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Armache M, Assi S, Wu R, Jain A, Lu J, Gordon L, Jacobs LM, Fundakowski CE, Rising KL, Leader AE, Fakhry C, Mady LJ. Readability of Patient Education Materials in Head and Neck Cancer: A Systematic Review. JAMA Otolaryngol Head Neck Surg 2024; 150:713-724. [PMID: 38900443 DOI: 10.1001/jamaoto.2024.1569] [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: 06/21/2024]
Abstract
Importance Patient education materials (PEMs) can promote patient engagement, satisfaction, and treatment adherence. The American Medical Association recommends that PEMs be developed for a sixth-grade or lower reading level. Health literacy (HL) refers to an individual's ability to seek, understand, and use health information to make appropriate decisions regarding their health. Patients with suboptimal HL may not be able to understand or act on health information and are at risk for adverse health outcomes. Objective To assess the readability of PEMs on head and neck cancer (HNC) and to evaluate HL among patients with HNC. Evidence Review A systematic review of the literature was performed by searching Cochrane, PubMed, and Scopus for peer-reviewed studies published from 1995 to 2024 using the keywords head and neck cancer, readability, health literacy, and related synonyms. Full-text studies in English that evaluated readability and/or HL measures were included. Readability assessments included the Flesch-Kincaid Grade Level (FKGL grade, 0-20, with higher grades indicating greater reading difficulty) and Flesch Reading Ease (FRE score, 1-100, with higher scores indicating easier readability), among others. Reviews, conference materials, opinion letters, and guidelines were excluded. Study quality was assessed using the Appraisal Tool for Cross-Sectional Studies. Findings Of the 3235 studies identified, 17 studies assessing the readability of 1124 HNC PEMs produced by professional societies, hospitals, and others were included. The mean FKGL grade ranged from 8.8 to 14.8; none of the studies reported a mean FKGL of grade 6 or lower. Eight studies assessed HL and found inadequate HL prevalence ranging from 11.9% to 47.0%. Conclusions and Relevance These findings indicate that more than one-third of patients with HNC demonstrate inadequate HL, yet none of the PEMs assessed were developed for a sixth grade or lower reading level, as recommended by the American Medical Association. This incongruence highlights the need to address the readability of HNC PEMs to improve patient understanding of the disease and to mitigate potential barriers to shared decision-making for patients with HNC. It is crucial to acknowledge the responsibility of health care professionals to produce and promote more effective PEMs to dismantle the potentially preventable literacy barriers.
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Affiliation(s)
- Maria Armache
- Department of Otolaryngology-Head & Neck Surgery, The Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Sahar Assi
- Cochlear Center for Hearing and Public Health, Johns Hopkins University, Baltimore, Maryland
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Richard Wu
- Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio
| | - Amiti Jain
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Joseph Lu
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Larissa Gordon
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Lisa M Jacobs
- Mixed Methods Research Lab, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Christopher E Fundakowski
- Department of Otolaryngology-Head and Neck Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Kristin L Rising
- Jefferson Center for Connected Care, Thomas Jefferson University, Philadelphia, Pennsylvania
- Department of Emergency Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Amy E Leader
- Department of Population Health, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
- Department of Medical Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
- Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Carole Fakhry
- Department of Otolaryngology-Head & Neck Surgery, The Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Leila J Mady
- Department of Otolaryngology-Head & Neck Surgery, The Johns Hopkins School of Medicine, Baltimore, Maryland
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Shash E, Bektash F, Elhosary M, Emam G, El-Sayed A, Abdelmenam D, Abdulmonem A L Najar R, Eid R. Enhancing Patient Outcomes Through Integrated Education and Navigation Programs at the Breast Cancer Comprehensive Center, National Cancer Institute, Cairo University. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2024:10.1007/s13187-024-02472-3. [PMID: 39012556 DOI: 10.1007/s13187-024-02472-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/20/2024] [Indexed: 07/17/2024]
Abstract
Breast cancer remains a significant global health challenge, particularly in low- and middle-income countries where disparities in healthcare exacerbate the disease burden. The Breast Cancer Comprehensive Center at the National Cancer Institute, Cairo University, has implemented integrated patient navigation and education programs aimed at enhancing patient outcomes and healthcare quality. This study evaluated the effectiveness of these programs involving 2202 participants over 12 months. The methodology included systematic data collection, material preparation, and the application of tailored educational strategies to facilitate the patient's journey from diagnosis to treatment. The study utilized three-phased patient navigation assistance to provide comprehensive support. The programs significantly improved patient satisfaction, with over 90% of participants reporting high levels of contentment with the services received. Key improvements included enhanced understanding of breast cancer (including risk factors, symptoms, importance of seeking early care, and treatment options), reduction in patient anxiety, improved treatment adherence, and streamlined diagnostic and treatment processes. Notably, the use of audio-visual educational tools effectively bridged the literacy gap among patients. The integration of patient navigation and education systems at BCCC-NCI has proven to be a highly effective model for improving breast cancer care. This model not only enhances patient understanding and treatment compliance but also facilitates a more efficient healthcare process. The study underscores the potential for replicating this approach in similar healthcare settings globally, suggesting that such integrations can significantly improve cancer care outcomes.
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Affiliation(s)
- Emad Shash
- Medical Oncology Department, National Cancer Institute, Cairo University, El Khalig Square, Kasr Al Aini Street, Cairo, 11796, Egypt.
- Director of the Breast Cancer Comprehensive Center, National Cancer Institute, Cairo University, Cairo, Egypt.
| | - Fatma Bektash
- Head of Patient Education Unit, Breast Cancer Comprehensive Center, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Mona Elhosary
- Head of Patient Navigation Unit, Breast Cancer Comprehensive Center, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Ghada Emam
- Deputy Director, Breast Cancer Comprehensive Center, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Asmaa El-Sayed
- Quality Unit Coordinator, Breast Cancer Comprehensive Center, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Dalia Abdelmenam
- Outpatient Coordinator, Breast Cancer Comprehensive Center, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Rania Abdulmonem A L Najar
- Outpatient Coordinator, Breast Cancer Comprehensive Center, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Reem Eid
- Deputy Director, Breast Cancer Comprehensive Center, National Cancer Institute, Cairo University, Cairo, Egypt
- Cancer Epidemiology & Statistics Department, National Cancer Institute, Cairo University, Cairo, Egypt
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Romojaro-Pérez C, Navarro-Brazález B, Bailón-Cerezo J, Torres-Lacomba M. Health literacy in prostate cancer: What do Spanish men know about prostate cancer? A cross-sectional descriptive study. Actas Urol Esp 2024:S2173-5786(24)00080-5. [PMID: 38908716 DOI: 10.1016/j.acuroe.2024.06.003] [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: 03/30/2024] [Revised: 05/23/2024] [Accepted: 05/26/2024] [Indexed: 06/24/2024]
Abstract
INTRODUCTION Prostate cancer is the tumor with the highest incidence in Spanish men. The implementation of health literacy and therapeutic education programs adapted to the needs of the population could be a resource to minimize the sequelae derived from the treatments used to combat this pathology. To this end, it would be necessary to know the level of health literacy about prostate cancer. OBJECTIVE To determine the level of health literacy in prostate cancer in the Spanish male population using the validated version of the PCKQ-12 for the Spanish population. METHODOLOGY Cross-sectional, population-based, descriptive study. Spanish-speaking men of legal age were included. To carry out the study, an ad hoc questionnaire was designed on the Google Forms platform, which was distributed via WhatsApp. Previously, it was necessary to validate the PCKQ-12 to the Spanish population in two phases, a first phase for translation and cross-cultural adaptation and a second phase to test the measurement properties. RESULTS The Spanish version of the PCKQ-12 showed good language, conceptual, semantic and content equivalence and could be used to assess health literacy in prostate cancer. Three hundred and seventy Spanish men with a mean age of 43.87 (SD 13.65) years responded to the questionnaire. The level of prostate cancer health literacy found was low (6.72 points), being 2 points higher in health men. CONCLUSION Health literacy about prostate cancer in the Spanish male population is low.
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Affiliation(s)
| | - B Navarro-Brazález
- Grupo de Investigación Fisioterapia en los Procesos de Salud de la Mujer, Unidad Docente de Fisioterapia, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain; Instituto Ramón y Cajal de Investigación-IRYCIS, Hospital Universitario Ramón y Cajal, Madrid, Spain.
| | - J Bailón-Cerezo
- Grupo de Investigación Fisioterapia en los Procesos de Salud de la Mujer, Unidad Docente de Fisioterapia, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain; Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - M Torres-Lacomba
- Grupo de Investigación Fisioterapia en los Procesos de Salud de la Mujer, Unidad Docente de Fisioterapia, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain; Instituto Ramón y Cajal de Investigación-IRYCIS, Hospital Universitario Ramón y Cajal, Madrid, Spain
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Tolstrup LK, Dieperink KB, Van Leeuwen M, Möller S, Fechner L, Clausen LH, Mattsson TO. Health-Related Quality of Life in Danish Cancer Survivors Referred to a Late Effects Clinic: A Prospective Cohort Study. Acta Oncol 2024; 63:426-432. [PMID: 38881340 PMCID: PMC11332500 DOI: 10.2340/1651-226x.2024.39937] [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: 01/24/2024] [Accepted: 05/28/2024] [Indexed: 06/18/2024]
Abstract
PURPOSE The Region of Southern Denmark has recently established four late effects clinics to help cancer survivors suffering from complex and severe late effects. This study aimed to capture and analyze the full range of physical, mental, and psychosocial issues using patient-reported outcomes. Moreover, we aimed to describe demographic data and the type and severity of the late effects. METHODS A prospective cohort study was conducted among cancer survivors referred to a late effects clinic. Before their first appointment, patients completed the European Organization for Research and Treatment of Cancer Quality of Life cancer survivorship core questionnaire (EORTC QLQ-SURV100). We compared mean scores of the EORTC QLQ-SURV100 scales that were comparable to the scales/items from the EORTC QLQ-C30 questionnaire with norm data for the Danish population and EORTC reference values. RESULTS All patients referred to the clinic within its first 2 years were included (n = 247). The mean age was 57 [23-85] years and 74% were females. The most common cancer diagnoses was breast cancer (39%). The five most commonly reported late effects were fatigue (66%), pain (51%), cognitive impairment (53%), sleep problems (42%), and neuropathy (40%). A total of 236 of the patients entering the clinic completed QLQ-SURV100. They reported significantly worse mean scores on all scales compared to the Danish norm population and EORTC reference values for pretreatment cancer patients, p < 0.001. Effect sizes were moderate or large for all scales. INTERPRETATION In this study, we collected demographic data and described the late effects presented by the patents referred to the clinic. Moreover, we captured and analyzed the full range of physical, mental, and psychosocial issues using QLQ-SURV100. Patients referred to the Late Effects Clinic (LEC) had a number of late effects and reported a significantly lower health-related quality of life compared to the general Danish population and patients who have just been diagnosed with cancer, suggesting the aim of helping patients suffering from late effects gain a better quality of life is in dire need.
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Affiliation(s)
- Lærke Kjær Tolstrup
- Department of Oncology, Odense University Hospital, Odense C, Denmark; Department of Clinical Research, University of Southern Denmark, Odense Denmark.
| | - Karin B Dieperink
- Department of Oncology, Odense University Hospital, Odense C, Denmark; Department of Clinical Research, University of Southern Denmark, Odense Denmark
| | - Marieke Van Leeuwen
- Division of Psychosocial Research & Epidemiology, the Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Sören Möller
- Department of Clinical Research, University of Southern Denmark, Odense Denmark; Open Patient data Explorative Network, Odense University Hospital, Odense C, Denmark
| | - Linnea Fechner
- Department of Oncology, Odense University Hospital, Odense C, Denmark
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Jolidon V, Eicher M, Peytremann-Bridevaux I, Arditi C. Inequalities in patients' experiences with cancer care: the role of economic and health literacy determinants. BMC Health Serv Res 2024; 24:733. [PMID: 38877526 PMCID: PMC11179203 DOI: 10.1186/s12913-024-11174-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 06/05/2024] [Indexed: 06/16/2024] Open
Abstract
BACKGROUND Patients with fewer socioeconomic and health literacy resources are disadvantaged in their access and use of healthcare, which may give rise to worse experiences with care and thus inequalities in patient experiences. However, only a limited number of studies have examined how socioeconomic and health literacy factors shape inequalities in patients' experiences with cancer care. OBJECTIVE To examine whether patients' experiences with cancer care differ according to their economic status and health literacy. METHODS Secondary analysis of data on 2789 adult patients diagnosed with cancer from the Swiss Cancer Patient Experiences-2 (SCAPE-2) study, a cross-sectional survey conducted in eight hospitals across Switzerland from September 2021 to February 2022. Regression analysis was applied to examine the independent effect of patients' economic status and health literacy on various outcomes of experiences with cancer care, covering eight different dimensions of patient-centred care, controlling for confounding factors. RESULTS Adjusted regression analysis showed that patients with lower economic status reported significantly worse experiences with cancer care in 12 out of 29 specific care experiences, especially in the dimensions of 'respect for patients' preferences' and 'physical comfort' where all items of experiences were associated with economic status. Additionally, lower health literacy was associated with worse patient experiences in 23 specific care experiences. All items in the dimensions of 'respect for patients' preferences', 'physical comfort' and 'emotional support' were associated with health literacy. DISCUSSION This study revealed significant inequalities in experiences with cancer care shaped by the economic status and health literacy of patients across different dimensions of patient-centred care. It is essential to address the needs of more disadvantaged patients who face obstacles in their access and use of the healthcare system, not only to mitigate inequalities in cancer care but also to avoid inequalities in health outcomes.
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Affiliation(s)
- Vladimir Jolidon
- Unisanté, University Center for Primary Care and Public Health, Department of Epidemiology and Health Systems, University of Lausanne, CH-1011 Lausanne, Switzerland
| | - Manuela Eicher
- Institute of Higher Education and Research in Healthcare (IUFRS), Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Department of Oncology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Isabelle Peytremann-Bridevaux
- Unisanté, University Center for Primary Care and Public Health, Department of Epidemiology and Health Systems, University of Lausanne, CH-1011 Lausanne, Switzerland
| | - Chantal Arditi
- Unisanté, University Center for Primary Care and Public Health, Department of Epidemiology and Health Systems, University of Lausanne, CH-1011 Lausanne, Switzerland.
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Black GB, Moreland J, Fulop NJ, Lyratzopoulos G, Nicholson BD, Whitaker KL. Personal and organisational health literacy in the non-specific symptom pathway for cancer: An ethnographic study. Health Expect 2024; 27:e14062. [PMID: 38704822 PMCID: PMC11070181 DOI: 10.1111/hex.14062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 04/17/2024] [Accepted: 04/18/2024] [Indexed: 05/07/2024] Open
Abstract
INTRODUCTION People being investigated for cancer face a wealth of complex information. Non-specific symptom pathways (NSS) were implemented in the United Kingdom in 2017 to address the needs of patients experiencing symptoms such as weight loss, fatigue or general practitioner 'gut feeling', who did not have streamlined pathways for cancer investigation. This study aimed to explore the health literacy skills needed by patients being investigated for cancer in NSS pathways. METHODS This study employed ethnographic methods across four hospitals in England, including interviews, patient shadowing and clinical care observations, to examine NSS pathways for cancer diagnosis. We recruited 27 patients who were shadowed and interviewed during their care. We also interviewed 27 professionals. The analysis focused on patient communication and understanding, drawing on the concepts of personal and organisational health literacy. RESULTS Our analysis derived six themes highlighting the considerable informational demands of the NSS pathway. Patients were required to understand complex blood tests and investigations in primary care and often did not understand why they were referred. The NSS pathway itself was difficult to understand with only a minority of patients appreciating that multiple organs were being investigated for cancer. The process of progressing through the pathway was also difficult to understand, particularly around who was making decisions and what would happen next. The results of investigations were complex, often including incidental findings. Patients whose persistent symptoms were not explained were often unsure of what to do following discharge. CONCLUSION We have identified several potential missed opportunities for organisations to support patient understanding of NSS pathways which could lead to inappropriate help-seeking post-discharge. Patients' difficulties in comprehending previous investigations and findings could result in delays, overtesting or inadequately targeted investigations, hindering the effective use of their medical history. Third, patients' limited understanding of their investigations and results may impede their ability to engage in patient safety by reporting potential care errors. PATIENT OR PUBLIC CONTRIBUTION Patient, public, clinical and policy representatives contributed to developing the research objectives through a series of meetings and individual conversations in preparation for the study. We have held several events in which patients and the public have had an opportunity to give feedback about our results, such as local interest groups in North London and academic conferences. A clinical contributor (J.-A. M.) was involved in data analysis and writing the manuscript.
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Affiliation(s)
- Georgia B. Black
- Centre for Cancer Screening, Prevention and Early Diagnosis, Wolfson Institute of Population HealthQueen Mary University of LondonLondonUK
- Department of Applied Health ResearchUniversity College LondonLondonUK
| | - Julie‐Ann Moreland
- Department of RadiologyOxford University Hospitals NHS Foundation TrustOxfordUK
| | - Naomi J. Fulop
- Department of Applied Health ResearchUniversity College LondonLondonUK
| | | | - Brian D. Nicholson
- Nuffield Department of Primary Care Health SciencesUniversity of OxfordOxfordUK
| | - Katriina L. Whitaker
- Department of Cancer Care, School of Health SciencesUniversity of SurreyGuildfordUK
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Ryman C, Warnicke C, Hugosson S, Zakrisson AB, Dahlberg K. Health literacy in cancer care: A systematic review. Eur J Oncol Nurs 2024; 70:102582. [PMID: 38608377 DOI: 10.1016/j.ejon.2024.102582] [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: 12/22/2023] [Revised: 03/18/2024] [Accepted: 03/25/2024] [Indexed: 04/14/2024]
Abstract
PURPOSE Health literacy (HL) is a set of knowledge and skills that enables individuals to interpret and act upon health information, which is essential for health equity. There is a growing body of evidence in the field of HL in cancer care but there is, to our knowledge, no systematic review that explores the association between sociodemographic factors and HL among patients with cancer. The aim of this study was therefore to conduct a systematic review of the existing literature that assesses HL levels and the relationship between HL and sociodemographic factors in an adult cancer population. METHODS This is a systematic review and its protocol was registered in PROSPERO (ID: CRD42021164071). The study was conducted in accordance with the PRISMA statement. The literature search, from December 2009 to September 2023, was made in six databases, AMED, CINAHL, Embase, MEDLINE, PsycINFO, and Web of Science Core Collection. RESULTS Fifteen studies were included in the review. The included studies used nine different measurement tools for assessing HL. In the included studies between 11.9 % and 86 % had limited HL. We identified a relationship between limited HL and annual income, education level, ethnicity, living in rural areas and multiple comorbidities. CONCLUSION The results indicate that limited HL is prevalent in the cancer population and should be acknowledge in everyday practice to meet health equity. Our awareness about sociodemographic factors and its association with HL, may enhance adherence to cancer treatment and quality of life, and lower physical and emotional distress.
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Affiliation(s)
- C Ryman
- Department of University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
| | - C Warnicke
- Department of University Health Care Research Center, Faculty of Humanities and Social Sciences, Örebro, Sweden
| | - S Hugosson
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - A-B Zakrisson
- Department of University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - K Dahlberg
- School of Health Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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Bourgeois A, Horrill T, Mollison A, Stringer E, Lambert LK, Stajduhar K. Barriers to cancer treatment for people experiencing socioeconomic disadvantage in high-income countries: a scoping review. BMC Health Serv Res 2024; 24:670. [PMID: 38807237 PMCID: PMC11134650 DOI: 10.1186/s12913-024-11129-2] [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: 09/12/2023] [Accepted: 05/21/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND Despite advances in cancer research and treatment, the burden of cancer is not evenly distributed. People experiencing socioeconomic disadvantage have higher rates of cancer, later stage at diagnoses, and are dying of cancers that are preventable and screen-detectable. However, less is known about barriers to accessing cancer treatment. METHODS We conducted a scoping review of studies examining barriers to accessing cancer treatment for populations experiencing socioeconomic disadvantage in high-income countries, searched across four biomedical databases. Studies published in English between 2008 and 2021 in high-income countries, as defined by the World Bank, and reporting on barriers to cancer treatment were included. RESULTS A total of 20 studies were identified. Most (n = 16) reported data from the United States, and the remaining included publications were from Canada (n = 1), Ireland (n = 1), United Kingdom (n = 1), and a scoping review (n = 1). The majority of studies (n = 9) focused on barriers to breast cancer treatment. The most common barriers included: inadequate insurance and financial constraints (n = 16); unstable housing (n = 5); geographical distribution of services and transportation challenges (n = 4); limited resources for social care needs (n = 7); communication challenges (n = 9); system disintegration (n = 5); implicit bias (n = 4); advanced diagnosis and comorbidities (n = 8); psychosocial dimensions and contexts (n = 6); and limited social support networks (n = 3). The compounding effect of multiple barriers exacerbated poor access to cancer treatment, with relevance across many social locations. CONCLUSION This review highlights barriers to cancer treatment across multiple levels, and underscores the importance of identifying patients at risk for socioeconomic disadvantage to improve access to treatment and cancer outcomes. Findings provide an understanding of barriers that can inform future, equity-oriented policy, practice, and service innovation.
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Affiliation(s)
- Amber Bourgeois
- Institute for Aging & Lifelong Health, University of Victoria, PO Box 1700, Victoria, BC, V8V 2Y2, Canada.
- BC Cancer, Nursing and Allied Health Research and Knowledge Translation, 686 West Broadway, Vancouver, BC, V5Z 1G1, Canada.
| | - Tara Horrill
- College of Nursing, University of Manitoba, 89 Curry Place, Winnipeg, MB, R3T 2N2, Canada
| | - Ashley Mollison
- Institute for Aging & Lifelong Health, University of Victoria, PO Box 1700, Victoria, BC, V8V 2Y2, Canada
| | - Eleah Stringer
- BC Cancer, Nursing and Allied Health Research and Knowledge Translation, 686 West Broadway, Vancouver, BC, V5Z 1G1, Canada
| | - Leah K Lambert
- BC Cancer, Nursing and Allied Health Research and Knowledge Translation, 686 West Broadway, Vancouver, BC, V5Z 1G1, Canada
- School of Nursing, University of British Columbia, 2211 Wesbrook Mall T201, Vancouver, BC, V6T 2B5, Canada
| | - Kelli Stajduhar
- Institute for Aging & Lifelong Health, University of Victoria, PO Box 1700, Victoria, BC, V8V 2Y2, Canada
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McCauley S, Stothers S, Semple C. Evaluation of patient satisfaction of receiving Systemic Anti-Cancer Therapy prescribed by nurse Non-Medical Prescribers. Eur J Oncol Nurs 2024; 70:102597. [PMID: 38795439 DOI: 10.1016/j.ejon.2024.102597] [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: 01/17/2024] [Revised: 04/18/2024] [Accepted: 04/21/2024] [Indexed: 05/28/2024]
Abstract
PURPOSE To evaluate patient satisfaction of patients receiving Systemic Anti-Cancer Treatment prescribed by nurse Non-Medical Prescribers as a new model of care at a Cancer Unit in Northern Ireland, United Kingdom. METHODS A cross-sectional survey design, with a convenience sample of patients from five tumour groups who received Systemic Anti-Cancer Therapy by nurse Non-Medical Prescribers, across a 3-month period in 2022 was employed. Anonymised data were collected via postal survey, which incorporated a minimally modified version of the 45-item Leeds Satisfaction Questionnaire (LSQ). RESULTS One-hundred and sixteen surveys were returned, yielding a 36% response rate. Overall patients' satisfaction levels with nurse non-medical prescribing of systemic anti-cancer therapy were high across all six subscales of the modified LSQ corroborated by qualitative free-text comments. Eighty-five percent of participants indicated they were happy to continue being prescribed systemic anti-cancer therapy by the nurse non-medical prescribers. CONCLUSION Overall patient satisfaction of Systemic Anti-Cancer Treatment prescribed by nurse Non-Medical Prescribers was positively rated; with high standards of compassionate, person-centred care reported, demonstrating an acceptable transformation in care delivery from a consultant-led model. Nonetheless, there was scope for improved health literacy to enhance patients' understanding and compliance with treatment.
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Affiliation(s)
- Sarah McCauley
- Cancer Services, Ulster Hospital, Upper Newtownards Road, Dundonald, Belfast, Northern Ireland, BT16 1RH, UK.
| | - Sheena Stothers
- Cancer Services, Ulster Hospital, Upper Newtownards Road, Dundonald, Belfast, Northern Ireland, BT16 1RH, UK; Institute of Nursing and Health Research, Ulster University, York Street, Belfast, Northern Ireland, BT15 1AP, UK
| | - Cherith Semple
- Cancer Services, Ulster Hospital, Upper Newtownards Road, Dundonald, Belfast, Northern Ireland, BT16 1RH, UK; Institute of Nursing and Health Research, Ulster University, York Street, Belfast, Northern Ireland, BT15 1AP, UK
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Rathnayaka Mudiyanselage AC, Saini R, Coyne E. Evaluation of the understandability, actionability and reliability of YouTube videos for brain, head, and neck cancer information. Eur J Oncol Nurs 2024; 70:102605. [PMID: 38795450 DOI: 10.1016/j.ejon.2024.102605] [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: 10/24/2023] [Revised: 03/12/2024] [Accepted: 05/03/2024] [Indexed: 05/28/2024]
Abstract
PURPOSE Online videos accessed via YouTube are a popular method to provide health education. Videos need to be critically evaluated for educational qualities as the information could influence health outcomes. The present study aimed to evaluate the understandability, actionability and reliability of videos available on YouTube regarding brain, head, and neck cancer information. METHODS A scoping review was conducted with a specific search strategy and inclusion/exclusion criteria based on previous studies. For each video, video characteristics and user engagement activities were recorded. Videos were evaluated using the PEMAT-A/V and modified DISCERN criteria. Spearman's rank correlation, Kruskal-Wallis test and Mann-Whitney U test were used for analysis. RESULTS Out of 200 retrieved videos, 37 were included and analysed. The median length of the video was 3 min and 33 s. The majority of videos were published by health institutional and private channels (43.2%, n = 16). Health institutional channels received the highest actionability (Md = 37.5, p = 0.049), while private channels resulted in lower views/day (Md = 0.46, p = 0.001) and likes/day (Md = 0.01, p = 0.002). Animated and narrated videos acquired the highest understandability score (Md = 92.31, p < 0.001). Videos with professional transcripts reported higher actionability (Md = 62.5, p = 0.004), reliability (Md = 3.33, p = 0.028), views/day (Md = 29.31, p = 0.026), and likes/day (Md = 0.272, p = 0.023). CONCLUSION YouTube videos pertaining to brain and head and neck cancer have low understandability, low actionability and moderate reliability. It is beneficial to have a stronger representation of trustworthy and credible organisations for sharing essential health information via YouTube. Including animations and professional video transcripts may improve their overall quality and consumer engagement.
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Affiliation(s)
- Anjali Chamika Rathnayaka Mudiyanselage
- School of Nursing & Midwifery, Griffith University, Queensland, 4215, Australia; Department of Nursing, Faculty of Allied Health Sciences, University of Peradeniya, Sri Lanka.
| | - Rashi Saini
- School of Nursing & Midwifery, Griffith University, Queensland, 4215, Australia
| | - Elisabeth Coyne
- School of Nursing & Midwifery, Griffith University, Queensland, 4215, Australia
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11
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Degenhardt M, Ernstmann N, Schellenberger B, Ansmann L, Heuser C. Treatment confidence and patient participation in multidisciplinary tumor conferences: A structural equation modeling approach. Cancer Med 2024; 13:e7199. [PMID: 38800961 PMCID: PMC11129163 DOI: 10.1002/cam4.7199] [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: 11/27/2023] [Revised: 03/23/2024] [Accepted: 04/04/2024] [Indexed: 05/29/2024] Open
Abstract
OBJECTIVE Multidisciplinary tumor conference (MTC) is a key instrument in multidisciplinary cancer care. In recent years, if and how patient participation in MTC can contribute to a more patient-centered care have been scientifically discussed. This study aimed to identify determinants of treatment confidence in the context of patient participation in MTC. Therefore, the association among health literacy-sensitive communication, trust in health-care providers (HCP), and treatment confidence is examined. METHODS This study used data from the multicenter, observational study "PINTU" on patient participation in MTC. Data were collected from November 2018 to February 2020. Validated scales for treatment confidence, health literacy-sensitive communication, and trust in providers were included in the structural equation modeling (SEM) analysis. RESULTS A total of 95 patients participated in MTC. The sample compromised n = 80 completed datasets. The SEM fit measures indicated good fit of the proposed model. The analysis showed a positive association between health literacy-sensitive communication and treatment confidence when adding the mediating effect of trust in providers. CONCLUSION Patient-centered communication during MTC in combination with a trustful relationship between participating patients and health-care providers is positively associated with treatment confidence. The results indicated the relevance of a trustful doctor-patient communication and relationship. Trainings for physicians targeting patient-centered communication could be a promising approach to strengthen patient participation.
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Affiliation(s)
- Marie Degenhardt
- Department for Psychosomatic Medicine and Psychotherapy, Faculty of Medicine, Center for Health Communication and Health Services ResearchUniversity Hospital BonnBonnGermany
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD)BonnGermany
| | - Nicole Ernstmann
- Department for Psychosomatic Medicine and Psychotherapy, Faculty of Medicine, Center for Health Communication and Health Services ResearchUniversity Hospital BonnBonnGermany
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD)BonnGermany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Chair of Health Services ResearchCologneGermany
| | - Barbara Schellenberger
- Department for Psychosomatic Medicine and Psychotherapy, Faculty of Medicine, Center for Health Communication and Health Services ResearchUniversity Hospital BonnBonnGermany
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD)BonnGermany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Chair of Health Services ResearchCologneGermany
| | - Lena Ansmann
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Chair of Medical SociologyCologneGermany
| | - Christian Heuser
- Department for Psychosomatic Medicine and Psychotherapy, Faculty of Medicine, Center for Health Communication and Health Services ResearchUniversity Hospital BonnBonnGermany
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD)BonnGermany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Chair of Health Services ResearchCologneGermany
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12
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Xu N, Sun BJ, Yue TM, Lee B. Factors Predicting Readmission and Mortality in Patients Admitted for Malignant Bowel Obstruction. Am Surg 2024:31348241250045. [PMID: 38676624 DOI: 10.1177/00031348241250045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2024]
Abstract
INTRODUCTION Malignant bowel obstruction (MBO) is a common complication of patients with advanced malignancies and has poor prognosis. Currently, there are limited guidelines for MBO management or predicting outcomes for these patients. OBJECTIVE To identify patient factors associated with readmission and mortality after hospital admission for MBO. PARTICIPANTS A 5-year retrospective review was performed from 2017 to 2022 at a single tertiary institution to evaluate patients admitted for MBO. All patients had advanced cancer of gastrointestinal or gynecologic primary. Patient demographics, socioeconomic factors, tumor characteristics, and inpatient outcomes were collected. Multivariable analyses were performed to determine variables predicting hospital readmission for recurrent MBO and 90-day mortality. RESULTS 210 patients were included. Mean age was 61 years, 28% were male, and 19% did not primarily speak English. 35% of patients lived over 50 miles from the hospital. On multivariable analysis, non-English speaking patients exhibited increased risk of readmission for MBO (OR = 2.82, P = .039). Older age was associated with decreased risk for MBO readmission (OR = .96, P = .007). Ascites was associated with increased mortality (OR = 2.17, P = .043). Earlier palliative care (PC) consultation predicted decreased readmission (OR = .24, P < .001) yet increased mortality at 90 days (OR = 3.20, P = .003). CONCLUSION Patient age, primary language, and PC consult were predictors for MBO readmission, which may impact 90-day mortality. Given the palliative nature of MBO, modifiable factors such as PC consultation and multidisciplinary goals of care discussions should be prioritized in order to reduce readmissions and focus on quality of life (QOL) for this patient population.
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Affiliation(s)
- Nova Xu
- Stanford University School of Medicine, Stanford, CA, USA
| | - Beatrice J Sun
- Section of Surgical Oncology, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Tiffany M Yue
- Stanford University School of Medicine, Stanford, CA, USA
| | - Byrne Lee
- Section of Surgical Oncology, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
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13
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Okere CA, Kvist T, Sak-Dankosky N, Yerris V. Spiritual interventions: Improving the lives of colorectal cancer survivors-A systematic literature review. J Adv Nurs 2024. [PMID: 38632872 DOI: 10.1111/jan.16196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 03/21/2024] [Accepted: 04/06/2024] [Indexed: 04/19/2024]
Abstract
AIM To systematically review the types of spiritual interventions available for colorectal cancer survivors and determine if they improve their lives. DESIGN Systematic review. DATA SOURCE A thorough literature search was conducted in July 2023 using PRIMO, PubMed/Medline, Cochrane, CINAHL, Scopus, and EMBASE. REVIEW METHODS As an extension of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist, the Synthesis Without Meta-Analysis reporting guideline was employed. A narrative synthesis was used to analyse the data. RESULTS Thirty-five articles were analysed for this study. The findings suggest that psychoeducational intervention, cognitive behavioural therapy intervention, mindfulness intervention, social intervention, and spiritual counselling improved CRC survivor's coping skills, boosted self-esteem, lessened anxiety, instilled hope, enhanced daily functioning, improved survival rates, improved neurological functional status and quality of life (QoL). CONCLUSION There is proof that spiritual interventions help CRC patients and improve their QoL. It has been discovered that spiritual intervention is helpful in the diagnosis, management, and treatment of CRC conditions. IMPACT CRC survivors may have impairments in their physical ability and daily functioning as a result of many symptoms, such as pain, bowel dysfunction, and exhaustion. Furthermore, individuals may encounter difficulties in several aspects of their psychological, emotional, social, and role functioning due to the presence of dread symptoms. Therefore, these study will help CRC survivors To implement spiritual interventions in the management of their long-term care. To cultivate problem-solving abilities, foster self-assurance, and enhance self-awareness. To alleviate symptoms, enhance everyday functioning, and improve QoL. NO INDUCEMENT No financial incentives were used to compensate patients or members of the public for this review.
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Affiliation(s)
| | - Tarja Kvist
- University of Eastern Finland, Kuopio, Finland
| | | | - Victor Yerris
- Institut Supérieur de Formation Bancaire, Geneva, Switzerland
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14
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Melhem SJ, Nabhani-Gebara S, Kayyali R. Evaluating online health information utilisation and its psychosocial implications among breast cancer survivors: Qualitative explorations. Health Promot Perspect 2024; 14:61-69. [PMID: 38623349 PMCID: PMC11016143 DOI: 10.34172/hpp.42682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 12/26/2023] [Indexed: 04/17/2024] Open
Abstract
Background This study investigated the online information-seeking behaviours of breast cancer patients at Jordan University Hospital, focusing on their dissatisfaction with available online health resources and its impact on their well-being and anxiety levels. Methods Employing descriptive phenomenology and convenience sampling, we conducted five Skype-based focus groups with 4-6 breast cancer survivors each, from March to July 2020. Data analysis was performed using NVivo, following Braun and Clark's inductive thematic analysis framework. Results The thematic analysis revealed critical insights into survivors' interactions with online cancer resources, identifying key subthemes such as the quality of online information, cyberchondriasis, health literacy and search strategies, the distress caused by counterproductive searches, and the tendency to avoid internet searches. Conclusion The study underscores the challenges breast cancer survivors face in accessing online health information, especially in Arabic. It highlights the need to improve the quality and accessibility of these resources. Enhancing the cultural relevance of online materials and educating patients on effective information evaluation are crucial. These measures can significantly boost health literacy, mitigate anxiety, and provide better support for breast cancer survivors.
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Affiliation(s)
- Samar J Melhem
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan. Amman-Jordan
- Department of Pharmacy, School of Life Sciences, Pharmacy and Chemistry, Kingston University London, Kingston upon Thames, Surrey KT1 1LQ, UK
| | - Shereen Nabhani-Gebara
- Department of Pharmacy, School of Life Sciences, Pharmacy and Chemistry, Kingston University London, Kingston upon Thames, Surrey KT1 1LQ, UK
| | - Reem Kayyali
- Department of Pharmacy, School of Life Sciences, Pharmacy and Chemistry, Kingston University London, Kingston upon Thames, Surrey KT1 1LQ, UK
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15
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Muñoz-Villaverde S, Serrano-Oviedo L, Martínez-García M, Pardo Y, Tares-Montserrat L, Gómez-Romero FJ, Garcimartin P. Spanish version of the short European Health Literacy Survey Questionnaire HLS-Q12: Transcultural adaptation and psychometric properties. PLoS One 2024; 19:e0299736. [PMID: 38421993 PMCID: PMC10903891 DOI: 10.1371/journal.pone.0299736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 02/14/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Health literacy has a direct impact on the health of populations. It is related to education, capacity for self-care, and management of health resources. The Health Literacy Survey Questionnaire HLS-Q12 is one of the reference instruments but has not yet been adapted to Spanish. The aims of the study were to cross-culturally adapt and evaluate the psychometric properties of the Spanish version of the HLS-Q12. METHODS Data was collected from June 2020 to March 2022. The sample consisted of 60 patients who initiated cancer treatment for the first time within a clinical trial. Double direct translation, back-translation, cognitive debriefing with a 10-patient sample, and an expert committee were used for cross-cultural adaptation. For validation of the HLS-Q12, a psychometric analysis was performed to assess feasibility, reliability, sensitivity to change and construct validity with other measures such as health-related quality of life, empowerment, and health needs. RESULTS The HLS-Q12 is equivalent at the semantic, conceptual, and content level to the original version and its psychometric properties demonstrated good internal consistency with a Cronbach's alpha of 0.88 and a McDonald´s omega of 0.91, a high degree of fit for the confirmatory factor analysis, and a statistically significant sensitivity to change (p = 0.025). CONCLUSIONS Based on robust psychometric values, the Spanish version of HLS-Q12 was found to be a good cross-culturally adapted tool for collecting correct information on health literacy in cancer patients regardless of tumour type or stage. Although more studies are needed, this version of HLS-Q12 could be used in research for collecting data on the health literacy needs of Spanish-speaking patients.
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Affiliation(s)
- Sergio Muñoz-Villaverde
- Oncology Clinical Trials Unit, Hospital del Mar, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Cancer Research Program, Barcelona, Spain
- Catalan Institute of Health, Casc Antic Primary Care Centre, Barcelona Territorial Management, Barcelona, Spain
| | - Leticia Serrano-Oviedo
- Translational Research Unit, University General Hospital of Ciudad Real, Servicio de Saud de Castilla-La Mancha (SESCAM), Spain
| | - María Martínez-García
- Oncology Clinical Trials Unit, Hospital del Mar, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Cancer Research Program, Barcelona, Spain
- Department of Medical Oncology, Hospital del Mar, Parc de Salud Mar, Barcelona, Spain
| | - Yolanda Pardo
- IMIM (Hospital del Mar Medical Research Institute), Health Services Research Group, Barcelona, Spain
- Institute of Health Carlos III, Centre for Biomedical Research Network, Epidemiology and Public Health (CIBERESP), ISCIII, Madrid, Spain
- Department of Psychiatry and Legal Medicine, School of Medicine, Universitat Autónoma de Barcelona, Bellaterra, Barcelona, Spain
| | - Llüisa Tares-Montserrat
- Oncology Clinical Trials Unit, Hospital del Mar, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Cancer Research Program, Barcelona, Spain
| | - Francisco Javier Gómez-Romero
- Translational Research Unit, University General Hospital of Ciudad Real, Servicio de Saud de Castilla-La Mancha (SESCAM), Spain
- School of Medicine at Ciudad Real, University of Castilla-La Mancha, Ciudad Real, Spain
| | - Paloma Garcimartin
- Nursing Directorate, Hospital del Mar, Barcelona, Spain
- Biomedical Network Research Centre for Cardiovascular Diseases, CIBERCV (Carlos III Health Institute), Madrid, Spain
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16
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Ali N, Nelson D, McInnerney D, Quaife SL, Laparidou D, Selby P, Kane R, Civello S, Skinner D, Pogson Z, Peake MD, Harding-Bell A, Cooke S. A systematic review on the qualitative experiences of people living with lung cancer in rural areas. Support Care Cancer 2024; 32:144. [PMID: 38316704 PMCID: PMC10844412 DOI: 10.1007/s00520-024-08342-4] [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: 09/22/2023] [Accepted: 01/23/2024] [Indexed: 02/07/2024]
Abstract
PURPOSE To synthesize the qualitative literature exploring the experiences of people living with lung cancer in rural areas. METHODS Searches were performed in MEDLINE, CINAHL, and PsycINFO. Articles were screened independently by two reviewers against pre-determined eligibility criteria. Data were synthesized using Thomas and Harden's framework for the thematic synthesis of qualitative research. The CASP qualitative checklist was used for quality assessment and the review was reported in accordance with the ENTREQ and PRISMA checklists. RESULTS Nine articles were included, from which five themes were identified: (1) diagnosis and treatment pathways, (2) travel and financial burden, (3) communication and information, (4) experiences of interacting with healthcare professionals, (5) symptoms and health-seeking behaviors. Lung cancer diagnosis was unexpected for some with several reporting treatment delays and long wait times regarding diagnosis and treatment. Accessing treatment was perceived as challenging and time-consuming due to distance and financial stress. Inadequate communication of information from healthcare professionals was a common concern expressed by rural people living with lung cancer who also conveyed dissatisfaction with their healthcare professionals. Some were reluctant to seek help due to geographical distance and sociocultural factors whilst others found it challenging to identify symptoms due to comorbidities. CONCLUSIONS This review provides a deeper understanding of the challenges faced by people with lung cancer in rural settings, through which future researchers can begin to develop tailored support to address the existing disparities that affect this population.
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Affiliation(s)
- Nabilah Ali
- Lincoln Medical School, College of Health and Science, Universities of Nottingham and Lincoln, Lincoln, LN6 7TS, UK
| | - David Nelson
- College of Health and Science, Lincoln International Institute for Rural Health, University of Lincoln, Lincoln, LN6 7TS, UK
- Macmillan Cancer Support, London, SE1 7UQ, UK
| | - Daisy McInnerney
- Centre for Cancer Screening, Prevention and Early Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, EC1M 6BQ, UK
| | - Samantha L Quaife
- Centre for Cancer Screening, Prevention and Early Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, EC1M 6BQ, UK
| | - Despina Laparidou
- Community and Health Research Unit, School of Health and Social Care, University of Lincoln, Lincoln, LN6 7TS, UK
| | - Peter Selby
- Lincoln Medical School, College of Health and Science, Universities of Nottingham and Lincoln, Lincoln, LN6 7TS, UK
- School of Medicine, University of Leeds, Leeds, LS2 9JT, UK
| | - Ros Kane
- School of Health and Social Care, University of Lincoln, Lincoln, LN6 7TS, UK
| | - Sarah Civello
- Lincoln County Hospital, United Lincolnshire Hospitals NHS Trust, Lincoln, LN2 5QY, UK
| | - Dawn Skinner
- Pilgrim Hospital, United Lincolnshire Hospitals NHS Trust, Boston, PE21 9QS, UK
| | - Zara Pogson
- Lincoln County Hospital, United Lincolnshire Hospitals NHS Trust, Lincoln, LN2 5QY, UK
| | - Michael D Peake
- Cancer Research UK, London, E20 1JQ, UK
- Glenfield Hospital, University of Leicester, Leicester, LE1 7RH, UK
| | - Ava Harding-Bell
- Swineshead Patient Participation Group, Swineshead Medical Group, Boston, PE20 3JE, UK
| | - Samuel Cooke
- College of Health and Science, Lincoln International Institute for Rural Health, University of Lincoln, Lincoln, LN6 7TS, UK.
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17
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Muñoz-Villaverde S, Martínez-García M, Serrano-Oviedo L, Gómez-Romero FJ, Sobrado-Sobrado AM, Cidoncha-Moreno MÁ, Riesgo-Martín J, Pedreira-Robles G, Garcimartin P. Impact of telenurse-led intervention in clinical trials on health literacy, empowerment, and health outcomes in patients with solid tumours: a pilot quasi-experimental study. BMC Nurs 2024; 23:86. [PMID: 38308260 PMCID: PMC10835870 DOI: 10.1186/s12912-023-01641-x] [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: 07/26/2023] [Accepted: 12/05/2023] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND During the COVID-19 pandemic, decentralised clinical trials incorporated self-monitoring, self-reporting, and telenursing tools to address health literacy and health empowerment of patients enrolled in clinical trials. We aimed to determine the impact of an educational intervention using telenursing consultations on health literacy, health empowerment, and health-related quality of life in cancer patients enrolled in clinical trials by measuring the level of satisfaction with the care received and assessing the views of healthcare professionals concerning the advanced practice nurse (APN) role in oncology clinical trials. METHODS In this pilot analytical, descriptive, longitudinal, quasi-experimental, and pre-post test study, an educational intervention was conducted by 5 visits with an APN using synchronous teleconsultation in patients starting cancer treatment for the first time in a clinical trial (n = 60), and health professionals working with the APN (n = 31). A descriptive analysis of the samples and questionnaires were utilised along with statistical comparisons. RESULTS After the intervention, patients' health literacy (31.7%), health empowerment (18.3%), and health-related quality of life (33.3%) increased (p < 0.05), with a decrease and trend towards resolution of care needs (p < 0.05). Satisfaction with the quality and care received in terms of perceived convenience, transition, and continuity of care showed positive results in 64.9 ± 20.7, 77.6 ± 19.5, and 72.1 ± 20.4 of respondents, respectively. On the overall assessment of the APN role, healthcare professionals expressed a high level of agreement with the statements related to their work performance. CONCLUSIONS The data indicates that a clinical trial APN-led telenursing educational intervention results in an overall increase in health literacy, an improvement in health empowerment and health-related quality of life, and a decrease in care needs of oncology clinical trials patients. Patients stated that they received a high quality of care and health professionals indicated high levels of acceptance with APNs. Based on these results, we suggest that the APN role should gain more recognition in the Spanish healthcare system and their professional competencies should be aligned with those of other countries.
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Affiliation(s)
- Sergio Muñoz-Villaverde
- Oncology Clinical Trials Unit, Hospital del Mar, Barcelona, Spain
- Cancer Research Programme, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Casc Antic Primary Care Centre, Catalan Institute of Health, Barcelona Territorial Management, Barcelona, Spain
| | - María Martínez-García
- Oncology Clinical Trials Unit, Hospital del Mar, Barcelona, Spain
- Cancer Research Programme, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Department of Medical Oncology, Hospital del Mar, Barcelona, Spain
| | - Leticia Serrano-Oviedo
- Translational Research Unit, University General Hospital of Ciudad Real, Servicio de Salud de Castilla-La Mancha (SESCAM), Ciudad Real, Spain.
| | - Francisco Javier Gómez-Romero
- Translational Research Unit, University General Hospital of Ciudad Real, Servicio de Salud de Castilla-La Mancha (SESCAM), Ciudad Real, Spain
- Faculty of Medicine of Ciudad Real, University of Castilla-La Mancha, Ciudad Real, Spain
| | | | | | - Juan Riesgo-Martín
- Casc Antic Primary Care Centre, Catalan Institute of Health, Barcelona Territorial Management, Barcelona, Spain
| | - Guillermo Pedreira-Robles
- ESIMar (Mar Nursing School), Universitat Pompeu Fabra Affiliated, Parc de Salut Mar, Barcelona, Spain
- SDHEd (Social Determinants and Health Education Research Group), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Paloma Garcimartin
- Nursing department, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
- Research Group in Nursing Care, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Biomedical Network Research Centre for Cardiovascular Diseases, CIBERCV (Carlos III Health Institute), Madrid, Spain
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18
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Pickwell-Smith BA, Spencer K, Sadeghi MH, Greenley S, Lind M, Macleod U. Where are the inequalities in colorectal cancer care in a country with universal healthcare? A systematic review and narrative synthesis. BMJ Open 2024; 14:e080467. [PMID: 38171631 PMCID: PMC10773363 DOI: 10.1136/bmjopen-2023-080467] [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: 10/02/2023] [Accepted: 11/23/2023] [Indexed: 01/05/2024] Open
Abstract
OBJECTIVE Patients diagnosed with colorectal cancer living in more deprived areas experience worse survival than those in more affluent areas. Those living in more deprived areas face barriers to accessing timely, quality healthcare. These barriers may contribute to socioeconomic inequalities in survival. We evaluated the literature for any association between socioeconomic group, hospital delay and treatments received among patients with colorectal cancer in the UK, a country with universal healthcare. DESIGN MEDLINE, EMBASE, CINAHL, CENTRAL, SCIE, AMED and PsycINFO were searched from inception to January 2023. Grey literature, including HMIC, BASE and Google Advanced Search, and forward and backward citation searches were conducted. Two reviewers independently reviewed titles, abstracts and full-text articles. Observational UK-based studies were included if they reported socioeconomic measures and an association with either hospital delay or treatments received. The QUIPS tool assessed bias risk, and a narrative synthesis was conducted. The review is reported to Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020. RESULTS 41 of the 7209 identified references were included. 12 studies evaluated 7 different hospital intervals. There was a significant association between area-level deprivation and a longer time from first presentation in primary care to diagnosis. 32 studies evaluated treatments received. There were socioeconomic inequalities in surgery and chemotherapy but not radiotherapy. CONCLUSION Patients with colorectal cancer face inequalities across the cancer care continuum. Further research is needed to understand why and what evidence-based actions can reduce these inequalities in treatment. Qualitative research of patients and clinicians conducted across various settings would provide a rich understanding of the complex factors that drive these inequalities. Further research should also consider using a causal approach to future studies to considerably strengthen the interpretation. Clinicians can try and mitigate some potential causes of colorectal cancer inequalities, including signposting to financial advice and patient transport schemes. PROSPERO REGISTRATION NUMBER CRD42022347652.
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Affiliation(s)
| | - Katie Spencer
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | | | | | - Michael Lind
- University of Hull, Hull, UK
- Hull and East Yorkshire Hospitals NHS Trust, Hull, UK
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19
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Hudson L, Burus T, Park L, Huang B, Hull PC, Vanderford NL. Cancer disparities in Appalachian Kentucky. J Rural Health 2024; 40:87-95. [PMID: 37095596 PMCID: PMC10593907 DOI: 10.1111/jrh.12763] [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: 01/20/2023] [Revised: 03/15/2023] [Accepted: 04/13/2023] [Indexed: 04/26/2023]
Abstract
PURPOSE Cancer is the second leading cause of death in the United States, and the disease burden is elevated in Appalachian Kentucky, due in part to health behaviors and inequities in social determinants of health. This study's goal was to evaluate Appalachian Kentucky's cancer burden compared to non-Appalachian Kentucky, and Kentucky compared to the United States (excluding Kentucky). METHODS The following data were analyzed: annual all-cause and all-site cancer mortality rates from 1968 to 2018; 5-year all-site and site-specific cancer incidence and mortality rates from 2014 to 2018; aggregated screening and risk factor data from 2016 to 2018 for the United States (excluding Kentucky), Kentucky, non-Appalachian Kentucky, and Appalachian Kentucky; and human papilloma virus vaccination prevalence by sex from 2018 for the United States and Kentucky. FINDINGS Since 1968, the United States has experienced a large decrease in all-cause and cancer mortality, but the reduction in Kentucky has been smaller and slower, driven by even smaller and slower reductions within Appalachian Kentucky. Appalachian Kentucky has higher overall cancer incidence and mortality rates and higher rates for several site-specific cancers compared to non-Appalachian Kentucky. Contributing factors include screening rate disparities and increased rates of obesity and smoking. CONCLUSIONS Appalachian Kentucky has experienced persistent cancer disparities, including elevated all-cause and cancer mortality rates for 50+ years, widening the gap between this region and the rest of the country. In addition to addressing social determinants of health, increased efforts aimed at improving health behaviors and increased access to health care resources could help reduce this disparity.
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Affiliation(s)
- Lauren Hudson
- College of Medicine, University of Kentucky, Lexington, Kentucky, USA
| | - Todd Burus
- Markey Cancer Center, University of Kentucky, Lexington, Kentucky, USA
| | - Lee Park
- Department of Statistics, College of Arts & Sciences, University of Kentucky, Lexington, Kentucky, USA
| | - Bin Huang
- Markey Cancer Center, University of Kentucky, Lexington, Kentucky, USA
- Division of Cancer Biostatistics, College of Medicine, University of Kentucky, Lexington, Kentucky, USA
- Kentucky Cancer Registry, Markey Cancer Center, University of Kentucky, Lexington, Kentucky, USA
| | - Pamela C. Hull
- Markey Cancer Center, University of Kentucky, Lexington, Kentucky, USA
- Department of Behavioral Science, College of Medicine, University of Kentucky, Lexington, Kentucky, USA
| | - Nathan L. Vanderford
- Markey Cancer Center, University of Kentucky, Lexington, Kentucky, USA
- Department of Toxicology and Cancer Biology, College of Medicine, University of Kentucky, Lexington, Kentucky, USA
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Murphy A, Lawlor A, Kirby A, Drummond FJ. A pragmatic dialogue amongst stakeholders on the impact of COVID-19 on Irish cancer patients and healthcare services and lessons learned. Support Care Cancer 2023; 32:19. [PMID: 38091145 DOI: 10.1007/s00520-023-08227-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 12/01/2023] [Indexed: 12/18/2023]
Abstract
PURPOSE COVID-19 disrupted cancer care services in Ireland, from screening and diagnostics to treatments, possibly impacting physical health outcomes owing to delayed diagnosis and treatment changes. This study explores how cancer care and patients in Ireland were affected by COVID-19 from the perspective of Irish policy, clinical and patient stakeholders using a qualitative approach. The findings could inform future strategic and implementation plans for the current challenges faced and lessons learned will be identified. METHODS A thematic analysis of a multi-stakeholder online workshop representing policy and clinical and patient stakeholders was completed. RESULTS The pandemic exasperated prior challenges including under-resourced services, access barriers, staff shortages and lack of interoperability in information technology (IT) systems. Overall, the measures implemented protected cancer patients from COVID-19; however, some groups were more vulnerable, with apparent demographic and socio-economic inequalities. Many hard-fought gains from the previous decade, in terms of cancer screening, diagnosis and survivorship, were eroded. As we transition to the peri-COVID-19 period, staff burnout, poor IT infrastructure and lack of good quality data must be addressed to minimise further disruptions and restore and enhance cancer services. CONCLUSIONS Overall, innovations and measures adopted during the pandemic protected cancer patients; however, some groups were particularly vulnerable, and inequalities may have widened further. Only proven effective and efficient innovations introduced during the pandemic should be retained and enhanced. Good quality data is needed to inform such decisions when choosing amongst them.
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Affiliation(s)
- Aileen Murphy
- Department of Economics, Cork University Business School, University College Cork, Cork, T12 CY82, Ireland.
| | - Amy Lawlor
- Department of Economics, Cork University Business School, University College Cork, Cork, T12 CY82, Ireland
| | - Ann Kirby
- Department of Economics, Cork University Business School, University College Cork, Cork, T12 CY82, Ireland
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21
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Melhem SJ, Kayyali R. Multilayer framework for digital multicomponent platform design for colorectal survivors and carers: a qualitative study. Front Public Health 2023; 11:1272344. [PMID: 38115846 PMCID: PMC10728820 DOI: 10.3389/fpubh.2023.1272344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 11/08/2023] [Indexed: 12/21/2023] Open
Abstract
Background The advent of eHealth services offers the potential to support colorectal cancer (CRC) survivors and their informal caregivers (ICs), yet research into user needs and design requirements remains scant. This exploratory qualitative study addresses this knowledge gap by focusing on the development of a Digital Multicomponent Platform (DMP) designed to provide comprehensive support to these populations. Aims The objective of this research is to use qualitative methodologies to identify key user needs and design requirements for eHealth services. It seeks to propose and apply a multi-tiered framework for creating a DMP that encapsulates the needs of CRC survivors and their ICs. Methods Skype-based focus groups (FGs) were utilized to gather qualitative data from CRC survivors and ICs. This approach served to elicit crucial themes integral to the design of the DMP. A multi-tiered framework was subsequently developed to integrate user-centered design (UCD) principles and requirements with predetermined outcomes, eHealth services, and IT infrastructure. Results The first stage of the analysis identified five crucial themes: (1) the importance of healthcare system interaction via eHealth, (2) interaction between healthcare providers and peers, (3) lifestyle and wellness considerations, (4) platform content and user interface requirements, (5) caregiver support. The second stage analysis applied the multi-tiered framework, to determine the DMP that was conceptualized from these themes, underscores the significance of personalized content, caregiver involvement, and integration with electronic health records (EHRs). Conclusion The study offers novel insights into the design and development of digital supportive care interventions for CRC survivors and their caregivers. The results highlight the utility of user-centered design principles, the significance of personalized content and caregiver involvement, and the need for a unified health data platform that promotes communication among patients, healthcare providers, and peers. This multi-tiered framework could serve as a prototype for future eHealth service designs.
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Affiliation(s)
- Samar J. Melhem
- Department of Pharmacy, School of Life Sciences, Pharmacy and Chemistry, Kingston University London, Kingston upon Thames, Surrey, United Kingdom
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22
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Allran O, Vanderford NL. A Qualitative Study of Participant Perceptions of a Cancer Research Education Program. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023; 38:1853-1860. [PMID: 37460855 PMCID: PMC10794550 DOI: 10.1007/s13187-023-02341-5] [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: 07/10/2023] [Indexed: 08/24/2023]
Abstract
Kentucky ranks first in the nation in cancer incidence and mortality rates, with the greatest burden of disease being in the Appalachian region. The cancer disparities in the Appalachian region of the state are tied to high poverty rates, low education attainment, low health care access, and high rates of poor health behaviors, such as tobacco use. The University of Kentucky (UK) Markey Cancer Center (MCC) developed the Appalachian Career Training in Oncology (ACTION) program to address the cancer and education disparities in the region. ACTION is a two-year program that focuses on cancer education and training for high school and undergraduate students from Appalachian Kentucky and features a variety of cancer-focused training activities, including faculty-mentored cancer research, clinical shadowing opportunities, cancer education activities, career development support, and community outreach projects. ACTION has been funded by the National Cancer Institute as a Youth Enjoy Science R25 research education program since 2018. The qualitative study herein used a semi-structured interview approach to identify participants' perceptions of the program including the influential aspects that have helped students pursue their desired academic career paths. Ten ACTION alumni were chosen to participate in the study, including students currently in medical school, graduate school, physician assistant school, and pharmacy school. Thematic analysis generated five themes: motivation for participation, career development, mentorship and future opportunities, knowledge gained, and program improvements. Overall, this study demonstrates that the ACTION program is having a significant impact on students' career preparation.
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Affiliation(s)
- Olivia Allran
- College of Public Health, University of Kentucky, Lexington, KY, USA
- Markey Cancer Center, University of Kentucky, Lexington, KY, USA
| | - Nathan L Vanderford
- Markey Cancer Center, University of Kentucky, Lexington, KY, USA.
- College of Medicine, University of Kentucky, Lexington, KY, USA.
- Department of Toxicology and Cancer Biology, College of Medicine, University of Kentucky, 800 Rose Street, H164, Lexington, KY, 40536-0096, USA.
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23
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Iwakura M, Kawagoshi A, Furukawa Y, Sugawara K, Wakabayashi T, Sato T, Wakasa M. Health literacy in older patients with abdominal tumours and its association with clinical characteristics: A cross-sectional study. Eur J Oncol Nurs 2023; 67:102461. [PMID: 37976753 DOI: 10.1016/j.ejon.2023.102461] [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: 08/04/2023] [Revised: 10/05/2023] [Accepted: 10/29/2023] [Indexed: 11/19/2023]
Abstract
PURPOSE Health literacy (HL) is pivotal in managing patients with abdominal cancer and is associated with treatment outcomes and care experience. However, detailed characteristics of HL and their associations with clinical features remain uncertain in the population. Therefore, we aimed to comprehensively investigate HL and its associations with clinical characteristics in older patients with abdominal tumours. METHODS We analysed 103 older patients with abdominal tumours prescribed perioperative rehabilitation programs in an acute care hospital. The Japanese version of the European Health Literacy Survey Questionnaire was used to measure comprehensive HL. Multivariate ordinal or linear regression analyses were used to explore the associations between HL and the following clinical characteristics: physical status, physical function, cardiopulmonary function, levels of activities of daily living (ADL), physical activity level, and health-related quality of life (HR-QoL). All regression analyses included patient demographics as covariates. RESULTS Approximately 50%-70% of the participants had difficulty accessing and appraising health-related information, and 20%-45% thought it was difficult to understand and apply the information. The percentage of limited HL levels in general HL, three health-relevant domains, and four competencies ranged from 62% to 83%. Moreover, regression analyses revealed that lower HL was associated with worse physical status/function, lower ADL, and poorer HR-QoL. CONCLUSION Most older patients with abdominal tumours have limited HL, which may lead them to make treatment decisions without fully understanding what healthcare providers advise. Furthermore, patients with lower HL are at a higher risk of poor treatment outcomes because of their worse clinical characteristics.
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Affiliation(s)
- Masahiro Iwakura
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, 1-1 Hondo 1-chome, Akita City, Akita, 010-8543, Japan.
| | - Atsuyoshi Kawagoshi
- Department of Rehabilitation, Akita City Hospital, 4-30 Kawamoto Matsuoka-Cho, Akita City, Akita, 010-0933, Japan
| | - Yutaka Furukawa
- Department of Rehabilitation, Akita City Hospital, 4-30 Kawamoto Matsuoka-Cho, Akita City, Akita, 010-0933, Japan
| | - Keiyu Sugawara
- Department of Rehabilitation, Akita City Hospital, 4-30 Kawamoto Matsuoka-Cho, Akita City, Akita, 010-0933, Japan
| | - Toshiki Wakabayashi
- Department of Gastrointestinal Surgery, Akita City Hospital, 4-30 Kawamoto Matsuoka-Cho, Akita City, Akita, 010-0933, Japan
| | - Tsutomu Sato
- Department of Gastrointestinal Surgery, Akita City Hospital, 4-30 Kawamoto Matsuoka-Cho, Akita City, Akita, 010-0933, Japan
| | - Masahiko Wakasa
- Department of Physical Therapy, Akita University Graduate School of Health Sciences, 1-1 Hondo 1-chome, Akita City, Akita, 010-8543, Japan
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Elshami M, Hoehn RS, Ammori JB, Hardacre JM, Selfridge JE, Bajor D, Mohamed A, Chakrabarti S, Mahipal A, Winter JM, Ocuin LM. Disparities in guideline-compliant care for patients with pancreatic ductal adenocarcinoma at minority-versus non-minority-serving hospitals. HPB (Oxford) 2023; 25:1502-1512. [PMID: 37558565 DOI: 10.1016/j.hpb.2023.07.903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 06/15/2023] [Accepted: 07/24/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND We examined disparities in guideline-compliant care at minority-serving hospitals (MSH) versus non-MSH among patients with localized or metastatic pancreatic adenocarcinoma (PDAC). METHODS Patients with PDAC were identified within the National Cancer Database (2004-2018). Guideline-compliant care was defined as surgery + chemotherapy ± radiation therapy for localized and chemotherapy for metastatic disease. Facilities in the top decile of minority patients treated were considered MSH. RESULTS A total of 190,950 patients were identified and most (59.6%) had metastatic disease. Overall, 6.4% of patients with localized and 8.2% of patients with metastatic disease were treated at MSH. Patients treated at MSH were less likely to receive guideline-compliant care (localized: OR = 0.78, 95% CI: 0.67-0.91; metastatic: OR = 0.77, 95% CI: 0.67-0.88). Minority patients were less likely to receive guideline-compliant care at non-MSH (localized: OR = 0.71, 95% CI: 0.67-0.75; metastatic: OR = 0.85, 95% CI: 0.82-0.89) or MSH (localized: OR = 0.85, 95% CI: 0.74-0.98; metastatic: OR = 0.91, 95% CI: 0.82-0.99). Patients treated at non-MSH or MSH who received guideline-compliant care were more likely to have higher OS regardless of stage or race. CONCLUSIONS MSH patients were less likely to receive guideline-compliant care and minority patients were less likely to receive guideline-compliant care regardless of MSH status. Guideline-compliant care was associated with improved OS.
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Affiliation(s)
- Mohamedraed Elshami
- Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Richard S Hoehn
- Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - John B Ammori
- Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Jeffrey M Hardacre
- Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Jennifer E Selfridge
- Division of Hematology and Oncology, Department of Medicine, University Hospitals Seidman Cancer Center, Case Western Reserve University Cleveland, OH, USA
| | - David Bajor
- Division of Hematology and Oncology, Department of Medicine, University Hospitals Seidman Cancer Center, Case Western Reserve University Cleveland, OH, USA
| | - Amr Mohamed
- Division of Hematology and Oncology, Department of Medicine, University Hospitals Seidman Cancer Center, Case Western Reserve University Cleveland, OH, USA
| | - Sakti Chakrabarti
- Division of Hematology and Oncology, Department of Medicine, University Hospitals Seidman Cancer Center, Case Western Reserve University Cleveland, OH, USA
| | - Amit Mahipal
- Division of Hematology and Oncology, Department of Medicine, University Hospitals Seidman Cancer Center, Case Western Reserve University Cleveland, OH, USA
| | - Jordan M Winter
- Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Lee M Ocuin
- Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
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25
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Portela-Pino I, Hernaiz-Sanchez A, Lomba-Portela L. Evaluation of health literacy and its predictive formative factors among Spanish military personnel. MILITARY PSYCHOLOGY 2023:1-8. [PMID: 37921646 DOI: 10.1080/08995605.2023.2274755] [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: 03/09/2023] [Accepted: 10/10/2023] [Indexed: 11/04/2023]
Abstract
Health literacy (HL) is an aspect that has been widely studied. However, in the military population there are hardly any studies on the influence of educational variables. Knowing the level of health literacy of military professionals is important as it has an impact on adequate health decision making, avoids the abuse of health services and makes it possible to ask for help when needed, especially in aspects related to mental health. The aim of this study was to measure the level of literacy, as well as its association with other training variables in a sample of military personnel. The study was carried out in 695 military personnel of the Spanish Army. A cross-sectional observational design was used, using a survey with the HLS-EU-Q47 scale. Among the results, it stands out that the level of health literacy of the military is high compared to the rest of the population. The results showed that the level of HL does not seem to be influenced by the level of languages, nor by the degree they hold, nor by experiences abroad. On the other hand, it was observed that the performance of professional internships and work in multidisciplinary teams, extracurricular training, does influence the level of HL, especially in the dimension related to health promotion. This fact seems to mean that the military have learned during these experiences to keep abreast of health-related issues, to understand, to value and to form a considered opinion on health-related information.
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Affiliation(s)
- Iago Portela-Pino
- Department of Health Sciences, Faculty of Health Sciences, Isabel I University, Burgos, Spain
| | | | - Lucía Lomba-Portela
- Department of Didactics, School Organisation and Research, University of Vigo, Vigo, Spain
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26
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Krishnan M, Agarwal P, Pinninti R, Rajappa S. Global inequalities in availability of systemic therapies for cancer care and strategies to address them. J Surg Oncol 2023; 128:1038-1044. [PMID: 37818905 DOI: 10.1002/jso.27439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 08/27/2023] [Indexed: 10/13/2023]
Abstract
Many Low and middle-income countries face challenges in delivering chemotherapy services due to limitations in infrastructure, inadequate healthcare facilities, and a shortage of trained medical professionals. High-income countries often have well-developed healthcare systems and advanced technology.
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Affiliation(s)
- Mridula Krishnan
- Division of Hematology and Oncology, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Priyal Agarwal
- Division of Hematology and Oncology, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Rakesh Pinninti
- Basavatarakam Indo American Cancer Hospital & RI, Hyderabad, Telangana, India
| | - Senthil Rajappa
- Basavatarakam Indo American Cancer Hospital & RI, Hyderabad, Telangana, India
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27
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Signorelli J, Tran T, Sirek ME, Díaz-Rohena Y, Taraba JL, Muluneh B, Basu N, Lilly J, Darling J. Development of oral oncolytic nonadherence estimator (ORACLE): A pretreatment nonadherence risk assessment for oral oncolytics. J Oncol Pharm Pract 2023:10781552231208442. [PMID: 37899586 DOI: 10.1177/10781552231208442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
INTRODUCTION To date, there is no adherence estimator to identify risk of nonadherence prior to initiating oral oncolytics. METHODS A workgroup was assembled through the National Community Oncology Dispensing Association and tasked with creating a tool to meet this need. Tool constructs were defined after a review of the literature identifying top barriers to adherence. A second literature search was conducted to identify questions targeting specific barriers from validated adherence questionnaires. Once a finalized draft was complete, the risk assessment tool was built into an electronic survey where a risk category can be automatically calculated for the patient. RESULTS The six most impactful factors affecting compliance to oral oncolytics were identified as patient's confidence, health literacy, perception of treatment, quality of life, social support, and complexity of chemotherapy regimen. A six-item questionnaire was created with five patient-directed questions and one clinician-directed question. Examples and descriptions were provided for clinicians to consider when categorizing complexity of a regimen. The tool was designed for responses to each question to be indexed into categories through a 10-point system. Results will be stratified into low, moderate, or high risk for nonadherence. CONCLUSION The creation of a tool to predict nonadherence prior to starting therapy is an unmet need for patients initiating oral oncolytics. The aim of this tool is to meet those needs and better guide clinicians to provide patients with strategies to better manage nonadherence. Next steps include tool validation and piloting in clinical practice.
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Affiliation(s)
| | - Thuy Tran
- Specialty Pharmacy Services, Atrium Health, Charlotte, NC, USA
| | | | - Yarelis Díaz-Rohena
- NCODA University, National Community Oncology Dispensing Association, Cazenovia, NY, USA
| | - Jodi L Taraba
- Department of Pharmacy, Mayo Clinic, Rochester, MN, USA
| | - Benyam Muluneh
- Division of Pharmacotherapy and Experimental Therapeutics, University of Carolina Eshelman School of Pharmacy, Chapel Hill, NC, USA
- Cancer Prevention and Control Program, University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
| | - Nayanika Basu
- Department of Pharmacy, University of Virginia Breast Care Center, Charlottesville VA, USA
| | - Jennifer Lilly
- Department of Pharmacy, Fort Wayne Medical Oncology and Hematology, Fort Wayne, IN, USA
| | - Julianne Darling
- NCODA University, National Community Oncology Dispensing Association, Birmingham, AL, USA
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28
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Tabak BM, Froner MB, Corrêa RS, Silva TC. The Intersection of Health Literacy and Public Health: A Machine Learning-Enhanced Bibliometric Investigation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6951. [PMID: 37887689 PMCID: PMC10606076 DOI: 10.3390/ijerph20206951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/10/2023] [Accepted: 10/13/2023] [Indexed: 10/28/2023]
Abstract
In recent decades, health literacy has garnered increasing attention alongside a variety of public health topics. This study aims to explore trends in this area through a bibliometric analysis. A Random Forest Model was utilized to identify keywords and other metadata that predict average citations in the field. To supplement this machine learning analysis, we have also implemented a bibliometric review of the corpus. Our findings reveal significant positive coefficients for the keywords "COVID-19" and "Male", underscoring the influence of the pandemic and potential gender-related factors in the literature. On the other hand, the keyword "Female" showed a negative coefficient, hinting at possible disparities that warrant further investigation. Additionally, evolving themes such as COVID-19, mental health, and social media were discovered. A significant change was observed in the main publishing journals, while the major contributing authors remained the same. The results hint at the influence of the COVID-19 pandemic and a significant association between gender-related keywords on citation likelihood, as well as changing publication strategies, despite the fact that the main researchers remain those who have been studying health literacy since its creation.
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Affiliation(s)
- Benjamin Miranda Tabak
- School of Public Policy and Government, Getulio Vargas Foundation, SGAN 602 Módulos A,B,C, Asa Norte, Brasília 70830-020, Brazil
| | - Matheus B. Froner
- School of Public Policy and Government, Getulio Vargas Foundation, SGAN 602 Módulos A,B,C, Asa Norte, Brasília 70830-020, Brazil
| | - Rafael S. Corrêa
- School of Public Policy and Government, Getulio Vargas Foundation, SGAN 602 Módulos A,B,C, Asa Norte, Brasília 70830-020, Brazil
| | - Thiago C. Silva
- Graduate Programme of Economics, Catholic University of Brasília, Taguatinga 71966-700, Brazil
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Mohamed NE, Leung TM, Benn EKT, Korn TG, Ali I, Patel D, Gonzalez A, Quale DZ. Depression and anxiety among patients treated for bladder cancer: examining clinical, demographic, and psychosocial predictors. AMERICAN JOURNAL OF CLINICAL AND EXPERIMENTAL UROLOGY 2023; 11:401-413. [PMID: 37941645 PMCID: PMC10628622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 07/07/2023] [Indexed: 11/10/2023]
Abstract
INTRODUCTION AND OBJECTIVE The significant impact of bladder cancer and treatment on patient health related quality of life (HRQoL) and emotional wellbeing has been documented. Increasing evidence from cancer research emphasizes the importance of examining patients supportive care needs and received social support as factors that could influence their emotional adjustment. The purpose of the study was to assess the demographic and clinical predictors of depression and anxiety among bladder cancer patients and its associations with patient reported supportive care needs and perceived availability of social support. METHODS A cross-sectional design was used to investigate the study questions. Bladder cancer patients were recruited from the Bladder Cancer Advocacy Network (BCAN) to complete a questionnaire that included the Hospital Anxiety and Depression Scale (HADS), bladder cancer patient need survey (BCNAS-32), and the social provisions scale (SPS). The inclusion criteria restricted our sample to include bladder cancer patients who were English speakers, aged 18-85 years, and were able and willing to provide informed consent. Patients who had metastatic disease, cancer recurrence, or other primary cancers at the time of assessment were excluded from the study. RESULTS Participants included 159 bladder cancer patients. The mean age was 62±9.4 years and 51% were male. Almost two-thirds (62%) of patients reported a diagnosis of muscle invasive bladder cancer (MIBC), 25% patient reported clinically significant levels of anxiety, 17% reported clinically significant levels of depression, and 13% and 17% reported abnormal borderline abnormal levels for anxiety and depression, respectively. Univariate regression analyses revealed significant associations between HADS total score, HADS depression and anxiety subscales, patient age, physical functioning/daily living needs, sexuality needs, and perceived social support with higher total scores, anxiety, and depression scores associated with younger age, higher unmet needs, and lower levels of social support. Multivariate regression analyses, showed similar findings confirming the associations depicted by the univariate regression analyses. CONCLUSIONS Bladder cancer patients experience significant levels of depression and anxiety and these levels are associated with patient age, supportive care unmet needs and lack of social support. Patient focused interventions could be tailored to address these issues with the goal to improve patient HRQoL and emotional adjustment.
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Affiliation(s)
- Nihal E Mohamed
- Department of Urology and Oncological Science, Icahn School of Medicine at Mount SinaiNew York, NY, USA
| | - Tung-Ming Leung
- Department of Urology and Oncological Science, Icahn School of Medicine at Mount SinaiNew York, NY, USA
| | - Emma KT Benn
- Center for Biostatistics and Department of Population Health Science and Policy, Icahn School of Medicine at Mount SinaiNew York, NY, USA
| | - Talia G Korn
- Department of Urology and Oncological Science, Icahn School of Medicine at Mount SinaiNew York, NY, USA
| | - Imran Ali
- Department of Medicine, Icahn School of Medicine at Mount SinaiNew York, NY, USA
| | - Dhruti Patel
- Department of Urology and Oncological Science, Icahn School of Medicine at Mount SinaiNew York, NY, USA
| | - Adam Gonzalez
- Department of Psychiatry & Behavioral Health, Renaissance School of Medicine at Stony Brook UniversityStony Brook, NY, USA
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30
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Andersen LP, Dietrich MS, Murphy BA, Deng J. Factors associated with quality of life among patients with a newly diagnosed oral cavity and oropharyngeal cancer. Eur J Oncol Nurs 2023; 66:102384. [PMID: 37611502 PMCID: PMC10786603 DOI: 10.1016/j.ejon.2023.102384] [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: 02/11/2023] [Revised: 06/07/2023] [Accepted: 07/01/2023] [Indexed: 08/25/2023]
Abstract
PURPOSE The objectives of this report were 1) to examine the quality of life (QOL) of patients with a newly diagnosed oral cavity or oropharyngeal (OCOP) cancer; and 2) to examine factors contributing to QOL before cancer treatment. METHODS The sample included 115 participants with a new diagnosis of OCOP cancer. Participants completed the demographic form, oral cancer disease and treatment form, Hospital Anxiety and Depression Scale (HADS), Brief Health Literacy Screen (BHLS), and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30). Pearson correlations and linear regressions were used for data analysis. RESULTS Participants had a median global health related QOL score of 66.7 (interquartile range, IQR = 50.0, 83.4) with median scores for the subdomains being generally high (all >80 of possible 100). Anxiety and depression were significantly inversely correlated with all areas of EORTC QOL (r = - 0.48 to -0.78, all p < .001). Multivariable associations were strongest with the physical functioning domain (R = 0.56, p < .001), with younger age, higher income, Stage I/II cancer (compared to Stage III/IV) significant contributors to the multiple correlation (beta > ± 0.20, p < .05). CONCLUSIONS Health care providers should be attentive to OCOP cancer patients with older age, lower household income, advanced cancer stage, and presence of anxious and/or depressive symptoms for indicators of poor QOL. CLINICIANS SHOULD CONSIDER THE BENEFIT OF: initiating supportive interventions before cancer treatment among OCOP cancer patients with poor QOL.
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Affiliation(s)
- Lucy P Andersen
- University of Pennsylvania, School of Nursing, Philadelphia, PA, USA
| | - Mary S Dietrich
- Vanderbilt University, Department of Biostatistics, Schools of Medicine & Nursing, Nashville, TN, USA.
| | - Barbara A Murphy
- Vanderbilt Medical Center, Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
| | - Jie Deng
- University of Pennsylvania, School of Nursing, Philadelphia, PA, USA.
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Mapoko BSE, Frambo A, Saidu Y, Mbassi EDB, Atenguena E, Azemafac K, Kobayashi E, Tabola L, Nkeng G, Sango A, Maison AM, Noa SA, Ntama A, Mapenya RRM, Tayou R, Kouya F, Mbah G, Douanla P, Fonkwa C, Biwole ME, Sando Z, Sone AM, Ndom P. Assessment of barriers to optimal cancer control in adult cancer treatment centres in Cameroon. Ecancermedicalscience 2023; 17:1601. [PMID: 37799946 PMCID: PMC10550327 DOI: 10.3332/ecancer.2023.1601] [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: 11/26/2022] [Indexed: 10/07/2023] Open
Abstract
Approximately 20,745 new cases of cancer were registered annually with 13,199 (64%) deaths in 2020 in Cameroon. Despite the increasing cancer burden, there is a paucity of reliable data that can enhance decision-making for cancer control in Cameroon. This assessment was, therefore, designed to generate data that may enable stakeholders, policymakers and funders to make data-driven decisions on cancer control. We conducted a cross-sectional survey in July 2020, which enabled us to collect data on key cancer variables from six adult cancer treatment centres in Cameroon. The key components of the assessment included case detection, service availability, human resource capacity, cost of chemotherapy and radiotherapy, the safety of chemotherapy sessions, data systems, patient education, palliative care, funding for chemotherapy and chemotherapy stock. Data were compiled and analysed using Microsoft Excel 2016. Data from four of the 6 sites show that 1,636 new cases were recorded representing an annual case detection rate of 11.8%. All the six assessed facilities offered chemotherapy services, 5/6 (83.3%) offered surgery for cancers, while just 1 (16.7%) offered radiotherapy services. In addition, none offered nuclear medicine services for cancer care and treatment. Similarly, none of the facilities had the WHO-recommended number of human resources for optimal cancer care. Overall, there were only 6 medical oncologists, 2 surgical oncologists, 3 radiation oncologists and 14 oncology nurses providing services across the 6 cancer treatment centres. Treatment services are expensive for an average national, with a complete course of chemotherapy followed by radiotherapy costing ~XAF 1,240,000 (~$2,480). None of the survey facilities had a recommended safe biosafety cabinet and clean room for the preparation of chemotherapies, rendering the preparation of chemotherapies suboptimal and hazardous. Data collection tools were manual, relatively available and very different across all the surveyed sites and the interval for data collection and transmission was collectively undefined. Optimal cancer care in adult cancer treatment centres is limited by several health systems and socio-economic factors. The identification of these barriers has enabled the formulation of action-oriented interventions, leveraging on the recently adopted national strategy for the prevention and control of cancers in the country.
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Affiliation(s)
| | - Andreas Frambo
- Clinton Health Access Initiative, Yaoundé 99322, Cameroon
| | - Yauba Saidu
- Clinton Health Access Initiative, Yaoundé 99322, Cameroon
- Institute for Global Health, University of Siena, Siena 53100, Italy
| | - Esther Dina Bell Mbassi
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala 99322, Cameroon
| | - Etienne Atenguena
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé 99322, Cameroon
| | - Kareen Azemafac
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé 99322, Cameroon
| | | | - Lionel Tabola
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé 99322, Cameroon
| | - Glenda Nkeng
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé 99322, Cameroon
| | - Anne Sango
- Faculty of Health Sciences, University of Buea, Buea 99322, Cameroon
| | - Anne Marthe Maison
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala 99322, Cameroon
| | - Sidonie Ananga Noa
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala 99322, Cameroon
| | - Ambroise Ntama
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala 99322, Cameroon
| | | | - Rachel Tayou
- Faculty of Health Sciences, University of Dschang, Dschang 99322, Cameroon
| | | | - Glenn Mbah
- Mbingo Baptist Hospital, Bamenda 99322, Cameroon
- Faculty of Health Sciences, University of Bamenda, Bamenda 99322, Cameroon
| | - Pelagie Douanla
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé 99322, Cameroon
| | | | - Martin Essomba Biwole
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala 99322, Cameroon
| | - Zacharie Sando
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé 99322, Cameroon
| | - Albert Mouelle Sone
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala 99322, Cameroon
| | - Paul Ndom
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé 99322, Cameroon
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Lee BE, Uhm JY, Kim MS. Effects of social support and self-efficacy on eHealth literacy in Korean women undergoing breast cancer treatment: A secondary analysis. Asia Pac J Oncol Nurs 2023; 10:100267. [PMID: 37661958 PMCID: PMC10471924 DOI: 10.1016/j.apjon.2023.100267] [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: 04/22/2023] [Accepted: 06/16/2023] [Indexed: 09/05/2023] Open
Abstract
Objective Patients with breast cancer need to seek out and understand relevant health information to make informed decisions about long-term and complicated illnesses. With the increased use of interventions using online health information, research on eHealth literacy should be expanded. However, existing studies on the factors affecting eHealth literacy in patients with breast cancer are currently lacking. This study, therefore, conducts a secondary analysis of a previous study that surveyed the quality of life of patients with breast cancer. The primary study found a significant correlation between eHealth literacy, social support, and self-efficacy. In this secondary analysis study, we specifically examine eHealth literacy among patients with breast cancer undergoing treatment, and how patient demographic characteristics, breast cancer-specific self-efficacy, and social support contribute to their eHealth literacy. Methods A total of 143 women receiving outpatient treatment or were hospitalized for breast cancer at a cancer hospital in South Korea participated in the study from January to November 2022. The eHealth Literacy Scale (eHEALS), Multidimensional Social Support Scale, and Breast Cancer Survivors Scale were utilized in the analysis. The data were analyzed using a multiple regression analysis. Results Full-time employment (β = 0.19, P = 0.006), a monthly family income of over 4 million won (3600 USD) (β = 0.14, P = 0.042), completing a high school education (β = 0.52, P < 0.001), completing college level or higher education (β = 0.54, P < 0.001), age (β = -0.23, P = 0.003), and social support (β = 0.21, P = 0.002) were predictors of eHealth literacy, explaining 40.2% of the total variance (F = 14.63, P < 0.001). Conclusions Social support was identified as a new factor influencing eHealth literacy among patients with breast cancer undergoing treatment. Therefore, nursing interventions to strengthen social support should be developed to improve eHealth literacy.
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Affiliation(s)
- Bang-Eun Lee
- Department of Nursing, Dongnam Institute of Radiological & Medical Sciences, Busan, South Korea
| | - Ju-Yeon Uhm
- Department of Nursing, Pukyong National University, Busan, South Korea
| | - Myoung Soo Kim
- Department of Nursing, Pukyong National University, Busan, South Korea
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Yuen EYN, Wilson C, Livingston PM, White V, McLeod V, Dufton PH, Hutchinson AM. Caregiver and care recipient health literacy, social support and connectedness on caregiver psychological morbidity: A cross-sectional dyad survey. Psychooncology 2023; 32:1257-1267. [PMID: 37430441 DOI: 10.1002/pon.6177] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/24/2023] [Accepted: 05/26/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND Caregivers play an important role supporting people diagnosed with cancer, yet report significant unmet information and support needs that impact on their psychological wellbeing. Health literacy and social connectedness are key factors that influence wellbeing, yet few studies have examined their relative role in psychological wellbeing of carers. This study investigated relationships between caregiver and care recipient health literacy, social support, and social connectedness on psychological morbidity in a cancer setting. METHODS This cross-sectional study included 125 caregiver-cancer care recipient dyads. Participants completed the Health Literacy Survey-EU-Q16, Social Connectedness Scale-Revised, the Medical Outcomes Study-Social Support Survey, and the Depression, Anxiety and Stress Scale-21 (DASS21). Relationships between factors were examined using hierarchical multiple regression with care recipient factors entered at Step 1 and caregiver factors at Step 2. RESULTS Most caregivers provided care for their spouse (69.6%); caregivers mean total DASS21 score was 24.38 (SD = 22.48). Mean DASS21 subscale scores for depression, anxiety, stress in caregivers were 4.02 (SD = 4.07), 2.7 (SD = 3.64), and 5.48 (SD = 4.24) respectively, suggesting normal range of depression and stress, and mild anxiety. Care recipients had a diagnosis of breast (46.4%), gastrointestinal (32.8%), lung (13.6%), or genitourinary (7.2%) cancer, and a mean DASS21 score of 31.95 (SD = 20.99). Mean DASS21 subscale scores for depression, anxiety, stress in care recipients were 5.10 (SD = 4.18), 4.26 (SD = 3.65), and 6.62 (SD = 3.99) respectively, suggesting mild depression and anxiety, and normal stress scores. Regression analyses showed that only caregiver factors (age, illness/disability, health literacy and social connectedness) were independent predictors of caregiver psychological morbidity (F [10,114] = 18.07, p < 0.001). CONCLUSION(S) Only caregiver, and not care recipient, factors were found to influence caregiver psychological morbidity. While both health literacy and social connectedness influenced caregiver psychological morbidity, perceived social connectedness had the strongest influence. Interventions that ensure caregivers have adequate health literacy skills, as well as understand the value of social connection when providing care, and are supported to develop skills to seek support, have the potential to promote optimal psychological wellbeing in cancer caregivers.
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Affiliation(s)
- Eva Y N Yuen
- School of Nursing and Midwifery, Centre for Quality and Patient Safety, Institute for Health Transformation, Deakin University, Burwood, Victoria, Australia
- Centre for Quality and Patient Safety - Monash Health Partnership, Deakin University, Burwood, Victoria, Australia
- School of Psychology and Public Health, LaTrobe University, Bundoora, Victoria, Australia
- Psycho-Oncology Research Unit, Olivia Newton John Cancer, Wellness and Research Centre, Austin Health, Heidelberg, Victoria, Australia
| | - Carlene Wilson
- School of Psychology and Public Health, LaTrobe University, Bundoora, Victoria, Australia
- Psycho-Oncology Research Unit, Olivia Newton John Cancer, Wellness and Research Centre, Austin Health, Heidelberg, Victoria, Australia
- Centre for Epidemiology and Biostatistics, University of Melbourne, Melbourne, Victoria, Australia
| | - Patricia M Livingston
- School of Nursing and Midwifery, Centre for Quality and Patient Safety, Institute for Health Transformation, Deakin University, Burwood, Victoria, Australia
| | - Victoria White
- School of Psychology, Deakin University, Burwood, Victoria, Australia
| | - Vicki McLeod
- Oncology Department, Monash Health, Clayton, Victoria, Australia
| | - Polly H Dufton
- Department of Nursing, University of Melbourne, Parkville, Victoria, Australia
- Olivia Newton-John Cancer, Wellness and Research Centre, Austin Health, Heidelberg, Victoria, Australia
| | - Alison M Hutchinson
- School of Nursing and Midwifery, Centre for Quality and Patient Safety, Institute for Health Transformation, Deakin University, Burwood, Victoria, Australia
- Centre for Quality and Patient Safety - Barwon Health Partnership, Deakin University, Geelong, Victoria, Australia
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Robertson NM, Burus T, Hudson L, Hull PC, Park L, Vanderford NL. Lung and Colorectal Cancer Disparities in Appalachian Kentucky: Spatial Analysis on the Influence of Education and Literacy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6363. [PMID: 37510595 PMCID: PMC10379284 DOI: 10.3390/ijerph20146363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/14/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023]
Abstract
Low educational attainment and high cancer incidence and mortality rates have long been a challenge in Appalachian Kentucky. Prior studies have reported disparities in cancer incidence and mortality between Appalachian and non-Appalachian populations, but the influence of education on this disparity has not been extensively studied. Herein, all cancers and two cancer sites with available screenings (colorectal and lung) were joined with education indicators (educational attainment and literacy) and one geographic indicator across all 120 Kentucky counties. This dataset was used to build choropleth maps and perform simple linear and spatial regression to assess statistical significance and to measure the strength of the linear relationship between county-level education and cancer-related outcomes in Appalachian and non-Appalachian Kentucky. Among all cancer sites, age-adjusted cancer incidence and mortality was higher in Appalachian versus non-Appalachian Kentucky. The percentage of the population not completing high school was positively correlated with increased colorectal and lung cancer incidence and mortality in Appalachia. Similarly, counties with a higher percentage of the population lacking basic literacy had the strongest correlation with colorectal and lung cancer incidence and mortality, which were concentrated in Appalachian Kentucky. Our findings suggest a need for implementing interventions that increase educational attainment and enhance basic literacy as a means of improving cancer outcomes in Appalachia.
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Affiliation(s)
| | - Todd Burus
- Markey Cancer Center, University of Kentucky, Lexington, KY 40536, USA
| | - Lauren Hudson
- College of Medicine, University of Kentucky, Lexington, KY 40536, USA
- Markey Cancer Center, University of Kentucky, Lexington, KY 40536, USA
| | - Pamela C Hull
- College of Medicine, University of Kentucky, Lexington, KY 40536, USA
- Markey Cancer Center, University of Kentucky, Lexington, KY 40536, USA
- Department of Behavioral Science, College of Medicine, University of Kentucky, Lexington, KY 40536, USA
| | - Lee Park
- Department of Statistics, College of Arts and Sciences, University of Kentucky, Lexington, KY 40536, USA
| | - Nathan L Vanderford
- College of Medicine, University of Kentucky, Lexington, KY 40536, USA
- Markey Cancer Center, University of Kentucky, Lexington, KY 40536, USA
- Department of Toxicology and Cancer Biology, College of Medicine, University of Kentucky, Lexington, KY 40536, USA
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Moodley Y, Bhadree S, Stopforth L, Kader S, Wexner S, van Wyk J, Neugut A, Kiran R. Patient's attitudes and perceptions around attending oncology consultations following surgery for colorectal cancer: A qualitative study. F1000Res 2023; 12:698. [PMID: 38173827 PMCID: PMC10762288 DOI: 10.12688/f1000research.134816.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/31/2023] [Indexed: 01/05/2024] Open
Abstract
Background: The oncology consultation following surgery for colorectal cancer (CRC) is usually the first step in the receipt of chemotherapy. Non-compliance with this consultation results in non-receipt of recommended chemotherapy, when appropriate, and worse clinical outcomes. This study sought to explore South African patients' attitudes and perceptions around attending scheduled oncology consultations following their CRC surgery. Methods: Semi-structured qualitative interviews were conducted with patients who had surgery for CRC at a quaternary South African hospital and who had to decide whether they would return for an oncology consultation. The "Model of health services use" informed the design of the interview guide, which included questions on factors that impact health seeking behavior. Demographics of participants, CRC disease stage, and compliance with scheduled oncology consultations were also collected. Descriptive statistics were used to analyse the quantitative data, while deductive thematic analysis was used to analyse the qualitative data. Results: Seven participants were interviewed. The median age was 60.0 years and four participants (57.1%) were female. Black African, White, and Asian participants accounted for 85.7% of the study sample. Most participants had stage III CRC (71.4%). The oncology consultation no-show rate was 14.3%. Participant's knowledge and beliefs around CRC proved to be an important predisposing factor that influenced follow-up decisions. Family support and religion were cited as important enabling factors. Travel costs to the hospital and frustrations related to the clinic appointment booking/scheduling process were cited as important disabling factors. Lastly, the participant's self-perceived need for additional oncology care also appeared to influence their decision to return for ongoing oncology consultation after the initial surgery. Conclusion: Several contextual factors can potentially influence a patient's compliance with a scheduled oncology consultation following CRC surgery. A multipronged approach which addresses these factors is required to improve compliance with oncology consultations.
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Affiliation(s)
- Yoshan Moodley
- University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa
- Stellenbosch University, Stellenbosch, Western Cape, South Africa
| | - Shona Bhadree
- University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa
| | - Laura Stopforth
- University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa
| | - Shakeel Kader
- University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa
| | | | - Jacqueline van Wyk
- University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa
- University of Cape Town, Rondebosch, Western Cape, South Africa
| | | | - Ravi Kiran
- Columbia University, New York, New York, USA
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Martin C, Hudson L, Vanderford NL. Piloting an Oral History Approach to Investigate Cancer Perspectives Among Residents of Appalachian Kentucky. JOURNAL OF APPALACHIAN HEALTH 2023; 5:95-113. [PMID: 38023110 PMCID: PMC10629891 DOI: 10.13023/jah.0501.07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
Introduction Kentucky ranks first in the U.S. in overall cancer incidence and mortality rates. Areas of the state that fall within the Appalachian Region, along Kentucky's eastern border, experience disproportionately high rates of cancer compared to non-Appalachian counties. Purpose: This pilot study investigates whether oral history interviews can be used to understand perspectives on cancer among residents of Appalachian Kentucky. Methods In 2020, participants (n = 5) who identified as being from and/or having strong connections to Appalachian Kentucky were recruited to participate in this pilot study. Participants included individuals working in cancer-related fields, oncology professionals, and those with personal cancer experience. Using an oral history approach, subjects were asked about challenges within Appalachia that contribute to high rates of cancer regionally. Interviews were analyzed using qualitative content analysis, and data were condensed into themes, subthemes, and subtopics. Relational content analysis was then used to illustrate relationships between the problems being faced in Appalachia and their contributing factors, with potential solutions to those problems. Results Six key themes emerged from analysis of the oral history interviews: (1) problems being faced in Appalachia; (2) contributing factors; (3) potential solutions; (4) Appalachian disposition; (5) experiences with and thoughts on cancer; and (6) defining success v. the future without changes (intervention). A further 25 subthemes were identified from within these themes. Taken together, these themes and subthemes point to potential areas for specific intervention to shift Appalachia's cancer burden. Implications This pilot study demonstrates potential benefit in using oral history interviews to elucidate Appalachian Kentuckians' perspectives on cancer. From the nuanced insights gained through this method, a set of culturally appropriate interventions were identified that could address the disproportionate cancer burden in the region. Future studies using an oral history approach could aim to reveal other specific aspects of how cancer impacts individuals, families, and communities.
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Melhem SJ, Nabhani-Gebara S, Kayyali R. Cancer literacy among Jordanian colorectal cancer survivors and informal carers: Qualitative explorations. Front Public Health 2023; 11:1116882. [PMID: 37020817 PMCID: PMC10067669 DOI: 10.3389/fpubh.2023.1116882] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 03/01/2023] [Indexed: 03/22/2023] Open
Abstract
IntroductionCancer patients face a variety of challenges in understanding their diagnosis and treatment options. Making informed decisions requires health literacy. There is scant research on how colorectal cancer (CRC) survivors and their caregivers engage with healthcare systems and obtain cancer-related knowledge to maintain proper health literacy, which is crucial for enhancing their outcomes.Materials and methodsIn-depth semi-structured interviews (IDIs) with CRC survivors (n = 15) and online focus groups (FG) with informal caregivers (ICs) were held in Amman between Jan-June 2020. In-depth interviews were conducted using semi-structured interview protocol that addressed the healthcare experience of CRC cancer survivors. FGs evaluated ICs' perspectives of e-health for cancer care support. IDIs and FGs were done in the local Jordanian Arabic dialect, which was then translated into English. Transcribed audio-recordings were thematically coded and framework analysis was used.ResultsThe findings are organized around a central concept of “exploring the level of literacy and its impact.” From the overarching theme, three themes and subthemes emerged, including: (1) The current state of counseling and information provision, (2) The impact of lack of information, awareness, and literacy and (3) The health system's influence on literacy.ConclusionsPoor cancer literacy hinders patients throughout their cancer journey. Empowering cancer patients is crucial for a more timely and positive patient experience. Increased cancer literacy together with the creation of health-literate organizations and systems have the potential to improve patients' treatment throughout the continuum of care.
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Habr D, Wolf Gianares B, Schuler KW, Chari D. Patients at the Heart of the Scientific Dialogue: An Industry Perspective. Oncol Ther 2023; 11:15-24. [PMID: 36705813 PMCID: PMC9881512 DOI: 10.1007/s40487-023-00220-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 01/13/2023] [Indexed: 01/28/2023] Open
Abstract
Pharmaceutical companies need to regularly communicate to patients all essential information about their medicines, especially data from the research studies that were conducted to evaluate the medicine’s benefits and risks. To do that, companies will need to make sure patients have access to and awareness of relevant information. This can be achieved by ensuring medical information is freely available to the reader, and working with publishers to facilitate open access (free) publications. Companies should also help improve patients’ understanding of medical terminology, offer simplified versions of scientific content, and deliver information through various formats (print versus digital, text versus audio versus video) to address different learning styles and literacy levels. This will empower patients with knowledge and improve shared decision-making. It will also be essential for pharmaceutical companies to involve patients in various stages of medicine development, such as getting their input on how the research studies for investigating these medicines are designed and reported to ensure relevant information to patients are well-captured and clear. This should also go in parallel with providing opportunities to elevate the patient voice through patient-partnered research and authorship on topics particularly relevant to them.
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Affiliation(s)
- Dany Habr
- Pfizer Oncology, Pfizer Inc., 235 East 42nd Street, New York, NY, 10011, USA.
| | | | - Kristine W Schuler
- Pfizer Oncology, Pfizer Inc., 235 East 42nd Street, New York, NY, 10011, USA
| | - Dheepa Chari
- Pfizer Oncology, Pfizer Inc., 235 East 42nd Street, New York, NY, 10011, USA
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Ziegler E, Klein J, Kofahl C. Do members of cancer peer support groups know more about cancer than non-members? Results from a cross-sectional study in Germany. Support Care Cancer 2023; 31:7. [PMID: 36512095 PMCID: PMC9745733 DOI: 10.1007/s00520-022-07488-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 11/09/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE This study aims to assess whether cancer-specific knowledge (CSK) is associated with membership in a cancer peer support group (PSG) and other factors. METHODS A cross-sectional study investigated the CSK of 1121 cancer patients of various entities across Germany. CSK was measured with the BCKS-14, a 14-item knowledge instrument which was previously participatory developed with patient representatives and oncologists. Associations between CSK and PSG membership, sociodemographic factors, internet use, and preferences in medical decision-making were analysed with t-tests and multiple linear regressions. RESULTS The t-test showed a statistically significant difference in CSK between members and non-members of PSGs. Knowledge for PSG members was on average 0.97 points higher (p < 0.001) and varied between 2 and 14 points compared to 0-14 points for non-members. Regression analysis revealed age, gender, time since diagnosis, education, internet use, and PSG activity to be statistically significant predictors. Younger (β = - 0.15; p < 0.001), female (β = 0.10; p = 0.001), higher educated patients (β = 0.27; p < 0.001) with and a diagnosis longer ago (β = 0.10; p = 0.002) who use the internet frequently for information seeking (β = 0.20; p ≤ 0.001) and members of cancer PSGs (β = 0.18; p ≤ 0.001) showed a higher CSK. CONCLUSION Overall, CSK of the participants shows a high degree of variance. CSK should be promoted for all patients and especially for older, newly diagnosed patients with low educational levels and PSGs introduced early on as they contribute to improving CSK among other benefits.
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Affiliation(s)
- Elâ Ziegler
- grid.13648.380000 0001 2180 3484Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany
| | - Jens Klein
- grid.13648.380000 0001 2180 3484Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany
| | - Christopher Kofahl
- grid.13648.380000 0001 2180 3484Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany
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Djaafar NS, Djaafar T. Health Literacy and Anxiety Among Hemodialysis Patients During the Coronavirus Disease Pandemic [Letter]. Psychol Res Behav Manag 2023; 16:1457-1458. [PMID: 37131957 PMCID: PMC10149071 DOI: 10.2147/prbm.s416214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 04/16/2023] [Indexed: 05/04/2023] Open
Affiliation(s)
- Nurseha S Djaafar
- Department of Nursing, Poltekkes Kemenkes Manado, Manado, Indonesia
- Correspondence: Nurseha S Djaafar, Department of Nursing, Poltekkes Kemenkes Manado, Wolter Mongonsidi Street, Malayang Dua, Manado, North Sulawesi, Indonesia, Email
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Harley RJ, Atchison K, Li J, Losego K, Wasserman-Wincko T, Johnson JT, Nilsen ML. Health Literacy and Adherence to Clinical Recommendations in Head and Neck Cancer. Health Lit Res Pract 2023; 7:e52-e60. [PMID: 36888985 PMCID: PMC9991085 DOI: 10.3928/24748307-20230222-01] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND After definitive cancer treatment, survivors of head and neck cancer (HNC) are commonly recommended to participate in therapies aimed at reducing the burden of treatment-related side effects. OBJECTIVE In this study, we evaluated whether adherence to referral to physical therapy (PT) and speech-language pathology therapy (SLPT) is related to patient health literacy (HL). METHODS This is a retrospective cohort analysis of patients attending a multidisciplinary HNC survivorship clinic between 2017 and 2019. HL was measured using the Brief Health Literacy Screen, with scores below 10 indicating inadequate HL. Chi-square and logistic regression were used to evaluate the association between HL and adherence to PT or SLPT referral. KEY RESULTS From the overall cohort (N = 454), 80 patients (18%) had inadequate HL. Compared to those with adequate HL, patients with inadequate HL were significantly less likely to complete initial PT evaluation (74% vs. 58%, p = .034) but were not significantly less likely to complete initial SLPT evaluation (70% vs. 61%, p = .37). After adjusting for age, primary tumor site, and treatment stage, we found that patients with inadequate HL were half as likely to follow up for initial PT evaluation (odds ratio 0.45, p = .032). CONCLUSION Overall, inadequate HL is associated with reduced adherence to PT but is not associated with adherence to SLPT among HNC survivors. These results highlight the clinical importance of HL and underscore the need for interventions to facilitate adherence to treatment for patients with inadequate HL. [HLRP: Health Literacy Research and Practice. 2023;7(1):e52-e60.].
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Affiliation(s)
| | | | | | | | | | | | - Marci L. Nilsen
- Address correspondence to Marci L. Nilsen, PhD, RN, Department of Acute and Tertiary Care, University of Pittsburgh, School of Nursing, 318A Victoria Building, 3500 Victoria Street, Pittsburgh, PA 15261;
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Domaradzki J. Can popular films instil carcinophobia? Images of cancer in popular Polish cinema. Front Oncol 2022; 12:1062286. [PMID: 36568191 PMCID: PMC9768482 DOI: 10.3389/fonc.2022.1062286] [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: 10/05/2022] [Accepted: 11/23/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction Although cancer is currently considered a serious socio-medical challenge and health education in Poland has been positioned as a public health priority, the impact of popular culture on people's ideas about cancer has been neglected. This study therefore aims to analyse the way popular Polish films portray cancer and the experience of cancer. Material and Methods Seven popular Polish films featuring cancer were analysed both quantitatively and qualitatively. The main categories included in the coding frame were disease, therapy, patient, physicians/oncologists and psychosocial issuses related to cancer. Results Polish films fail to provide the audience with basic information about the disease, its diagnoses and treatment and cancer is often represented as a mysterious disease with an unclear cause, an unpredictable and unsuccessful course of treatment, characterised by pain, suffering and inevitable death. Films may therefore instil carcinophobia. Since films accurately reflect problems of daily life faced by cancer patients and their families they have educational potential. Conclusion Although Polish films reinforce harmful stereotypes about cancer, its treatment, oncological institutions and specialists, cinema has the ability to raise the public's and health professionals' awareness regarding the psycho-social and emotional strains faced by cancer patients and the medical problems related to cancer.
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Domaradzki J. Can popular films instil carcinophobia? Images of cancer in popular Polish cinema. Front Oncol 2022; 12. [DOI: https:/doi.org/10.3389/fonc.2022.1062286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/24/2023] Open
Abstract
IntroductionAlthough cancer is currently considered a serious socio-medical challenge and health education in Poland has been positioned as a public health priority, the impact of popular culture on people’s ideas about cancer has been neglected. This study therefore aims to analyse the way popular Polish films portray cancer and the experience of cancer.Material and MethodsSeven popular Polish films featuring cancer were analysed both quantitatively and qualitatively. The main categories included in the coding frame were disease, therapy, patient, physicians/oncologists and psychosocial issuses related to cancer.ResultsPolish films fail to provide the audience with basic information about the disease, its diagnoses and treatment and cancer is often represented as a mysterious disease with an unclear cause, an unpredictable and unsuccessful course of treatment, characterised by pain, suffering and inevitable death. Films may therefore instil carcinophobia. Since films accurately reflect problems of daily life faced by cancer patients and their families they have educational potential.ConclusionAlthough Polish films reinforce harmful stereotypes about cancer, its treatment, oncological institutions and specialists, cinema has the ability to raise the public’s and health professionals’ awareness regarding the psycho-social and emotional strains faced by cancer patients and the medical problems related to cancer.
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Vela‐Vallespín C, Medina‐Perucha L, Jacques‐Aviñó C, Codern‐Bové N, Harris M, Borras JM, Marzo‐Castillejo M. Women's experiences along the ovarian cancer diagnostic pathway in Catalonia: A qualitative study. Health Expect 2022; 26:476-487. [PMID: 36447409 PMCID: PMC9854297 DOI: 10.1111/hex.13681] [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: 10/07/2022] [Revised: 11/16/2022] [Accepted: 11/17/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Early detection of symptoms and prompt diagnosis of ovarian cancer are considered important avenues for improving patient experiences and outcomes. METHODS This qualitative study used a phenomenological approach to perform patient interviews, collecting individual accounts of the prediagnostic phase in women diagnosed and treated for ovarian cancer in 2016-2017. Purposive sampling was used to obtain a diverse sample of 24 participants, while thematic content analysis was used to extract themes and subthemes from interview data. RESULTS Three themes and nine subthemes were identified. The first theme was women's delay in recognizing symptoms and seeking care, with subthemes on the lack of knowledge about early signs of ovarian cancer, gender-related barriers and false reassurance from negative test results. A second theme was missed opportunities during healthcare encounters, due to misattribution of women's symptoms by their physicians, underestimation of symptom severity and need for mediation and inadequate tests and/or false negative results. Finally, interviews highlighted the use of resources and alternative healthcare pathways, including complementary/alternative medicines, access to private health care and women's capacity for action and decision-making (agency) about their health. CONCLUSION Delayed diagnosis of ovarian cancer is rooted in both individual factors (lack of health literacy, reluctance to seek care) and systemic issues (missed opportunities in healthcare encounters, access to timely specialist care). Further research is needed to investigate the extent to which traditional gender roles and socioeconomic inequalities condition women's ability to manage their own health and to interact with health professionals and the health system. PATIENT AND PUBLIC CONTRIBUTION In addition to the patient participation during the interviews, one author was a representative of a patient association.
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Affiliation(s)
- Carmen Vela‐Vallespín
- Primary Health Care Center Riu Nord i Riu Sud, Catalan Health InstitutBarcelonaSpain,Research Support Unit Metropolitana NordUniversity Institute for Primary Health Care Research (IDIAP) Jordi Gol, Catalan Health InstituteBarcelonaSpain
| | - Laura Medina‐Perucha
- Unitat Transversal de la RecercaFundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol)BarcelonaSpain,Unitat Transversal de la RecercaUniversitat Autònoma de BarcelonaBarcelonaSpain
| | - Constanza Jacques‐Aviñó
- Unitat Transversal de la RecercaFundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol)BarcelonaSpain,Unitat Transversal de la RecercaUniversitat Autònoma de BarcelonaBarcelonaSpain
| | - Núria Codern‐Bové
- Department of NursingEscola Universitària d'Infermeria i Teràpia Ocupacional de Terrassa, Universitat Autònoma BarcelonaBarcelonaSpain,Evaluation and Qualitative ResearchÀreaQBarcelonaSpain
| | | | - Josep M. Borras
- Department Clinical Sciences, Bellvitge Biomedical Research Institute (IDIBELL)University of BarcelonaBarcelonaSpain
| | - Mercè Marzo‐Castillejo
- Research Support Unit Metropolitana SudUniversity Institute for Primary Health Care Research IDIAPJordi GolBarcelonaSpain
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BG B, Anand VK, Kaur S, Gupta N, Rastogi S. Knowledge of patients with sarcoma about their illness-a cross-sectional questionnaire-based study (KNOWSARC). Ecancermedicalscience 2022; 16:1467. [PMID: 36819820 PMCID: PMC9934869 DOI: 10.3332/ecancer.2022.1467] [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: 07/17/2022] [Indexed: 11/06/2022] Open
Abstract
Objective To explore the knowledge of Indian patients with sarcoma about their illness in the sarcoma medical oncology clinic of a tertiary care centre. Method This prospective cross-sectional questionnaire-based study was done on patients attending the adult sarcoma clinic at the All India Institute of Medical Sciences, New Delhi. Patients aged between 18 and 60 years who gave consent and could understand Hindi or English were recruited for the study. A questionnaire (bilingual - English/Hindi) was given to the patients in the language they understood. The questionnaire captured the knowledge of patients about their illness (cancer/sarcoma), sub-type of sarcoma, the occurrence of the disease (common or rare), origin (bone or soft tissue), metastatic or non-metastatic and the understanding of the possibility of recurrence/progression. Result There were 102 patients in the study with a median age of 31.5 years. About 62% of patients had soft tissue sarcomas, and the rest had bone sarcomas. The most common sarcoma in the studied population was Ewing's sarcoma (23.5%). Metastatic disease was present in 48 (47.1%) of the total patients studied. About 87.2% of patients were aware that they had some form of cancer, and only 62 (69.9%) patients said that they had sarcoma. Only 55 of the 102 patients (56%) knew that the illness was rare. About 70.6% of patients knew about their disease's actual stage. More patients with metastatic disease understood the stage correctly (35 of 54 patients) as compared to patients with the non-metastatic disease (37 of 48 patients) (77% versus 64.8%, p = 0.001). About 77% of patients reported the site of origin of cancer correctly. The patients who had a higher level of education and belonged to a higher socioeconomic status had significantly better knowledge regarding the diagnosis, stage, rarity and prognosis of the disease. Conclusion Our patients have poor knowledge about different types of sarcomas, and very few patients know that sarcoma is a rare malignancy. The most crucial factor that influenced the knowledge was the level of education. Through this study, we could identify the sub-group wherein the knowledge gap was significant. Thus, active patient education programmes can help these patients to identify their illness and henceforth therapeutically manage it more wisely.
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Affiliation(s)
- Bharath BG
- Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi 110029, India
| | | | - Simran Kaur
- Department of Physiology, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Nishkarsh Gupta
- Department of Onco-Anaesthesia, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Sameer Rastogi
- Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi 110029, India
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Tabernero J, Bowling TE, Rivers J, Chari D, Ghith J, Ferdinand R, Shanahan K, Shore ND. Improving access to oncology publications for advocates and people with cancer. Cancer 2022; 128:3757-3763. [PMID: 36098654 PMCID: PMC9826100 DOI: 10.1002/cncr.34447] [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: 11/12/2021] [Revised: 05/03/2022] [Accepted: 05/19/2022] [Indexed: 01/11/2023]
Abstract
Journal articles provide reliable and current information about cancer research. This can offer hope to people with cancer and help them make decisions about their care. Here, the authors suggest ways in which different groups may help people with cancer to find, view, and understand articles. For example, journals should make articles free to view if they describe research that could change patient care. Also, clear titles and easy-to-follow summaries or videos may help people to find relevant articles and understand the main findings. It is important to explore ways to best share research with all those whose lives it may affect.
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Affiliation(s)
- Josep Tabernero
- Vall d'Hebron Hospital Campus and Institute of Oncology, International Oncology Bureau‐Quiron, University of Vic‐Central University of CataloniaBarcelonaSpain
| | | | - Jamil Rivers
- METAvivor Research & SupportAnnapolisMarylandUSA
| | | | | | | | | | - Neal D. Shore
- Carolina Urologic Research CenterMyrtle BeachSouth CarolinaUSA
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Dealing with the Vicissitudes and Abject Consequences of Head and Neck Cancer: A Vital Role for Psycho-Oncology. Curr Oncol 2022; 29:6714-6723. [PMID: 36135096 PMCID: PMC9497961 DOI: 10.3390/curroncol29090527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/22/2022] [Accepted: 09/14/2022] [Indexed: 11/17/2022] Open
Abstract
Patients with head and neck cancer face important life-altering effects in appearance and function, affecting distress and quality of life and requiring the involvement of a multidisciplinary team. Psycho-oncology makes an important contribution to the field, as head and neck cancers carry a huge adaptational toll. To illustrate the value of this discipline, we report two cases of patients with advanced head and neck cancer for which the treatment-related body changes were of major significance. A commentary by the treating surgeons and psycho-oncologists precedes a general discussion about the clinical management of such patients. The article outlines strategies to address health literacy, doctor–patient communication, treatment decision-making, and emotional distress; placing the person at the center of oncological care. It calls for the broad application of principles of psychological first aid by healthcare professionals in oncology.
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Klein J, Kofahl C, Ziegler E. Development and psychometric properties of a brief generic cancer knowledge scale for patients (BCKS-10). Cancer Causes Control 2022; 33:1173-1179. [PMID: 35829829 PMCID: PMC9277979 DOI: 10.1007/s10552-022-01601-x] [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: 12/21/2021] [Accepted: 06/21/2022] [Indexed: 11/27/2022]
Abstract
Purpose This study aims to introduce the development and psychometric properties of a brief generic cancer knowledge scale for patients (BCKS-10) that includes different elements of knowledge and skills (terminology, diagnosis, treatment, prevention, and numeracy). Although cancer knowledge is a central dimension of cancer literacy, most previous studies either investigated cancer knowledge among the general population, or among patients with a specific cancer diagnosis. Methods Qualitative interviews (n = 11) and a quantitative survey (n = 267) among peer support group leaders were conducted to further develop the BCKS-10 after literature screening. n = 500 patients with cancer were recruited across Germany between October 2020 and February 2021. Construct validity, item discrimination and reliability were tested. Results ANOVA revealed no significant differences of the knowledge score between various cancer sites, a significant positive association with education, and a negative association with migration background by trend supporting construct validity. In terms of item discrimination, the corrected item-total correlation of 8 out of 10 items were above the threshold of 0.3. Cronbach’s alpha of about 0.68 revealed an acceptable internal consistency as the tool is brief and consists of different dimensions. Conclusion Overall, the findings show that the BCKS-10 is a suitable tool to briefly assess cancer knowledge among patients independent of cancer site. However, further surveys have to be conducted to validate the psychometric properties and enhance the BCKS-10. Supplementary Information The online version contains supplementary material available at 10.1007/s10552-022-01601-x.
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Affiliation(s)
- J Klein
- Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | - C Kofahl
- Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - E Ziegler
- Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
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Kanu C, Brown CM, Rascati K, Moczygemba LR, Mackert M, Wilfong L. General versus disease-specific health literacy in patients with breast cancer: a cross-sectional study. Support Care Cancer 2022; 30:5533-5538. [PMID: 35316403 DOI: 10.1007/s00520-022-06988-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 03/13/2022] [Indexed: 11/25/2022]
Abstract
Health literacy is recognized as a critical factor affecting communication across the continuum of cancer care and plays a key role in patients' ability to meaningfully discuss their condition with healthcare providers. However, there is no consensus on the best approach to measure health literacy in clinical practice. The aims of this study were to compare general and disease-specific measurements of health literacy in patients with breast cancer as well as examine their relationships with patient-provider communication. During office visits, patients with HER-2 + breast cancer who received care at oncology clinics with value-based models of care completed a survey including the 6-item cancer health literacy tool (CHLT-6), 6-item newest vital sign (NVS), 2 items measuring difficulty of patient-provider communication, and 11 demographic/clinical items. The mean age of 146 participants was 57.1 ± 10.8 years. Most participants had adequate general health literacy as measured by the NVS (79%) and a high probability of adequate cancer health literacy (≥ 0.7) as measured by the CHLT-6 (92%). Most patients easily communicated with healthcare providers (90.2%) and understood information they provided (83.5%). However, there was no significant relationship between patient-provider communication and health literacy. Both the CHLT-6 and NVS may be useful tools to assess the health literacy of patients with cancer in clinical practice. Study findings of adequate health literacy and ease of communication might have been influenced by the value-based care models adopted by participating clinics. Further research in more diverse samples of patients with cancer and different types of oncology practice settings is warranted.
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Affiliation(s)
- Chisom Kanu
- College of Pharmacy, University of Texas at Austin, Austin, TX, USA.
| | - Carolyn M Brown
- College of Pharmacy, University of Texas at Austin, Austin, TX, USA
| | - Karen Rascati
- College of Pharmacy, University of Texas at Austin, Austin, TX, USA
| | | | - Michael Mackert
- Moody College of Communication, University of Texas at Austin, Austin, TX, USA
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Interrogating Patterns of Cancer Disparities by Expanding the Social Determinants of Health Framework to Include Biological Pathways of Social Experiences. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042455. [PMID: 35206642 PMCID: PMC8872134 DOI: 10.3390/ijerph19042455] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 02/15/2022] [Accepted: 02/17/2022] [Indexed: 02/01/2023]
Abstract
The objective of this article is to call for integrating biological pathways of social experiences in the concept model of cancer disparities and social determinants of health (SDH) fields. Black, Indigenous, and People of Color (BIPOC) populations experience more negative outcomes across the cancer continuum. Social conditions are instrumental in better understanding the contemporary and historical constructs that create these patterns of disparities. There is an equally important body of evidence that points to the ways that social conditions shape biological pathways. To date, these areas of research are, for the most part, separate. This paper calls for a bridging of these two areas of research to create new directions for the field of cancer disparities. We discuss inflammation, epigenetic changes, co-morbidities, and early onset as examples of the biological consequences of social conditions that BIPOC populations experience throughout their lifespan that may contribute to disproportionate tumorigenesis and tumor progression.
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