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Murnaghan S, Scruton S, Urquhart R. Psychosocial interventions that target adult cancer survivors' reintegration into daily life after active cancer treatment: a scoping review. JBI Evid Synth 2024; 22:607-656. [PMID: 38015073 PMCID: PMC10986786 DOI: 10.11124/jbies-23-00044] [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] [Indexed: 11/29/2023]
Abstract
OBJECTIVE This review explored psychosocial interventions targeting adult cancer survivors' reintegration following active cancer treatment. This included the types of interventions tested and the tools used to measure reintegration. INTRODUCTION Cancer survivors face lingering health issues following the completion of cancer treatment. Many cancer survivors still experience unmet psychosocial care needs despite receiving follow-up care. Further, many survivorship interventions do not specifically address outcomes important to survivors. A number of primary studies have identified reintegration as an outcome important to cancer survivors. Reintegration is a concept that focuses on returning to normal activities, routines, and social roles after cancer treatment; however, it is emerging and abstract. INCLUSION CRITERIA Studies involving adult cancer survivors (18 years or older at diagnosis) of any cancer type or stage were included in this review. Studies with psychosocial interventions targeted at reintegrating the person into daily life after cancer treatment were included. Interventions addressing clinical depression or anxiety, and interventions treating solely physical needs that were largely medically focused were excluded. METHODS A literature search was conducted in MEDLINE (Ovid), CINAHL (EBSCOhost), and Embase. Gray literature was searched using ProQuest Dissertations and Theses (ProQuest). Reference lists of included studies were searched. Studies were screened at the title/abstract and full-text levels, and 2 independent reviewers extracted data. Manuscripts in languages other than English were excluded due to feasibility (eg, cost, time of translations). Findings were summarized narratively and reported in tabular and diagrammatic format. RESULTS The 3-step search strategy yielded 5617 citations. After duplicates were removed, the remaining 4378 citations were screened at the title and abstract level, then the remaining 306 citations were evaluated at the full-text level by 2 independent reviewers. Forty studies were included that evaluated psychosocial interventions among adult cancer survivors trying to reintegrate after active cancer treatment (qualitative n=23, mixed methods n=8, quantitative n=8, systematic review n=1). Included articles spanned 10 different countries/regions. Over half of all included articles (n=25) focused primarily on breast cancer survivors. Many studies (n=17) were conducted in primary care or community-based settings. The most common types of interventions were peer-support groups (n=14), follow-up education and support (n=14), exercise programs (n=6), and multidisciplinary/multicomponent programs (n=6). While the majority of included studies characterized the outcome qualitatively, 9 quantitative tools were also employed. CONCLUSIONS This review identified 6 types of interventions to reintegrate survivors back into their daily lives following cancer treatment. An important thread across intervention types was a focus on personalization in the form of problem/goal identification. Given the number of qualitative studies, future research could include a qualitative systematic review and meta-aggregation. Quantitative tools may not be as effective for evaluating reintegration. More primary studies, including mixed methods studies, utilizing consistent measurement tools are required. Furthermore, this work provides a basis for future research to continue examining the complexity of implementing such interventions to successfully achieve reintegration. To do so, primary studies evaluating interventions from an implementation science and complex systems perspective would be useful. REVIEW REGISTRATION Open Science Framework https://osf.io/r6bmx.
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Affiliation(s)
- Sarah Murnaghan
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Sarah Scruton
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Robin Urquhart
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
- Department of Surgery, Nova Scotia Health, Halifax, NS, Canada
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Levy T, Huxley K, Vuu S, Lewis LK. Physical activity for people with chronic conditions: a systematic review of toolkits to promote adherence. Disabil Rehabil 2023:1-14. [PMID: 38131330 DOI: 10.1080/09638288.2023.2296525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023]
Abstract
PURPOSE The World Health Organisation (WHO) recommends that health professionals develop and implement "adherence counselling toolkits" to promote adherence to long-term therapies in people with chronic conditions. This prospectively registered review aimed to systematically identify and evaluate existing toolkits developed to promote adherence to physical activity in people with chronic conditions. MATERIALS AND METHODS Grey literature and six e-databases were searched for studies investigating the use of "toolkits" to promote adherence to physical activity or exercise recommendations in people with chronic conditions (Medline, PsycInfo, EmCare, Cochrane, CINAHL Plus, Pedro). A two-stage screening process was completed by two independent reviewers. RESULTS Five studies describing five toolkits were included. Three toolkits displayed all WHO recommended features, including information on adherence, a clinically useful way of using this information, and behavioural tools for maintaining habits. The included toolkits featured "adherence" to the intervention; however, this was not their primary aim. There were trends towards improved physical activity with some of the included toolkits. CONCLUSIONS There are a lack of rigorously developed toolkits that focus on adherence to physical activity in people with chronic conditions. Toolkits should be developed, tested, and implemented to improve adherence and outcomes for people with chronic conditions.
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Affiliation(s)
- Tamina Levy
- Caring Futures Institute, Flinders University, Adelaide, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
- Flinders Medical Centre, Rehabilitation and Palliative Services, Adelaide, Australia
| | - Kelly Huxley
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
- Flinders Medical Centre, Rehabilitation and Palliative Services, Adelaide, Australia
| | - Sally Vuu
- Caring Futures Institute, Flinders University, Adelaide, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Lucy K Lewis
- Caring Futures Institute, Flinders University, Adelaide, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
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Iqbal MP, Newman B, Ellis LA, Mears S, Harrison R. Characterising consumer engagement in virtual models of care: A systematic review and narrative synthesis. PATIENT EDUCATION AND COUNSELING 2023; 115:107922. [PMID: 37542823 DOI: 10.1016/j.pec.2023.107922] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 07/14/2023] [Accepted: 07/20/2023] [Indexed: 08/07/2023]
Abstract
BACKGROUND Widespread adoption of digital tools and technologies now support the delivery of virtual healthcare. Although, consumer engagement is central to care processes in virtual care models, there is paucity of evidence regarding the nature and outcomes of consumer engagement. This study aimed to determine the nature of consumer engagement used in virtual models of care, and its impact on quality and safety of care. METHODS A systematic review was undertaken with a narrative synthesis, with a search strategy applied to five electronic databases (CINAHL, EMBASE, MEDLINE, PsycINFO and Web of Science) RESULTS: Fifty-eight studies were included in the review that utilised a variety of virtual models of care across care services. Consumer engagement, such as patients' active involvement in monitoring, capturing and reporting their health data, was a common feature of the identified virtual models. CONCLUSION Increasing use of virtual models of care requires consideration of the role of patients and their support persons in the use of technology and in wider care processes that occur at a distance from health professionals. Ensuring consumers are equipped with necessary support to effectively engage in virtual care is important to ensure equity in access to, and outcomes of, virtual care models.
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Affiliation(s)
- Maha Pervaz Iqbal
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.
| | - Bronwyn Newman
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Louise A Ellis
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Stephen Mears
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Reema Harrison
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
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Deng H, Vu KQ, Franco JR, Shepler LJ, Abouzeid CA, Hamner JW, Mercier HW, Taylor JA, Kazis LE, Slavin MD, Ryan CM, Schneider JC. Digital Interventions for Social Participation in Adults with Long-term Physical Conditions: A Systematic Review. J Med Syst 2023; 47:26. [PMID: 36792791 PMCID: PMC9931567 DOI: 10.1007/s10916-023-01914-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 01/20/2023] [Indexed: 02/17/2023]
Abstract
This review aims to identify and evaluate digital interventions for social participation in the growing population of adults with long-term physical conditions. Articles were sourced from MEDLINE, EMBASE, CINAHL and PsycINFO databases using subject headings and keywords related to "social participation" and "digital technology". Studies that adopted digital technology interventions to improve social participation in adults with long-term physical conditions were included. Data on study methodology, participant and digital intervention characteristics, and findings related to social participation were extracted. The search yielded a total of 4646 articles and 14 articles met criteria for final review with five randomized controlled trials, two non-randomized clinical trials and seven one-group pretest-posttest clinical trials. Studies were organized based on the digital intervention strategy implemented to improve social participation: group support (n = 4), individual skill training or counseling (n = 6), education and support (n = 3), and mixed intervention (n = 1). The group support interventions developed a social network among participants through videoconference, app, or virtual reality platform. Three studies reported positive improvements in different aspects of social participation. Individual skill training or counseling mainly utilized phone calls to help participants cope with activity participation and interpersonal relationship issues. Only two studies demonstrated benefits for social participation. The education and support intervention, which used messages and website information to increase participants' knowledge and provide support, showed positive findings in three studies. This review suggests digital interventions for improving social participation in adults with long-term physical conditions are feasible and the effectiveness of different strategies may vary.Registration: This review was prospectively registered on the International Prospective Register of Systematic Reviews (PROSPERO) (registry number: CRD42021254105).
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Affiliation(s)
- Huan Deng
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, 300 1st Avenue, Boston, MA, 02129, USA
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
| | - Kevin Q Vu
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, 300 1st Avenue, Boston, MA, 02129, USA
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
| | - Jessie R Franco
- Department of Rehabilitation Services, Brigham and Women's Hospital, Boston, MA, USA
| | - Lauren J Shepler
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, 300 1st Avenue, Boston, MA, 02129, USA
| | - Cailin A Abouzeid
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, 300 1st Avenue, Boston, MA, 02129, USA
| | - J W Hamner
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, 300 1st Avenue, Boston, MA, 02129, USA
| | - Hannah W Mercier
- Occupational Therapy Program, Stony Brook University, Stony Brook, NY, USA
| | - J Andrew Taylor
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
- Cardiovascular Research Laboratory, Spaulding Rehabilitation Hospital, Boston, MA, USA
| | - Lewis E Kazis
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, 300 1st Avenue, Boston, MA, 02129, USA
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
- Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, USA
| | - Mary D Slavin
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, 300 1st Avenue, Boston, MA, 02129, USA
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
- Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, USA
| | - Colleen M Ryan
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
- Shriners Hospitals for Children-Boston®, Boston, MA, USA
| | - Jeffrey C Schneider
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, 300 1st Avenue, Boston, MA, 02129, USA.
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA.
- Department of Physical Medicine and Rehabilitation, Massachusetts General Hospital, Boston, MA, USA.
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Larsen MH, Mengshoel AM, Andersen MH, Borge CR, Ahlsen B, Dahl KG, Eik H, Holmen H, Lerdal A, Mariussen KL, Thoresen L, Tschamper MK, Urstad KH, Vidnes TK, Wahl AK. "A bit of everything": Health literacy interventions in chronic conditions - a systematic review. PATIENT EDUCATION AND COUNSELING 2022; 105:2999-3016. [PMID: 35641366 DOI: 10.1016/j.pec.2022.05.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 05/10/2022] [Accepted: 05/12/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To systematically evaluate health literacy (HL) interventions in chronic conditions by exploring theoretical perspectives, intervention content and effectiveness. METHOD We searched MEDLINE, Cochrane, CINAHL, EMBASE, ERIC, Web of Science and PsycINFO. Standardised systematic review methods were used, and sequences informing our research question were extracted and analysed. The study includes a descriptive summary of the included papers. RESULTS We included 39 unique interventions, with diabetes and heart disease as the most targeted chronic conditions. Fifty-four percent of papers included a definition of HL, but the studies showed significant heterogeneity of theoretical underpinnings, modes, measures and content. We identified 23 HL measures, mostly assessing functional HL. The HL interventions were often more complex than the measures indicated. A significant change in HL was found in 28 studies. Study quality was generally poor. CONCLUSIONS Interventions optimizing HL appear important to improve health outcomes in chronic conditions. To ensure cumulative knowledge development of this field we need theory-based interventions, consistency in methods and more tailored and comprehensive measures to capture the interventions' complexity. PRACTICE IMPLICATIONS A more valid understanding of HL interventions and measurements is needed to reach an agreed understanding of their components and intentions.
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Affiliation(s)
- Marie H Larsen
- Faculty of Medicine, Institute of Health and Society, Department of Interdisciplinary Health Sciences-University of Oslo, Oslo, Norway; Lovisenberg Diaconal University College, Oslo, Norway.
| | - Anne Marit Mengshoel
- Faculty of Medicine, Institute of Health and Society, Department of Interdisciplinary Health Sciences-University of Oslo, Oslo, Norway.
| | - Marit H Andersen
- Faculty of Medicine, Institute of Health and Society, Department of Interdisciplinary Health Sciences-University of Oslo, Oslo, Norway; Department of Transplantation Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
| | - Christine R Borge
- Faculty of Medicine, Institute of Health and Society, Department of Interdisciplinary Health Sciences-University of Oslo, Oslo, Norway; Lovisenberg Diaconal Hospital AS, Oslo, Norway.
| | - Birgitte Ahlsen
- Faculty of Health Sciences, Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway.
| | - Kari Gire Dahl
- Department of Transplantation Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
| | - Hedda Eik
- Faculty of Medicine, Institute of Health and Society, Department of Interdisciplinary Health Sciences-University of Oslo, Oslo, Norway; Faculty of Health Sciences, Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway.
| | - Heidi Holmen
- Faculty of Health Sciences, Department of Nursing and Health Promotion - Oslo Metropolitan University, Norway.
| | - Anners Lerdal
- Faculty of Medicine, Institute of Health and Society, Department of Interdisciplinary Health Sciences-University of Oslo, Oslo, Norway; Lovisenberg Diaconal Hospital AS, Oslo, Norway.
| | | | - Lisbeth Thoresen
- Faculty of Medicine, Institute of Health and Society, Department of Interdisciplinary Health Sciences-University of Oslo, Oslo, Norway.
| | - Merete K Tschamper
- Faculty of Medicine, Institute of Health and Society, Department of Interdisciplinary Health Sciences-University of Oslo, Oslo, Norway; National Centre for Epilepsy, Devision of Clinical Neuroscience, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
| | - Kristin H Urstad
- Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.
| | - Tone K Vidnes
- Faculty of Medicine, Institute of Health and Society, Department of Interdisciplinary Health Sciences-University of Oslo, Oslo, Norway; Department of Transplantation Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
| | - Astrid K Wahl
- Faculty of Medicine, Institute of Health and Society, Department of Interdisciplinary Health Sciences-University of Oslo, Oslo, Norway; Department of Transplantation Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
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Bonetti L, Tolotti A, Anderson G, Nania T, Vignaduzzo C, Sari D, Barello S. Nursing interventions to promote patient engagement in cancer care: A systematic review. Int J Nurs Stud 2022; 133:104289. [PMID: 35751947 DOI: 10.1016/j.ijnurstu.2022.104289] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 05/18/2022] [Accepted: 05/20/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND Patient engagement is becoming increasingly relevant in cancer care. Nurses have been recognized as crucial in promoting active engagement of people with carcer. Despite the growing interest on this topic and the relevance of patient engagement interventions to improve patient' conditions, to the best of our knowledge there is no synthesis of the literature on the characteristics and impact of nurse-led patient engagement intervention for adults with cancer. OBJECTIVE This review aims to systematically summarize nurse-led patient engagement interventions for adult patients diagnosed with cancer and to describe the state of the art on the impact of these interventions on patients' outcomes. DESIGN Systematic review. SETTING(S) Hospital and outpatient care. PARTICIPANTS Adults with cancer. METHODS We searched PubMed, CINAHL, Embase, Scopus, Web of Science and Cochrane library from 2005 to 2021. We included randomized clinical trials, quasi-experimental studies and single-arm, pre-test/post-test studies written in English, Spanish, French and Italian. All the included articles reported nurse-led patient engagement interventions designed to improve patient engagement in the management of their own disease and to assess outcomes related to patient engagement. We appraised the methodological quality of the included articles with the Joanna Briggs Institute appraisal tools. RESULTS Twenty-four articles met the inclusion criteria. Four distinct types of nurse-led engagement interventions, showing different degrees of complexity, were classified: (i) generic health information delivery, (ii) patient-specific information delivery, (iii) personalized decision support and (iv) motivational support. These interventions were effective in supporting behavioral changes and reducing symptoms burden of adults with cancer. In addition, many of the retrieved studies showed significant increase in patients' knowledge, informed decisions making, perceived quality of nurse-patient interaction and quality of life after the engagement intervention. CONCLUSIONS This systematic review summarized a wide variety of nurse-led patient engagement interventions with different degrees of complexity. In addition, a significant positive effect of these interventions was found on outcomes such as patient activation, self-efficacy, health literacy and quality of life. Among those identified, nurse-led motivational interventions appear to be the most effective ones for improving engagement outcomes in adults with cancer. REGISTRATION NUMBER PROSPERO Nr: CRD42020146189.
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Affiliation(s)
- Loris Bonetti
- Nursing Research Competence Centre, Department of Nursing, Ente Ospedaliero Cantonale (EOC), Viale Officina, 3, 6500 Bellinzona, Switzerland; University of Applied Sciences and Arts of Southern Switzerland, Department of Business Economics, Health and Social Care, Via Violino, 11, Manno 6928, Switzerland.
| | - Angela Tolotti
- Nursing Development and Research Unit, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Via Gallino, 12, Bellinzona, Switzerland.
| | - Gloria Anderson
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.
| | - Tiziana Nania
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
| | - Camilla Vignaduzzo
- EngageMinds HUB - Consumer, Food & Health Engagement Research Center, Department of Phychology, Università Cattolica del Sacro Cuore, Milano and Cremona, L.Go Gemelli 1, 20123 Milan, Italy.
| | - Davide Sari
- Department of Nursing, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Via Gallino, 12, Bellinzona, Switzerland.
| | - Serena Barello
- EngageMinds HUB - Consumer, Food & Health Engagement Research Center, Department of Phychology, Università Cattolica del Sacro Cuore, Milano and Cremona, L.Go Gemelli 1, 20123 Milan, Italy.
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Baer LK, Brister L, Mazanec SR. Development and Implementation of an Advanced Practitioner-Led Survivorship Clinic for Patients Status Post Allogeneic Transplant. J Adv Pract Oncol 2022; 12:775-783. [PMID: 35295542 PMCID: PMC8631341 DOI: 10.6004/jadpro.2021.12.8.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background: Survivor recovery from hematopoietic cell transplantation (HCT) is long term, with significant physical and psychological morbidities that impact quality of life and reentry into personal and social lives. The optimal timing of when and how to deliver comprehensive HCT survivorship care is not well defined. Purpose: The purpose of this study was to design, implement, and evaluate an advanced practitioner (AP)-led pilot survivorship clinic incorporating an individual and group format for patients post HCT at the 1-year transition period. Methods: A survey assessing physical, social, emotional, and spiritual needs and concerns was mailed to a sample of patients who underwent HCT between 2009 and 2014. This phase 1 survey was utilized in the phase 2 design of an AP-led pilot survivorship clinic for patients post allogeneic HCT. A total of 15 patients were approached, out of which 7 enrolled over a 12-month period in the pilot survivorship clinic. Results: The needs assessment survey noted the most prevalent moderate to high concerns were in the emotional domain, with 52% of respondents identifying fear of cancer returning and new cancer developing. The pilot survivorship clinic incorporating a group visit format with multiple sessions was not feasible for both patients and APs within the context of a small- to medium-sized HCT program. Conclusion: The needs assessment survey underscored the importance of addressing all four quality of life domains in cancer survivors. A hybrid survivorship clinic with one comprehensive group visit may be beneficial for HCT survivors at the 1-year transition for small- to medium-sized HCT programs.
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Affiliation(s)
- Linda K Baer
- University Hospitals Seidman Cancer Center, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Lauren Brister
- University Hospitals Seidman Cancer Center, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Susan R Mazanec
- University Hospitals Seidman Cancer Center, University Hospitals Cleveland Medical Center, Cleveland, Ohio.,Case Western Reserve University, Cleveland, Ohio
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Mikles SP, Griffin AC, Chung AE. Health information technology to support cancer survivorship care planning: A systematic review. J Am Med Inform Assoc 2021; 28:2277-2286. [PMID: 34333588 PMCID: PMC8449616 DOI: 10.1093/jamia/ocab134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 06/13/2021] [Accepted: 06/23/2021] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE The study sought to conduct a systematic review to explore the functions utilized by electronic cancer survivorship care planning interventions and assess their effects on patient and provider outcomes. MATERIALS AND METHODS Based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines, studies published from January 2000 to January 2020 were identified in PubMed, CINAHL, EMBASE, PsychINFO, Scopus, Web of Science, and the ACM Digital Library . The search combined terms for cancer, survivorship, care planning, and health information technology (HIT). Eligible studies evaluated the effects of a HIT intervention on usability, knowledge, process, or health-related outcomes. A total of 578 abstracts were reviewed, resulting in 60 manuscripts describing 40 studies. Thematic analyses were used to define meta-themes of system functions, and Fisher's exact tests were used to examine associations between functions and outcomes. RESULTS Patients were the target end users for 18 interventions, while 12 targeted providers and 10 targeted both groups. Interventions used patient-reported outcomes collection (60%), automated content generation (58%), electronic sharing (40%), persistent engagement (28%), and communication features (20%). Overall, interventions decreased the time to create survivorship care plans (SCPs) and supported care planning knowledge and abilities, but results were mixed for effects on healthcare utilization, SCP sharing, and provoking anxiety. Persistent engagement features were associated with improvements in health or quality-of-life outcomes (17 studies, P = .003). CONCLUSIONS Features that engaged users persistently over time were associated with better health and quality-of-life outcomes. Most systems have not capitalized on the potential of HIT to share SCPs across a care team and support care coordination.
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Affiliation(s)
- Sean P Mikles
- Lineberger Comprehensive Cancer Outcomes Program, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Ashley C Griffin
- Carolina Health Informatics Program, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Arlene E Chung
- Lineberger Comprehensive Cancer Outcomes Program, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Carolina Health Informatics Program, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Division of General Medicine and Clinical Epidemiology, Department of Medicine, UNC School of Medicine, Chapel Hill, North Carolina, USA
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, UNC School of Medicine, Chapel Hill, North Carolina, USA
- Program on Health and Clinical Informatics, UNC School of Medicine, Chapel Hill, North Carolina, USA
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9
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Ingle MP, Valdovinos C, Ford KL, Zhou S, Bull S, Gornail S, Zhang X, Moore S, Portz J. Patient Portals to Support Palliative and End-of-Life Care: Scoping Review. J Med Internet Res 2021; 23:e28797. [PMID: 34528888 PMCID: PMC8485198 DOI: 10.2196/28797] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 07/02/2021] [Accepted: 07/27/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Although patient portals are widely used for health promotion, little is known about the use of palliative care and end-of-life (PCEOL) portal tools available for patients and caregivers. OBJECTIVE This study aims to identify and assess the user perspectives of PCEOL portal tools available to patients and caregivers described and evaluated in the literature. METHODS We performed a scoping review of the academic literature directed by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) extension for Scoping Review and searched three databases. Sources were included if they reported the development or testing of a feature, resource, tool, or intervention; focused on at least one PCEOL domain defined by the National Coalition for Hospice and Palliative Care; targeted adults with serious illness or caregivers; and were offered via a patient portal tethered to an electronic medical record. We independently screened the titles and abstracts (n=796) for eligibility. Full-text (84/796, 10.6%) sources were reviewed. We abstracted descriptions of the portal tool name, content, targeted population, and reported user acceptability for each tool from included sources (n=19). RESULTS In total, 19 articles describing 12 tools were included, addressing the following PCEOL domains: ethical or legal (n=5), physical (n=5), and psychological or psychiatric (n=2). No tools for bereavement or hospice care were identified. Studies have reported high acceptability of tools among users; however, few sources commented on usability among older adults. CONCLUSIONS PCEOL patient portal tools are understudied. As medical care increasingly moves toward virtual platforms, future research should investigate the usability and acceptability of PCEOL patient portal resources and evaluate their impact on health outcomes.
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Affiliation(s)
- M Pilar Ingle
- Graduate School of Social Work, University of Denver, Denver, CO, United States
| | - Cristina Valdovinos
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CO, United States
| | - Kelsey L Ford
- Colorado School of Public Health, University of Colorado, Aurora, CO, United States
| | - Shou Zhou
- Colorado School of Public Health, University of Colorado, Aurora, CO, United States
| | - Sheana Bull
- Colorado School of Public Health, University of Colorado, Aurora, CO, United States
| | - Starlynne Gornail
- Colorado School of Public Health, University of Colorado, Aurora, CO, United States
| | - Xuhong Zhang
- Colorado School of Public Health, University of Colorado, Aurora, CO, United States
| | - Susan Moore
- Colorado School of Public Health, University of Colorado, Aurora, CO, United States
| | - Jennifer Portz
- Department of General Internal Medicine, University of Colorado, Aurora, CO, United States
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10
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Alejos D, Tregubenko P, Jayarangaiah A, Steinberg L, Kumar A. We need to do better: Readability analysis of online patient information on cancer survivorship and fertility preservation. J Cancer Policy 2021; 28:100276. [DOI: 10.1016/j.jcpo.2021.100276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 01/11/2021] [Accepted: 01/31/2021] [Indexed: 10/22/2022]
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