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Schwartz-Attias I, David T, Amromin T, Bar-Yosef M, Bartov Y, Ben Yaakov O, Bernstein L, Broitman M, Cohen A, Cohen O, Eisenberg L, Eshel N, Gindi Amsalem N, Gorelik N, Gerbi S, Raz H, Naamneh N, Nemtsov S, Pintel D, Sztrigler K, Goldberg S, Melnikov S. Recommendations from the Professional Advisory Committee on Nursing Practice When Caring for Adolescents and Young Adults with Cancer in Israel. J Adolesc Young Adult Oncol 2024; 13:235-238. [PMID: 37889616 DOI: 10.1089/jayao.2023.0091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/29/2023] Open
Affiliation(s)
- Irit Schwartz-Attias
- Academic Nursing School, Meir Medical Center, Clalit Health Services, Kefer-Sava, Israel
| | - Tova David
- Nursing Administration and Hematology Day Care, Assuta Medical Center, Tel Aviv, Israel
| | | | - Michal Bar-Yosef
- Department of Oncology and Pediatric Hematology Oncology and Bone Marrow Transplantation, Sourasky, Tel-Aviv Medical Center, Tel Aviv, Israel
| | - Yael Bartov
- Ziva Tal Academic School of Nursing and AYA Clinical Day Care and Oncology, Sheba Medical Center, Tel Hashomer, Israel
| | - Orna Ben Yaakov
- Department of Oncology, Rambam Health Care Campus, Haifa, Israel
| | | | - Marcela Broitman
- Department of Oncology and Pediatric Hematology Oncology and Bone Marrow Transplantation, Sourasky, Tel-Aviv Medical Center, Tel Aviv, Israel
| | - Amira Cohen
- Nursing Administration, Shamir Medical Center, Tzrifin, Israel
| | - Osnat Cohen
- Department of Oncology, Rabin Medical Center, Petah Tikva, Israel
| | - Limor Eisenberg
- National Head Nurse Office, Nursing Division, Ministry of Health, Jerusalem, Israel
| | - Nurit Eshel
- Nursing Administration, Clalit Health Services, Tel Aviv, Israel
| | - Nati Gindi Amsalem
- Ziva Tal Academic School of Nursing and AYA Clinical Day Care and Oncology, Sheba Medical Center, Tel Hashomer, Israel
| | - Natan Gorelik
- Nursing Administration and Hematology Day Care, Assuta Medical Center, Tel Aviv, Israel
| | - Shimrit Gerbi
- Ziva Tal Academic School of Nursing and AYA Clinical Day Care and Oncology, Sheba Medical Center, Tel Hashomer, Israel
| | - Haya Raz
- Nursing Department, Jerusalem College of Technology, Jerusalem, Israel
| | - Nahla Naamneh
- Nursing Administration, Leumit Health Care Services, Tel Aviv, Israel
| | - Svetlana Nemtsov
- Department of Oncology, Rambam Health Care Campus, Haifa, Israel
| | - Dalit Pintel
- Nursing Administration, Clalit Health Services, Tel Aviv, Israel
| | - Keren Sztrigler
- Pediatric Hematology-Oncology Day Care, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Shoshy Goldberg
- National Head Nurse Office, Nursing Division, Ministry of Health, Jerusalem, Israel
| | - Semyon Melnikov
- Nursing Department, Steyer School of Health Professions, Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
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Ke Y, Zhou H, Chan RJ, Chan A. Decision aids for cancer survivors' engagement with survivorship care services after primary treatment: a systematic review. J Cancer Surviv 2024; 18:288-317. [PMID: 35798994 PMCID: PMC10960885 DOI: 10.1007/s11764-022-01230-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/22/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE To elucidate existing decision aids (DAs) in supporting cancer survivors' decisions to engage in cancer survivorship care services after primary treatment. Secondary objectives are to assess the DA acceptability, impact of DAs, and implementation barriers. METHODS Databases (PubMed, Embase, PsycINFO, CINAHL) were searched to collect publications from inception through September 2021. Studies describing the development or evaluation of DAs used for survivorship care services after primary cancer treatment were included. Article selection and critical appraisal were conducted independently by two authors. RESULTS We included 16 studies that described 13 DAs and addressed multiple survivorship care domains: prevention of recurrence/new cancers in Hodgkin lymphoma survivors and breast cancer gene mutation carriers, family building options, health insurance plans, health promotion (substance use behavior, cardiovascular disease risk reduction), advanced care planning, and post-treatment follow-up intensity. The electronic format was used to design most DAs for self-administration. The content presentation covered decisional context, options, and value clarification exercises. DAs were acceptable and associated with higher knowledge but presented inconclusive decisional outcomes. Implementation barriers included lack of design features for connectivity to care, low self-efficacy, and low perceived DA usefulness among healthcare professionals. Other survivor characteristics included age, literacy, preferred timing, and setting. CONCLUSIONS A diverse range of DAs exists in survivorship care services engagement with favorable knowledge outcomes. Future work should clarify the impact of DAs on decisional outcomes. IMPLICATIONS FOR CANCER SURVIVORS DA characterization and suggestions for prospective developers could enhance support for cancer survivors encountering complex decisions throughout the survivorship continuum.
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Affiliation(s)
- Yu Ke
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | - Hanzhang Zhou
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | - Raymond Javan Chan
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA5042, Australia
- School of Nursing, Queensland University of Technology, Kelvin Grove, Australia
- Princess Alexandra Hospital, Metro South Hospital and Health Services, Woolloongabba, QLD, Australia
| | - Alexandre Chan
- Department of Clinical Pharmacy Practice, University of California Irvine, Irvine, CA, USA.
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Feifer D, Helton G, Wolfe J, Volandes A, Snaman JM. Adolescents and young adults with cancer conversations following participation in an advance care planning video pilot. Support Care Cancer 2024; 32:164. [PMID: 38367086 DOI: 10.1007/s00520-024-08372-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 02/11/2024] [Indexed: 02/19/2024]
Abstract
PURPOSE Advance care planning (ACP) discussions can help adolescents and young adults (AYAs) communicate their preferences to their caregivers and clinical team, yet little is known about willingness to hold conversations, content, and evolution of care preferences. We aimed to assess change in care preferences and reasons for such changes over time and examine the reasons for engaging or not engaging in ACP discussions and content of these discussions among AYAs and their caregivers. METHODS We conducted a pilot randomized controlled trial of a novel video-based ACP tool among AYA patients aged 18-39 with advanced cancer and their caregivers. Participants were asked their care preferences at baseline, after viewing the video or hearing verbal description (post questionnaire), and again 3 months later. Three-month phone calls also queried if any ACP conversations occurred since the initial study visit. Study team notes from these phone calls were evaluated using content analysis. RESULTS Forty-five AYAs and 40 caregivers completed the 3-month follow-up. Nearly half of AYAs and caregivers changed their care preference from post questionnaire to 3-month follow-up. Increased reflection and learning on the topic (n = 45) prompted preference change, with participants often noting the nuanced and context-specific nature of these decisions (n = 20). Most AYAs (60%) and caregivers (65%) engaged in ACP conversation(s), often with a family member. Disease-related factors (n = 8), study participation (n = 8), and a desire for shared understanding (n = 6) were common reasons for initiating discussions. Barriers included disease status (n = 14) and timing (n = 12). ACP discussions focused on both specific wishes for treatment (n = 26) and general conversations about goals and values (n = 18). CONCLUSION AYAs and caregivers acknowledged the complexity of ACP decisions, identifying obstacles and aids for these discussions. Clinicians should support a personalized approach to ACP that captures these nuances, promoting ACP as an iterative, longitudinal, and collaborative process. TRIAL REGISTRATION This trial was registered 10/31/2019 with ClinicalTrials.gov (Identifier: NCT0414907).
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Affiliation(s)
- Deborah Feifer
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA, 02215, USA
- Doctor of Medicine Program, Emory School of Medicine, Atlanta, GA, USA
| | - Gabrielle Helton
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA, 02215, USA
- Doctor of Medicine Program, University of Colorado School of Medicine, Aurora, CO, USA
| | | | | | - Jennifer M Snaman
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA, 02215, USA.
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
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Darabos K, Berger AJ, Barakat LP, Schwartz LA. Cancer-Related Decision-Making Among Adolescents, Young Adults, Caregivers, and Oncology Providers. QUALITATIVE HEALTH RESEARCH 2021; 31:2355-2363. [PMID: 34382889 PMCID: PMC9198895 DOI: 10.1177/10497323211037654] [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: 06/13/2023]
Abstract
Decision-making among adolescents and young adults with cancer (AYA) is often complex, ongoing, and multifaceted, involving caregiver and oncology provider perspectives. Engagement in decision-making against the backdrop of normative developmental processes of acquiring autonomy and gaining independence contributes to the complexity of decision-making. Semi-structured qualitative interviews from 11 AYA and caregiver dyads and eight oncology providers examined decision-making processes with specific attention to the role of shared decision-making, cognitive and emotional processes, and coping with the decision-making experience. Five decision-making patterns were identified, with collaborative decision-making and AYA-driven decisions most commonly described. Utilizing hypothesis coding, AYA and caregivers explained how cognitive (i.e., pros/cons) and emotional (i.e., shock and fear of missing out) processes influenced cancer-related decisions. Coping strategies provided clarity and respite when engaged in decision-making. Our findings illuminate important implications for how to best support decision-making among AYA and caregivers, including the role oncology providers can play during decision-making.
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Affiliation(s)
- Katie Darabos
- Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | | | - Lamia P. Barakat
- Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- University of Pennsylvania, Philadelphia, PA, USA
| | - Lisa A. Schwartz
- Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- University of Pennsylvania, Philadelphia, PA, USA
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