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Pross T, Karsten MM, Blohmer JU. From Gaps to Solutions: Semi-Structured Interviews to Identify Care Gaps in Breast Cancer Care and How to Solve Them with Digital Solutions. Geburtshilfe Frauenheilkd 2024; 84:845-854. [PMID: 39229629 PMCID: PMC11368466 DOI: 10.1055/a-2369-1489] [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: 04/15/2024] [Accepted: 07/17/2024] [Indexed: 09/05/2024] Open
Abstract
Background Standardized treatment pathways should make it easier for medical staff and patients to achieve the best possible individual treatment outcome by making sure all relevant information are taken into consideration. The aim of this paper is to identify gaps in care along the treatment pathway through semi-structured patient interviews. Subsequently, it will be discussed if mobile health applications can close these identified gaps in care. Material and Methods Nine semi-structured interviews of patients with invasive lobular breast cancer were conducted in March 2023 in German at the breast cancer center at Charité Universitätsmedizin Berlin, which were subsequently transcribed word for word and processed using a thematic analysis approach. Results Eight recurring themes are identified in the patient interviews: 1. Limited capacity to absorb information, 2. Discrepancy between information needs and information provision, 3. Need for individual initiative, 4. Uncertainty, 5. not being seen and heard, 6. Patient's desires and suggestions for improvement, 7. Use of mobile health apps, 8. Support through an app for patients. Conclusions The identified gaps in care of breast cancer patients can be largely addressed through the use of digital health solutions after the establishment of regulatory frameworks, thus improving care for patients with early breast cancer. Trial Registration The interviews were done within a registry for which ethical approval was obtained by the Ethics Committee of Charité Universitätsmedizin Berlin EA4/180/17.
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Affiliation(s)
- Therese Pross
- Department of Gynecology with Breast Center, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Maria Margarete Karsten
- Department of Gynecology with Breast Center, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Jens-Uwe Blohmer
- Department of Gynecology with Breast Center, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
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2
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Harris E, Yorke J, Law K, Winter-Roach MB, Taylor S. Advanced Ovarian Cancer Patients' Experiences of Surgical Treatment: A Qualitative Analysis. Semin Oncol Nurs 2024; 40:151679. [PMID: 38890076 DOI: 10.1016/j.soncn.2024.151679] [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: 02/27/2024] [Revised: 05/17/2024] [Accepted: 05/20/2024] [Indexed: 06/20/2024]
Abstract
OBJECTIVES Recommended treatment for advanced ovarian cancer involves a combination of debulking surgery and chemotherapy. Surgery places a significant burden on a patient's physical, social, sexual, and emotional wellbeing. Existing research exploring the impact of surgery is often limited to questionnaire administration with large gaps between data collection time points, missing key aspects of the perioperative period. Little is known of the experience of ovarian cancer surgical treatment from a patient perspective. This research aims to qualitatively explore advanced ovarian cancer patients' experience of surgery and identify areas in which quality of life may be impacted. METHODS Semi-structured telephone or face-to-face interviews were conducted with patients who had undergone combined surgical and chemotherapy treatment. Interviews were audio-recorded and transcribed verbatim. Transcripts were analyzed using an inductive approach to thematic analysis. RESULTS Twenty ovarian cancer patients who had undergone debulking surgery participated in interviews lasting between 33 and 68 minutes. Qualitative analysis generated five key themes: (1) care services; (2) experiences of a stoma; (3) preoperative experience; (4) impact of surgery; and (5) coping mechanisms. CONCLUSIONS Understanding the patient experience of surgical treatment for advanced ovarian cancer can help inform and improve future care. This research explored the ways in which a patient's quality of life is impacted by surgery and highlights areas in which further support may be needed. Knowledge of the patient experience may also aid decision-making for both clinicians and patients when considering different treatment pathways. IMPLICATIONS FOR NURSING PRACTICE Results highlighted two crucial points in the surgical pathway where patients' need for emotional support was significant: during pre-op and recovering from surgery as an inpatient. Nursing staff are key to providing reassurance during this time. Specialized stoma nurses were also essential for supporting patients to adapt to their stomas both physically and psychologically.
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Affiliation(s)
- Emily Harris
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Janelle Yorke
- School of Nursing, The Hong Kong Polytechnic University, Manchester, Kowloon, Hong Kong, SAR, China
| | - Kate Law
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Manchester, United Kingdom; Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine & Health, University of Manchester, United Kingdom
| | - Mr Brett Winter-Roach
- Department of Gynaecology, Clinical Support and Specialist Surgery, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Sally Taylor
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Manchester, United Kingdom; Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine & Health, University of Manchester, United Kingdom.
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Jeon JH, Adams M, Higgins MG, Vemuru SR, Ludwigson AM, Huynh V, Baurle E, Rojas K, Matlock DD, Lee C, Kim S, Tevis S. Breast Cancer Surgery: A Qualitative Exploration of Concerns Over Time. J Surg Res 2024; 300:272-278. [PMID: 38830302 PMCID: PMC11345857 DOI: 10.1016/j.jss.2024.05.019] [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: 12/04/2023] [Revised: 05/07/2024] [Accepted: 05/09/2024] [Indexed: 06/05/2024]
Abstract
INTRODUCTION As outcomes for breast cancer patients improve, addressing the side effects and distress of treatment can optimize survivorship. Although distress in breast cancer is well known in literature, there is a lack of information on how these concerns change through the phases of the cancer care continuum. Therefore, this study investigates the longitudinal trajectory of worry in patients with nonmetastatic breast cancer. METHODS Female patients with newly diagnosed stage I-III breast cancer comprised a mixed-methods, longitudinal study at a cancer center from June 2019 to June 2023. Patients completed an open-ended survey regarding their top three concerns. Responses were obtained before surgery and two weeks, three, six, nine months, and one year postoperatively. Responses were qualitatively coded and analyzed to determine themes of cancer-related distress. RESULTS Participants (n = 262) were aged an average 57.53 y (±12.54), 65.8% had stage I disease at diagnosis, and 91.1% were White. Responses revealed that patients' top three sources of concerns varied by treatment phase. Overall, patients were worried about their cancer diagnosis and the risk of recurrence. Preoperatively, patients were worried about treatment timeline, while postoperative concerns transitioned to physical appearance and surgical side effects. CONCLUSIONS Breast cancer patients consistently reported worries about cancer diagnosis, recurrence, and metastasis as well as the side effects and fear of treatments. However, patient worry appeared to be intrinsically linked with their treatment phase. Therefore, support and interventions should be catered to reflect the changing patterns of patients' sources of distress to optimize breast cancer patients' quality of life.
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Affiliation(s)
- Jasmine H Jeon
- Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts.
| | - Monica Adams
- Adult and Child Center for Outcomes Research and Delivery Science (ACCORDS), University of Colorado Anschutz Medical Center, Aurora, Colorado
| | - Madeline G Higgins
- Department of Surgery, University of Colorado Anschutz Medical Center, Aurora, Colorado
| | - Sudheer R Vemuru
- Department of Surgery, University of Colorado Anschutz Medical Center, Aurora, Colorado
| | | | - Victoria Huynh
- Department of Surgery, University of Colorado Anschutz Medical Center, Aurora, Colorado
| | - Erin Baurle
- Division of Medical Oncology, Department of Medicine, University of Colorado Anschutz Medical Center, Aurora, Colorado
| | - Kristin Rojas
- Division of Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Dan D Matlock
- Division of Geriatric Medicine, University of Colorado Anschutz Medical Center, Aurora, Colorado
| | - Clara Lee
- Division of Surgery, University of North Carolina, Chapel Hill, North Carolina
| | - Simon Kim
- Department of Surgery, University of Colorado Anschutz Medical Center, Aurora, Colorado; Division of Urology, University of Colorado Anschutz Medical Center, Aurora, Colorado
| | - Sarah Tevis
- Department of Surgery, University of Colorado Anschutz Medical Center, Aurora, Colorado
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4
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Güvener YÖ. The Significance of Religion and Spirituality Among Turkish Women Surviving Breast Cancer Without Treatment: A Qualitative Study. JOURNAL OF RELIGION AND HEALTH 2024; 63:2727-2744. [PMID: 38619687 PMCID: PMC11319412 DOI: 10.1007/s10943-024-02039-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/20/2024] [Indexed: 04/16/2024]
Abstract
The health of breast cancer survivors is a global concern. It is crucial to adopt a holistic approach when understanding their journey from illness to wellness in order to ensure that the transition is as smooth as possible. This study focused on the experiences of Muslim women who had overcome breast cancer and were adapting to life post-treatment. Snowball sampling was used to select the participants for this qualitative study. Fifteen women who had successfully completed breast cancer treatment and been declared cancer-free were interviewed. These interviews were semi-structured, using open-ended questions to explore their experiences in-depth. The interviews were conducted by phone, and the data were analyzed using qualitative content analysis. The study identified four main themes, nine subthemes, and 41 codes. The main themes were as follows: (a) a life changed by cancer and the difficulties encountered; (b) transition from active treatment to treatment-free living; (c) coping mechanisms; and (d) future hopes and expectations. The findings highlighted the survivors' desire to move past their experience of cancer and normalize their lives, as well as emphasizing their need for support. The participants shared detailed accounts of their journey, the obstacles they encountered during this transition, and the critical role of religion and spirituality in overcoming these challenges. Understanding and effectively managing the experiences of women after breast cancer treatment is vital not only for improving survival rates but also for facilitating their healing process.
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Clougher D, Ciria-Suarez L, Medina JC, Anastasiadou D, Racioppi A, Ochoa-Arnedo C. What works in peer support for breast cancer survivors: A qualitative systematic review and meta-ethnography. Appl Psychol Health Well Being 2024; 16:793-815. [PMID: 37493002 DOI: 10.1111/aphw.12473] [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: 01/23/2023] [Accepted: 07/06/2023] [Indexed: 07/27/2023]
Abstract
Breast cancer is associated with adverse physical and psychological consequences. Although research has identified the various benefits linked to psychosocial interventions, mixed results have been found in relation to peer support. The aim of the present systematic review and meta-ethnography is to explore the qualitative evidence on the experience of breast cancer survivors in peer support. A systematic search of the literature was conducted until June 2023, and a meta-ethnographic approach was used to synthesize the included papers. Eleven articles were included, collecting the experience of 345 participants. The following four core areas involved in peer support implementation were identified from the synthesis: Peer support can create understanding and a mutual therapeutic and emotional connection; peer support can facilitate an educational and supportive patient-centered journey; peer support should monitor group members for unpleasant emotional experiences; peer support should have professional supervision of recruitment and training to prioritize quality. These results can be used as patient-centered insights by healthcare professionals to provide evidence-informed peer support programs and address current limitations in the field.
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Affiliation(s)
- Derek Clougher
- eHealth ICOnnecta't and Psycho-Oncology Services, Institut Català d'Oncologia, Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Laura Ciria-Suarez
- eHealth ICOnnecta't and Psycho-Oncology Services, Institut Català d'Oncologia, Barcelona, Spain
- Psycho-Oncology and Digital Health Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain
| | - Joan C Medina
- eHealth ICOnnecta't and Psycho-Oncology Services, Institut Català d'Oncologia, Barcelona, Spain
- Psycho-Oncology and Digital Health Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain
- Department of Psychology and Education Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
- Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain
| | - Dimitra Anastasiadou
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Anna Racioppi
- Psycho-Oncology and Digital Health Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain
| | - Cristian Ochoa-Arnedo
- eHealth ICOnnecta't and Psycho-Oncology Services, Institut Català d'Oncologia, Barcelona, Spain
- Psycho-Oncology and Digital Health Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain
- Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain
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Heidkamp P, Hiltrop K, Breidenbach C, Kowalski C, Pfaff H, Geiser F, Ernstmann N. Coping with breast cancer during medical and occupational rehabilitation: a qualitative study of strategies and contextual factors. BMC Womens Health 2024; 24:183. [PMID: 38504261 PMCID: PMC10949761 DOI: 10.1186/s12905-024-03012-3] [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: 04/20/2023] [Accepted: 03/05/2024] [Indexed: 03/21/2024] Open
Abstract
PURPOSE This study aimed to gain a deeper understanding of the coping processes of breast cancer survivors (BCSs) during medical and occupational rehabilitation after acute treatment. METHODS This study is part of the mixed-methods Breast Cancer Patients' Return to Work study conducted in Germany. Data were collected through semistructured interviews with 26 female BCSs 5-6 years after their diagnosis. A qualitative content analysis was conducted to investigate the coping strategies and contextual factors of coping of BCSs. RESULTS The participants used different strategies for coping with their breast cancer, namely, approach- versus avoidance-oriented coping and emotion- versus problem-focused coping. During the medical rehabilitation process, coping behavior was used mainly to address disease management and its consequences. During the occupational rehabilitation process, most coping strategies were used to overcome discrepancies between the patient's current work capacity and the job requirements. The contextual factors of coping were in the health, healthcare, work-related, and personal domains. CONCLUSION The study findings provide in-depth insights into the coping processes for BCSs during the rehabilitation phase and highlight the importance of survivorship care after acute cancer treatment. IMPLICATIONS FOR CANCER SURVIVORS The results indicate that BCSs employ approach- and avoidance-oriented strategies to cope with their cancer during rehabilitation. As both attempts are helpful in the short term to cope with physical and emotional consequences of the cancer, healthcare and psychosocial personnel should respect the coping strategies of BCSs while also being aware of the potential long-term negative impact of avoidance-oriented coping on the rehabilitation process.
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Affiliation(s)
- Paula Heidkamp
- University Hospital Bonn, Department for Psychosomatic Medicine and Psychotherapy, Center for Health Communication and Health Services Research, Bonn, Germany.
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Chair of Health Services Research, Cologne, Germany.
- University Hospital Bonn, Center for Integrated Oncology, Bonn, Germany.
| | - Kati Hiltrop
- University Hospital Bonn, Department for Psychosomatic Medicine and Psychotherapy, Center for Health Communication and Health Services Research, Bonn, Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Chair of Health Services Research, Cologne, Germany
- University Hospital Bonn, Center for Integrated Oncology, Bonn, Germany
| | - Clara Breidenbach
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Chair of Health Services Research, Cologne, Germany
- German Cancer Society, Berlin, Germany
| | | | - Holger Pfaff
- University of Cologne, Faculty of Human Sciences & Faculty of Medicine and University Hospital Cologne, Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Chair of Quality Development and Evaluation in Rehabilitation, Cologne, Germany
| | - Franziska Geiser
- University Hospital Bonn, Department of Psychosomatic Medicine and Psychotherapy, Bonn, Germany
| | - Nicole Ernstmann
- University Hospital Bonn, Department for Psychosomatic Medicine and Psychotherapy, Center for Health Communication and Health Services Research, Bonn, Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Chair of Health Services Research, Cologne, Germany
- University Hospital Bonn, Center for Integrated Oncology, Bonn, Germany
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Hulse SB, Balogun Z, Rosenzweig MQ, Marsland AL, Palmer VM. I'm still me, I'm still a person: war metaphor use and meaning making in women with metastatic breast cancer. Support Care Cancer 2024; 32:108. [PMID: 38231307 PMCID: PMC10794408 DOI: 10.1007/s00520-024-08309-5] [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: 08/14/2023] [Accepted: 01/08/2024] [Indexed: 01/18/2024]
Abstract
PURPOSE The war metaphor is one strategy used frequently in breast cancer to inspire individuals in a "fight" against cancer and assist patients in navigating their illness experience. Despite prominent use, the emotional impact of this language has not been examined in the context of meaning making among women with metastatic breast cancer (MBC). METHODS This study involved a semi-structured interview considering the war metaphor's impact on women's illness experience with MBC. Participants (n = 22) had been diagnosed with MBC for at least 6 months or following 1 disease progression and were undergoing treatment at an NCI-designated cancer center in Western Pennsylvania at the time of interview. Each participant underwent an individual interview exploring the war metaphor's impact on illness experience. Qualitative thematic analysis was performed to assess feelings about the war metaphor and emotional response to the lived experience of cancer. RESULTS Two themes were identified surrounding metaphor use and participants' experiences with meaning making in cancer. First, women with MBC perceive the diagnosis as an "unfair fight" due to its incurable nature. Second, patients use alternative language of "living life" and communicate resistance to being defined by their cancer diagnosis. CONCLUSION War metaphors are one collection of terminology people use to understand their diagnosis. However, their use may apply pressure to prioritize positivity in the face of diagnosis and treatment, in a unique clinical context where this may not be adaptive. These findings affirm a need to consider patients' lived experiences to best facilitate psychological adjustment to illness.
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Affiliation(s)
- Sarah B Hulse
- Department of Psychology, Kenneth P. Dietrich School of Arts and Sciences, University of Pittsburgh, Pittsburgh, PA, USA.
- Division of Breast Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, 19104, USA.
| | - Zainab Balogun
- School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Anna L Marsland
- Department of Psychology, Kenneth P. Dietrich School of Arts and Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Vanessa M Palmer
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
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Keikhaee R, Sanaat Z, Mousavi S, Shaghaghi A. Cross-Cultural Adaptation and Psychometric Validation of the Interview Satisfaction Questionnaire (ISQ) to Assess Unmet Health Communication Needs of Iranian Breast Cancer Patients. HEALTH COMMUNICATION 2023:1-11. [PMID: 38053361 DOI: 10.1080/10410236.2023.2288712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
Autonomous and patient-centered health communication (PCHC) between a healthcare provider (HCP) and a client (HCC) is a critical fundament for successful healthcare outcomes. A standard and validated data collection tool for studying the satisfaction of Iranian breast cancer patients (BCPs) with various aspects of their health communication with HCPs does not exist. The current study assessed the application, feasibility, and cultural appropriateness of the Persian-translated version of the interview satisfaction questionnaire (ISQ) in the Iranian context. A standard translation/back-translation procedure was used to prepare a preliminary Persian version of the ISQ (ISQ-P) which was then evaluated for content and face validity by a panel of experts. The study data were collected from 200 breast cancer patients and used to estimate the internal consistency measure of Cronbach's alpha and intra-class correlation coefficient. Confirmatory factor analysis (CFA) was performed to verify the compatibility of the instrument's identified dimensions with the original ISQ's factor structure. The calculated content validity index (CVI = 0.89), content validity ratio (CVR = 0.49), and Cronbach's alpha coefficient (0.79) indicated the appropriateness of the ISQ-P for its intended purpose. The CFA's outputs (root mean square error of approximation (RMSEA) = 0.09, comparative fit index (CFI) = 0.954, Tucker-Lewis index (TLI) = 0.931, standardized root mean square residual (SRMR) = 0.04) affirmed the fitness of the study data to the original 4-factor conceptual model. The study findings supported the suitability of ISQ-P for assessing health communication episodes by Persian-speaking BCPs. However, due to cultural variation, cross-border diversity of health systems, and organizational circumstances, further validity and reliability appraisal of the ISQ-P in distinct sub-samples is recommended.
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Affiliation(s)
- Razieh Keikhaee
- Department of Health Education and Promotion, Faculty of Health, Tabriz University of Medical Sciences
| | - Zohreh Sanaat
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences
| | - Saeid Mousavi
- Department of Bio-Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences
| | - Abdolreza Shaghaghi
- Department of Health Education and Promotion, Faculty of Health, Tabriz University of Medical Sciences
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Parkin S, Neale J, Strang J. Conceptualising retention in treatment with long-acting injectable buprenorphine (for opioid use disorder) as a journey: Findings from a longitudinal qualitative study. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 122:104221. [PMID: 37865052 DOI: 10.1016/j.drugpo.2023.104221] [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: 07/27/2023] [Revised: 09/22/2023] [Accepted: 09/27/2023] [Indexed: 10/23/2023]
Abstract
BACKGROUND Conceptualisations of the 'patient journey' are popular within health service research. Patient journeys provide a person-centred approach to health care that typically prioritise subjective patient experience with the aim of improving relevant forms of intervention. This article explores the conceptualisation of retention in treatment for opioid use disorder (OUD) using long-acting injectable buprenorphine (LAIB) as a journey. METHODS Data derive from a longitudinal qualitative study, involving semi-structured interviews (held at six time-points), with participants who each initiated LAIB for the first time. Data analysis for this article focuses exclusively upon the experiences of those who had continued with LAIB treatment throughout one year (11 participants). Framework and thematic narrative analyses of 64 interviews with 11 participants sought to identify 'retention-narratives' that would indicate a 'retention journey' associated with LAIB treatment. FINDINGS Shared treatment experiences consisted of three distinct phases (Withdrawal and Separation, Transformation, and Engagement) that progressed in a linear and intersecting manner through time. Each phase had features that defined treatment experiences at a given time but changed as treatment progressed. All 11 participants experienced multiple features within each of the three treatment phases and all participants reported separation from their respective service provider throughout the first 12 months of treatment. Although some valued the latter separation, most were dissatisfied by reduced levels of contact. CONCLUSION Retention in treatment for OUD with LAIB, for at least 12-months, can be conceptualised as a journey. This conceptualisation emphasises the benefits (and challenges) clinicians and patients may expect to encounter during the first year of a LAIB treatment programme. An added implication of conceptualising LAIB treatment in this manner is that optimal benefits of the medication (as observed by participants) began to emerge during 'months 7-12' of the retention journey.
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Affiliation(s)
- Stephen Parkin
- National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, SE5 8BB, UK.
| | - Joanne Neale
- National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, SE5 8BB, UK; Centre for Social Research in Health, University of New South Wales, NSW 2052, Australia
| | - John Strang
- National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, SE5 8BB, UK; South London & Maudsley (SLaM) NHS Foundation Trust, London SE5 8AZ, UK
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Campaña C, Cabieses B, Obach A, Vezzani F. " Healthcare should be the same for everyone": perceived inequities in therapeutic trajectories of adult patients with lung cancer in Chile, a qualitative study. Front Public Health 2023; 11:1228304. [PMID: 37663832 PMCID: PMC10468573 DOI: 10.3389/fpubh.2023.1228304] [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: 06/01/2023] [Accepted: 07/19/2023] [Indexed: 09/05/2023] Open
Abstract
Background Globally, it has been reported that different social determinants of health affect health outcomes in lung cancer (LC). Research on the therapeutic trajectories of patients (TTP) is a novel field for identifying barriers and facilitators in health. The objective of this study was to reveal perceived differences in TTP with LC in Chile according to selected social determinants of health (SDH) and the experiences of patients, health professionals, and civil society leaders. Methods This is a qualitative paradigm, one case-study design. Online semi-structured interviews were conducted with patients with LC, health professionals, and civil society leaders. The strategies for the recruitment process included social networks, civil society organizations, health professionals, and the snowball technique. A thematic analysis was carried out. Results Selected SDH impact LC's TTP in Chile, particularly concerning health system access, health services, information, and patient navigation experiences. The analysis of the experiences of the participants allowed us to identify barriers related to the selected SDH in three stages of the TTP: initiation, examinations, and diagnosis and treatment. Individuals with limited education, those residing outside the capital, women, and those in the public health system encountered more barriers throughout their TTP. Discussion Study findings suggest that being a woman with low education, from the public health system, and not from the capital might represent one of the most powerful intersections for experiencing barriers to effective healthcare in LC in Chile. It is necessary to monitor the TTP from an SDH perspective to guarantee the rights of access, opportunity, quality, and financial protection.
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Affiliation(s)
- Carla Campaña
- Centre of Global Intercultural Health (CeSGI) ICIM, Universidad del Desarrollo, Santiago, Chile
- Programa de Doctorado en Ciencias e Innovación en Medicina (DCIM), Universidad del Desarrollo, Santiago, Chile
| | - Báltica Cabieses
- Centre of Global Intercultural Health (CeSGI) ICIM, Universidad del Desarrollo, Santiago, Chile
- Center for Cancer Prevention and Control (CECAN), ANID FONDAP 152220002, Santiago, Chile
| | - Alexandra Obach
- Centre of Global Intercultural Health (CeSGI) ICIM, Universidad del Desarrollo, Santiago, Chile
- Center for Cancer Prevention and Control (CECAN), ANID FONDAP 152220002, Santiago, Chile
| | - Francisca Vezzani
- Centre of Global Intercultural Health (CeSGI) ICIM, Universidad del Desarrollo, Santiago, Chile
- Center for Cancer Prevention and Control (CECAN), ANID FONDAP 152220002, Santiago, Chile
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Wu S, Zhao L, Li Q. Stomatin-like protein-2 contributes the migration and invasion of breast cancer cells via regulating ERK/FOXO3a signaling pathway. CHINESE J PHYSIOL 2023; 66:257-265. [PMID: 37635485 DOI: 10.4103/cjop.cjop-d-22-00117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023] Open
Abstract
Breast cancer (BC) is the most common tumor in women, and its incidence is increasing, ranking first among female malignant tumors. It is urgently needed to find new and reliable biomarkers of BC and to understand the cellular changes that cause metastasis. Stomatin-like protein-2 (SLP-2) is a member of the stomatin protein superfamily. Studies have shown that SLP-2 was highly expressed in some tumors and played an important role in tumor genesis and development. SLP-2 regulated the extracellular signal-regulated kinase (ERK) pathway, and activation of ERK phosphorylated FOXO3a, which was involved in BC progression. However, its possible role in the progression of BC remains unclear. In this study, we found the high expression of SLP-2 in BC tissues and cells. SLP-2 promoted the viability of BC cells. In addition, we found that SLP-2 stimulated the motility of BC cells in vitro. Mechanically, our results revealed that SLP-2 could mediate FOXO3a expression and ERK signaling pathway, thereby contributing to the viability and motility of BC cells. Therefore, SLP-2 has the potential to serve as a promising target for BC treatment.
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Affiliation(s)
- Shengming Wu
- Department of Breast Surgery, Nanjing Liuhe District Hospital of Traditional Chinese Medicine, Nanjing, Jiangsu, China
| | - Lingang Zhao
- Department of Pharmacy, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Qian Li
- Key Laboratory of Particle and Radiation Imaging, Ministry of Education, Department of Engineering Physics, Tsinghua University, Beijing, China
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Álvarez-Pérez Y, Duarte-Díaz A, Toledo-Chávarri A, Abt-Sacks A, Ramos-García V, Torres-Castaño A, Rivero-Santana A, Perestelo-Pérez L. Digital Health Literacy and Person-Centred Care: Co-Creation of a Massive Open Online Course for Women with Breast Cancer. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3922. [PMID: 36900935 PMCID: PMC10001393 DOI: 10.3390/ijerph20053922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/20/2023] [Accepted: 02/21/2023] [Indexed: 06/18/2023]
Abstract
The diagnosis of breast cancer (BC) can make the affected person vulnerable to suffering the possible consequences of the use of low-quality health information. Massive open online courses (MOOCs) may be a useful and efficient resource to improve digital health literacy and person-centred care in this population. The aim of this study is to co-create a MOOC for women with BC, using a modified design approach based on patients' experience. Co-creation was divided into three sequential phases: exploratory, development and evaluation. Seventeen women in any stage of BC and two healthcare professionals participated. In the exploratory phase, a patient journey map was carried out and empowerment needs related to emotional management strategies and self-care guidelines were identified, as well as information needs related to understanding medical terminology. In the development phase, participants designed the structure and contents of the MOOC through a Moodle platform. A MOOC with five units was developed. In the evaluation phase, participants strongly agreed that their participation was useful for the MOOC's development and participating in the co-creation process made the content more relevant to them (experience in the co-creation); most of the participants positively evaluated the content or interface of the MOOC (acceptability pilot). Educational interventions designed by women with BC is a viable strategy to generate higher-quality, useful resources for this population.
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Affiliation(s)
- Yolanda Álvarez-Pérez
- Canary Islands Health Research Institute Foundation (FIISC), 38109 Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 38109 Tenerife, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), 28029 Madrid, Spain
| | - Andrea Duarte-Díaz
- Canary Islands Health Research Institute Foundation (FIISC), 38109 Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 38109 Tenerife, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), 28029 Madrid, Spain
| | - Ana Toledo-Chávarri
- Canary Islands Health Research Institute Foundation (FIISC), 38109 Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 38109 Tenerife, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), 28029 Madrid, Spain
| | - Analía Abt-Sacks
- Canary Islands Health Research Institute Foundation (FIISC), 38109 Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 38109 Tenerife, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), 28029 Madrid, Spain
| | - Vanesa Ramos-García
- Canary Islands Health Research Institute Foundation (FIISC), 38109 Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 38109 Tenerife, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), 28029 Madrid, Spain
| | - Alezandra Torres-Castaño
- Canary Islands Health Research Institute Foundation (FIISC), 38109 Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 38109 Tenerife, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), 28029 Madrid, Spain
| | - Amado Rivero-Santana
- Canary Islands Health Research Institute Foundation (FIISC), 38109 Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 38109 Tenerife, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), 28029 Madrid, Spain
| | - Lilisbeth Perestelo-Pérez
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 38109 Tenerife, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), 28029 Madrid, Spain
- Evaluation Unit (SESCS), Canary Islands Health Service (SCS), 38109 Tenerife, Spain
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A Digital Cancer Ecosystem to Deliver Health and Psychosocial Education as Preventive Intervention. Cancers (Basel) 2022; 14:cancers14153724. [PMID: 35954388 PMCID: PMC9367518 DOI: 10.3390/cancers14153724] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 07/27/2022] [Accepted: 07/28/2022] [Indexed: 12/04/2022] Open
Abstract
Health education and psychosocial interventions prevent emotional distress, and the latter has been shown to have an impact on survival. In turn, digital health education interventions may help promote equity by reaching a higher number of cancer patients, both because they avoid journeys to the hospital, by and having a better efficiency. A total of 234 women recently diagnosed with breast cancer in a comprehensive cancer center used the digital ecosystem ICOnnecta’t from March 2019 to March 2021. ICOnnecta’t consists of four care levels, provided to patients according to their level of distress. The second level of this intervention consists of an educational campus, which was analyzed to track users’ interests and their information-seeking behavior. Overall, 99 out of 234 women (42.3%) used the educational campus. There were no significant differences in sociodemographic and clinical variables between the campus users and non-users. Among users, the median number of resources utilized per user was four (interquartile range: 2−9). Emotional and medical resources were the contents most frequently viewed and the audiovisual format the most consulted (p < 0.01). Resources were used mainly within the first three months from enrolment. Users who were guided to visit the virtual campus were more active than spontaneous users. Offering an early holistic health educational platform inside a digital cancer ecosystem, with health professionals involved, can reach more patients, promoting equity in the access of cancer information and prevention, from the very beginning of the disease.
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Gomez D, Carmona-Bayonas A, Hernandez R, Higuera O, Rogado J, Pacheco-Barcia V, Valero M, Gil-Raga M, Mar Muñoz M, Carrión-Galindo R, Jimenez-Fonseca P, Calderon C. Stoic attitude in patients with cancer from the NEOcoping study: Cross-sectional study. PLoS One 2022; 17:e0269712. [PMID: 35901019 PMCID: PMC9333303 DOI: 10.1371/journal.pone.0269712] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 05/26/2022] [Indexed: 11/20/2022] Open
Abstract
Aim Stoicism has been applied to describe a wide range of behaviors in the face of disease and influences an individual’s use of coping strategies. This study tested the relationship between stoicism and social support, optimism, psychological distress, and coping strategies in patients with cancer. Method NEOcoping is a multicenter, cross-sectional study. Participants’ data were collected using a standardized, self-report form and LSS, MSPSS, Mini-MAC, BSI-18, and LOT-R questionnaires. Linear regression analyses were used to assess the association between stoicism and distress scores in both genders. A total of 932 individuals with non-metastatic, resected cancer were recruited. Results Males perceived a higher risk of recurrence and toxicity with adjuvant chemotherapy and obtained higher stoic attitude scores than females. Women scored higher on somatization, depression, and anxiety. Patients with high stoicism scores were older and experienced more maladaptive coping (helplessness, anxious preoccupation), and depression, while those with lower stoicism scores had greater perceived social support, optimism, and positive attitude. In both males and females, stoicism correlated negatively with perceived social support, optimism, and positive attitude, and positively with helplessness, anxious preoccupation, and depression. In men, stoicism was directly and negatively associated with social support and optimism, and positively with anxious preoccupation. In women, stoicism was positively associated. In women, stoicism was directly and negatively associated with social support and positively with age and optimism. Stoicism was directly and positively associated with helplessness. Discussion A stoic attitude was associated with lower social support, reduced optimism, and passive coping strategies (helplessness and anxious preoccupation) in this series of patients with cancer.
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Affiliation(s)
- David Gomez
- Department of Medical Oncology, Hospital Universitario Central of Asturias, IPSA, Oviedo, Spain
| | - Alberto Carmona-Bayonas
- Department of Hematology and Medical Oncology, Hospital Universitario Morales Meseguer, Instituto Murciano de Investigación Biosanitaria (IMIB), UMU, Murcia, Spain
| | - Raquel Hernandez
- Department of Medical Oncology, Hospital Universitario de Canarias, Tenerife, Spain
| | - Oliver Higuera
- Department of Medical Oncology, Hospital Universitario La Paz, Madrid, Spain
| | - Jacobo Rogado
- Department of Medical Oncology, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - Vilma Pacheco-Barcia
- Department of Medical Oncology, Hospital Central de la Defensa Gomez Ulla, Madrid, Spain
| | - María Valero
- Department of Medical Oncology, Hospital Quirón salud Sagrado Corazón, Sevilla, Spain
| | - Mireia Gil-Raga
- Department of Medical Oncology, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
| | - Mª Mar Muñoz
- Department of Medical Oncology, Hospital Virgen de La Luz, Cuenca, Spain
| | - Rafael Carrión-Galindo
- Department of Medical Oncology, Hospital Universitario del Sureste, Arganda del Rey-Madrid, Spain
| | | | - Caterina Calderon
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona, Spain
- * E-mail:
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