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Campbell K, Harris F, Stoddart K. The Hematology Cancer Patient Experience of "Facing Death" in the Last Year of Life: A Constructivist Grounded Theory Study. Cancer Nurs 2024; 47:132-140. [PMID: 36480369 DOI: 10.1097/ncc.0000000000001180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND For hematology cancer patients, the process of dying is described as "troublesome." Qualitative studies have focused on views of healthcare professionals and caregiver stakeholders. To date, there have been no studies from the patient's perspective on facing death while in the last year of life. OBJECTIVE The aim of this study was to develop an understanding of the hematology cancer patient's experience of the process of dying in the last year of life. METHODS The study method was constructivist grounded theory using semistructured interviews, a constant comparison technique, and memoing to collection and analysis of data. The 21 participants were attending a UK cancer center, a cancer unit, or a hospice. RESULTS This article describes 1 core category within the incurable hematology cancer illness trajectory through 4 subcategories: transitional phase, chronic phase, dying phase, and liminal phase. CONCLUSION This unique study illustrates that, although life can be prolonged, "facing death" still occurs upon hospitalization and relapse regularly over the illness trajectory. IMPLICATIONS FOR PRACTICE It is important that clinical practice acknowledges those participants in an incurable illness trajectory while living are focused on avoiding death rather than the ability to cure the disease. Services need to be responsive to the ambiguity of both living and dying by providing holistic management simultaneously, especially after critical episodes of care, to enhance the process of care in the last year of life, and assessment should incorporate the discussion of experiencing life-threatening events.
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Affiliation(s)
- Karen Campbell
- Author Affiliations: Edinburgh Napier University (Dr Campbell); Professor, University of West of Scotland (Dr Harris); and University of Stirling (Dr Stoddart), Scotland
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Roydhouse J, Thompson D, Nicholson L, Harrup R, Campbell J, Jose K. Patient and carer experiences of living with multiple myeloma and myelodysplastic syndrome. Psychooncology 2024; 33:e6245. [PMID: 37983678 DOI: 10.1002/pon.6245] [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: 07/05/2023] [Revised: 10/27/2023] [Accepted: 10/30/2023] [Indexed: 11/22/2023]
Abstract
OBJECTIVE Multiple myeloma (MM) and myelodysplastic syndrome (MDS) are treatable but incurable conditions that can substantially impact the daily lives of people living with these conditions and their carers. We sought to understand the experience of people living with and carers affected by these conditions in Tasmania, a regional area of Australia. METHODS Exploratory qualitative study. People living with MM or MDS or their carers in Southern Tasmania were recruited by a haematology nurse and invited to participate in focus groups. Data collection was by groups held online and face-to-face in 2022. Thematic analysis was used. RESULTS Ten groups were held with 48 participants (n = 23 with MM, n = 9 with MDS, n = 16 carers). Key themes arising from focus groups with people living with MM/MDS were (1) Relationships and Support; (2) Positive Attitude; (3) Perception of Condition; and (4) Symptoms and Comorbidities. Some people with MM/MDS had to take on a caring role for their carer due to carer illness. Key themes arising from carer focus groups included (1) Supportive Relationships; (2) Accommodating Change; and (3) Own Needs. Not all carers viewed their caring role as burdensome. CONCLUSION Future work should consider what supports are required for patients acting as carers, and carer burden should not be assumed.
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Affiliation(s)
- Jessica Roydhouse
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | | | | | | | - Julie Campbell
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Kim Jose
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
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Sheridan R, McCaughan D, Hewison A, Roman E, Smith A, Patmore R, Howell D. Experiences and preferences for psychosocial support: a qualitative study exploring the views of patients with chronic haematological cancers. BMJ Open 2023; 13:e070467. [PMID: 37597866 PMCID: PMC10441118 DOI: 10.1136/bmjopen-2022-070467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 08/02/2023] [Indexed: 08/21/2023] Open
Abstract
OBJECTIVES Patients with chronic haematological cancers are often treated on a relapsing-remitting pathway, which may extend for many years. Such diagnoses are associated with uncertainties that often cause anxiety and distress, meaning patients (and families) are susceptible to potentially prolonged emotional difficulties, across the cancer journey. Experiences and preferences regarding psychosocial needs and support over time are relatively unexplored, which this study aimed to address. SETTING AND DESIGN Set within the UK's Haematological Malignancy Research Network (an ongoing population-based cohort that generates evidence to underpin improved clinical practice) a qualitative, exploratory study was conducted, using semistructured interviews. Reflexive thematic analysis was used to assess the interview data via an exploratory, inductive approach, underpinned by the research questions. PARTICIPANTS Thirty-five patients were included with chronic lymphocytic leukaemia, follicular lymphoma, marginal zone lymphoma or myeloma; 10 of whom were interviewed alongside a relative. RESULTS Five themes were identified from the data: (1) accessing support, (2) individual coping behaviour affecting support preferences, (3) divergent and fluctuating thoughts on patient support forums, (4) the role, influence and needs of family and friends and (5) other sources of support and outstanding needs. Findings suggest that patients' individual attitudes towards support varied over time. This also influenced whether support was perceived to be available, and if it was then used. CONCLUSION This study highlighted the variation in preferences towards psychosocial support among patients with chronic haematological cancers. As patients can live for many years with significant emotional difficulties, they may benefit from frequent monitoring of their psychosocial well-being, as well as signposting to holistic support, if this is needed.
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Affiliation(s)
| | | | - Ann Hewison
- Department of Health Sciences, University of York, York, UK
| | - Eve Roman
- Department of Health Sciences, University of York, York, UK
| | | | - Russell Patmore
- Queens Centre for Oncology and Haematology, Castle Hill Hospital, Cottingham, UK
| | - Debra Howell
- Department of Health Sciences, University of York, York, UK
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Xu X, Chen X, Wang T, Qiu C, Li M. Relationship between illness perception and family resilience in gynecologic cancer patients: the mediating role of couple illness communication. Support Care Cancer 2023; 31:522. [PMID: 37581695 DOI: 10.1007/s00520-023-07992-0] [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: 05/11/2023] [Accepted: 08/10/2023] [Indexed: 08/16/2023]
Abstract
OBJECTIVE To analyze the current family resilience levels of Chinese patients with gynecologic cancer and explore the mediating role of couple illness communication between illness perception and family resilience to facilitate patient adaptation to cancer. METHODS A total of 310 patients with gynecologic cancer were selected from the gynecology ward of a tertiary care hospital in Jinan, Shandong Province, China. All participants provided their demographic and clinical information and completed the Brief Illness Perception Questionnaire (BIPQ), Couples' Illness Communication Scale (CICS), and Family Hardiness Index (FHI). The mediating effect of couple illness communication was analyzed using SPSS26.0 and Amos21.0. RESULTS The family resilience score of patients with gynecologic cancer was moderate (55.78 ± 8.65). Illness perception was negatively correlated with couple illness communication(p < 0.05) and family resilience(p < 0.01), while couple illness communication was positively correlated with family resilience (p < 0.01). Couple illness communication mediated the relationship between illness perception and family resilience [β = - 0.071; 95% confidence interval: (- 0.127)-(- 0.013)]. CONCLUSIONS The family resilience of patients with gynecologic cancer must be further improved. Since couple illness communication mediates the relationship between illness perception and family resilience in this population, it is important to improve patients' illness perceptions and couple illness communication to enhance their family resilience.
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Affiliation(s)
- Xiaoxiang Xu
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Xiaoxin Chen
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Tianyi Wang
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Chengmiao Qiu
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Min Li
- Department of Gynecology, Qilu Hospital of Shandong University, Jinan, 250012, China.
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Zeng L, Huang H, Liu Y, Ruan C, Fan S, Xia Y, Zhou J. The core symptom in multiple myeloma patients undergoing chemotherapy: a network analysis. Support Care Cancer 2023; 31:297. [PMID: 37097532 PMCID: PMC10126563 DOI: 10.1007/s00520-023-07759-7] [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: 11/23/2022] [Accepted: 04/16/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND During chemotherapy for multiple myeloma, symptoms include those related to the disease, as well as adverse effects of the treatment. Few studies have explored the relationships between these symptoms. Network analysis could identify the core symptom in the symptom network. OBJECTIVE The aim of this study was to explore the core symptom in multiple myeloma patients undergoing chemotherapy. METHODS This was a cross-sectional study in which sequential sampling was used to recruit 177 participants from Hunan, China. Demographic and clinical characteristics were surveyed using a self-developed instrument. The symptoms of chemotherapy-treated multiple myeloma, including pain, fatigue, worry, nausea, and vomiting, were measured using a questionnaire with good reliability and validity. The mean ± SD, frequency, and percentages were used as descriptive statistics. Network analysis was used to estimate the correlation between symptoms. RESULTS The results showed that 70% of multiple myeloma patients using chemotherapy exhibited pain. In the network analysis, worrying was the dominant symptom, and the strongest relationship was between nausea and vomiting in chemotherapy-treated multiple myeloma patients' symptoms. CONCLUSION Worrying is the core symptom of multiple myeloma patients. Interventions could be most effective if there is a symptom management focus on worrying when providing care to chemotherapy-treated multiple myeloma patients. Nausea combined with vomiting could be better managed, which would decrease the cost of health care. Understanding the relationship between the symptoms of multiple myeloma patients undergoing chemotherapy is beneficial for precise symptom management. IMPLICATIONS FOR PRACTICE Nurses and health care teams should be a priority to intervene in the worrying for chemotherapy-treated multiple myeloma patients to maximize the effectiveness of an intervention. Except, nausea and vomiting should be managed together in a clinical setting.
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Affiliation(s)
- Lihong Zeng
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Hui Huang
- The Third Xiangya Hospital, Central South University, Changsha, China.
| | - Yaqi Liu
- The Third Xiangya Hospital, Central South University, Changsha, China
| | - Chunhong Ruan
- The Third Xiangya Hospital, Central South University, Changsha, China
| | - Sisi Fan
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Yuting Xia
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Jiandang Zhou
- The Third Xiangya Hospital, Central South University, Changsha, China.
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Kirkpatrick S, Campbell K, Harding S. A survey of quality-of-life tools used in the routine care of patients with multiple myeloma. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2023; 32:S10-S14. [PMID: 36913337 DOI: 10.12968/bjon.2023.32.5.s10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
BACKGROUND New treatment options have significantly improved the life expectancy of myeloma patients such that their cause of death is increasingly likely to be from something other than myeloma. Furthermore, the adverse effects of short- or long-term treatments as well as the disease are impacting on quality of life (QoL) for longer periods of time. Understanding people's QoL and what is important to them, is part of providing holistic care. Although QoL data has been collected for many years in myeloma studies, they have not been used to inform patient outcomes. There is growing evidence that supports the assessment of 'fitness' and consideration of QoL as part of routine myeloma care. A national survey was carried out to discover which QoL tools are currently being used in the routine care of myeloma patients, by whom and at which time point. METHODS An online survey using SurveyMonkey was adopted for flexibility and accessibility. The link to the survey was circulated via Bloodwise, Myeloma UK and Cancer Research UK contact lists. Paper questionnaires were circulated at the UK Myeloma Forum. RESULTS Data about practices in 26 centres were collected. This included sites across England and Wales. Three out of 26 centres collect QoL data as part of standard care. QoL tools used include EORTC QLQ-My20/24, MyPOS, FACT-BMT and Quality of Life Index. Questionnaires were completed by patients before, during or after a clinic appointment. Clinical nurse specialists calculate the scores and create a care plan. CONCLUSION Despite growing evidence to support an holistic approach to management of myeloma patients, there is a lack of evidence to confirm that health-related QoL is being addressed in standard care. This is an area that needs further research.
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Affiliation(s)
| | - Karen Campbell
- Associate Professor of Cancer Nursing, School of Health and Social Care, Edinburgh Napier University, Edinburgh
| | - Sam Harding
- Research Fellow, North Bristol NHS Trust, Bristol
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Dombeck C, Swezey T, Gonzalez Sepulveda JM, Reeve BB, LeBlanc TW, Chandler D, Corneli A. Patient perspectives on considerations, tradeoffs, and experiences with multiple myeloma treatment selection: a qualitative descriptive study. BMC Cancer 2023; 23:65. [PMID: 36658490 PMCID: PMC9850680 DOI: 10.1186/s12885-022-10458-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 12/19/2022] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Advances in multiple myeloma treatment and a proliferation of treatment options have resulted in improved survival rates and periods of symptom-free remission for many multiple myeloma patients. As a result, health-related quality of life (HRQoL) concerns related to myeloma treatments have become increasingly salient for this patient population and represent an important consideration guiding patients' treatment choices. To gain an understanding of patients' experiences with choosing myeloma therapies and explore the HRQoL concerns that are most important to them, we interviewed a diverse sample of US-based multiple myeloma patients about their treatment considerations. METHODS We conducted a qualitative descriptive study using in-depth interviews. Participants reflected on (1) the factors that were most important to them when thinking about multiple myeloma treatment and how these have changed over time, (2) how they might weigh the importance of treatment efficacy vs. side effects, (3) trade-offs they would be willing to make regarding efficacy vs. HRQoL, and (4) treatment changes they had experienced. Interviews were audio-recorded and transcribed, and narratives were analyzed using applied thematic analysis. RESULTS We interviewed 21 patients, heterogeneous in their disease trajectory and treatment experience. Participants were 36 to 78 years, 52% female, and 38% Black. Efficacy was named as the most important treatment consideration by almost two-thirds of participants, and over half also valued HRQoL aspects such as the ability to maintain daily functioning and enjoyment of life. Participants expressed concern about potential treatment side effects and preferred more convenient treatment options. Although participants stated largely trusting their clinicians' treatment recommendations, many said they would stop a clinician-recommended treatment if it negatively impacted their HRQoL. Participants also said that while they prioritized treatment efficacy, they would be willing to change to a less efficacious treatment if side effects became intolerable. CONCLUSIONS Our findings link to other reports reflecting considerations that are important to multiple myeloma patients, including the importance placed on increasing life expectancy and progression-free survival, but also the tension between treatment efficacy and quality of life. Our results extend these findings to a racially diverse US-based patient population at different stages in the disease trajectory.
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Affiliation(s)
- Carrie Dombeck
- grid.26009.3d0000 0004 1936 7961Department of Population Health Sciences, Duke University School of Medicine, 215 Morris Street, Durham, NC 27701 USA
| | - Teresa Swezey
- grid.26009.3d0000 0004 1936 7961Department of Population Health Sciences, Duke University School of Medicine, 215 Morris Street, Durham, NC 27701 USA
| | - Juan Marcos Gonzalez Sepulveda
- grid.26009.3d0000 0004 1936 7961Department of Population Health Sciences, Duke University School of Medicine, 215 Morris Street, Durham, NC 27701 USA ,grid.26009.3d0000 0004 1936 7961Department of Medicine, Duke University School of Medicine, Durham, NC USA ,grid.26009.3d0000 0004 1936 7961Duke Clinical Research Institute, Duke University School of Medicine, NC Durham, USA
| | - Bryce B. Reeve
- grid.26009.3d0000 0004 1936 7961Department of Population Health Sciences, Duke University School of Medicine, 215 Morris Street, Durham, NC 27701 USA ,grid.26009.3d0000 0004 1936 7961Duke Clinical Research Institute, Duke University School of Medicine, NC Durham, USA ,grid.26009.3d0000 0004 1936 7961Duke Cancer Institute, Duke University School of Medicine, Durham, NC USA
| | - Thomas W. LeBlanc
- grid.26009.3d0000 0004 1936 7961Department of Population Health Sciences, Duke University School of Medicine, 215 Morris Street, Durham, NC 27701 USA ,grid.26009.3d0000 0004 1936 7961Department of Medicine, Duke University School of Medicine, Durham, NC USA ,grid.26009.3d0000 0004 1936 7961Duke Cancer Institute, Duke University School of Medicine, Durham, NC USA
| | - David Chandler
- grid.417886.40000 0001 0657 5612Amgen, Inc, Thousand Oaks, CA USA
| | - Amy Corneli
- grid.26009.3d0000 0004 1936 7961Department of Population Health Sciences, Duke University School of Medicine, 215 Morris Street, Durham, NC 27701 USA ,grid.26009.3d0000 0004 1936 7961Department of Medicine, Duke University School of Medicine, Durham, NC USA ,grid.26009.3d0000 0004 1936 7961Duke Clinical Research Institute, Duke University School of Medicine, NC Durham, USA
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Camilleri M, Bekris G, Sidhu G, Buck C, Elsden E, McCourt O, Horder J, Newrick F, Lecat C, Sive J, Papanikolaou X, Popat R, Lee L, Xu K, Kyriakou C, Rabin N, Yong K, Fisher A. The impact of COVID-19 on autologous stem cell transplantation in multiple myeloma: A single-centre, qualitative evaluation study. Support Care Cancer 2022; 30:7469-7479. [PMID: 35657402 PMCID: PMC9163289 DOI: 10.1007/s00520-022-07173-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 05/24/2022] [Indexed: 11/29/2022]
Abstract
Autologous stem cell transplantation (ASCT) is standard of care in biologically fit, newly diagnosed multiple myeloma (MM) patients, offering better therapeutic outcomes and improved quality of life (QoL). However, with the UK's 1st national lockdown on 23/03/2020, several guidelines recommended deferring ASCT due to risks of infection, with resource limitations forcing some units to suspend ASCT entirely. Such changes to patients' treatment plans inevitably altered their lived experience during these uncertain times with expected impact on QoL. We conducted a qualitative study using semi-structured interviews to gain insight into MM patients' understanding of their disease, initial therapy and ASCT, and their response to therapy changes. A clinical snapshot of how COVID-19 affected the MM ASCT service in a single UK institution is also provided, including changes to chemotherapy treatment plans, timing, and prioritisation of ASCT. Framework analysis identified 6 overarching themes: (1) beliefs about ASCT, (2) perceptions of information provided about MM and ASCT, (3) high levels of fear and anxiety due to COVID-19, (4) feelings about ASCT disruption or delay due to COVID-19, (5) perceptions of care, and (6) importance of social support. Example subthemes were beliefs that ASCT would provide a long-remission/best chance of normality including freedom from chemotherapy and associated side-effects, disappointment, and devastation at COVID-related treatment delays (despite high anxiety about infection) and exceptionally high levels of trust in the transplant team. Such insights will help us adjust our service and counselling approaches to be more in tune with patients' priorities and expectations.
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Affiliation(s)
- Marquita Camilleri
- University College Hospital Cancer Institute, Paul O'Gorman Building, 72 Huntley Street, London, WC1E 6DD, UK.
- Haematology Department, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
| | - Georgios Bekris
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Govundeep Sidhu
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Caroline Buck
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Esma Elsden
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Orla McCourt
- University College Hospital Cancer Institute, Paul O'Gorman Building, 72 Huntley Street, London, WC1E 6DD, UK
- Therapies & Rehabilitation, University College London Hospitals NHS Foundation Trust, London, UK
| | - Jackie Horder
- Haematology Department, University College London Hospital, University College London Hospitals NHS Foundation Trust, London, UK
| | - Fiona Newrick
- Haematology Department, University College London Hospital, University College London Hospitals NHS Foundation Trust, London, UK
| | - Catherine Lecat
- University College Hospital Cancer Institute, Paul O'Gorman Building, 72 Huntley Street, London, WC1E 6DD, UK
- Haematology Department, University College London Hospital, University College London Hospitals NHS Foundation Trust, London, UK
| | - Jonathan Sive
- Haematology Department, University College London Hospital, University College London Hospitals NHS Foundation Trust, London, UK
| | - Xenofon Papanikolaou
- Haematology Department, University College London Hospital, University College London Hospitals NHS Foundation Trust, London, UK
| | - Rakesh Popat
- Haematology Department, University College London Hospital, University College London Hospitals NHS Foundation Trust, London, UK
| | - Lydia Lee
- Haematology Department, University College London Hospital, University College London Hospitals NHS Foundation Trust, London, UK
| | - Ke Xu
- Haematology Department, University College London Hospital, University College London Hospitals NHS Foundation Trust, London, UK
| | - Charalampia Kyriakou
- Haematology Department, University College London Hospital, University College London Hospitals NHS Foundation Trust, London, UK
| | - Neil Rabin
- Haematology Department, University College London Hospital, University College London Hospitals NHS Foundation Trust, London, UK
| | - Kwee Yong
- University College Hospital Cancer Institute, Paul O'Gorman Building, 72 Huntley Street, London, WC1E 6DD, UK
- Haematology Department, University College London Hospital, University College London Hospitals NHS Foundation Trust, London, UK
| | - Abigail Fisher
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
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Zhang X, JingWang, Gao W, Li L, LiangYu, Liu K, Li N. Nursing Methods and Experience of Local Anesthesia Patients under Arthroscope. SCANNING 2022; 2022:3689344. [PMID: 35950089 PMCID: PMC9348952 DOI: 10.1155/2022/3689344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 07/09/2022] [Accepted: 07/18/2022] [Indexed: 06/15/2023]
Abstract
In order to solve the nursing problems of local anesthesia patients under arthroscopy, a nursing method and experience based on local anesthesia patients under arthroscopy was proposed. From June 2019 to May 2021, 478 patients who underwent knee arthroscopy under spinal anesthesia or local anesthesia were retrospectively investigated, including 186 cases (38.9%) under local anesthesia and 292 cases (61.1%) under spinal anesthesia. 2% lidocaine plus epinephrine was injected locally and intra-articular in patients with local anesthesia, and 0.75% bupivacaine in patients with spinal anesthesia. It was found that in the local anesthesia group and spinal anesthesia group, 94.1% (175/186) and 98.3% (287/292) patients did not feel pain during operation. 93.0% (173/186 cases) and 96.2% (281/292 cases) of patients in the two groups were satisfied or very satisfied with the effect of anesthesia, respectively. The experimental results showed that local anesthesia was a simple and effective anesthesia method for knee arthroscopy, which was more reliable and safer than spinal anesthesia. Local anesthesia could be used for knee arthroscopy or cleaning and rinsing, free body removal, or even common meniscinoplasty.
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Affiliation(s)
- Xiaowei Zhang
- Department of Nursing, Huaxin College of Hebei Geo University, Shijiazhuang, Hebei 050700, China
| | - JingWang
- Shijiazhuang Vocational College of Technology and Information, Shijiazhuang, Hebei 050000, China
| | - Weixu Gao
- Shijiazhuang Vocational College of Technology and Information, Shijiazhuang, Hebei 050000, China
| | - Lijuan Li
- Department of Nursing, Huaxin College of Hebei Geo University, Shijiazhuang, Hebei 050700, China
| | - LiangYu
- Hebei Yiling Hospital, Shijiazhuang, Hebei 050091, China
| | - Kun Liu
- The First Hospital of Hebei Medical University, Shijiazhuang, Hebei 050031, China
| | - Nan Li
- Shijiazhuang Jilian Medical Secondary School, Shijiazhuang, Hebei 050071, China
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Rubins Z, Gibson BJ, Chantry A. What Can Patient Narratives Reveal to Us About the Experience of a Diagnosis of Myeloma? A Qualitative Scoping Review. J Patient Exp 2022; 9:23743735221079133. [PMID: 35187224 PMCID: PMC8855462 DOI: 10.1177/23743735221079133] [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] [Indexed: 11/30/2022] Open
Abstract
In recent years, there have been major advances in treatment options for myeloma
and an improved prognosis as a result. There is a wealth of literature that
explores the experience of specific treatments from a clinical perspective but
there is comparatively little known about the reality of living with myeloma.
This research aims to explore the experience of a myeloma diagnosis, to map out
key patient experience literature, and examine common themes to support both
medical practice and the planning of further research. Following a scoping
review methodology, PubMed, StarPlus (the University of Sheffield online
database), and Scopus were searched and 15 studies identified for analysis and
qualitative synthesis. The literature indicated that myeloma was increasingly
being experienced as a chronic condition rather than an acute diagnosis and that
there are challenges meeting the needs of patients, understanding the overall
symptom burden and the role of the family. The paper identifies emotional and
psychological adjustment and coping as a potential area requiring further
exploration in the context of a whole team approach to care.
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Affiliation(s)
- Zoë Rubins
- University of Sheffield Medical School, Sheffield, UK
| | - Barry J Gibson
- Academic Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Andrew Chantry
- University of Sheffield Medical School, Sheffield, UK.,Department of Oncology and Metabolism, Sheffield Hospitals NHS Foundation Trust, Sheffield, UK
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Burden of Treatment among Elderly Patients with Cancer: A Scoping Review. Healthcare (Basel) 2021; 9:healthcare9050612. [PMID: 34069688 PMCID: PMC8160635 DOI: 10.3390/healthcare9050612] [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] [Received: 03/20/2021] [Revised: 04/23/2021] [Accepted: 05/08/2021] [Indexed: 11/17/2022] Open
Abstract
Background: The objective of this scoping review is to understand how treatment burden is experienced in elderly patients with cancer and what the most prevalent dimensions of treatment burden are among this population. According to one conceptual model, there are six dimensions of treatment burden, including financial, medication, administrative, time/travel, lifestyle, and healthcare. Methods: A scoping review methodology framework was used to collected data from EMBASE CINAHL (Cumulative Index to Nursing and Allied Health Literature), Medline/PubMed, Scopus, Web of Science, Embase, and Cochrane from 2000 to March 2020. Studies which focused on treatment burden among elderly patients with cancer (+65 years) were selected. Data were extracted using a standardized proforma. Results: The results identified 3319 total papers. Of these, 24 met the inclusion criteria and were included in the scoping review. A significant proportion of these studies was conducted in the United States (n = 10) using self-reported, cross-sectional data. Financial burden was the most prevalent dimension of treatment burden, with 11 studies focusing on the direct and indirect costs associated with cancer treatment. Other but less obvious aspects of treatment burden elderly patients experienced included the length of time taken to access and administer treatment and medication-related burdens. Conclusions: Emerging findings suggest that the financial aspects of cancer treatment are a significant burden for most elderly cancer patients. Personalized healthcare interventions targeting ways to reduce and screen for treatment burden, particularly those related to cost, are urgently needed.
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