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Ku M, Gates P, Renehan S. Feasibility of an online cognitive rehabilitation programme in patients with a haematological malignancy undergoing autologous stem cell transplantation. Intern Med J 2021; 51:1665-1672. [PMID: 33465274 DOI: 10.1111/imj.15204] [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: 08/30/2020] [Revised: 11/25/2020] [Accepted: 12/30/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Chemotherapy-related cognitive impairment (CRCI) is a known adverse event that can impact cancer survivors, resulting in long-standing effect on quality of life and activities of daily living. Currently, there is limited knowledge regarding the aetiology and therapy for CRCI. Although CRCI following autologous stem cell transplantation (AuSCT) is emerging as a potentially significant concern for patients with underlying haematological malignancies, it is an area that requires further research. AIMS This pilot study aimed to assess (i) the prevalence of CRCI in patients with haematological malignancies both pre-AuSCT and post-AuSCT and (ii) the feasibility of a cognitive rehabilitation programme (CRP) in survivorship care post-AuSCT. METHODS Over a 12-month period, consecutive patients planned for AuSCT were approached for the study. Enrolled patients were administered a 9-week course of CRP, commencing day 40 ± 5 post-AuSCT. Participants were evaluated using a neuropsychological tool and validated questionnaires at baseline, pre-CRP (day 40 ± 5 post-AuSCT), post-CRP and 6 months post-CRP. RESULTS Thirty-two patients were enrolled. The mean age was 59 years (SD = 11.5), 23 (72%) were male and 18 (56%) had multiple myeloma. Participants reported high satisfaction using the CRP, and most devoted significant amount of time as requested. CONCLUSIONS While there appeared to be a low incidence of significant CRCI in our patient population, the incorporation of CRP in survivorship care appeared to be feasible. A larger randomised study examining the efficacy of CRP should be further explored.
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Affiliation(s)
- Matthew Ku
- Department of Clinical Haematology, St Vincent's Hospital, Melbourne, Victoria, Australia.,University of Melbourne, Melbourne, Victoria, Australia
| | - Priscilla Gates
- Autologous Bone Marrow Transplant/Survivorship, Clinical Haematology, Olivia Newton-John Cancer Wellness and Research Centre, Austin Health, Melbourne, Victoria, Australia.,Clinical Haematology, Olivia Newton-John Cancer Wellness and Research Centre, Austin Health, Melbourne, Victoria, Australia
| | - Steffi Renehan
- Clinical Haematology, Olivia Newton-John Cancer Wellness and Research Centre, Austin Health, Melbourne, Victoria, Australia
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Li L, Yeo W. Value of quality of life analysis in liver cancer: A clinician’s perspective. World J Hepatol 2017; 9:867-883. [PMID: 28804570 PMCID: PMC5534362 DOI: 10.4254/wjh.v9.i20.867] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 04/10/2017] [Accepted: 05/24/2017] [Indexed: 02/06/2023] Open
Abstract
Health related quality of life (HRQOL) is increasingly recognized as an important clinical parameter and research endpoint in patients with hepatocellular carcinoma (HCC). HRQOL in HCC patients is multifaceted and affected by medical factor which encompasses HCC and its complications, oncological and palliative treatment for HCC, underlying liver disease, as well as the psychological, social or spiritual reaction to the disease. Many patients presented late with advanced disease and limited survival, plagued with multiple symptoms, rendering QOL a very important aspect in their general well being. Various instruments have been developed and validated to measure and report HRQOL in HCC patients, these included general HRQOL instruments, e.g., Short form (SF)-36, SF-12, EuroQoL-5D, World Health Organization Quality of Life Assessment 100 (WHOQOL-100), World Health Organization Quality of Life Assessment abbreviated version; general cancer HRQOL instruments, e.g., the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30, Functional Assessment of Cancer Therapy (FACT)-General, Spitzer Quality of Life Index; and liver-cancer specific HRQOL instruments, e.g., EORTC QLQ-HCC18, FACT-Hepatobiliary (FACT-Hep), FACT-Hep Symptom Index, Trial Outcome Index. Important utilization of HRQOL in HCC patients included description of symptomatology and HRQOL of patients, treatment endpoint in clinical trial, prognostication of survival, benchmarking of palliative care service and health care valuation. In this review, difficulties regarding the use of HRQOL data in research and clinical practice, including choosing a suitable instrument, problems of missing data, data interpretation, analysis and presentation are examined. Potential solutions are also discussed.
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What Are the Components of Interventions Focused on Quality-of-Life Assessment in Palliative Care Practice? A Systematic Review. J Hosp Palliat Nurs 2016. [DOI: 10.1097/njh.0000000000000248] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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King S, Green HJ. Psychological intervention for improving cognitive function in cancer survivors: a literature review and randomized controlled trial. Front Oncol 2015; 5:72. [PMID: 25859431 PMCID: PMC4373254 DOI: 10.3389/fonc.2015.00072] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 03/10/2015] [Indexed: 12/24/2022] Open
Abstract
Although the impact of cancer and associated treatments on cognitive functioning is becoming an increasingly recognized problem, there are few published studies that have investigated psychological interventions to address this issue. A waitlist randomized controlled trial methodology was used to assess the efficacy of a group cognitive rehabilitation intervention ("ReCog") that successfully targeted cancer-related cognitive decline in previously published pilot research. Participants were 29 cancer survivors who were randomly allocated to either the intervention group or a waitlist group who received the intervention at a later date, and 16 demographically matched community volunteers with no history of cancer (trial registration ACTRN12615000009516, available at http://www.ANZCTR.org.au/ACTRN12615000009516.aspx). The study was the first to include an adapted version of the Traumatic Brain Injury Self-Efficacy Scale to assess cognitive self-efficacy (CSE) in people who have experienced cancer. Results revealed participating in the intervention was associated with significantly faster performance on one objective cognitive task that measures processing speed and visual scanning. Significantly larger improvements for the intervention group were also found on measures of perceived cognitive impairments and CSE. There was some evidence to support the roles of CSE and illness perceptions as potential mechanisms of change for the intervention. Overall, the study provided additional evidence of feasibility and efficacy of group psychological intervention for targeting cancer-related cognitive decline.
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Affiliation(s)
- Summer King
- Menzies Health Institute Queensland and School of Applied Psychology, Griffith University, Gold Coast, QLD, Australia
| | - Heather Joy Green
- Menzies Health Institute Queensland and School of Applied Psychology, Griffith University, Gold Coast, QLD, Australia
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Besse KTC, Faber-te Boveldt ND, Janssen GHP, Vernooij-Dassen M, Vissers KCP, Engels Y. Pain Assessment with Short Message Service and Interactive Voice Response in Outpatients with Cancer and Pain: A Feasibility Study. Pain Pract 2015; 16:320-6. [DOI: 10.1111/papr.12278] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Revised: 09/17/2014] [Accepted: 11/06/2014] [Indexed: 11/27/2022]
Affiliation(s)
- Kees T. C. Besse
- Department of Anesthesiology, Pain and Palliative Medicine; Radboud University Nijmegen Medical Centre; Nijmegen the Netherlands
| | - Nienke D. Faber-te Boveldt
- Department of Anesthesiology, Pain and Palliative Medicine; Radboud University Nijmegen Medical Centre; Nijmegen the Netherlands
| | - Ge H. P. Janssen
- Department of Anesthesiology, Pain and Palliative Medicine; Radboud University Nijmegen Medical Centre; Nijmegen the Netherlands
| | - Myrra Vernooij-Dassen
- Scientific Institute for Quality of Healthcare; Radboud University Nijmegen Medical Centre; Nijmegen the Netherlands
- Department of Primary and Community Care; Radboud University Nijmegen Medical Centre; Nijmegen the Netherlands
- Kalorama Foundation; Beek-Ubbergen the Netherlands
| | - Kris C. P. Vissers
- Department of Anesthesiology, Pain and Palliative Medicine; Radboud University Nijmegen Medical Centre; Nijmegen the Netherlands
| | - Yvonne Engels
- Department of Anesthesiology, Pain and Palliative Medicine; Radboud University Nijmegen Medical Centre; Nijmegen the Netherlands
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Catania G, Beccaro M, Costantini M, Ugolini D, De Silvestri A, Bagnasco A, Sasso L. Effectiveness of complex interventions focused on quality-of-life assessment to improve palliative care patients' outcomes: a systematic review. Palliat Med 2015; 29:5-21. [PMID: 24938651 DOI: 10.1177/0269216314539718] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND One of the most crucial palliative care challenges is in determining how patient' needs are defined and assessed. Assessing quality of life has been defined as a priority in palliative care, and it has become a central concept in palliative care practice. AIM To determine to what extent interventions focused on measuring quality of life in palliative care practice are effective in improving outcomes in palliative care patients. DESIGN Systematic review according to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and hand searches. DATA SOURCES MEDLINE, CINAHL, EMBASE, PsycINFO, and the Cochrane Library were searched for articles published until June 2012, and through hand searching from references lists of included articles. Only studies that included adult palliative care patients, in any palliative care clinical practice setting of care, and with an experimental, quasi-experimental, or observational analytical study design were eligible for inclusion. All studies were independently reviewed by two investigators who scored them for methodological quality by using the Edwards Method Score. RESULTS In total, 11 articles (of 8579) incorporating information from 10 studies were included. Only three were randomized controlled trials. The quality of the evidence was found from moderate to low. Given a wide variability among patients' outcomes, individual effect size (ES) was possible for 6 out of 10 studies, 3 of which found a moderate ES on symptoms (ES = 0.68) and psychological (ES = 0.60) and social (ES = 0.55) dimensions. CONCLUSION Effectiveness of interventions focused on quality-of-life assessment is moderate. Additional studies should explore the complexity of the real palliative care world more accurately and understand the effects of independent variables included in complex palliative care interventions.
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Affiliation(s)
- Gianluca Catania
- U.O.S. Regional Palliative Care Network, IRCCS Azienda Ospedaliera Universitaria San Martino-IST-Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Monica Beccaro
- Academy of Sciences of Palliative Medicine, Bologna, Italy
| | - Massimo Costantini
- Palliative Care Unit, IRCCS Arcispedale S Maria Nuova, Reggio Emilia, Italy
| | - Donatella Ugolini
- Department of Internal Medicine, University of Genoa, Genoa, Italy Unit of Clinical Epidemiology, IRCCS Azienda Ospedaliera Universitaria San Martino-IST-Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy
| | | | | | - Loredana Sasso
- Department of Health Sciences, University of Genoa, Genoa, Italy
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Bogaardt H, Veerbeek L, Kelly K, van der Heide A, van Zuylen L, Speyer R. Swallowing problems at the end of the palliative phase: incidence and severity in 164 unsedated patients. Dysphagia 2014; 30:145-51. [PMID: 25533181 DOI: 10.1007/s00455-014-9590-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 12/04/2014] [Indexed: 11/25/2022]
Abstract
Swallowing problems are reported to be a common finding in patients who receive palliative care. In existing literature, the incidence of swallowing problems is mostly described in small numbers of patients at the start of the palliative phase. As we hypothesized that the incidence of dysphagia might increase as the palliative phase progresses, this study describes the incidence of swallowing problems and related problems in 164 unsedated patients at the end of the palliative phase, defined by the last 72 h before their death. To determine the incidence of swallowing problems and related problems, questionnaires were completed bereaved by relatives and nursing staff. Our data shows that in the palliative phase the incidence of swallowing problems can be as high as 79 %. A significant correlation was found between swallowing problems and reduced psycho-social quality of life as assessed by nursing staff (ρ = -.284). Overall the nursing staff rated the incidence and severity of swallowing problems (and related problems like frequent coughing, loss of appetite, and problems with oral secretions) lower than the relatives. This study suggests that incidence of swallowing problems at the end of the palliative phase is high and that these difficulties may not only result in discomfort for patients, but also can raise concern for caregivers. More information and education on management of swallowing problems in palliative settings might be needed for both relatives and nursing staff. However, the data also suggest that any intervention should be proportional to the level of distress caused by the intervention.
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Affiliation(s)
- Hans Bogaardt
- Speech Pathology, Faculty of Health Sciences, The University of Sydney, 75 East Street, Lidcombe, Sydney, NSW, 2141, Australia,
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Kumar SP. Reporting of "quality of life": a systematic review and quantitative analysis of research publications in palliative care journals. Indian J Palliat Care 2012; 18:59-67. [PMID: 22837613 PMCID: PMC3401736 DOI: 10.4103/0973-1075.97475] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
CONTEXT Palliative care clinical practice depends upon an evidence-based decision-making process which in turn is based upon current research evidence. One of the most important goals in clinical palliative care is to improve patients' quality of life (QoL). AIM This study aimed to perform a quantitative analysis of research publications in palliative care journals for reporting characteristics of articles on QoL. SETTINGS AND DESIGN This was a systematic review of palliative care journals. MATERIALS AND METHODS Twelve palliative care journals were searched for articles with "QoL" in the title of the articles published from 2006 to 2010. The reporting rates of all journals were compared. The selected articles were categorized into assessment and treatment, and subsequently grouped into original and review articles. The original articles were subgrouped into qualitative and quantitative studies, and the review articles were grouped into narrative and systematic reviews. Each subgroup of original article category was further classified according to study designs. STATISTICAL ANALYSIS USED Descriptive analysis using frequencies and percentiles was done using SPSS for Windows, version 11.5. RESULTS The overall reporting rate among all journals was 1.95% (71/3634), and Indian Journal of Palliative Care (IJPC) had the highest reporting rate of 5.08% (3/59), followed by Palliative Medicine (PM) with 3.71% (20/538), and Palliative and Supportive Care (PSC) with 3.64% (9/247) reporting. CONCLUSIONS The overall reporting rate for QoL articles in palliative care journals was 1.95% and there were very few randomized clinical trials and systematic reviews found. The study findings indicate further high-quality research to establish an adequate evidence base for QoL.
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Affiliation(s)
- Senthil P Kumar
- Department of Physiotherapy, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India
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Quality Indicators for Care of Cancer Patients in Their Last Days of Life: Literature Update and Experts' Evaluation. J Palliat Med 2012; 15:308-16. [DOI: 10.1089/jpm.2011.0393] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Giesinger JM, Wintner LM, Oberguggenberger AS, Gamper EM, Fiegl M, Denz H, Kemmler G, Zabernigg A, Holzner B. Quality of life trajectory in patients with advanced cancer during the last year of life. J Palliat Med 2011; 14:904-12. [PMID: 21711125 DOI: 10.1089/jpm.2011.0086] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Due to the high mortality of cancer a large number of patients pass a preterminal phase of their illness. Within this phase medical care aims at maintaining patients' quality of life (QOL) and reducing symptom burden. Our study investigated the patient-reported severity of QOL impairments during the last year of life, with a special focus on their course at the end of life. METHODS All patients with cancer receiving palliative care at Natters State Hospital (Austria) were considered as eligible for the study. QOL data were collected with the EORTC QLQ-C30 questionnaire as part of computerized patient-reported outcome monitoring (ePROM) within clinical routine. QOL was investigated longitudinally in regard to its course toward death as well as to changes in determinants of global QOL. RESULTS Eighty-five patients participated in the ePROM (255 assessments in total). Regarding trajectories, physical, role and cognitive functioning, fatigue and global QOL worsened sharply during the last 3 months of life. A steady decline was found for emotional functioning, pain, appetite loss and taste alterations. The impact of role functioning, sleep disturbances, and taste alterations on global QOL increased within the last 3 months of life. CONCLUSION Our results indicate that most aspects of QOL are considerably impaired in patients with advanced cancer. Furthermore, they highlight the importance of assessing QOL in general and taste alterations in particular within palliative care.
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Affiliation(s)
- Johannes M Giesinger
- Department of Psychiatry and Psychotherapy, Innsbruck Medical University, Innsbruck, Austria.
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