular characteristics may predominate. Broad social media based recruitment may have merit in widening the pool of potential peer mentors.
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Affiliation(s)
- Catherine Walshe
- International Observatory on End of Life Care, Division of Health Research, Lancaster University, Bailrigg, Lancaster, UK.
| | - Diane Roberts
- Division of Nursing, Midwifery and Social Work, Manchester University, Manchester, UK
| | - Lynn Calman
- Macmillan Survivorship Research Group, School of Health Sciences, Southampton University, Southampton, UK
| | - Lynda Appleton
- Clatterbridge Cancer Centre NHS Foundation Trust, Wirral, UK
| | | | | | - Suzanne Skevington
- Manchester Centre for Health Psychology, School of Psychological Sciences, Manchester University, Manchester, UK
| | | | - Gunn Grande
- Division of Nursing, Midwifery and Social Work, Manchester University, Manchester, UK
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Moore A, Motagh S, Sadeghirad B, Begum H, Riva JJ, Gaber J, Dolovich L. Volunteer Impact on Health-Related Outcomes for Seniors: a Systematic Review And Meta-Analysis. Can Geriatr J 2021; 24:44-72. [PMID: 33680263 PMCID: PMC7904324 DOI: 10.5770/cgj.24.434] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Volunteers are increasingly promoted to improve health-related outcomes for community-dwelling elderly without synthesized evidence for effectiveness. This systematic review and meta-analysis evaluates the effects of unpaid volunteer interventions on health-related outcomes for such seniors. METHODS MEDLINE, EMBASE and Cochrane (CENTRAL) were searched up to November 2018. We included English language, randomized trials. Two reviewers independently identified studies, extracted data, and assessed evidence certainty (using GRADE). Meta-analysis used random-effects models. Univariate meta-regressions investigated the relationship between volunteer intervention effects and trial participant age, percentage females, and risk of bias. RESULTS 28 included studies focussed on seniors with a variety of chronic conditions (e.g., dementia, diabetes) and health states (e.g., frail, palliative). Volunteers provided a range of roles (e.g., counsellors, educators and coaches). Low certainty evidence found that volunteers may improve both physical function (MD = 3.2 points on the 100-point SF-36 physical component score [PCS]; 95% CI: 1.09, 5.27) and physical activity levels (SMD = 0.5, 95% CI: 0.14 to 0.83). Adverse events were not increased. CONCLUSION Volunteers may increase physical activity levels and subjective ratings of physical function for seniors without apparent harm. These findings support the WHO call to action on evidence-based policies to align health systems in support of older adults.
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Affiliation(s)
- Ainsley Moore
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada
| | - Shahrzad Motagh
- The Michael G. DeGroote Institute of Pain Research and Care, McMaster University, Hamilton, ON, Canada
| | - Behnam Sadeghirad
- The Michael G. DeGroote Institute of Pain Research and Care, McMaster University, Hamilton, ON, Canada
| | - Housne Begum
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada
| | - John J. Riva
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada
- Health Evidence and Impact, McMaster University, Hamilton, ON, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
| | - Jessica Gaber
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada
| | - Lisa Dolovich
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada
- Health Evidence and Impact, McMaster University, Hamilton, ON, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
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Gaber J, Oliver D, Valaitis R, Cleghorn L, Lamarche L, Avilla E, Parascandalo F, Price D, Dolovich L. Experiences of integrating community volunteers as extensions of the primary care team to help support older adults at home: a qualitative study. BMC FAMILY PRACTICE 2020; 21:92. [PMID: 32416718 PMCID: PMC7231411 DOI: 10.1186/s12875-020-01165-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 05/10/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Increasing the integration of community volunteers into primary health care delivery has the potential to improve person-focused, coordinated care, yet the use of volunteers in primary care is largely unexplored. Health Teams Advancing Patient Experience: Strengthening Quality (Health TAPESTRY) is a multi-component intervention involving trained community volunteers functioning as extensions of primary care teams, supporting care based on older adults' health goals and needs. This study aimed to gain an understanding of volunteer experiences within the program and client and health care provider perspectives on the volunteer role. METHODS This study used a qualitative descriptive approach embedded in a pragmatic randomized controlled trial. Participants included Health TAPESTRY volunteers, health care providers, volunteer coordinator, and program clients, all connected to two primary care practice sites in a large urban setting in Ontario, Canada. Data collection included semi-structured focus groups and interviews with all participants, and the completion of a measure of attitudes toward older adults and self-efficacy for volunteers. Qualitative data were inductively coded and analyzed using a constant comparative approach. Quantitative data were summarized using descriptive statistics. RESULTS Overall, 30 volunteers and 64 other participants (clients, providers, volunteer coordinator) were included. Themes included: 1. Volunteer training: "An investment in volunteers"; 2. Intergenerational volunteer pairing: "The best of both worlds"; 3. Understanding the volunteer role and its scope: "Lay people involved in care"; 4. Volunteers as extensions of primary care teams: "Being the eyes where they live"; 5. The disconnect between volunteers and the clinical team: "Is something being done?"; 6. "Learning… all the time": Impacts on volunteers; and 7. Clients' acceptance of volunteers. CONCLUSIONS This study showed that it is possible to integrate community volunteers into the primary care setting, adding human connections to deepen the primary care team's understanding of their patients. Program implementation suggestions that emerged included: using role play in training, making volunteer role boundaries and specifications clear, and making efforts to connect volunteers and the primary care team they are supporting. This exploration of stakeholder voices has the potential to help improve volunteer program uptake and acceptability, as well as volunteer recruitment, retention, and training. TRIAL REGISTRATION For RCT: https://clinicaltrials.gov/ct2/show/NCT02283723, November 5, 2014.
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Affiliation(s)
- Jessica Gaber
- Department of Family Medicine, McMaster University, David Braley Health Sciences Centre, 1280 Main Street West, Hamilton, ON L8S 4K1 Canada
| | - Doug Oliver
- Department of Family Medicine, McMaster University, David Braley Health Sciences Centre, 1280 Main Street West, Hamilton, ON L8S 4K1 Canada
| | - Ruta Valaitis
- School of Nursing, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1 Canada
| | - Laura Cleghorn
- Department of Family Medicine, McMaster University, David Braley Health Sciences Centre, 1280 Main Street West, Hamilton, ON L8S 4K1 Canada
| | - Larkin Lamarche
- Department of Family Medicine, McMaster University, David Braley Health Sciences Centre, 1280 Main Street West, Hamilton, ON L8S 4K1 Canada
| | - Ernie Avilla
- Department of Medicine, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1 Canada
| | - Fiona Parascandalo
- Department of Family Medicine, McMaster University, David Braley Health Sciences Centre, 1280 Main Street West, Hamilton, ON L8S 4K1 Canada
| | - David Price
- Department of Family Medicine, McMaster University, David Braley Health Sciences Centre, 1280 Main Street West, Hamilton, ON L8S 4K1 Canada
| | - Lisa Dolovich
- Department of Family Medicine, McMaster University, David Braley Health Sciences Centre, 1280 Main Street West, Hamilton, ON L8S 4K1 Canada
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Dolovich L, Gaber J, Valaitis R, Ploeg J, Oliver D, Richardson J, Mangin D, Parascandalo F, Agarwal G. Exploration of volunteers as health connectors within a multicomponent primary care-based program supporting self-management of diabetes and hypertension. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:734-746. [PMID: 31777125 DOI: 10.1111/hsc.12904] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 08/30/2019] [Accepted: 11/12/2019] [Indexed: 06/10/2023]
Abstract
Volunteers support health and social care worldwide, yet there is little research on integrating these unpaid community members into primary care. 'Health Teams Advancing Patient Experience, Strengthening Quality through Health Connectors for Diabetes Management' (Health TAPESTRY-HC-DM) integrates volunteer 'health connectors' into a community- and primary care-based program supporting client self-management in Hamilton, Canada. Volunteers supported clients through goal setting, motivation, education and connections to community resources and primary care. This study aimed to create and apply a volunteer program evaluation framework to explore: (a) volunteer training effectiveness (learning online content, in-person training, self-efficacy in role tasks, training overall); (b) feasibility of program implementation (process measures, reflections on client encounters, understanding of volunteer roles/responsibilities, client perspectives on volunteer program); and (c) effects of volunteering on volunteers (health outcomes, self-efficacy, value of volunteering). A concurrent triangulation, mixed-methods design was used. Data were collected in 2016, sources included: volunteer online training quizzes, focus groups, self-efficacy survey, Veterans RAND 12-Item (VR-12) survey, in-person training feedback forms and narratives of client visits; client interviews; and quantitative implementation data. Quantitative data analysis included descriptive statistics, paired samples t tests, and effect size (Cohen's d). Qualitative data used descriptive thematic analysis. Nineteen volunteers and 12 clients participated in this evaluation. Findings demonstrate the volunteer program evaluation framework in action. Online training increased knowledge. In-person training received largely positive evaluations. Self-efficacy was high post-training and higher after volunteering. VR-12 sub-scale means increased descriptively. Volunteers understood themselves as healthcare system connectors, feeling fulfilled with their contributions and learning new skills. They identified barriers including not having the resources and skills of healthcare professionals. Clients found volunteers were a major program strength, appreciating their company and regular goals follow-up. Using a volunteer program evaluation framework generated rich and comprehensive data demonstrating the feasibility of bringing volunteers into primary care.
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Affiliation(s)
- Lisa Dolovich
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada
- Leslie Dan Faculty of Pharmacy University of Toronto, Toronto, ON, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Jessica Gaber
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada
| | - Ruta Valaitis
- Aging, Community and Health Research Unit, School of Nursing, McMaster University, Hamilton, ON, Canada
| | - Jenny Ploeg
- Aging, Community and Health Research Unit, School of Nursing, McMaster University, Hamilton, ON, Canada
| | - Doug Oliver
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada
| | - Julie Richardson
- School of Rehabilitation Science and Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Dee Mangin
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada
| | - Fiona Parascandalo
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada
| | - Gina Agarwal
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
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Lee MK, Suh SR. Effects of Peer-Led Interventions for Patients With Cancer: A Meta-Analysis. Oncol Nurs Forum 2019; 45:217-236. [PMID: 29466347 DOI: 10.1188/18.onf.217-236] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PROBLEM IDENTIFICATION To evaluate the effects of peer-led supportive interventions for patients with cancer.
. LITERATURE SEARCH Six electronic databases (EMBASE, MEDLINE®, Google Scholar, Cochrane Library, ProQuest Medical Library, and CINAHL®) were searched for articles published from 1997 to May 2017.
. DATA EVALUATION A total of 159 studies were identified. Eighteen (16 randomized, controlled trials [RCTs] and 2 non-RCTs) were eligible for systematic review and 16 for meta-analysis. The Cochrane risk of bias tool and Comprehensive Meta-Analysis software were used for analysis.
. SYNTHESIS The authors synthesized the results of the effect size of each trial according to cancer symptoms, coping, emotional health, quality of life, self-efficacy, sexuality, social support, and health-related behaviors.
. IMPLICATIONS FOR RESEARCH The findings from this study suggest that an additional tiered evaluation that has a theoretical underpinning and high-quality methodology is required to confirm the efficacy of peer-led supportive interventions within cancer care models.
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Mirrielees JA, Breckheimer KR, White TA, Denure DA, Schroeder MM, Gaines ME, Wilke LG, Tevaarwerk AJ. Breast Cancer Survivor Advocacy at a University Hospital: Development of a Peer Support Program with Evaluation by Patients, Advocates, and Clinicians. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2017; 32:97-104. [PMID: 26477478 PMCID: PMC4837082 DOI: 10.1007/s13187-015-0932-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Peer-to-peer support programs provide unique psychosocial and educational support for breast cancer patients. A Patient Survivor Advocacy (PSA) program was developed by the University of Wisconsin Breast Center (UWBC) to provide support for newly diagnosed patients from peers who had completed primary treatment. In this study, we evaluated patient, advocate, and clinician experience with the PSA program. A program matching volunteer peer advocates at least 1 year removed from primary treatment with newly diagnosed patients was developed. Peer advocates were recruited from the practices of UWBC clinicians and received in-person training on six dimensions of peer advocacy. Trained advocates were then paired based on demographic and medical history with new patients referred to the program. Survey assessment tools were distributed to assess peer advocate and patient satisfaction, as well as clinician experience. Forty patients have been matched with seven advocates, with contact largely by email (53 %) or phone (36 %). Patients and peer advocates reported satisfaction with the program. The majority of patients (92.9 %) reported that the program was "helpful" and that they would recommend the PSA program to another woman with breast cancer. All peer advocates (100 %) responded with a sense of achievement in their advocate roles. Clinicians noted challenges in referral to the program. Peer advocates can provide key emotional and psychosocial support to newly diagnosed breast cancer patients. The peer advocate, patient, and clinician feedback collected in this study will inform the future development of this program at our and peer institutions.
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Farrelly A, White V, Young MA, Jefford M, Ieropoli S, Duffy J, Winship I, Meiser B. Implementing a telephone based peer support intervention for women with a BRCA1/2 mutation. Fam Cancer 2016; 14:373-82. [PMID: 25820212 DOI: 10.1007/s10689-015-9797-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Women with a BRCA1/2 gene mutation face complex risk management decisions and communication issues that can lead to increased levels of distress and unmet needs. We describe the implementation of a peer-support program that aims to reduce distress among women with a BRCA1/2 mutation, including peer and support recipient satisfaction with the program, challenges and lessons learnt. Participants with a BRCA1/2 mutation were matched with a trained peer volunteer (also a mutation carrier) to have regular one-on-one phone calls, over 4 months. Details of the calls, including topics discussed, time spent and number, were collected. Peers and recipients completed surveys assessing how they felt the contact went, satisfaction with the program, and preferences for matching. Satisfaction with the program was high for both peers and recipients. 80% of pairs ended contact through mutual agreement. Peers and recipients differed in the importance placed on age and surgery experience to determine matches. The most challenging aspect of the program for peers was difficulty in contacting recipients. Peer support for women with a BRCA1/2 mutation is feasible. However, to encourage continued involvement by peers and recipients greater flexibility in the method and delivery of contact is needed. We advocate the use of text-messaging and/or email as mechanisms for pairs to arrange and maintain contact. These strategies should be in addition to, rather than replacing, calls. A mixed medium intervention, where recipients can tailor the method of communication to suit their needs, may be preferable and effective, though this would need to be tested.
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Affiliation(s)
- Ashley Farrelly
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Road, Melbourne, VIC, 3004, Australia
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13
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Giese-Davis J, Bliss-Isberg C, Wittenberg L, White J, Star P, Zhong L, Cordova MJ, Houston D, Spiegel D. Peer-counseling for women newly diagnosed with breast cancer: A randomized community/research collaboration trial. Cancer 2016; 122:2408-17. [DOI: 10.1002/cncr.30036] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 03/01/2016] [Accepted: 03/22/2016] [Indexed: 11/07/2022]
Affiliation(s)
- Janine Giese-Davis
- Psychosocial Oncology Division, Department of Oncology; University of Calgary; Calgary Alberta Canada
- Psychosocial Resources; Tom Baker Cancer Centre; Calgary Alberta Canada
- Department of Psychiatry and Behavioral Sciences; Stanford University School of Medicine; Stanford California
| | | | - Lynne Wittenberg
- Department of Psychiatry and Behavioral Sciences; Stanford University School of Medicine; Stanford California
| | - Jennifer White
- Psychosocial Oncology Division, Department of Oncology; University of Calgary; Calgary Alberta Canada
- Psychosocial Resources; Tom Baker Cancer Centre; Calgary Alberta Canada
| | | | - Lihong Zhong
- Psychosocial Oncology Division, Department of Oncology; University of Calgary; Calgary Alberta Canada
- Psychosocial Resources; Tom Baker Cancer Centre; Calgary Alberta Canada
| | - Matthew J. Cordova
- Martinez Outpatient Clinic and Community Living Center; VA Northern California Health Care System; Martinez California
| | | | - David Spiegel
- Department of Psychiatry and Behavioral Sciences; Stanford University School of Medicine; Stanford California
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Schoenberger YM, Benz R, McNees P, Meneses K. Patient-centered outcome evaluation of the Rural Breast Cancer Survivors Intervention. Support Care Cancer 2015; 24:1841-8. [PMID: 26452487 DOI: 10.1007/s00520-015-2974-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 09/28/2015] [Indexed: 11/28/2022]
Abstract
PURPOSE Patient-centered evaluation is a critical but often overlooked component of intervention research. The Rural Breast Cancer Survivors (RBCS) Intervention is a survivorship education and support intervention designed for rural breast cancer survivors. Here, we describe evaluation of the RBCS Intervention from the participants' experience. METHODS Three hundred sixty-four breast cancer survivors participating in the RBCS Intervention were asked to complete the RBCS Evaluation Survey that consisted of 6 quantitative statements and 12 qualitative questions via mail. RESULTS Two hundred twenty-one participants (61 %) returned the RBCS Evaluation Survey. All 221 completed the qualitative component, and 91 (25 %) completed the quantitative. Overall, participants indicated that the education materials were easy to understand and addressed their quality of life concerns. Majority (94 %) indicated that the survivorship information was helpful in making health decisions and communicating concerns to family (87 % strongly agree/agree) and oncology team (88 % strongly agree/agree). Only 66 % indicated that the survivorship educational materials were provided at an appropriate time after completion of primary breast cancer treatment. Qualitative data suggested that participants had positive perceptions and experiences and found the RBCS Intervention helpful. One-on-one interaction with the intervention nurses was the single most highly valued aspect. CONCLUSION Overall, the RBCS Intervention was helpful. Education materials addressed quality of life concerns. Breast cancer survivors developed skills in communicating with their family and oncology team. Intervention nurses were identified as the most valuable aspect of the program. Suggestions include earlier timing of survivorship education and support, and adaptation using social media access to serve other rural survivors. RELEVANCE Patient-centered evaluations, using both quantitative and qualitative data, provide enriched understanding of evidence-based survivorship interventions and should be considered a standard for future work.
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Affiliation(s)
- Yu-Mei Schoenberger
- Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, 1720 2nd Ave S, MT 624, Birmingham, AL, 35294, USA.
| | - Rachel Benz
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Patrick McNees
- School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, 35294, USA.,Kirchner Group, Birmingham, AL, 35242, USA
| | - Karen Meneses
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
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Drageset S, Lindstrøm TC, Giske T, Underlid K. Women's experiences of social support during the first year following primary breast cancer surgery. Scand J Caring Sci 2015; 30:340-8. [DOI: 10.1111/scs.12250] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 04/22/2015] [Indexed: 01/17/2023]
Affiliation(s)
- Sigrunn Drageset
- Faculty of Health and Social Sciences; Bergen University College; Bergen Norway
| | | | - Tove Giske
- Haraldsplass Deaconess University College; Bergen Norway
| | - Kjell Underlid
- Faculty of Health and Social Sciences; Bergen University College; Bergen Norway
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Palmer NRA, Weaver KE, Hauser SP, Lawrence JA, Talton J, Case LD, Geiger AM. Disparities in barriers to follow-up care between African American and White breast cancer survivors. Support Care Cancer 2015; 23:3201-9. [PMID: 25821145 DOI: 10.1007/s00520-015-2706-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 03/16/2015] [Indexed: 01/09/2023]
Abstract
PURPOSE Despite recommendations for breast cancer survivorship care, African American women are less likely to receive appropriate follow-up care, which is concerning due to their higher mortality rates. This study describes differences in barriers to follow-up care between African American and White breast cancer survivors. METHODS We conducted a mailed survey of women treated for non-metastatic breast cancer in 2009-2011, 6-24 months post-treatment (N = 203). Survivors were asked about 14 potential barriers to follow-up care. We used logistic regression to explore associations between barriers and race, adjusting for covariates. RESULTS Our participants included 31 African American and 160 White survivors. At least one barrier to follow-up care was reported by 62 %. Compared to White survivors, African Americans were more likely to identify barriers related to out-of-pocket costs (28 vs. 51.6 %, p = 0.01), other health care costs (21.3 vs. 45.2 %, p = 0.01), anxiety/worry (29.4 vs. 51.6 %, p = 0.02), and transportation (4.4 vs. 16.1 %, p = 0.03). After adjustment for covariates, African Americans were three times as likely to report at least one barrier to care (odds ratio (OR) = 3.3, 95 % confidence interval (CI) = 1.1-10.1). CONCLUSIONS Barriers to care are common among breast cancer survivors, especially African American women. Financial barriers to care may prevent minority and underserved survivors from accessing follow-up care. Enhancing insurance coverage or addressing out-of-pocket costs may help address financial barriers to follow-up care among breast cancer survivors. Psychosocial care aimed at reducing fear of recurrence may also be important to improve access among African American breast cancer survivors.
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Affiliation(s)
- Nynikka R A Palmer
- Division of General Internal Medicine at San Francisco General Hospital, University of California San Francisco, San Francisco, CA, USA.
| | - Kathryn E Weaver
- Social Science and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Sally P Hauser
- General Surgery, Wake Forest Comprehensive Cancer Center, Winston-Salem, NC, USA
| | - Julia A Lawrence
- General Surgery, Wake Forest Comprehensive Cancer Center, Winston-Salem, NC, USA
| | - Jennifer Talton
- Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - L Douglas Case
- Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Ann M Geiger
- Health Services and Economics Branch, Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
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White VM, Young MA, Farrelly A, Meiser B, Jefford M, Williamson E, Ieropoli S, Duffy J, Winship I. Randomized controlled trial of a telephone-based peer-support program for women carrying a BRCA1 or BRCA2 mutation: impact on psychological distress. J Clin Oncol 2014; 32:4073-80. [PMID: 25403211 DOI: 10.1200/jco.2013.54.1607] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To assess the effectiveness of a telephone-based peer-delivered intervention in reducing distress among women with a BRCA1 or BRCA2 gene mutation. The intervention involved trained peer volunteers contacting women multiple times over a 4-month period to provide informational, emotional, and practical support. METHODS Three hundred thirty-seven participants completed the baseline questionnaire, and those reporting interest in talking to other mutation carriers were randomly assigned to either the usual care group (UCG; n = 102) or the intervention group (IG; n = 105). Participants and researchers were not blinded to group allocation. Two follow-up questionnaires were completed, one at the end of the intervention (4 months after random assignment, time 2) and one 2 months later (time 3). Outcomes included breast cancer distress (primary outcome), unmet information needs, cognitive appraisals about mutation testing, and feelings of isolation. RESULTS There was a greater decrease in breast cancer distress scores in the IG than UCG at time 2 (mean difference, -5.96; 95% CI, -9.80 to -2.12; P = .002) and time 3 (mean difference, -3.94; 95% CI, -7.70 to -0.17; P = .04). There was a greater reduction in unmet information needs in the IG than UCG (P < .01), with unmet needs being lower in the IG than UCG at time 2. There was a greater reduction in Cognitive Appraisals About Genetic Testing stress subscale scores in the IG than UCG (P = .02), with significantly lower scores among the IG than UCG at time 2 (P < .01). CONCLUSION The intervention is effective in reducing distress and unmet information needs for this group of women. Identifying strategies for prolonging intervention effects is warranted.
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Affiliation(s)
- Victoria M White
- Victoria M. White, Ashley Farrelly, and Michael Jefford, Cancer Council Victoria; Elizabeth Williamson and Ingrid Winship, The University of Melbourne; Ingrid Winship, Royal Melbourne Hospital; Elizabeth Williamson, Monash University, Melbourne; Mary-Anne Young and Michael Jefford, Peter MacCallum Cancer Centre, East Melbourne; Sandra Ieropoli, Early in Life Mental Health Service, Monash Health Mental Health Program, Clayton, Victoria; Bettina Meiser, Prince of Wales Clinical School, The University of New South Wales, Sydney; and Jessica Duffy, Hereditary Cancer Clinic, Prince of Wales Hospital, Randwick, New South Wales, Australia.
| | - Mary-Anne Young
- Victoria M. White, Ashley Farrelly, and Michael Jefford, Cancer Council Victoria; Elizabeth Williamson and Ingrid Winship, The University of Melbourne; Ingrid Winship, Royal Melbourne Hospital; Elizabeth Williamson, Monash University, Melbourne; Mary-Anne Young and Michael Jefford, Peter MacCallum Cancer Centre, East Melbourne; Sandra Ieropoli, Early in Life Mental Health Service, Monash Health Mental Health Program, Clayton, Victoria; Bettina Meiser, Prince of Wales Clinical School, The University of New South Wales, Sydney; and Jessica Duffy, Hereditary Cancer Clinic, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Ashley Farrelly
- Victoria M. White, Ashley Farrelly, and Michael Jefford, Cancer Council Victoria; Elizabeth Williamson and Ingrid Winship, The University of Melbourne; Ingrid Winship, Royal Melbourne Hospital; Elizabeth Williamson, Monash University, Melbourne; Mary-Anne Young and Michael Jefford, Peter MacCallum Cancer Centre, East Melbourne; Sandra Ieropoli, Early in Life Mental Health Service, Monash Health Mental Health Program, Clayton, Victoria; Bettina Meiser, Prince of Wales Clinical School, The University of New South Wales, Sydney; and Jessica Duffy, Hereditary Cancer Clinic, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Bettina Meiser
- Victoria M. White, Ashley Farrelly, and Michael Jefford, Cancer Council Victoria; Elizabeth Williamson and Ingrid Winship, The University of Melbourne; Ingrid Winship, Royal Melbourne Hospital; Elizabeth Williamson, Monash University, Melbourne; Mary-Anne Young and Michael Jefford, Peter MacCallum Cancer Centre, East Melbourne; Sandra Ieropoli, Early in Life Mental Health Service, Monash Health Mental Health Program, Clayton, Victoria; Bettina Meiser, Prince of Wales Clinical School, The University of New South Wales, Sydney; and Jessica Duffy, Hereditary Cancer Clinic, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Michael Jefford
- Victoria M. White, Ashley Farrelly, and Michael Jefford, Cancer Council Victoria; Elizabeth Williamson and Ingrid Winship, The University of Melbourne; Ingrid Winship, Royal Melbourne Hospital; Elizabeth Williamson, Monash University, Melbourne; Mary-Anne Young and Michael Jefford, Peter MacCallum Cancer Centre, East Melbourne; Sandra Ieropoli, Early in Life Mental Health Service, Monash Health Mental Health Program, Clayton, Victoria; Bettina Meiser, Prince of Wales Clinical School, The University of New South Wales, Sydney; and Jessica Duffy, Hereditary Cancer Clinic, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Elizabeth Williamson
- Victoria M. White, Ashley Farrelly, and Michael Jefford, Cancer Council Victoria; Elizabeth Williamson and Ingrid Winship, The University of Melbourne; Ingrid Winship, Royal Melbourne Hospital; Elizabeth Williamson, Monash University, Melbourne; Mary-Anne Young and Michael Jefford, Peter MacCallum Cancer Centre, East Melbourne; Sandra Ieropoli, Early in Life Mental Health Service, Monash Health Mental Health Program, Clayton, Victoria; Bettina Meiser, Prince of Wales Clinical School, The University of New South Wales, Sydney; and Jessica Duffy, Hereditary Cancer Clinic, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Sandra Ieropoli
- Victoria M. White, Ashley Farrelly, and Michael Jefford, Cancer Council Victoria; Elizabeth Williamson and Ingrid Winship, The University of Melbourne; Ingrid Winship, Royal Melbourne Hospital; Elizabeth Williamson, Monash University, Melbourne; Mary-Anne Young and Michael Jefford, Peter MacCallum Cancer Centre, East Melbourne; Sandra Ieropoli, Early in Life Mental Health Service, Monash Health Mental Health Program, Clayton, Victoria; Bettina Meiser, Prince of Wales Clinical School, The University of New South Wales, Sydney; and Jessica Duffy, Hereditary Cancer Clinic, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Jessica Duffy
- Victoria M. White, Ashley Farrelly, and Michael Jefford, Cancer Council Victoria; Elizabeth Williamson and Ingrid Winship, The University of Melbourne; Ingrid Winship, Royal Melbourne Hospital; Elizabeth Williamson, Monash University, Melbourne; Mary-Anne Young and Michael Jefford, Peter MacCallum Cancer Centre, East Melbourne; Sandra Ieropoli, Early in Life Mental Health Service, Monash Health Mental Health Program, Clayton, Victoria; Bettina Meiser, Prince of Wales Clinical School, The University of New South Wales, Sydney; and Jessica Duffy, Hereditary Cancer Clinic, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Ingrid Winship
- Victoria M. White, Ashley Farrelly, and Michael Jefford, Cancer Council Victoria; Elizabeth Williamson and Ingrid Winship, The University of Melbourne; Ingrid Winship, Royal Melbourne Hospital; Elizabeth Williamson, Monash University, Melbourne; Mary-Anne Young and Michael Jefford, Peter MacCallum Cancer Centre, East Melbourne; Sandra Ieropoli, Early in Life Mental Health Service, Monash Health Mental Health Program, Clayton, Victoria; Bettina Meiser, Prince of Wales Clinical School, The University of New South Wales, Sydney; and Jessica Duffy, Hereditary Cancer Clinic, Prince of Wales Hospital, Randwick, New South Wales, Australia
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Okuyama S, Jones W, Ricklefs C, Tran ZV. Psychosocial telephone interventions for patients with cancer and survivors: a systematic review. Psychooncology 2014; 24:857-70. [PMID: 25328103 DOI: 10.1002/pon.3704] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 08/28/2014] [Accepted: 09/16/2014] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Over one third of patients with cancer experience elevated psychosocial distress. As screening for distress becomes more common, the number of patients referred for psychosocial care will increase. Psychosocial telephone interventions are recommended as a convenient and exportable alternative to in-person interventions addressing psychosocial distress. This study reviews the efficacy of randomized controlled trials (RCTs) of psychosocial telephone interventions for patients with cancer. METHODS We conducted a systematic review of peer-reviewed RCTs evaluating telephone interventions in adult patients with cancer across the survivorship continuum. RESULTS Through a database search, 480 articles were identified. After manual review, 13 were included, with 7 additional studies identified by back citation, totaling 20 studies. Participants were largely Caucasian, highly educated, with mean age ranging from 49 to 75 years. Most participants were patients with breast cancer (n = 13 studies). Sample sizes were generally small, with most patients recruited from large medical centers. Only one screened for psychosocial need. Interventions varied greatly in length and intensity. Eight studies reported significant effects post-intervention in the hypothesized direction on at least one psychosocial outcome measure. Of these eight studies, four included more than one follow-up assessment; of these, only one reported significant effects at last follow-up. No clear commonalities were found among studies reporting significant effects. CONCLUSIONS Methodological concerns and lack of consistency in adherence to CONSORT reporting guidelines were identified. This body of research would benefit from well-designed, theory-based RCTs adequately powered to provide more definitive evidence for intervention efficacy. This will probably require multi-institutional collaborations, guided by intervention and research methodology best practices.
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Affiliation(s)
- Sonia Okuyama
- University of Colorado Cancer Center, Cancer Prevention and Control, Aurora, CO, USA
| | - Whitney Jones
- Colorado School of Public Health, Department of Community and Behavioral Health, Aurora, CO, USA
| | - Christine Ricklefs
- University of Colorado Cancer Center, Cancer Prevention and Control, Aurora, CO, USA
| | - Zung Vu Tran
- Colorado School of Public Health, Department of Biostatistics and Informatics, Aurora, CO, USA
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McGrath P. Patient perspectives on the usefulness of routine telephone follow-up as psychosocial support for hematologic malignancies: Australian findings. Oncol Nurs Forum 2014; 41:40-4. [PMID: 24368238 DOI: 10.1188/14.onf.40-44] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To explore the use of routine telephone follow-up as a supportive care strategy for patients with hematologic malignancies from the patients' perspectives. RESEARCH APPROACH A qualitative design based on a series of open-ended interviews and one focus group. SETTING Leukaemia Foundation of Queensland, Australia. PARTICIPANTS 50 participants recruited from the Leukaemia Foundation of Queensland database that represented a sample of major diagnostic groups, age, gender, and geographic location of patients with hematologic malignancies. METHODOLOGIC APPROACH Interviews and focus groups were open-ended and were recorded, transcribed verbatim, coded, and thematically analyzed to form the basis of the findings. FINDINGS The majority of participants in the study saw a perceived benefit in regular telephone follow-up as a supportive care service. Benefits included the positive aspects of individualized attention, potential support created for those not open to conventional types of support, and the positive effects of allowing support organizations to keep track of patient progress. However, some participants did not want to receive regular telephone follow-up support because of a desire to move on and access to other support through friends, family, or healthcare professionals. CONCLUSIONS The results from the current study affirm previous research. Attitudes toward a telephone follow-up support service vary from patient to patient. Research demonstrates that patients with cancer responded with attitudes that range from favorable to unfavorable toward the benefits and usefulness of telephone support. INTERPRETATION Oncology nurses provide supportive care for patients with hematologic malignancies, and they serve as a key professional group to provide follow-up telephone supportive care. Based on the findings from the current article, oncology nurses who provide supportive care should be aware of differing attitudes among patients with hematologic malignancies toward telephone follow-up support. Nurses participating in support initiatives should recognize the notion of patient receptivity and how it affects telephone support strategies.
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Affiliation(s)
- Pam McGrath
- Centre for Community Science, Griffith Health Institute, Queensland, Australia
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