Radiation Therapy Survivorship: Healthcare Providers’ Perspectives on Education and Care

Acute skin toxicity and self-management ability among Chinese breast cancer radiotherapy patients: a qualitative study

OBJECTIVES

Radiation dermatitis is the most common reaction to radiotherapy, almost all breast cancer patients receive radiotherapy on an outpatient basis. Currently, there are no studies on the experience of radiation dermatitis and the ability to self-manage it. Therefore, we aimed to use qualitative approaches to gain a deeper understanding of the actual experiences and self-management ability in order to provide a reference for further improving the effectiveness of self-management and to optimize symptom management strategies.

METHODS

A descriptive qualitative study was conducted using purposive sampling to select 17 breast cancer patients undergoing radiotherapy. Semi-structured interviews were conducted from September to November 2023. The Colaizzi seven-step analysis method was used to classify the data into summarized themes.

RESULTS

Four themes were identified from the interview responses: (1) multiple self-reported skin symptoms in breast cancer patients with radiation dermatitis; (2) the multidimensional impact on patient's quality of life, especially pruritus, ulceration; (3) the ability to self-manage radiation dermatitis: strong mental toughness, positive response, and self-doubt; (4) challenges faced: concerns about radiotherapy side effects and recurrence, targeted symptom management and continuity of care after the radiotherapy.

CONCLUSIONS

Healthcare professionals should consider patients' self-reported symptoms when assessing radiation dermatitis. For pruritus and pain, we can enhance precision symptom management to improve patients' quality of life. By utilizing information technology tools, we can increase breast cancer patients' ability and confidence in managing radiation dermatitis effectively while enhancing accurate symptom management during radiotherapy.

Enhancing patient education in cancer care: Intelligent cancer patient education model for effective communication

BACKGROUND

The incidence of cancer is on the rise annually, whereas there exists a significant deficit of healthcare personnel. Inadequate communication between healthcare providers and patients may result in adverse emotional outcomes for the latter and interfere with their treatment progress. A viable solution to alleviate patient distress involves utilizing text generation models as an efficacious tool for delivering patient education.

MATERIALS AND METHODS

In this study, we proposed an intelligent cancer patient education model (ICPEM) based on the pre-trained T5 model. Meanwhile, we presented a new method for optimizing the model's comprehension of the patient's intent through simulating the inquiries that the patient may ask. The datasets used include a doctor and patient dialogue dataset and a cancer patient education scenario dataset. After prompt-tuning, the model is capable of educating patients through four major aspects including medical examination, health care, radiotherapy, chemotherapy.

RESULTS

We conducted a comprehensive evaluation of the model by employing both automated and manual metrics. Our findings indicate that the responses generated by the model effectively catered to the requirements of patient education. Furthermore, our visualization analysis demonstrated the model's proficiency in processing sentences that are prone to confusion while maintaining a robust comprehension of human intent. Finally, several shortcomings of the model are presented, such as the inadequate amount of knowledge and the limited range of responses.

CONCLUSION

We proposed a method for training and deploying medical language models in a low-resource environment. The proposed model facilitated the comprehension of cancer patients' intentions, resulting in suitable responses, which promotes effective patient-provider communication.

Instruments to Evaluate Self-Management of Radiation Dermatitis in Patients With Breast Cancer

PROBLEM IDENTIFICATION

Radiation dermatitis (RD) is an expected side effect of radiation to the breast and chest wall. Healthcare providers routinely grade the severity of RD without assessing its impact on quality of life for patients with breast cancer. Instruments are needed to identify a patient's ability and confidence to self-manage RD.

LITERATURE SEARCH

A search was conducted of published literature from 2001 to 2018 that included patients who had received radiation therapy for breast cancer. A validated instrument was used to assess RD.

DATA EVALUATION

Eleven instruments were identified and evaluated for assessing self-management.

SYNTHESIS

One instrument was identified that measured a patient's ability to self-manage symptoms. The Patient-Reported Outcomes Measurement Information System Self-Efficacy for Managing Chronic Conditions-Manage Symptoms should be considered for clinical integration.

IMPLICATIONS FOR PRACTICE

Using a validated instrument to assess patients' needs and ability to self-manage RD will promote personalized care plans tailored to each patient. Findings can be used to implement a patient-reported outcome measure into clinical practice, develop educational programs for RD management, and create personalized care plans.