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Aizpurua-Perez I, Arregi A, Gonzalez D, Urruticoechea A, Labaka A, Minguez-Alcaide X, Ugartemendia G, Pascual-Sagastizabal E, Echeverria R, Perez-Tejada J. A randomized controlled trial of the effectiveness of a one-to-one peer support intervention on resilience, social support, and salivary cortisol in recently diagnosed women with breast cancer. Eur J Oncol Nurs 2024; 71:102616. [PMID: 38885598 DOI: 10.1016/j.ejon.2024.102616] [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: 10/29/2023] [Revised: 05/11/2024] [Accepted: 05/18/2024] [Indexed: 06/20/2024]
Abstract
PURPOSE Peer support has been suggested as a way to help women diagnosed with breast cancer to better cope with their situation, but studies on its effectiveness have conflicting results. This randomized controlled trial aimed to study the effectiveness of a one-to-one peer support intervention on psychological resilience, social support, and salivary cortisol among breast cancer patients. METHODS The sample consisted of 121 newly diagnosed women at Onkologikoa Hospital. Patients who were prescribed chemotherapy were randomly assigned to Intervention Group 1 (IG1) or Control Group 1 (CG1). Similarly, those prescribed adjuvant radiotherapy were assigned to IG2 or CG2. Women in IG1 received 8 biweekly social support sessions from volunteer survivors who had successfully overcome breast cancer, while IG2 received 6 biweekly sessions. CG1 and CG2 only received standard care. Resilience, social support, and salivary cortisol were assessed at baseline (T1) and at the end of the intervention (T2). RESULTS We found a non-significant, yet a small to moderate size increase in resilience from T1 to T2 in IG1 (p = 0.246; dDc = 0.47). Upon regression analysis, we observed that this increase was determined by changes in cortisol (β = -0.658, p = 00.010), affective support (β = -0.997, p = 00.014), and emotional support (β = 0.935, p = 00.008). We also found a significant decrease in resilience levels in CG2 from T1 to T2 (p = 0.003; dDc = 0.88). CONCLUSION The present study suggests that peer support can exert a protective psychological influence on women diagnosed with breast cancer, and further indicates an exciting avenue for future intervention development in the breast cancer care continuum. TRIAL REGISTRATION ClinicalTrials.gov NCT05077371.
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Affiliation(s)
- Ibane Aizpurua-Perez
- Department of Basic Psychological Processes and Their Development, University of the Basque Country, San Sebastian, Spain.
| | - Amaia Arregi
- Department of Basic Psychological Processes and Their Development, University of the Basque Country, San Sebastian, Spain.
| | | | | | - Ainitze Labaka
- Department of Nursing II, University of the Basque Country, San Sebastian, Spain.
| | - Xavier Minguez-Alcaide
- Department of Social Psychology, University of the Basque Country, San Sebastian, Spain.
| | | | - Eider Pascual-Sagastizabal
- Department of Basic Psychological Processes and Their Development, University of the Basque Country, San Sebastian, Spain.
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Taylor J, Fradgley EA, Clinton‐McHarg T, Hall A, Paul CL. Perceived importance of emotional support provided by health care professionals and social networks: Should we broaden our focus for the delivery of supportive care? Asia Pac J Clin Oncol 2023; 19:681-689. [PMID: 36698247 PMCID: PMC10947305 DOI: 10.1111/ajco.13922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 12/08/2022] [Accepted: 12/26/2022] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Emotional support provided by health care professionals (HCPs) for people diagnosed with cancer is associated with improved outcomes. Support via social networks may also be important. AIMS To report among a sample of distressed patients and caregivers, (1) the importance attributed to different sources of emotional support (HCPs and social networks) by distressed cancer patients and caregivers; (2) the proportion who indicate they did not receive sufficient levels of emotional support; and (3) potential associations between respondents' demographic and clinical characteristics and reported lack of emotional support. METHODS This study utilised cross-sectional data from telephone interviews collected during the usual-care phase of the Structured Triage and Referral by Telephone (START) trial. Participants completed a telephone interview 6 months after their initial call to the Cancer Council Information and Support service and included recall of importance and sufficiency of emotional support. RESULTS More than two-thirds of patients (n = 234) and caregivers (n = 152) reported that family and friends were very important sources of emotional support. Nurses (69% and 42%) and doctors (68% and 47%) were reported very important, while a lower proportion reported that psychologists and psychiatrists were very important (39%, and 43%). Insufficient levels of support were reported by 36% of participants. Perceptions of insufficient support were significantly associated with distress levels (p < .0001) and not having a partner (p = .0115). CONCLUSION Social networks, particularly family, are an important source of emotional support. Higher levels of distress, those without partners, and caregivers may require targeted interventions to increase their access to emotional support.
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Affiliation(s)
- Jo Taylor
- School of Medicine and Public healthUniversity of NewcastleCallaghanNew South WalesAustralia
- Priority Research Centre for Health BehaviourUniversity of NewcastleCallaghanNew South WalesAustralia
- Priority Research Centre for Cancer Research Innovation and TranslationUniversity of NewcastleCallaghanNew South WalesAustralia
- Hunter Medical Research InstituteNew Lambton HeightsNewcastleNew South WalesAustralia
| | - Elizabeth A. Fradgley
- School of Medicine and Public healthUniversity of NewcastleCallaghanNew South WalesAustralia
- Priority Research Centre for Health BehaviourUniversity of NewcastleCallaghanNew South WalesAustralia
- Priority Research Centre for Cancer Research Innovation and TranslationUniversity of NewcastleCallaghanNew South WalesAustralia
- Hunter Medical Research InstituteNew Lambton HeightsNewcastleNew South WalesAustralia
- Cancer Institute New South WalesCancer Institute New South Wales, EveleighSydneyAustralia
| | - Tara Clinton‐McHarg
- Priority Research Centre for Health BehaviourUniversity of NewcastleCallaghanNew South WalesAustralia
- Priority Research Centre for Cancer Research Innovation and TranslationUniversity of NewcastleCallaghanNew South WalesAustralia
- School of PsychologyUniversity of NewcastleCallaghanNew South WalesAustralia
| | - Alix Hall
- School of Medicine and Public healthUniversity of NewcastleCallaghanNew South WalesAustralia
- Priority Research Centre for Health BehaviourUniversity of NewcastleCallaghanNew South WalesAustralia
- Hunter Medical Research InstituteNew Lambton HeightsNewcastleNew South WalesAustralia
- Hunter New England Population HealthHunter New England Area Health ServiceNewcastleNew South WalesAustralia
| | - Christine L. Paul
- School of Medicine and Public healthUniversity of NewcastleCallaghanNew South WalesAustralia
- Priority Research Centre for Health BehaviourUniversity of NewcastleCallaghanNew South WalesAustralia
- Priority Research Centre for Cancer Research Innovation and TranslationUniversity of NewcastleCallaghanNew South WalesAustralia
- Hunter Medical Research InstituteNew Lambton HeightsNewcastleNew South WalesAustralia
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Kiemen A, Czornik M, Weis J. How effective is peer-to-peer support in cancer patients and survivors? A systematic review. J Cancer Res Clin Oncol 2023:10.1007/s00432-023-04753-8. [PMID: 37120782 PMCID: PMC10374798 DOI: 10.1007/s00432-023-04753-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 04/08/2023] [Indexed: 05/01/2023]
Abstract
PURPOSE Core components of peer-to-peer (PTP) support for cancer survivors include informational, emotional, and psychosocial aspects. Previous literature on peer support in cancer includes both professionally and peer-led support. Our objective was to summarize studies on the effects of non-professionally led PTP support in cancer. METHODS We performed a systematic research on studies in PTP support of adult cancer survivors with an interventional design, comparing outcomes of PTP support against any control. We included all studies with a precise definition of a PTP support, published from January 2000 up to March 2023 in peer-reviewed journals in English or German. RESULTS Out of N = 609 identified publications, we were are able to include n = 18 randomized-controlled trials (RCTs) fulfilling our inclusion criteria. Main settings were dyadic support via telephone, face-to-face (FTF), and web-based online support. Most common outcomes were distress, depressive symptoms, anxiety, and quality of life (QoL). Overall, we found only small effects of PTP support on depression/anxiety, coping, or sexual functioning. Beneficial effects associated with the PTP intervention were apparent in particular in BRCA, in FTF settings, and in assessments of cancer-specific QoL outcomes. CONCLUSION This review shows that there are a few RCT investigating the effect of PTP support with short-term effects. Overall, there is a need for more RCTs with high methodological standards to evaluate the effectiveness of PTP support.
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Affiliation(s)
- A Kiemen
- Comprehensive-Cancer Centre Freiburg (CCCF), Medical Faculty of the Albert-Ludwigs University, Endowed Professorship for Self-Help Research University Clinic, Hugstetterstr. 49, 79106, Freiburg, Germany.
| | - M Czornik
- Comprehensive-Cancer Centre Freiburg (CCCF), Medical Faculty of the Albert-Ludwigs University, Endowed Professorship for Self-Help Research University Clinic, Hugstetterstr. 49, 79106, Freiburg, Germany
| | - J Weis
- Comprehensive-Cancer Centre Freiburg (CCCF), Medical Faculty of the Albert-Ludwigs University, Endowed Professorship for Self-Help Research University Clinic, Hugstetterstr. 49, 79106, Freiburg, Germany
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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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Grant E, Johnson L, Prodromidis A, Giannoudis PV. The Impact of Peer Support on Patient Outcomes in Adults With Physical Health Conditions: A Scoping Review. Cureus 2021; 13:e17442. [PMID: 34589348 PMCID: PMC8462539 DOI: 10.7759/cureus.17442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2021] [Indexed: 11/14/2022] Open
Abstract
Little is known about the impact of peer support programmes on physical health populations or on the methods used to evaluate such programmes. The present study undertakes a scoping review of research related to peer support programmes or interventions in physical health populations, guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR). The search was carried out across the Medline, PsycINFO, and Cochrane databases and focused on papers that evaluated peer support intervention(s) in adults with physical health conditions. The search identified an initial 7,903 records, which were narrowed down to 21 records that met the inclusion criteria; their findings were narratively synthesized. The scoping review found considerable heterogeneity among eligible records in terms of their study design, outcome measurements and findings reported. Qualitative methods of evaluation generated more consistent findings compared to objective outcome measures and suggested that peer support was beneficial for patients’ health and wellbeing by reducing feelings of isolation and creating a sense of community as well as providing an opportunity for information consolidation. The scoping review highlights the inconsistencies in methods used to evaluate peer support interventions and programmes in healthcare settings among different physical health populations. It also draws attention to the lack of peer support research in particular areas, including in acute physical health populations such as in major trauma. The scoping review emphasizes the need for future studies to address this gap in peer support research.
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Affiliation(s)
- Ellie Grant
- Clinical and Health Psychology, Leeds Teaching Hospitals NHS Trust, Leeds, GBR
| | - Louise Johnson
- Clinical and Health Psychology, Leeds Teaching Hospitals NHS Trust, Leeds, GBR
| | | | - Peter V Giannoudis
- Academic Department of Trauma and Orthopaedics, University of Leeds, Leeds, GBR
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Serfaty M, King M, Nazareth I, Moorey S, Aspden T, Tookman A, Mannix K, Gola A, Davis S, Wood J, Jones L. Manualised cognitive-behavioural therapy in treating depression in advanced cancer: the CanTalk RCT. Health Technol Assess 2020; 23:1-106. [PMID: 31097078 DOI: 10.3310/hta23190] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND With a prevalence of up to 16.5%, depression is one of the commonest mental disorders in people with advanced cancer. Depression reduces the quality of life (QoL) of patients and those close to them. The National Institute for Health and Care Excellence (NICE) guidelines recommend treating depression using antidepressants and/or psychological treatments, such as cognitive-behavioural therapy (CBT). Although CBT has been shown to be effective for people with cancer, it is unclear whether or not this is the case for people with advanced cancer and depression. OBJECTIVES To assess the clinical effectiveness and cost-effectiveness of treatment as usual (TAU) plus manualised CBT, delivered by high-level Improving Access to Psychological Therapy (IAPT) practitioners, versus TAU for people with advanced cancer and depression, measured at baseline, 6, 12, 18 and 24 weeks. DESIGN Parallel-group, single-blind, randomised trial, stratified by whether or not an antidepressant was prescribed, comparing TAU with CBT plus TAU. SETTING Recruitment took place in oncology, hospice and primary care settings. CBT was delivered in IAPT centres or/and over the telephone. PARTICIPANTS Patients (N = 230; n = 115 in each arm) with advanced cancer and depression. Inclusion criteria were a diagnosis of cancer not amenable to cure, a DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) diagnosis of depressive disorder using the Mini-International Neuropsychiatric Interview, a sufficient understanding of English and eligibility for treatment in an IAPT centre. Exclusion criteria were an estimated survival of < 4 months, being at high risk of suicide and receiving, or having received in the last 2 months, a psychological intervention recommended by NICE for treating depression. INTERVENTIONS (1) Up to 12 sessions of manualised individual CBT plus TAU delivered within 16 weeks and (2) TAU. OUTCOME MEASURES The primary outcome was the Beck Depression Inventory, version 2 (BDI-II) score at 6, 12, 18 and 24 weeks. Secondary outcomes included scores on the Patient Health Questionnaire-9, the Eastern Cooperative Oncology Group Performance Status, satisfaction with care, EuroQol-5 Dimensions and the Client Services Receipt Inventory, at 12 and 24 weeks. RESULTS A total of 80% of treatments (185/230) were analysed: CBT (plus TAU) (n = 93) and TAU (n = 92) for the BDI-II score at all time points using multilevel modelling. CBT was not clinically effective [treatment effect -0.84, 95% confidence interval (CI) -2.76 to 1.08; p = 0.39], nor was there any benefit for other measures. A subgroup analysis of those widowed, divorced or separated showed a significant effect of CBT on the BDI-II (treatment effect -7.21, 95% CI -11.15 to -3.28; p < 0.001). Economic analysis revealed that CBT has higher costs but produces more quality-adjusted life-years (QALYs) than TAU. The mean service costs for participants (not including the costs of the interventions) were similar across the two groups. There were no differences in EQ-5D median scores at baseline, nor was there any advantage of CBT over TAU at 12 weeks or 24 weeks. There was no statistically significant improvement in QALYs at 24 weeks. LIMITATIONS Although all participants satisfied a diagnosis of depression, for some, this was of less than moderate severity at baseline, which could have attenuated treatment effects. Only 64% (74/115) took up CBT, comparable to the general uptake through IAPT. CONCLUSIONS Cognitive-behavioural therapy (delivered through IAPT) does not achieve any clinical benefit in advanced cancer patients with depression. The benefit of CBT for people widowed, divorced or separated is consistent with other studies. Alternative treatment options for people with advanced cancer warrant evaluation. Screening and referring those widowed, divorced or separated to IAPT for CBT may be beneficial. Whether or not improvements in this subgroup are due to non-specific therapeutic effects needs investigation. TRIAL REGISTRATION Current Controlled Trials ISRCTN07622709. FUNDING This project was funded by the National Institute for Health Research Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 19. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Marc Serfaty
- Division of Psychiatry, University College London, London, UK.,Priory Hospital North London, London, UK
| | - Michael King
- Division of Psychiatry, University College London, London, UK.,Research Department of Primary Care & Population Health, University College London, London, UK
| | - Irwin Nazareth
- Research Department of Primary Care & Population Health, University College London, London, UK
| | - Stirling Moorey
- South London and Maudsley NHS Foundation Trust, London, UK.,Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Trefor Aspden
- Division of Psychiatry, University College London, London, UK
| | - Adrian Tookman
- Marie Curie Hospice, Royal Free Hampstead NHS Trust, London, UK
| | - Kathryn Mannix
- Palliative Care Service, Newcastle upon Tyne Hospital NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Anna Gola
- Research Department of Primary Care & Population Health, University College London, London, UK.,Marie Curie Palliative Care Research Department, University College London, London, UK
| | - Sarah Davis
- Division of Psychiatry, University College London, London, UK.,Palliative Care Service, Newcastle upon Tyne Hospital NHS Foundation Trust, Newcastle upon Tyne, UK
| | - John Wood
- Research Department of Primary Care & Population Health, University College London, London, UK
| | - Louise Jones
- Division of Psychiatry, University College London, London, UK.,Marie Curie Hospice, Royal Free Hampstead NHS Trust, London, UK
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Decreasing menopausal symptoms of Asian American breast cancer survivors through a technology-based information and coaching/support program. Menopause 2020; 26:373-382. [PMID: 30461556 DOI: 10.1097/gme.0000000000001249] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE One of the most prevalent and distressing symptoms after breast cancer treatment is menopausal symptoms. Asian American breast cancer survivors have lower quality of life and often receive inadequate management of menopausal symptoms compared to other racial/ethnic groups. Technology-based programs could be a solution to fill the gap in care. The purpose of this study was to test the efficacy of a technology-based information and coaching/support program on menopausal symptoms of Asian American breast cancer survivors. METHODS This study adopted a randomized pretest/post-test group design among 91 Asian American breast cancer survivors (42 in an intervention group who used the program and the American Cancer Society Web site and 49 in a control group who used only the American Cancer Society Web site). The intervention was a theory-driven and culturally tailored intervention program that aimed to provide information and coaching/support using computers and mobile devices. Multiple instruments were used to measure background characteristics and menopausal symptoms at pretest, post 1-month, and post 3 months. An intent-to-treat linear mixed-model growth curve analysis was used to analyze the data. RESULTS The intervention group showed a significant decrease in the distress scores of menopausal symptoms over time: physical (β = -0.07, P = 0.08), psychological (β = -0.13, P = 0.05), psychosomatic (β = -0.17, P = 0.06), and total symptoms (β = -0.19, P = 0.01). Theory-based variables including attitudes, social influences, and self-efficacy partially mediated the impact of the intervention on the distress scores of menopausal symptoms (P < 0.10). CONCLUSIONS The program was effective in alleviating menopausal symptoms of Asian American breast cancer survivors.
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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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Peer support interventions for breast cancer patients: a systematic review. Breast Cancer Res Treat 2019; 174:325-341. [PMID: 30600413 DOI: 10.1007/s10549-018-5033-2] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 10/27/2018] [Indexed: 12/13/2022]
Abstract
PURPOSE Due to the clear efficacy of peer support as a means of improving emotional well-being and healthy behaviors in a highly cost-effective manner, this program is widely used. Controversy remains, however, with regard to its efficacy in breast cancer patients. Given the heterogeneity of peer support interventions, this review aimed to categorize, assess, and synthesize the existing evidence from randomized controlled trials (RCTs) to clarify the effects of different types of peer support on breast cancer patients. METHODS We searched Pubmed, EMBase, CENTRAL, CINAHL, PsychINFO, Chinese National Knowledge Infrastructure (CNKI) and Wanfang Data for English and Chinese language RCTs. The Cochrane Collaboration 'risk of bias' tool for systematic reviews was used to assess the methodological quality of each RCT. RESULTS Of the 1494 studies screened, 15 studies met eligibility criteria for inclusion, comprising 1695 breast cancer patients. Overall, there were more positive effects than invalid or negative effects across peer interventions, with notable exceptions: unmoderated and unstructured group peer support interventions as well as Internet-based models without peer training had no effect or adverse effects on proximal and distal outcomes. However, adding other peer roles to the peer support structure or using one-on-one models could significantly improve the patients' negative emotions. Peer education showed promising effects on stress management, quality of life, and healthy behaviors. CONCLUSIONS This systematic review found that different types of peer support have different effects on outcomes for breast cancer patients. Web-based group peer support without peer training must be avoided or used with caution in the future. Peer education is recommended for breast cancer patient support models, given its excellent results and cost-effectiveness.
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Schouten B, De Jonckheere D, Aerts M, Decaestecker J, Walgraeve D, Vankrunkelsven P, Hellings J. An explorative study on systematic assessment of QOL and care needs with the CARES-SF in the early follow-up of patients with digestive cancer. Support Care Cancer 2018; 27:2715-2724. [PMID: 30498993 DOI: 10.1007/s00520-018-4565-7] [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: 05/07/2018] [Accepted: 11/20/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE Systematic assessment of QOL and care needs was applied in two gastroenterology departments to support "Cancer Care for the Whole Patient." METHODS Patients with digestive cancer were asked to complete the Cancer Rehabilitation Evaluation System-Short Form (CARES-SF) at the start of treatment and 3 months later. Both times CARES data were processed, and summary reports on the retained insights were sent to the reference nurse for use in further follow-up of the patient. Patients' and reference nurse's experiences with the systematic CARES-assessment were explored with several survey questions and semi-structured interviews, respectively. RESULTS The mean age of the 51 participants was 63 years (SD11.17), 52.9% was male. With the CARES-SF, a large variety of problems and care needs was detected. Problems most frequently experienced, and most burdensome for QOL are a mix of physical complaints, side effects from treatment, practical, relational, and psychosocial difficulties. Only for a limited number of experienced problems a desire for extra help was expressed. All patients positively evaluate the timing and frequency of the CARES-assessment. The majority believes that this assessment could contribute to the discussion of problems and needs with healthcare professionals, to get more tailored care. Reference nurses experienced the intervention as an opportunity to systematically explore patients' well-being in a comprehensive way, leading to detection and discussion of specific problems or needs in greater depth, and more efficient involvement of different disciplines in care. CONCLUSIONS Systematic QOL and needs assessment with the CARES-SF in oncology can contribute to more patient-centeredness and efficiency of care.
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Affiliation(s)
- Bojoura Schouten
- Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium.
| | - Dominiek De Jonckheere
- AZ Delta Hospital, Rode-Kruisstraat 20, 8800, Roeselare, Belgium.,Department of Gastroenterology and Hepatology, AZ Delta Hospital, Rode-Kruisstraat 20, 8800, Roeselare, Belgium
| | - Marc Aerts
- Department of Gastroenterology and Hepatology, Jessa Hospital, Salvatorstraat 11, 3500, Hasselt, Belgium
| | - Jochen Decaestecker
- AZ Delta Hospital, Rode-Kruisstraat 20, 8800, Roeselare, Belgium.,Department of Gastroenterology and Hepatology, AZ Delta Hospital, Rode-Kruisstraat 20, 8800, Roeselare, Belgium.,Department of Gastroenterology and Hepatology, Campus Gasthuisberg, University Hospitals KULeuven, Herestraat 49, 3000, Leuven, Belgium
| | - Daan Walgraeve
- Department of Gastroenterology and Hepatology, Jessa Hospital, Salvatorstraat 11, 3500, Hasselt, Belgium
| | - Patrick Vankrunkelsven
- Department of Public health and Primary Care, Faculty of Medicine, KULeuven, Kapucijnenvoer 33, PB 7001, 3000, Leuven, Belgium.,Belgian Center for Evidence-Based Medicine (CEBAM), Kapucijnenvoer 33- blok J, 3000, Leuven, Belgium
| | - Johan Hellings
- Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium.,AZ Delta Hospital, Rode-Kruisstraat 20, 8800, Roeselare, Belgium.,Department of Gastroenterology and Hepatology, AZ Delta Hospital, Rode-Kruisstraat 20, 8800, Roeselare, Belgium
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Toija AS, Kettunen TH, Leidenius MHK, Vainiola THK, Roine RPA. Effectiveness of peer support on health-related quality of life in recently diagnosed breast cancer patients: a randomized controlled trial. Support Care Cancer 2018; 27:123-130. [PMID: 30338354 PMCID: PMC6280804 DOI: 10.1007/s00520-018-4499-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 10/03/2018] [Indexed: 11/30/2022]
Abstract
Purpose Breast cancer is the most common cancer of Finnish women. Peer support could be a way to help breast cancer patients to deal with the disease but studies on its effectiveness have produced conflicting results. The aim of this randomized controlled trial was to study the effectiveness of peer support on health-related quality of life (HRQoL) of breast cancer patients. Methods Patients with recently diagnosed breast cancer at the Helsinki University Hospital were randomly allocated to intervention (n = 130) or control (n = 130) groups. The intervention group patients received peer support via telephone one to five times according to their preference. The control group received usual care only. HRQoL was assessed with generic (15D) and disease-specific (EORTC QLQ-30 and its breast cancer specific module BR23) instruments at baseline and at 3-, 6-, and 12-month follow-up points. Results The mean (SD) age of the patients was 60.0 (10.5) years and their baseline mean 15D score 0.922 (0.066). At baseline, the intervention and control groups did not differ from each other. During follow-up, the 15D score deteriorated statistically significantly (p < 0.001) and clinically importantly in both groups but slightly less in the intervention group although the difference was not significant. Regarding individual 15D dimensions, the EORTC-QLQ30, or its breast-specific module, peer support did not show any consistent advantage compared to usual care. Conclusion Peer support had no clear effect on the HRQoL of breast cancer patients.
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Affiliation(s)
- Anu Susanna Toija
- University of Jyväskylä, PL 35 (L), 40014, Jyväskylä, Finland. .,EJY, Kauppamiehentie 6, 02100, Espoo, Finland.
| | - Tarja Helena Kettunen
- University of Jyväskylä, PL 35 (L), 40014, Jyväskylä, Finland.,Central Finland Health Care District, Unit of Primary Health Care, Keskussairaalantie 19, 40620, Jyväskylä, Finland
| | | | | | - Risto Paavo Antero Roine
- University of Helsinki and Helsinki University Hospital, PL 100, 00029 HUS, Helsinki, Finland.,University of Eastern Finland, PL 1627, 70211, Kuopio, Finland
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Efficace F, Boccadoro M, Palumbo A, Petrucci MT, Cottone F, Cannella L, Zamagni E, Niscola P, Kyriakou C, Caravita T, Offidani M, Mandelli F, Cavo M. A prospective observational study to assess clinical decision-making, prognosis, quality of life and satisfaction with care in patients with relapsed/refractory multiple myeloma: the CLARITY study protocol. Health Qual Life Outcomes 2018; 16:127. [PMID: 29914509 PMCID: PMC6006751 DOI: 10.1186/s12955-018-0953-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 06/04/2018] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Treatment decision-making in patients with relapsed/refractory multiple myeloma (RRMM) is challenging for a number of reasons including, the heterogeneity of disease at relapse and the number of possible therapeutic approaches. This study broadly aims to generate new evidence-based data to facilitate clinical decision-making in RRMM patients. The primary objective is to investigate the prognostic value of patient self-reported fatigue severity for overall survival. METHODS This multicenter prospective observational study will consecutively enroll 312 patients with multiple myeloma who have received at least 1 prior line of therapy and are considered as RRMM according to the International Myeloma Working Group (IMWG) criteria. Eligible RRMM participants will be adults (≥ 18 years old) patients and will be enrolled irrespective of comorbidities and performance status. At the time of study inclusion, data to calculate the frailty score are to be available. Patients will be followed up for 30 months and patient-reported outcome (PRO) assessment is planned at baseline and thereafter at 3, 6, 12, and 24 months. The following PRO validated questionnaires will be used: the European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30), the EORTC QLQ-MY20 and the EORTC QLQ-INFO25. Satisfaction with care and preference for involvement in treatment decisions will also be evaluated. Clinical, laboratory and treatment related information will be prospectively collected in conjunction with pre scheduled PRO assessments. Cox regression analyses will be used to assess the prognostic value of baseline fatigue severity (EORTC QLQ-C30) and other patient-reported health-related quality of life parameters. DISCUSSION Clinical decision-making in RRMM is a challenge and outcome prediction is also an important aspect to enhance personalized treatment planning. Given the paucity of PRO data in this population, this prospective observational study aims to provide novel information that may facilitate patients' management in routine practice. TRIAL REGISTRATION This trial is registered as identifier NCT03190525 .
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Affiliation(s)
- Fabio Efficace
- Health Outcomes Research Unit, Gruppo Italiano Malattie EMatologiche dell'Adulto (GIMEMA), GIMEMA Data Center and Health Outcomes Research Unit, Via Benevento, 6, 00161, Rome, Italy.
| | - Mario Boccadoro
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Antonio Palumbo
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Maria Teresa Petrucci
- Department of Cellular Biotechnologies and Hematology, Sapienza University of Rome, Rome, Italy
| | - Francesco Cottone
- Health Outcomes Research Unit, Gruppo Italiano Malattie EMatologiche dell'Adulto (GIMEMA), GIMEMA Data Center and Health Outcomes Research Unit, Via Benevento, 6, 00161, Rome, Italy
| | - Laura Cannella
- Health Outcomes Research Unit, Gruppo Italiano Malattie EMatologiche dell'Adulto (GIMEMA), GIMEMA Data Center and Health Outcomes Research Unit, Via Benevento, 6, 00161, Rome, Italy
| | - Elena Zamagni
- Seragnoli Institute of Hematology, Bologna University School of Medicine, Bologna, Italy
| | - Pasquale Niscola
- Haematology Unit and Pathology Department, S. Eugenio Hospital Rome, Rome, Italy
| | - Charalampia Kyriakou
- Department of Haematology, London North West and University College London Hospitals, London, UK
| | - Tommaso Caravita
- Haematology Unit and Pathology Department, S. Eugenio Hospital Rome, Rome, Italy
| | - Massimo Offidani
- Clinica di Ematologia, AOU Ospedali Riuniti di Ancona, Ancona, Italy
| | - Franco Mandelli
- Health Outcomes Research Unit, Gruppo Italiano Malattie EMatologiche dell'Adulto (GIMEMA), GIMEMA Data Center and Health Outcomes Research Unit, Via Benevento, 6, 00161, Rome, Italy
| | - Michele Cavo
- Institute of Hematology Seragnoli, DIMES, University of Bologna, Bologna, Italy
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15
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Callari A, Mauri M, Miniati M, Mancino M, Bracci G, Dell'Osso L, Greco C. Treatment of Depression in Patients with Breast Cancer: A Critical Review. TUMORI JOURNAL 2018; 99:623-33. [DOI: 10.1177/030089161309900511] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Aims and background To summarize current knowledge on psychopharmacological and psychotherapeutic options for patients with breast cancer and comorbid depression, starting from the psychiatric viewpoint. Issues on diagnostic boundaries of depression and outcome measures are raised. Methods We completed a literature review from the last 30 years (until March 2012) using PubMed by pairing the key words: ‘breast cancer and depression treatment’ (about 1431 works, including 207 reviews), ‘breast cancer and antidepressants’ (about 305 works, including 66 reviews), and in particular ‘selective serotonin reuptake inhibitors and breast cancer’ (38 works, including 10 reviews) and ‘breast cancer and psychotherapy’ (603 works, including 84 reviews). Papers in the English language were selected, including recent reviews. Results There is little evidence for the superiority of any one specific intervention with pharmacological options or psychotherapy. The heterogeneity of assessment criteria, the small number of subjects collected in systematic studies, the difficulty in adopting standardized outcome measures, and the limited numbers of available drugs with a favorable side effect profile are the main limitations that emerge from the literature. No conclusive findings are available on mid-term/long-term treatment strategies, or when depression is part of a bipolar disorder. Conclusions Further research is necessary to define the most appropriate approach to depression when it occurs in comorbidity with breast cancer. A more accurate definition of the clinical phenotypes of depression in the special population of patients with breast cancer is suggested as a key issue.
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Affiliation(s)
- Antonio Callari
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Mauro Mauri
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Mario Miniati
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | | | - Giulia Bracci
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
- Department of Psychiatry, Columbia University Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA
| | - Liliana Dell'Osso
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Carlo Greco
- Department of Radiotherapy, University of Pisa, Pisa, Italy
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16
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Ritvo P, Obadia M, Santa Mina D, Alibhai S, Sabiston C, Oh P, Campbell K, McCready D, Auger L, Jones JM. Smartphone-Enabled Health Coaching Intervention (iMOVE) to Promote Long-Term Maintenance of Physical Activity in Breast Cancer Survivors: Protocol for a Feasibility Pilot Randomized Controlled Trial. JMIR Res Protoc 2017; 6:e165. [PMID: 28838886 PMCID: PMC5590009 DOI: 10.2196/resprot.6615] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Revised: 12/22/2016] [Accepted: 03/25/2017] [Indexed: 12/12/2022] Open
Abstract
Background Although physical activity has been shown to contribute to long-term disease control and health in breast cancer survivors, a majority of breast cancer survivors do not meet physical activity guidelines. Past research has focused on promoting physical activity components for short-term breast cancer survivor benefits, but insufficient attention has been devoted to long-term outcomes and sustained exercise adherence. We are assessing a health coach intervention (iMOVE) that uses mobile technology to increase and sustain physical activity maintenance in initially inactive breast cancer survivors. Objective This pilot randomized controlled trial (RCT) is an initial step in evaluating the iMOVE intervention and will inform development of a full-scale pragmatic RCT. Methods We will enroll 107 physically inactive breast cancer survivors and randomly assign them to intervention or control groups at the University Health Network, a tertiary cancer care center in Toronto, Canada. Participants will be women (age 18 to 74 years) stratified by age (55 years and older/younger than 55 years) and adjuvant hormone therapy (AHT) exposure (AHT vs no AHT) following breast cancer treatment with no metastases or recurrence who report less than 60 minutes of preplanned physical activity per week. Both intervention and control groups receive the 12-week physical activity program with weekly group sessions and an individualized, progressive, home-based exercise program. The intervention group will additionally receive (1) 10 telephone-based health coaching sessions, (2) smartphone with data plan, if needed, (3) supportive health tracking software (Connected Wellness, NexJ Health Inc), and (4) a wearable step-counting device linked to a smartphone program. Results We will be assessing recruitment rates; acceptability reflected in selective, semistructured interviews; and enrollment, retention, and adherence quantitative intervention markers as pilot outcome measures. The primary clinical outcome will be directly measured peak oxygen consumption. Secondary clinical outcomes include health-related quality of life and anthropometric measures. All outcome measures are administered at baseline, after exercise program (month 3), and 6 months after program (month 9). Conclusions This pilot RCT will inform full-scale RCT planning. We will assess pilot procedures and interventions and collect preliminary effect estimates. Trial Registration ClinicalTrials.gov NCT02620735; https://clinicaltrials.gov/ct2/show/NCT02620735 (Archived by WebCite at https://clinicaltrials.gov/ct2/show/NCT02620735)
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Affiliation(s)
- Paul Ritvo
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada.,Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Maya Obadia
- Cancer Rehabilitation and Survivorship Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Daniel Santa Mina
- Cancer Rehabilitation and Survivorship Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.,Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Shabbir Alibhai
- General Internal Medicine, University Health Network, Toronto, ON, Canada.,Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Catherine Sabiston
- Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Paul Oh
- Cardiovascular Prevention and Rehabilitation Program, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Kristin Campbell
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
| | - David McCready
- Surgical Oncology, University Health Network, Toronto, ON, Canada.,Division of Surgery, University of Toronto, Toronto, ON, Canada
| | - Leslie Auger
- Kinesiology Program, University of Guelph-Humber, Toronto, ON, Canada
| | - Jennifer Michelle Jones
- Cancer Rehabilitation and Survivorship Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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17
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Beatty L, Kemp E, Butow P, Girgis A, Schofield P, Turner J, Hulbert-Williams NJ, Levesque JV, Koczwara B. A systematic review of psychotherapeutic interventions for women with metastatic breast cancer: Context matters. Psychooncology 2017; 27:34-42. [DOI: 10.1002/pon.4445] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 03/29/2017] [Accepted: 04/17/2017] [Indexed: 01/25/2023]
Affiliation(s)
- Lisa Beatty
- Flinders University; Adelaide South Austalia Australia
- Flinders Centre for Innovation in Cancer; Bedford Park South Austalia Australia
| | - Emma Kemp
- Flinders University; Adelaide South Austalia Australia
- Flinders Centre for Innovation in Cancer; Bedford Park South Austalia Australia
| | - Phyllis Butow
- University of Sydney; Sydney New South Wales Australia
| | - Afaf Girgis
- Ingham Institute for Applied Medical Research; South Western Sydney Clinical School; University of New South Wales; Sydney New South Wales Australia
| | - Penelope Schofield
- Department of Psychology, School of Health Sciences, Faculty of Health, Arts and Design; Swinburne University of Technology; Hawthorn Australia
- Department of Cancer Experiences Research; Peter MacCallum Cancer Center; East Melbourne Victoria Australia
- Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences; The University of Melbourne; Parkville Victoria Australia
| | - Jane Turner
- University of Queensland; Brisbane New South Wales Australia
| | | | - Janelle V. Levesque
- Ingham Institute for Applied Medical Research; South Western Sydney Clinical School; University of New South Wales; Sydney New South Wales Australia
| | - Bogda Koczwara
- Flinders Centre for Innovation in Cancer; Bedford Park South Austalia Australia
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18
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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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19
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Paul CL, Boyes AW, O'Brien L, Baker AL, Henskens FA, Roos I, Clinton-McHarg T, Bellamy D, Colburn G, Rose S, Cox ME, Fradgley EA, Baird H, Barker D. Protocol for a Randomized Controlled Trial of Proactive Web-Based Versus Telephone-Based Information and Support: Can Electronic Platforms Deliver Effective Care for Lung Cancer Patients? JMIR Res Protoc 2016; 5:e202. [PMID: 27784648 PMCID: PMC5103105 DOI: 10.2196/resprot.6248] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 08/30/2016] [Accepted: 09/20/2016] [Indexed: 01/22/2023] Open
Abstract
Background Community-based services such as telephone support lines can provide valuable informational, emotional, and practical support for cancer patients via telephone- or Web-based (live chat or email) platforms. However, very little rigorous research has examined the efficacy of such services in improving patient outcomes. Objective This study will determine whether: proactive telephone or Web-delivered support produces outcomes superior to printed information; and Web-delivered support produces outcomes comparable to telephone support. Methods A consecutive sample of 501 lung cancer outpatients will be recruited from 50 Australian health services to participate in a patient-randomized controlled trial (RCT). Eligible individuals must: be 18 years or older; have received a lung cancer diagnosis (including mesothelioma) within the previous 4 months; have an approximate life expectancy of at least 6 months; and have Internet access. Participants will be randomly allocated to receive: (1) an information booklet, (2) proactive telephone support, or (3) proactive Web support, chat, and/or email. The primary patient outcomes will be measured by the General Health Questionnaire (GHQ-12) and Health Education and Impact Questionnaire (heiQ) at 3 and 6 months post recruitment. The acceptability of proactive recruitment strategies will also be assessed. Results It is hypothesized that participants receiving telephone or Web support will report reduced distress (GHQ-12 scores that are 0.3 standard deviations (SD) lower) and greater self-efficacy (heiQ scores that are 0.3 SDs higher) than participants receiving booklets. Individuals receiving Web support will report heiQ scores within 0.29 SDs of individuals receiving telephone support. Conclusions If proven effective, electronic approaches such as live-chat and email have the potential to increase the accessibility and continuity of supportive care delivered by community-based services. This evidence may also inform the redesigning of helpline-style services to be effective and responsive to patient needs.
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Affiliation(s)
- Christine L Paul
- Priority Research Centre for Health Behaviour, School of Medicine and Public Health, University of Newcastle, Callaghan, Australia.
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20
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Im EO, Ji X, Zhang J, Kim S, Lee Y, Chee E, Chee W, Tsai HM, Nishigaki M, Yeo SA, Schapira M, Mao JJ. Issues in Developing and Evaluating a Culturally Tailored Internet Cancer Support Group. Comput Inform Nurs 2016; 34:462-469. [PMID: 27379523 PMCID: PMC5067957 DOI: 10.1097/cin.0000000000000261] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The purpose of this article is to explore practical issues in developing and implementing a culturally tailored Internet Cancer Support Group for a group of ethnic minority patients with cancer-Asian Americans. Throughout the research process of the original study testing the Internet cancer support group, the research team made written records of practical issues and plausible rationales for the issues. Weekly group discussion among research team members was conducted, and the discussion records were evaluated and analyzed using a content analysis (with individual words as the unit of analysis). The codes from the analysis process were categorized into idea themes, through which the issues were extracted. The issues included those in (1) difficulties in using multiple languages, (2) collaboration with the information technology department and technical challenges, (3) difficulties in recruitment, (4) difficulties in retention, (5) optimal timing, and (6) characteristics of the users. Based on the findings, we suggest that researchers plan a workable translation process, check technical needs in advance, use multiple strategies to recruit and retain research participants, plan the right time for data collection, and consider characteristics of the users in the study design.
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Affiliation(s)
- Eun-Ok Im
- School of Nursing, University of Pennsylvania
| | - Xiaopeng Ji
- School of Nursing, University of Pennsylvania
| | - Jingwen Zhang
- Annenberg School for Communication, University of Pennsylvania
| | - Sangmi Kim
- School of Nursing, University of Pennsylvania
| | - Yaelim Lee
- School of Nursing, University of Pennsylvania
| | - Eunice Chee
- School of Engineering and Applied Science, University of Pennsylvania
| | | | - Hsiu-Min Tsai
- Chang Gung University of Science and Technology, Taiwan
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21
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Rush SE, Sharma M. Mindfulness-Based Stress Reduction as a Stress Management Intervention for Cancer Care: A Systematic Review. J Evid Based Complementary Altern Med 2016; 22:348-360. [PMID: 27489233 DOI: 10.1177/2156587216661467] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Cancer is acknowledged as a source of stress for many individuals, often leading to suffering, which can be long-lasting. Mindfulness-based stress reduction offers an effective way of reducing stress among cancer patients by combining mindfulness meditation and yoga in an 8-week training program. The purpose of this study was to inspect studies from October 2009 to November 2015 and examine whether mindfulness-based stress reduction can be utilized as a viable method for managing stress among cancer patients. A systematic search from Medline, CINAHL, and Alt HealthWatch databases was conducted for quantitative articles involving mindfulness-based stress reduction interventions targeting cancer patients. A total of 13 articles met the inclusion criteria. Of these 13 studies, 9 demonstrated positive changes in either psychological or physiological outcomes related to anxiety and/or stress, with 4 describing mixed results. Despite the limitations, mindfulness-based stress reduction appears to be promising for stress management among cancer patients.
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Affiliation(s)
- Sarah E Rush
- 1 James Madison University, Harrisonburg, VA, USA
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Aycinena AC, Jennings KA, Gaffney AO, Koch PA, Contento IR, Gonzalez M, Guidon E, Karmally W, Hershman D, Greenlee H. ¡Cocinar Para Su Salud! Development of a Culturally Based Nutrition Education Curriculum for Hispanic Breast Cancer Survivors Using a Theory-Driven Procedural Model. HEALTH EDUCATION & BEHAVIOR 2016; 44:13-22. [PMID: 27179286 DOI: 10.1177/1090198116642236] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We developed a theory-based dietary change curriculum for Hispanic breast cancer survivors with the goal of testing the effects of the intervention on change in dietary intake of fruits/vegetables and fat in a randomized, clinical trial. Social cognitive theory and the transtheoretical model were used as theoretical frameworks to structure curriculum components using the Nutrition Education DESIGN Procedure. Formative assessments were conducted to identify facilitators and barriers common to Hispanic women and test the degree of difficulty and appropriateness of program materials. Focus groups provided valuable insight and informed preimplementation modifications to the dietary program. The result was a systematically planned, evidence-based, culturally tailored dietary intervention for Hispanic breast cancer survivors, ¡Cocinar Para Su Salud! (Cook for Your Health!). The methodology described here may serve as a framework for the development of future dietary interventions among diverse and minority populations. Short- and long-term study results will be reported elsewhere.
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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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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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Agboola SO, Ju W, Elfiky A, Kvedar JC, Jethwani K. The effect of technology-based interventions on pain, depression, and quality of life in patients with cancer: a systematic review of randomized controlled trials. J Med Internet Res 2015; 17:e65. [PMID: 25793945 PMCID: PMC4381812 DOI: 10.2196/jmir.4009] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Revised: 02/18/2015] [Accepted: 02/18/2015] [Indexed: 02/06/2023] Open
Abstract
Background The burden of cancer is increasing; projections over the next 2 decades suggest that the annual cases of cancer will rise from 14 million in 2012 to 22 million. However, cancer patients in the 21st century are living longer due to the availability of novel therapeutic regimens, which has prompted a growing focus on maintaining patients’ health-related quality of life. Telehealth is increasingly being used to connect with patients outside of traditional clinical settings, and early work has shown its importance in improving quality of life and other clinical outcomes in cancer care. Objective The aim of this study was to systematically assess the literature for the effect of supportive telehealth interventions on pain, depression, and quality of life in cancer patients via a systematic review of clinical trials. Methods We searched PubMed, EMBASE, Google Scholar, CINAHL, and PsycINFO in July 2013 and updated the literature search again in January 2015 for prospective randomized trials evaluating the effect of telehealth interventions in cancer care with pain, depression, and quality of life as main outcomes. Two of the authors independently reviewed and extracted data from eligible randomized controlled trials, based on pre-determined selection criteria. Methodological quality of studies was assessed by the Cochrane Collaboration risk of bias tool. Results Of the 4929 articles retrieved from databases and relevant bibliographies, a total of 20 RCTs were included in the final review. The studies were largely heterogeneous in the type and duration of the intervention as well as in outcome assessments. A majority of the studies were telephone-based interventions that remotely connected patients with their health care provider or health coach. The intervention times ranged from 1 week to 12 months. In general, most of the studies had low risk of bias across the domains of the Cochrane Collaboration risk of bias tool, but most of the studies had insufficient information about the allocation concealment domain. Two of the three studies focused on pain control reported significant effects of the intervention; four of the nine studies focus on depression reported significant effects, while only the studies that were focused on quality of life reported significant effects. Conclusions This systematic review demonstrates the potential of telehealth interventions in improving outcomes in cancer care. However, more high-quality large-sized trials are needed to demonstrate cogent evidence of its effectiveness.
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Affiliation(s)
- Stephen O Agboola
- Partners Healthcare Center for Connected Health, Boston, MA, United States.
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Meyer A, Coroiu A, Korner A. One-to-one peer support in cancer care: a review of scholarship published between 2007 and 2014. Eur J Cancer Care (Engl) 2014; 24:299-312. [DOI: 10.1111/ecc.12273] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2014] [Indexed: 11/26/2022]
Affiliation(s)
- A. Meyer
- Section of Psychosocial Oncology; Department of Medical Psychology and Medical Sociology; University Medical Center Leipzig; Leipzig Germany
| | - A. Coroiu
- Department of Educational and Counselling Psychology; McGill University; Montreal Quebec Canada
| | - A. Korner
- Department of Educational and Counselling Psychology; McGill University; Montreal Quebec Canada
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Fulcher CD, Kim HJ, Smith PR, Sherner TL. Putting evidence into practice: evidence-based interventions for depression. Clin J Oncol Nurs 2014; 18 Suppl:26-37. [PMID: 25427607 DOI: 10.1188/14.cjon.s3.26-37] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Depression is a distressing emotion that occurs during various times of the cancer trajectory. Depression often goes unrecognized and untreated, which can significantly affect cost, quality of life, and treatment adherence. The Oncology Nursing Society's Putting Evidence Into Practice depression project team reviewed current literature to identify evidence-based interventions to reduce depression in people with cancer. Pharmacologic and nonpharmacologic interventions were evaluated, and opportunities for nurses to integrate recommendations into practice are offered in this article.
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Affiliation(s)
| | - Hee-Ju Kim
- College of Nursing, Catholic University of Korea, Seoul
| | - Patsy R Smith
- College of Nursing, University of Oklahoma Health Sciences Center, Oklahoma City
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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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Thornton LM, Cheavens JS, Heitzmann CA, Dorfman CS, Wu SM, Andersen BL. Test of mindfulness and hope components in a psychological intervention for women with cancer recurrence. J Consult Clin Psychol 2014; 82:1087-100. [PMID: 24884347 DOI: 10.1037/a0036959] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Psychological interventions can attenuate distress and enhance coping for those with an initial diagnosis of cancer, but there are few intervention options for individuals with cancer recurrence. To address this gap, we developed and tested a novel treatment combining Mindfulness, Hope Therapy, and biobehavioral components. METHOD An uncontrolled, repeated measures design was used. Women (N = 32) with recurrent breast or gynecologic cancers were provided 20 treatment sessions in individual (n = 12) or group (n = 20) formats. On average, participants were middle aged (M = 58) and Caucasian (81%). Independent variables (i.e., hope and mindfulness) and psychological outcomes (i.e., depression, negative mood, worry, and symptoms of generalized anxiety disorder) were assessed pre-treatment and 2, 4, and 7 months later. Session-by-session therapy process (positive and negative affect, quality-of-life) and mechanism (use of intervention-specific skills) measures were also included. RESULTS Distress, anxiety, and negative affect decreased, whereas positive affect and mental-health-related quality-of-life increased over the course of treatment, as demonstrated in mixed-effects models with the intent-to-treat sample. Both hope and mindfulness increased, and use of mindfulness skills was related to decreased anxiety. CONCLUSIONS This treatment was feasible to deliver and was acceptable to patients. The trial serves as preliminary evidence for a multi-component intervention tailored to treat difficulties specific to recurrent cancer. The blending of the components was novel as well as theoretically and practically consistent. A gap in the literature is addressed, providing directions for testing interventions designed for patients coping with the continuing stressors and challenges of cancer recurrence.
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Li Q, Lin Y, Liu X, Xu Y. A systematic review on patient-reported outcomes in cancer survivors of randomised clinical trials: direction for future research. Psychooncology 2014; 23:721-30. [DOI: 10.1002/pon.3504] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Revised: 01/25/2014] [Accepted: 01/25/2014] [Indexed: 01/09/2023]
Affiliation(s)
- Qiuping Li
- Department of Health Statistics; Fourth Military Medical University; Xi'an Shaanxi Province China
- Wuxi Medical School; Jiangnan University; Wuxi Jiangsu Province China
| | - Yi Lin
- Wuxi Medical School; Jiangnan University; Wuxi Jiangsu Province China
| | - Xiwen Liu
- Department of Nursing; Fourth Military Medical University; Xi'an Shaanxi Province China
| | - Yongyong Xu
- Department of Health Statistics; Fourth Military Medical University; Xi'an Shaanxi Province China
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Abstract
OBJECTIVES To review nursing research contributions and future opportunities for nurses in cooperative oncology group research in SWOG (formerly Southwest Oncology Group). DATA SOURCES Peer-reviewed journal articles, grant submissions, professional manuals, research policy reports, and meeting minutes. CONCLUSION Nurses and nurse researchers have had active roles in SWOG research involving quality of life, symptom management, recruitment and adherence, and data quality. There are opportunities for nurses to make greater contributions to cooperative group research, particularly in cancer survivorship, health outcomes, and quality of life. IMPLICATIONS FOR NURSING PRACTICE Nursing science and evidence-based practice will be enhanced by conducting nursing research in the multi-site cooperative group setting.
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Mustafa M, Carson‐Stevens A, Gillespie D, Edwards AGK. Psychological interventions for women with metastatic breast cancer. Cochrane Database Syst Rev 2013; 2013:CD004253. [PMID: 23737397 PMCID: PMC11032751 DOI: 10.1002/14651858.cd004253.pub4] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Psychological symptoms are associated with metastatic breast cancer. This is the basis for exploring the impact of psychological interventions on psychosocial and survival outcomes. One early study appeared to show significant survival and psychological benefits from psychological support while subsequent studies have revealed conflicting results. This review is an update of a Cochrane review first published in 2004 and previously updated in 2007. OBJECTIVES To assess the effects of psychological interventions on psychosocial and survival outcomes for women with metastatic breast cancer. SEARCH METHODS We searched the Cochrane Breast Cancer Group Specialised Register, MEDLINE (OvidSP), EMBASE (OvidSP), PsycINFO (OvidSP), CINAHL (EBSCO), online trials and research registers in June/July 2011. Further potentially relevant studies were identified from handsearching references of previous trials, systematic reviews and meta-analyses. SELECTION CRITERIA Randomised controlled trials (RCTs) and cluster RCTs of psychological interventions, which recruited women with metastatic breast cancer. Outcomes selected for analyses were overall survival, psychological outcomes, pain, quality of life, condition-specific outcome measures, relationship and social support measures, and sleep quality. Studies were excluded if no discrete data were available on women with metastatic breast cancer. DATA COLLECTION AND ANALYSIS Two review authors independently extracted the data and assessed the quality of the studies using the Cochrane Collaboration risk of bias tool. Where possible, authors were contacted for missing information. Data on the nature and setting of the intervention, relevant outcome data, and items relating to methodological quality were extracted. Meta-analyses was performed using a random-effects or fixed-effect Mantel-Haenszel model, depending on expected levels of heterogeneity. MAIN RESULTS Ten RCTs with 1378 women were identified. Of the seven RCTs on group psychological interventions, three were on cognitive behavioural therapy and four were on supportive-expressive group therapy. The remaining three studies were individual based and the types of psychological interventions were not common to either cognitive behavioural or supportive-expressive therapy. A clear pattern of psychological outcomes could not be discerned as a wide variety of outcome measures and durations of follow-up were used in the included studies. The overall effect of the psychological interventions across six studies, on one-year survival, favoured the psychological intervention group with an odds ratio (OR) of 1.46 (95% confidence interval (CI) 1.07 to 1.99). Pooled data from four studies did not show any survival benefit at five-years follow-up (OR 1.03, 95% CI 0.42 to 2.52). There was evidence of a short-term benefit for some psychological outcomes and improvement in pain scores. AUTHORS' CONCLUSIONS Psychological interventions appear to be effective in improving survival at 12 months but not at longer-term follow-up, and they are effective in reducing psychological symptoms only in some of the outcomes assessed in women with metastatic breast cancer. However, findings of the review should be interpreted with caution as there is a relative lack of data in this field, and the included trials had reporting or methodological weaknesses and were heterogeneous in terms of interventions and outcome measures.
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Affiliation(s)
- Mohammed Mustafa
- Cardiff UniversityCochrane Institute of Primary Care and Public Health, School of Medicine2nd Floor, Neuadd MeirionnyddHeath ParkCardiffWalesUKCF14 4YS
| | - Andrew Carson‐Stevens
- Cardiff UniversityCochrane Institute of Primary Care and Public Health, School of Medicine2nd Floor, Neuadd MeirionnyddHeath ParkCardiffWalesUKCF14 4YS
| | - David Gillespie
- Cardiff UniversitySouth East Wales Trials Unit, Institute of Translation, Innovation, Methods and Engagement4th Floor, Neuadd MeirionnyddHeath ParkCardiffWalesUKCF14 4YS
| | - Adrian GK Edwards
- Cardiff UniversityCochrane Institute of Primary Care and Public Health, School of Medicine2nd Floor, Neuadd MeirionnyddHeath ParkCardiffWalesUKCF14 4YS
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A Randomized Trial of Dyadic Peer Support Intervention for Newly Diagnosed Breast Cancer Patients in Korea. Cancer Nurs 2013; 36:E15-22. [DOI: 10.1097/ncc.0b013e3182642d7c] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Heron-Speirs HA, Baken DM, Harvey ST. Moderators of psycho‐oncology therapy effectiveness: Meta‐analysis of socio‐demographic and medical patient characteristics. ACTA ACUST UNITED AC 2012. [DOI: 10.1111/cpsp.12010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Dennis CL. Peer support for postpartum depression: volunteers' perceptions, recruitment strategies and training from a randomized controlled trial. Health Promot Int 2012; 28:187-96. [PMID: 22388589 DOI: 10.1093/heapro/das003] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
A randomized controlled trial evaluated the effect of telephone-based peer support (mother-to-mother) on preventing postpartum depression among high-risk mothers. This paper reports volunteers' perceptions, which showed that peer support is an effective preventative intervention. Two-hundred and five (205) volunteers were recruited and trained to provide peer support to 349 mothers randomized to the intervention group. Volunteers' perceptions were measured at 12 weeks using the Peer Volunteer Experience Questionnaire, completed by 69% (121) of the 175 volunteers who provided support to at least one mother. Large majorities felt that the training session had prepared them for their role (94.2%), that volunteering did not interfere with their lives (81.8%) and that providing support helped them grow as individuals (87.8%). Over 90% stated that they would become a peer volunteer again, given the opportunity. Recruitment and retention of effective volunteers is essential to the success of any peer-support intervention. Results from this study can assist clinicians and program planners to provide effective training, sufficient on-going support and evaluation and appropriate matching of volunteers to mothers who desire peer support and are at high risk of postpartum depression.
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Affiliation(s)
- Cindy-Lee Dennis
- Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
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Heron-Speirs HA, Harvey ST, Baken DM. Moderators of psycho‐oncology therapy effectiveness: Addressing design variable confounds in meta‐analysis. ACTA ACUST UNITED AC 2012. [DOI: 10.1111/j.1468-2850.2012.01274.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Crane-Okada R, Freeman E, Kiger H, Ross M, Elashoff D, Deacon L, Giuliano AE. Senior Peer Counseling by Telephone for Psychosocial Support After Breast Cancer Surgery: Effects at Six Months. Oncol Nurs Forum 2011; 39:78-89. [DOI: 10.1188/12.onf.78-89] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Hailey D, Roine R, Ohinmaa A, Dennett L. Evidence of benefit from telerehabilitation in routine care: a systematic review. J Telemed Telecare 2011; 17:281-7. [PMID: 21844172 DOI: 10.1258/jtt.2011.101208] [Citation(s) in RCA: 96] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
We systematically reviewed the evidence on the effectiveness of telerehabilitation (TR) applications. The review included reports on rehabilitation for any disability, other than mental health conditions, and drug or alcohol addiction. All forms of telecommunications technology for TR and all types of study design were considered. Study quality was assessed using an approach that considered both study performance and study design. Judgements were made on whether each TR application had been successful, whether reported outcomes were clinically significant, and whether further data were needed to establish the application as suitable for routine use. Sixty-one scientifically credible studies that reported patient outcomes or administrative changes were identified through computerized literature searches on five databases. Twelve clinical categories were covered by the studies. Those dealing with cardiac or neurological rehabilitation were the most numerous. Thirty-one of the studies (51%) were of high or good quality. Study results showed that 71% of the TR applications were successful, 18% were unsuccessful and for 11% the status was unclear. The reported outcomes for 51% of the applications appeared to be clinically significant. Poorer-quality studies tended to have worse outcomes than those from high- or good-quality studies. We judged that further study was required for 62% of the TR applications and desirable for 23%. TR shows promise in many fields, but compelling evidence of benefit and of impact on routine rehabilitation programmes is still limited. There is a need for more detailed, better-quality studies and for studies on the use of TR in routine care.
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Affiliation(s)
- David Hailey
- School of Information Systems and Technology, University of Wollongong, 22 Sinclair Street, Kambah, ACT 2902, Australia
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Altschuler A, Rosenbaum E, Gordon P, Canales S, Avins AL. Audio recordings of mindfulness-based stress reduction training to improve cancer patients' mood and quality of life--a pilot feasibility study. Support Care Cancer 2011; 20:1291-7. [PMID: 21688161 DOI: 10.1007/s00520-011-1216-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2011] [Accepted: 06/06/2011] [Indexed: 11/24/2022]
Abstract
PURPOSE Mindfulness-based stress reduction (MBSR), typically taught in eight weekly classes, helps patients cope with illness, including cancer. Current research is almost exclusively based on post-treatment class attendance. Research suggests that short courses and alternative delivery techniques may also be beneficial. This pilot study assessed whether it would be feasible for cancer patients receiving chemotherapy to listen to MBSR audio recordings individually during treatment and at home and evaluate whether the intervention shows preliminary evidence of efficacy to improve patients' mood and quality of life (QoL). METHODS Patients were recruited from two oncology clinics. Inclusion criteria included a score ≥ 8 on the Hospital Anxiety and Depression Scale (HADS). Participants were asked to listen to study CDs containing MBSR instructions at least 5 days/week for 3 months and to maintain study diaries of their meditation practices. RESULTS Twenty-three patients enrolled in the study, and 20 (87%; 95% confidence interval (CI), 66% to 97%) completed the study protocol. Analysis showed that participants listened to study CDs an average of 39 times during the study; mean HADS scores declined from 18.3 to 12.2 (change = -6.1 points; 95% CI, -2.9 to -9.4). Participants reported subjectively that participation improved their mood and QoL. CONCLUSIONS This pilot study demonstrates the feasibility of investigating an individual audio MBSR intervention for patients with cancer and provides preliminary evidence that MBSR may benefit chemotherapy patients' mood and QoL. Fully powered comparative clinical trials to asses this MBSR modality to help improve mood and QoL for patients receiving chemotherapy are feasible and needed.
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Affiliation(s)
- Andrea Altschuler
- Division of Research, Kaiser Permanente, 2000 Broadway, Oakland, CA 94612, USA.
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Marcus AC, Garrett KM, Cella D, Wenzel L, Brady MJ, Fairclough D, Pate-Willig M, Barnes D, Emsbo SP, Kluhsman BC, Crane L, Sedlacek S, Flynn PJ. Can telephone counseling post-treatment improve psychosocial outcomes among early stage breast cancer survivors? Psychooncology 2011; 19:923-32. [PMID: 19941285 DOI: 10.1002/pon.1653] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To determine whether a telephone counseling program can improve psychosocial outcomes among breast cancer patients post-treatment. METHODS A randomized trial was conducted involving 21 hospitals and medical centers, with assessments (self-administered questionnaires) at baseline, 12 and 18 months post-enrollment. Eligibility criteria included early stage diagnosis, enrollment during last treatment visit, and the ability to receive the intervention in English. Endpoints included distress (Impact of Event Scale), depression (Center for Epidemiologic Studies Depression Scale), and two study-specific measures: sexual dysfunction and personal growth. The control group (n=152) received a resource directory for breast cancer; the intervention group (n=152) also received a one-year, 16 session telephone counseling program augmented with additional print materials. RESULTS Significant intervention effects were found for sexual dysfunction at 12 (p=0.03) and 18 months (p=0.04) and personal growth (12 months: p=0.005; 18 months: p=0.03). No differences by group were found in mean scores for distress and depression, with both groups showing significant improvement at 12 and 18 months (all p values for within-group change from baseline were <or=0.003). However, when dichotomized at cutpoints suggestive of the need for a clinical referral, the control group showed virtually no change at 18 months, whereas the intervention group showed about a 50% reduction in both distress (p=0.07) and depression (p=0.06). CONCLUSIONS Telephone counseling may provide a viable method for extending psychosocial services to cancer survivors nationwide.
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Affiliation(s)
- Alfred C Marcus
- AMC Cancer Research Center of the University of Colorado Cancer Center, University of Colorado, Denver, CO 80214, USA.
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Lemieux J, Goodwin PJ, Bordeleau LJ, Lauzier S, Théberge V. Quality-of-life measurement in randomized clinical trials in breast cancer: an updated systematic review (2001-2009). J Natl Cancer Inst 2011; 103:178-231. [PMID: 21217081 DOI: 10.1093/jnci/djq508] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Quality-of-life (QOL) measurement is often incorporated into randomized clinical trials in breast cancer. The objectives of this systematic review were to assess the incremental effect of QOL measurement in addition to traditional endpoints (such as disease-free survival or toxic effects) on clinical decision making and to describe the extent of QOL reporting in randomized clinical trials of breast cancer. METHODS We conducted a search of MEDLINE for English-language articles published between May-June 2001 and October 2009 that reported: 1) a randomized clinical trial of breast cancer treatment (excluding prevention trials), including surgery, chemotherapy, hormone therapy, symptom control, follow-up, and psychosocial intervention; 2) the use of a patient self-report measure that examined general QOL, cancer-specific or breast cancer-specific QOL or psychosocial variables; and 3) documentation of QOL outcomes. All selected trials were evaluated by two reviewers, and data were extracted using a standardized form for each variable. Data are presented in descriptive table formats. RESULTS A total of 190 randomized clinical trials were included in this review. The two most commonly used questionnaires were the European Organization for Research and Treatment of Cancer QOL Questionnaire and the Functional Assessment of Cancer Therapy/Functional Assessment of Chronic Illness Therapy. More than 80% of the included trials reported the name(s) of the instrument(s), trial and QOL sample sizes, the timing of QOL assessment, and the statistical method. Statistical power for QOL was reported in 19.4% of the biomedical intervention trials and in 29.9% of the nonbiomedical intervention trials. The percentage of trials in which QOL findings influenced clinical decision making increased from 15.2% in the previous review to 30.1% in this updated review for trials of biomedical interventions but decreased from 95.0% to 63.2% for trials of nonbiomedical interventions. Discordance between reviewers ranged from 1.1% for description of the statistical method (yes vs no) to 19.9% for the sample size for QOL. CONCLUSION Reporting of QOL methodology could be improved.
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Affiliation(s)
- Julie Lemieux
- Santé des populations: Unité de recherche en santé des populations (URESP), Centre de recherche FRSQ du Centre hospitalier affilié universitaire de Québec (CHA), Service d'hémato-oncologie du CHA and Centre des Maladies du Sein Deschênes-Fabia du CHA, Quebec City, QC, Canada.
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Bennett JA, Cameron LD, Brown PM, Whitehead LC, Porter D, Ottaway-Parkes T, Robinson E. Time since diagnosis as a predictor of symptoms, depression, cognition, social concerns, perceived benefits, and overall health in cancer survivors. Oncol Nurs Forum 2010; 37:331-8. [PMID: 20439217 DOI: 10.1188/10.onf.331-338] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To assess whether health and other factors are different in short-term cancer survivors (less than five years since diagnosis), long-term survivors (5-10 years), and very long-term survivors (more than 10 years). DESIGN A cross-sectional survey. SETTING New Zealand. SAMPLE 836 survivors of adult-onset cancers (6 months to 43 years since diagnosis). METHODS Survivors were recruited using community-based methods and answered a mailed questionnaire. MAIN RESEARCH VARIABLES Physical and emotional health, depression, symptoms, cognitive difficulty, social concerns, and perceived benefits of cancer. FINDINGS Physical and emotional health, depression, physical symptoms, and perceived benefits of cancer were not associated with time since diagnosis, but longer time since diagnosis was associated with decreases in cognitive difficulties and social concerns. The survivors in this study reported a mean of 8.4 physical symptoms, regardless of time since diagnosis, with the most frequent being fatigue (76%), aches and pain (75%), and trouble sleeping (68%). CONCLUSIONS Most survivors enjoyed a moderately good level of health. However, some adverse effects, such as symptoms, were similar in short-, long-, and very long-term survivors, suggesting that interventions may be needed to prevent persistent issues as time progresses. IMPLICATIONS FOR NURSING The findings suggest a need to reconsider the common attitude that survivors who finish treatment should be able to return to normal life. Assessment of symptoms, particularly fatigue, pain, and sleep issues, is important even in very long-term survivors.
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Sharif F, Abshorshori N, Tahmasebi S, Hazrati M, Zare N, Masoumi S. The effect of peer-led education on the life quality of mastectomy patients referred to breast cancer-clinics in Shiraz, Iran 2009. Health Qual Life Outcomes 2010; 8:74. [PMID: 20653966 PMCID: PMC2919455 DOI: 10.1186/1477-7525-8-74] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2010] [Accepted: 07/23/2010] [Indexed: 11/22/2022] Open
Abstract
Background Breast cancer among women is a relatively common with a more favorable expected survival rates than other forms of cancers. This study aimed to determine the improved quality of life for post-mastectomy women through peer education. Methods Using pre and post test follow up and control design approach, 99 women with stage I and II of breast cancer diagnosis were followed one year after modified radical mastectomy. To measure the quality of life an instrument designed by the European organization for research and treatment of cancer, known as the Quality of Life Question (QLQ-30) and it's breast cancer supplementary measure (QLQ-BR23) at three points in time (before, immediately and two months after intervention) for both groups were used. The participant selection was a convenient sampling method and women were randomly assigned into two experimental and control groups. The experimental group was randomly assigned to five groups and peer educators conducted weekly educational programs for one month. Tabulated data were analyzed using chi square, t test, and repeated measurement multivariate to compare the quality of life differences over time. Results For the experimental group, the results showed statistically significant improvement in all performance aspects of life quality and symptom reduction (P < 0.001), while the control group had no significant differences in all aspects of life quality. Conclusion The findings of this study suggest that peer led education is a useful intervention for post-mastectomy women to improves their quality of life.
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Affiliation(s)
- Farkhondeh Sharif
- Mental Health Nursing Department, Fatemeh, Faculty of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
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Wittenberg L, Yutsis M, Taylor S, Giese-Davis J, Bliss-Isberg C, Star P, Spiegel D. Marital Status Predicts Change in Distress and Well-being in Women Newly Diagnosed With Breast Cancer and Their Peer Counselors. Breast J 2010; 16:481-9. [DOI: 10.1111/j.1524-4741.2010.00964.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Crane-Okada R, Freeman E, Ross M, Kiger H, Giuliano AE. Training senior peer counselors to provide telephone support for newly diagnosed breast cancer survivors. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2010; 25:174-179. [PMID: 20082171 DOI: 10.1007/s13187-009-0028-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Volunteers require carefully designed and evaluable training before providing support to newly diagnosed older breast cancer survivors (BCS) after surgery. A training module and 20-h course incorporating discussion, role plays, dyads, and written material were created to supplement core training of senior peer counselors, who provided a telephone support intervention in a randomized controlled trial. Twelve volunteers began the training, ten completed the course, and six of the ten subsequently provided telephone support to 107 BCS. Specialized supplemental training, along with ongoing supervision, effectively prepared volunteers to provide support via telephone to BCS, augmenting professional support.
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Affiliation(s)
- Rebecca Crane-Okada
- Division of Nursing Research and Education, Department of Population Sciences, Beckman Research Institute, City of Hope National Medical Center, Duarte, CA 91010, USA.
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Weinberger T, Forrester A, Markov D, Chism K, Kunkel EJS. Women at a dangerous intersection: diagnosis and treatment of depression and related disorders in patients with breast cancer. Psychiatr Clin North Am 2010; 33:409-22. [PMID: 20385344 DOI: 10.1016/j.psc.2010.01.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Breast cancer is a relatively common diagnosis for American women and depressive symptoms occur in many women with breast cancer. Identification of women with breast cancer and concomitant depressive symptoms and mood disorders requires particular attention by heath care providers, and may be aided by the administration of a variety of diagnostic and/or screening tools. Insomnia is also a significant problem for women with breast cancer at various stages of diagnosis and treatment, including after remission. Although many studies on the treatment of depression in women with breast cancer have been done, and the data do point to the efficacy of several antidepressants in this population, there are no data to support the widely held hypothesis that treatment of depression in patients with breast cancer may positively affect morbidity and mortality. Breast cancer treatments may give rise to depressive symptoms and this should be considered in the approach to pharmacotherapy. Several psychotherapeutic modalities offer relief of the symptoms and syndromes of depression in breast cancer. Future research can answer the question of which approach is most appropriate for which patients, and whether therapy can improve a variety of health outcomes and survival for women with breast cancer.
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Affiliation(s)
- Tal Weinberger
- Consultation-Liaison Psychiatry, Thomas Jefferson University, 1020 Sansom Street, Suite 1652, PA 19107, USA
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Dennis CL. Postpartum depression peer support: Maternal perceptions from a randomized controlled trial. Int J Nurs Stud 2010; 47:560-8. [DOI: 10.1016/j.ijnurstu.2009.10.015] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2008] [Revised: 10/22/2009] [Accepted: 10/29/2009] [Indexed: 01/25/2023]
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Salzer MS, Palmer SC, Kaplan K, Brusilovskiy E, Ten Have T, Hampshire M, Metz J, Coyne JC. A randomized, controlled study of Internet peer-to-peer interactions among women newly diagnosed with breast cancer. Psychooncology 2010; 19:441-6. [DOI: 10.1002/pon.1586] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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