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Koshy B, Avudaiappan SL, Anand AS. Efficacy of Early Health Intervention Programs on Adverse Effects of Chemotherapy Among Women With Breast Cancer: A Randomized Controlled Trial. Cureus 2024; 16:e63604. [PMID: 39087201 PMCID: PMC11290592 DOI: 10.7759/cureus.63604] [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] [Accepted: 07/01/2024] [Indexed: 08/02/2024] Open
Abstract
Aim Breast cancer is the most frequently diagnosed cancer and the primary cause of cancer-related mortality among women. Advances in medical science have led to chemotherapy drugs that significantly reduce cancer mortality and increase patient's life expectancy. However, the systemic nature of chemotherapy leads to a wide range of physical and psychosocial challenges. Chemotherapy is usually given on an outpatient basis and hence patients have to manage treatment-related symptoms at home. This study aimed to evaluate the efficacy of early health intervention programs, specifically health education and progressive muscle relaxation, in managing the adverse effects of chemotherapy among women with breast cancer. Methods A randomized controlled trial was carried out at the chemotherapy unit of a tertiary care hospital in Thiruvananthapuram, Kerala, India. The research involved 340 female breast cancer patients receiving their initial chemotherapy cycle, divided equally into an experimental group and a control group. Patients in the intervention group received an early health intervention program on the day of their first chemotherapy cycle. These interventions included a 40-minute session comprising health education to manage the adverse effects of chemotherapy at home and a demonstration of progressive muscle relaxation techniques, which must be practiced by the patients two times daily till the end of chemotherapy. Participants in the control group received routine care from the hospital. The primary outcome variable was the adverse effects of chemotherapy. Sociodemographic and clinical information were collected using a structured questionnaire. The severity of adverse effects was assessed using the Common Terminology Criteria for Adverse Events, version 3 (CTCAE v3). Result The average age of participants was 54.7 ± 9.7 years in the control group and 52.4 ± 9 years in the experimental group. The majority in both groups had invasive breast cancer, with 144 (84.7%) in the control group and 153 (90%) in the experimental group. In the post-test, most participants in the control group experienced severe fatigue (136, 80%), mucositis (82, 48.2%), nausea (83, 49.1%), and vomiting (81, 47.6%). Conversely, the majority in the experimental group reported mild mucositis (110, 64.7%), nausea (92, 54.1%), and vomiting (93, 54.7%), along with moderate fatigue (116, 68.2%). Hair loss was incomplete for all participants in the control group and 115 (97.6%) participants in the experimental group. There was a significant difference between the experimental and control groups regarding fatigue (p < 0.001), insomnia (p < 0.01), anorexia (p < 0.01), mucositis (p < 0.01), nausea (p < 0.01), vomiting (p < 0.01), leukopenia (p = 0.001), neutrophil count (p < 0.01), hair loss (p < 0.05), and taste alteration (p < 0.01) during the post-test. Conclusion The study demonstrated that early health interventions, such as health education and progressive muscle relaxation, significantly reduced the adverse effects experienced by breast cancer patients undergoing chemotherapy. This suggests that providing supportive education and exercise training to both patients and caregivers can be beneficial in managing these side effects.
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Affiliation(s)
- Beena Koshy
- Nursing, Government Medical College, Thiruvananthapuram, Thiruvananthapuram, IND
- Nursing, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| | | | - Aravindh S Anand
- Radiation Oncology, Government Medical College, Thiruvananthapuram, Thiruvananthapuram, IND
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Dural G, Çitlik Saritaş S. The Effect of the Neuman Systems Model-Based Training and Follow-up on Self-Efficacy and Symptom Control in Patients Undergoing Chemotherapy. Nurs Sci Q 2024; 37:154-165. [PMID: 38491883 DOI: 10.1177/08943184231224453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2024]
Abstract
In this article, the authors aimed to determine the effect of the training and follow-up based on the Neuman systems model provided to patients undergoing chemotherapy on their self-efficacy and symptom control. The study was carried out with a randomized controlled experimental study model design. The sample consisted of 102 patients including 52 in the experimental group and 50 in the control group. The data were collected using the Patient Information Form, the Cancer Behavior Inventory-Brief (CBI-B), and the Edmonton Symptom Assessment Scale (ESAS). A personal training program prepared according to the Neuman systems model was applied to the experimental group patients. In the intergroup comparison of the experimental and control group patients, there was an increase in the posttest CBI-B scores and a decrease in the ESAS scores in the experimental group compared to the control group, and the intergroup difference was statistically significant (p < .05). According to the results, to improve the self-efficacy and symptom control in patients undergoing chemotherapy, using this education and follow-up program is recommended.
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Affiliation(s)
- Gül Dural
- Department of Internal Medicine Nursing, Faculty of Health Sciences, Fırat University, Elazığ, Turkey
| | - Seyhan Çitlik Saritaş
- Department of Internal Medicine Nursing, Faculty of Health Sciences, Malatya Turgut Ozal University, Malatya, Turkey
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Fenta ET, Ayal BG, Kidie AA, Anagaw TF, Mekonnen TS, Ketema Bogale E, Berihun S, Tsega TD, Mengistie Munie C, Talie Fenta T, Kassie Worku N, Shiferaw Gelaw S, Tiruneh MG. Barriers to Medication Adherence Among Patients with Non-Communicable Disease in North Wollo Zone Public Hospitals: Socio-Ecologic Perspective, 2023. Patient Prefer Adherence 2024; 18:733-744. [PMID: 38533490 PMCID: PMC10964781 DOI: 10.2147/ppa.s452196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 03/11/2024] [Indexed: 03/28/2024] Open
Abstract
Background The practice of taking medication as directed by a healthcare provider is known as medication adherence. Therefore, the application of a socio-ecological model to this study identifies multilevel factors on barriers of medication adherence on chronic non-communicable disease and provides information to develop scientific health communication interventional strategies to improve medication adherence. Objective This study aimed to explore barriers of medication adherence on non-communicable disease prevention and care among patients in North Wollo Zone public hospitals, northeast Ethiopia. Methods A phenomenological study design was carried out between February 5 and February 30, 2023. The study participants were chosen using a heterogeneous purposive sampling technique. In-depth interviews and targeted focus groups were used to gather data. The focus group discussions and in-depth interviews were captured on audio, accurately transcribed, and translated into English. Atlas TI-7 was utilized to do the thematic analysis. Results Four main themes, intrapersonal, interpersonal, community level, and health care related, as well as seven subthemes, financial problems, lack of family support, poor communication with healthcare providers, effects of social ceremonies, remote healthcare facility, and drug scarcity, were identified by this study. In this study participants reported that lack of knowledge about the disease and drugs were the main barrier for medication adherence. The study revealed that financial problems for medication and transportation cost were the main factor for medication adherence for non-communicable disease patients. Conclusion This study explored that lack of knowledge, financial problem, lack of family support, poor communication with healthcare providers, social ceremony effects, remote healthcare facility, and scarcity of drugs were barriers of medication adherence among non-communicable disease patients. In order to reduce morbidity and mortality from non-communicable diseases, it is advised that all relevant bodies look for ways to reduce medication adherence barriers for patients at every level of influence.
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Affiliation(s)
- Eneyew Talie Fenta
- Department of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Birtukan Gizachew Ayal
- Department of Public Health, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia
| | - Atitegeb Abera Kidie
- Department of Public Health, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia
| | - Tadele Fentabil Anagaw
- Department of Health Promotion and Behavioral Science, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Tesfaye Shumet Mekonnen
- Department of Public Health, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia
| | - Eyob Ketema Bogale
- Department of Health Promotion and Behavioral Science, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Sileshi Berihun
- Department of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Tilahun Degu Tsega
- Department of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | | | - Tizazu Talie Fenta
- Department of Medical Laboratory Science, Gamby Medical and Business College, Bahir Dar, Ethiopia
| | - Nigus Kassie Worku
- Department of Public Health, College of Medicine and Health Science, Dire Dawa University, Dire Dawa, Ethiopia
| | - Sintayehu Shiferaw Gelaw
- Department of Public Health, College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Misganaw Guadie Tiruneh
- Department of Health System and Policy, Institute of Public Health, College of Medicine and Health Science University of Gondar, Gondar, Ethiopia
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Kedida BD, Mukacho MM, Alemayehu M, Samuiel S, Kussa S, Sisay Y, Markos D, Mimani W. Women's experiences with breast cancer during diagnosis and therapy, Wolaita, Ethiopia: a qualitative study. BMC Womens Health 2024; 24:176. [PMID: 38481324 PMCID: PMC10935930 DOI: 10.1186/s12905-024-03016-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 03/07/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Breast cancer is the most common cancer in women and the most frequent cancer worldwide. After being diagnosed with breast cancer, women experience unexpected and stressful events. In Ethiopia, specifically in the study area, the experiences of women with breast cancer, the challenges they face during treatment and follow-up have not been thoroughly investigated. OBJECTIVE This qualitative study explores the experiences of women diagnosed with breast cancer and undergoing therapy at a University-based hospital in Ethiopia. METHODS A qualitative research design was used, to explore the experiences of women diagnosed with breast cancer and undergoing therapy. A purposively selected sample of ten women who had been diagnosed with breast cancer and were receiving therapy was recruited. Recruitment was conducted from August 1 to September 30, 2022. Semi-structured face-to-face interviews were conducted to collect data on their experiences. The interviews were transcribed verbatim, and a thematic analysis approach was employed utilizing open coding. The coded data were then analysed to reveal important insights and understandings about the participants' experiences with breast cancer during the diagnosis and therapy journey. RESULT The thematic analysis of the data revealed four prominent themes: women's mixed emotions, characterized by a sense of high threat and hope upon receiving breast cancer diagnosis results; dealing with the changes, both physical and psychological, that the cancer and its treatment bring about in women's bodies and emotional well-being; dealing with the challenges associated with accessing therapy, including unfavourable hospital conditions and financial hardship; and experiencing care and supports from health care providers, family and friends, and faith-based communities. CONCLUSION These findings underscore the importance of providing comprehensive support and care for women with breast cancer. Enhancing the hospital environment, addressing resource shortages, and prioritising patient well-being are crucial steps towards improving the experiences of breast cancer patients in the study area.
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Affiliation(s)
- Beimnet Desalegn Kedida
- School of Public Health, Collage of Health Science and Medicine, Wolaita Sodo University, P. O. Box: 138, Wolaita Sodo, Ethiopia.
| | | | - Mihiretu Alemayehu
- School of Public Health, Collage of Health Science and Medicine, Wolaita Sodo University, P. O. Box: 138, Wolaita Sodo, Ethiopia
| | - Serawit Samuiel
- School of Public Health, Collage of Health Science and Medicine, Wolaita Sodo University, P. O. Box: 138, Wolaita Sodo, Ethiopia
| | - Sintayehu Kussa
- School of Public Health, Collage of Health Science and Medicine, Wolaita Sodo University, P. O. Box: 138, Wolaita Sodo, Ethiopia
| | - Yordanos Sisay
- School of Public Health, Collage of Health Science and Medicine, Wolaita Sodo University, P. O. Box: 138, Wolaita Sodo, Ethiopia
| | - Desta Markos
- School of Public Health, Collage of Health Science and Medicine, Wolaita Sodo University, P. O. Box: 138, Wolaita Sodo, Ethiopia
| | - Worku Mimani
- Wolaita Sodo University Comprehensive Specialty Hospital, Wolaita Sodo, Ethiopia
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Sadwal S, Bharati S, Dar ZA, Kaur S. Chemopreventive potential of hydroethanolic Murraya koenigii leaves extract against DMBA induced breast carcinogenesis: In-silico and in-vivo study. JOURNAL OF ETHNOPHARMACOLOGY 2024; 319:117124. [PMID: 37678421 DOI: 10.1016/j.jep.2023.117124] [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: 03/17/2023] [Revised: 07/28/2023] [Accepted: 09/03/2023] [Indexed: 09/09/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Murraya koenigii (MK), a member of the Rutaceae family and widely known as the curry-leaf tree, is indigenous to India, Sri Lanka, and other south Asian nations. It is a renowned medicinal herb because of the wide range of bioactive components found in its leaves, such as girinimbine, koenimbine, mahanimbine and mahanine among others. All these bioactive components make this plant beneficial for treating a variety of ailments and diseases. Biological and pharmacological activities of MK include anti-oxidant, anti-microbial, anti-ulcer, anti-helminthic, anti-malarial, anti-trichomonal, hepatoprotective, anti-diabetic, etc. AIM OF THE STUDY: The present study aimed to evaluate the possible protective effect of hydroethanolic Murraya koenigii leaves extract (HEMKLE) against 7,12-Dimethylbenz[a]anthracene (DMBA)-induced breast cancer in rats, which further paves the way for future breast cancer treatment. MATERIALS AND METHODS For the preparation of hydroethanolic Murraya koenigii leaves extract (HEMKLE), Murraya koenigii (MK) leaves were taken from the botanical garden of the Panjab University campus, Chandigarh, and authenticated from the Department of Botany, Panjab University (accession number 22417). The phytochemical characterization of HEMKLE was performed using liquid chromatography-mass spectrometry (LC-MS). Following this, an in-silico molecular docking analysis was performed using Maestro Schrodinger software, and an in-vivo study was conducted. For the in-vivo study, female SD rats were divided into four different groups. Group I (C), Group II (DMBA), Group III (HEMKLE), and Group IV (HEMKLE + DMBA). Histopathogy, oxidative and antioxidant status, immunohistochemistry of estrogen receptor-α, TUNEL assays, mRNA and protein expression of apoptotic pathway genes were conducted in in-vivo study. RESULTS In LC-MS, major phytochemical constituents including flavonoids and carbazole alkaloids were identified. In-silico docking study revealed the strong binding affinity between the identified compounds with caspase-3. Additionally, koenine displayed the highest binding affinity/minimum energy of -9.21 kcal/mol with 6BDV as compared to other phytochemicals. Furthermore, in-vivo experimentation revealed that HEMKLE administration in Group IV(HEMKLE + DMBA) significantly inhibits the tumor incidence and volume as compared to alone DMBA treated group. The antioxidant action of HEMKLE was proven from the in-vivo analysis of antioxidant marker enzymes, histopathology, immunohistochemistry of ER-α studies. Further, increase number of TUNEL positive cells was observed in co-treated animals as compared to alone DMBA treated animals. In Group IV (HEMKLE + DMBA), upregulated expression of pro-apoptotic genes and downregulated expression of anti-apoptotic gene were observed when compared to Group II(DMBA) suggested the apoptotic effect of HEMKLE. CONCLUSION The results of the present study provide clear evidence of the chemopreventive capabilities of HEMKLE in rats with DMBA-induced breast cancer. The observed outcomes could potentially be attributed to the existence of diverse phytochemicals within the HEMKLE.
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Affiliation(s)
- Shilpa Sadwal
- Department of Biophysics, Panjab University, Chandigarh, India.
| | - Sanjay Bharati
- Manipal College of Health Profession, Manipal Academy of Higher Education, Karnataka, India.
| | - Zahid Ahmad Dar
- University Institute of Pharmaceutical Sciences, Panjab University, Chandigarh, India.
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Yeo HY, Wong JHY, Chan SJ, Latu ATF, Han CH, Anwar M, Marra CA. Exploring the Important Determinants Shaping Treatment Preferences: Qualitative Insights into Breast Cancer Patient Experiences and Perspectives in New Zealand. Patient Prefer Adherence 2023; 17:3525-3537. [PMID: 38148974 PMCID: PMC10750490 DOI: 10.2147/ppa.s443217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 12/19/2023] [Indexed: 12/28/2023] Open
Abstract
Purpose Despite the importance of acknowledging patient preferences in treatment decision-making, little is known about the treatment preferences and the factors underlying those preferences of breast cancer patients. This study aims explore patient experience and perspective regarding treatment preferences and identify the important determinants that shape these preferences in the context of New Zealand. Patients and Methods Semi-structured online interviews comprised of six focus group discussions and five individual interviews were performed with 26 breast cancer patients. The interviews were recorded, transcribed, and analyzed using the reflexive thematic analysis approach. Results Four main themes were derived: (1) positive treatment outcomes; (2) the negative impact of treatment-related side effects on quality of life; (3) treatment accessibility, availability, and timeliness; (4) cost of treatment. Patients revealed a strong preference towards treatments that yield longer survival, achieve remission, and prevent cancer recurrence. Additionally, patients favored treatments with minimal side effects that had minimal impact on their quality of life. There was a notable preference for treatments that were easily accessible and available in a timely manner. However, patients faced challenging decisions in balancing the costs of treatments with their benefits, leading to a consistent preference for treatments supported by government funding or medical insurance to alleviate financial burdens. Conclusion Our study reveals that breast cancer patients in New Zealand have different perceptions and preferences regarding cancer treatment. Patients frequently find themselves making trade-offs among various attributes of a treatment, aligning these decisions with their personal values and beliefs. By considering these preferences and trade-offs in future studies that measure patient preferences, healthcare professionals can enhance their support for patients in making informed choices that align with their values and priorities. Additionally, healthcare policymakers can develop patient-centered policies that cater to the unique needs and preferences of breast cancer patients.
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Affiliation(s)
- Hui Yee Yeo
- School of Pharmacy, University of Otago, Dunedin, New Zealand
- Clinical Research Center, Hospital Seberang Jaya, Seberang Jaya, Penang, Malaysia
| | | | - Suz Jack Chan
- School of Pharmacy, University of Otago, Dunedin, New Zealand
| | | | - Catherine H Han
- Auckland Oncology, Auckland, New Zealand
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Mudassir Anwar
- School of Pharmacy, University of Otago, Dunedin, New Zealand
| | - Carlo A Marra
- School of Pharmacy, University of Otago, Dunedin, New Zealand
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Öcalan S, Üzar-Özçetin YS. "I am in a Fight with My Brain": A Qualitative Study on Cancer-Related Ruminations of Individuals with Cancer. Semin Oncol Nurs 2023; 39:151450. [PMID: 37210226 DOI: 10.1016/j.soncn.2023.151450] [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: 12/19/2022] [Revised: 03/30/2023] [Accepted: 04/19/2023] [Indexed: 05/22/2023]
Abstract
OBJECTIVE This study aimed to determine the cancer-related ruminations from the subjective perspectives of individuals with cancer. DATA SOURCES The study adopted a qualitative design, and participants (N = 16) were individuals with cancer. The analysis and interpretation of data were carried out according to the phenomenological-hermeneutical method. CONCLUSION The following four themes emerged as a result of the analysis of qualitative data revealing the experiences of individuals with cancer: (1) attributed meanings to cancer-related ruminations, (2) perceived ruminations toward an uncertain future, (3) losing against intrusive ruminations, and (4) fighting with ruminations. The results underline the negative impact of ruminative thoughts on the disease process and social life of individuals with cancer. Individuals with cancer struggle with intense thoughts about the cause, treatment, and future of the disease from the moment they are diagnosed with cancer. In order to stop ruminative thoughts, individuals with cancer have tried solutions such as distracting activities and avoiding thoughts. IMPLICATIONS FOR NURSING PRACTICE Nurses have an important role in catching verbal and nonverbal cues for rumination, as they are constantly together with individuals with cancer and make observations. Therefore, nurses can raise awareness about their ruminative thoughts and teach coping skills to individuals with cancer.
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Affiliation(s)
- Sinem Öcalan
- MSc, PhD Candidate, RN, Research Assistant, Psychiatric Nursing Department, Faculty of Nursing, Hacettepe University, Ankara, Turkey.
| | - Yeter Sinem Üzar-Özçetin
- PhD, RN, Associate Professor, School of Nursing, Midwifery, and Health Systems, UCD Health Sciences Centre, University College Dublin, Dublin, Ireland
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Öcalan S, Üzar-Özçetin YS. "Cancer Never Goes Out of Your Mind Even for a Single Second". Cancer-Related Ruminations From the Perspectives of Cancer Survivors. Semin Oncol Nurs 2023; 39:151427. [PMID: 37069011 DOI: 10.1016/j.soncn.2023.151427] [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: 12/08/2022] [Revised: 03/15/2023] [Accepted: 03/21/2023] [Indexed: 04/19/2023]
Abstract
OBJECTIVE This study aimed to explore a deeper understanding of how cancer survivors experience and manage ruminative thoughts. DATA SOURCES A descriptive qualitative design. The study was conducted with cancer survivors (n = 21). A semistructured interview guide was used for data collection, and content analysis method was implemented to gain a better understanding from the collected data. The study procedure and reporting adhere to the guideline for reporting qualitative research COnsolidated criteria for REporting Qualitative research (COREQ) checklist. CONCLUSION Three main themes were developed: "Struggling within cognitions", "Coping", and "Required needs". The results highlight that cancer survivors have intrusive ruminative thoughts about cancer and need support to cope with these thoughts. It was also found that over time, they experienced changes in their perspectives, gained meaning, and were able to use deliberate ruminations. IMPLICATIONS FOR NURSING PRACTICE Nurses have an effective role in providing care and determining the needs of individuals. Nurses can easily recognize intrusive ruminations, help cancer survivors raise awareness about the effects of ruminative thoughts on them, and support them in coping with intrusive ruminations using effective interventions.
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Affiliation(s)
- Sinem Öcalan
- Faculty of Nursing, Psychiatric Nursing Department, Hacettepe University, Ankara, Turkey 06100.
| | - Yeter Sinem Üzar-Özçetin
- University College Dublin, School of Nursing, Midwifery, and Health Systems, UCD Health Sciences Centre, Dublin, Ireland
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Akkila S, Shariati S, Milton L, Behroozian T, Zhang L, Lou J, Lam E, Wong G, Karam I, Chow E. Comparison of neoadjuvant versus adjuvant chemotherapy for breast cancer patients prior to receiving radiation therapy using Edmonton Symptom assessment system (ESAS) scores. Support Care Cancer 2023; 31:236. [PMID: 36971851 DOI: 10.1007/s00520-023-07700-y] [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: 11/22/2022] [Accepted: 03/19/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND AND PURPOSE Patients undergoing radiotherapy (RT) for breast cancer may receive adjuvant or neoadjuvant chemotherapy prior to the initiation of RT treatment. In the present study, baseline Edmonton Symptom Assessment System (ESAS) scores of patients who received neoadjuvant and adjuvant chemotherapy were collected prior to RT and compared to assess the association of each chemotherapy intent with pre-RT symptom burden. MATERIAL AND METHODS The ESAS and Patient-Reported Functional Status (PRFS) tools were used to collect patient-reported symptoms at baseline. Patient and treatment-related factors were collected prospectively from February 2018 to September 2020. Univariate general linear regression analysis was applied to compare baseline scores between adjuvant and neoadjuvant chemotherapy patients. RESULTS A total of 338 patients were included for analysis. Comparison of baseline ESAS scores revealed that patients who received adjuvant chemotherapy were more likely to report higher scores, reflecting higher symptom burden, compared to patients receiving neoadjuvant chemotherapy, including tiredness (p = 0.005), lack of appetite (p = 0.0005), shortness of breath (p < 0.0001), and PRFS (p = 0.012). CONCLUSION This study suggests an association between patients who have received adjuvant chemotherapy for breast cancer and higher RT baseline ESAS scores when compared to patients who received neoadjuvant chemotherapy. Due to these findings, considerations should be made by healthcare providers of the symptom burden during RT for patients who receive adjuvant chemotherapy.
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Affiliation(s)
- Shereen Akkila
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada
| | - Saba Shariati
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada
| | - Lauren Milton
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada
| | - Tara Behroozian
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada
| | | | - Julia Lou
- McMaster University, Hamilton, ON, Canada
| | - Emily Lam
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada
| | - Gina Wong
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada
| | - Irene Karam
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada
| | - Edward Chow
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.
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Solomon K, Tamire M, Solomon N, Bililign N, Kaba M. Misconceptions About Female Cancers Contributing to Late Presentation to Health Facilities in Ethiopia: A Qualitative Study. Int J Womens Health 2023; 15:299-309. [PMID: 36814529 PMCID: PMC9939666 DOI: 10.2147/ijwh.s395824] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 02/03/2023] [Indexed: 02/16/2023] Open
Abstract
Introduction Morbidity and mortality from female cancers is a major public health problem in low- and middle-income countries, including Ethiopia. More than three quarters of women visiting health facilities are diagnosed with late-stage cervical and breast cancer. Evidence reveals that misconception affects timely health seeking behavior which could have averted expensive treatment and poor survival. This study aimed to explore misconceptions about female cancers that may have contributed to late presentation of the problem to health facilities in Sidama region, Ethiopia. Methods A descriptive qualitative study was carried out in June 2021. Nine focus group discussions (six with women and three with men) and 14 key informants were conducted. Data were collected using interview guide until all information get saturated. Data were inductively coded and qualitative content analysis was applied. Results A total of 63 (24 men and 39 women) people participated in this study. Nearly all (12) key informant interviewees have awareness about cervical and breast cancer, yet reported that their community members clearly lack awareness and they are working to improve misconceptions regarding cervical and breast cancer. The focus group discussion participants (15 men and 36 women) reported lack of detailed information related to cervical and breast cancer. Women believe that cervical and breast cancer mainly resulted from poor hygiene, trauma, having multiple sexual partners, early marriage, breast exposure to heat, not breast feeding, birth complication, urinating in the sun, hereditary, devil's intrusion and God's punishment. Conclusion There were misconceptions among the community on what cervical and breast cancer mean, how they could happen, what the symptoms are, why and when to screen, when to seek health care and how to use modern treatment options. Therefore, we recommended the design of social and behavioral change strategies to address the misconceptions among different population groups.
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Affiliation(s)
- Kalkidan Solomon
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia,Correspondence: Kalkidan Solomon, Email
| | - Mulugeta Tamire
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Nahom Solomon
- Department of Public Health, School of Public Health, College of Medicine and Health Sciences, Mizan Tepi University, Mizan-Aman, Ethiopia
| | - Nigus Bililign
- Department of Midwifery, School of Midwifery, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Mirgissa Kaba
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Muacevic A, Adler JR, Desai SR, Chen PL, Seminario-Vidal L. Perspectives on and Quality of Life in Skin of Color Patients With Mycosis Fungoides/Sézary Syndrome: A Qualitative Analysis. Cureus 2023; 15:e34054. [PMID: 36824562 PMCID: PMC9941020 DOI: 10.7759/cureus.34054] [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: 11/24/2022] [Accepted: 01/22/2023] [Indexed: 01/23/2023] Open
Abstract
Background Prior quantitative studies have described the diminished health-related quality of life (HRQoL) faced by the overall mycosis fungoides (MF)/Sézary syndrome (SS) population; yet, little is known about how the disease affects HRQoL in skin of color (SOC) patients. This qualitative study sought to explore the lived experiences of SOC patients with MF/SS and gain deeper insights into the impact the disease has on various facets of HRQoL. Methodology Interviews with SOC patients with MF/SS ≥18 were recruited from a cutaneous lymphoma clinic. A thematic analysis was performed to identify overarching themes. Results Ten patients were invited to participate from July to September 2021. One patient with SS and seven patients with MF (four in the early stage and four in the advanced stage), with a median age of 60.5 years, agreed to participate. Emerging themes included diagnostic and therapeutic delays frequently due to initial misdiagnoses with other skin conditions. Physical and functional burdens significantly hindered participants' abilities to carry out daily responsibilities and maintain employment, and impacts on physical appearance (e.g., darkened skin) led to increased self-consciousness and lack of social acceptance. Participants regarded family and faith as main sources of support in addition to developing healthy coping strategies, such as self-acceptance and adaptability. All participants reported feeling satisfied with their access to healthcare information and the quality of care received. Conclusions Our findings provide greater insights into how HRQoL is impacted across SOC patients with MF/SS, which can help raise awareness among healthcare providers and assist with creating interdisciplinary healthcare approaches to better support the needs of this population.
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12
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Akingbade O, Adediran V, Somoye IE, Alade AS, Chow KM. Perceived feasibility and usefulness of mHealth interventions for psychoeducational support among Nigerian women receiving chemotherapy for breast cancer: a focus group study. Support Care Cancer 2022; 30:9723-9734. [DOI: 10.1007/s00520-022-07403-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 10/07/2022] [Indexed: 11/06/2022]
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13
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Akuoko CP, Chambers S, Yates P. Healthcare providers’ perspectives of the supportive care needs of women with advanced breast cancer in Ghana. BMC Womens Health 2022; 22:350. [PMID: 35982431 PMCID: PMC9389751 DOI: 10.1186/s12905-022-01931-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 08/11/2022] [Indexed: 11/10/2022] Open
Abstract
Background The study sought to understand the supportive care needs of women with advanced breast cancer from the perspectives of healthcare professionals (HCPs) and key informants of charitable/non-governmental organisations (NGOs), that provide supportive care services to women with advanced breast cancer, in Ghana. Methods A qualitative descriptive approach was employed via one-to-one semi-structured interviews with 13 HCPs and key informants of charitable/NGOs in Ghana that provide supportive care services to women with advanced breast cancer. The study was underpinned by Bradshaw’s taxonomy of social needs and Fitch’s supportive care framework. The data were analysed using a deductive content analysis approach. Results Healthcare providers and key informants perceived that women with advanced breast cancer in Ghana have numerous and complex supportive care needs in key areas that align with Fitch’s supportive care framework, including informational, psychological, emotional, physical, practical, social, sexuality and spiritual needs. Conclusion Participants perceived that women who have advanced breast cancer in Ghana require ongoing information about their condition, treatments and related effects, as well as spiritual support and guidance particularly due to the fatalistic beliefs they often associate with the condition. Tailored supportive care interventions and services, which address the unique sociocultural circumstances for this cohort, are required. Additional research is needed to explore how multidisciplinary teams can work collaboratively to provide comprehensive support to women in addressing their needs. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-022-01931-7.
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14
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Dahabre R, Roziner I, Bentley G, Poikonen-Saksela P, Mazzocco K, Sousa B, Pat-Horenczyk R. The moderating role of coping flexibility in reports of somatic symptoms among early breast cancer patients. Soc Sci Med 2022; 308:115219. [PMID: 35863152 DOI: 10.1016/j.socscimed.2022.115219] [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: 01/29/2022] [Revised: 06/30/2022] [Accepted: 07/11/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The current study assessed breast cancer patients' somatic symptoms during the first six months post diagnosis and examined the moderating role of coping flexibility (i.e., trauma-focused and forward-focused coping strategies) on the association between reported somatic symptoms three months after breast cancer diagnosis and somatic symptoms six months after diagnosis. METHOD AND MEASURES An international sample of 702 women diagnosed with breast cancer from four countries (Finland, Israel, Italy, Portugal) completed self-reported questionnaires at three time points: at the time of diagnosis (M0), three months post diagnosis (M3), and six months post diagnosis (M6). The questionnaires included the coping flexibility scale and questions about demographics, medical data, and somatic symptoms. RESULTS The highest level of somatic symptoms was reported after three months post diagnosis (M3), as compared to M0 and M6. Both trauma-focused and forward-focused coping strategies moderated the relationship between somatic symptoms at M3 and somatic symptoms at M6. CONCLUSION The findings highlight the importance of assessing somatic symptoms soon after breast cancer diagnosis and throughout the early phase of treatment. Coping flexibility can buffer the stability of the somatic symptoms during this initial phase.
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Affiliation(s)
- Rawan Dahabre
- Paul Baerwald School of Social Work and Social Welfare, Hebrew University of Jerusalem, Israel
| | - Ilan Roziner
- Department of Communication Disorders, Tel-Aviv University, Tel-Aviv, Israel
| | - Gabriella Bentley
- Paul Baerwald School of Social Work and Social Welfare, Hebrew University of Jerusalem, Israel
| | - Paula Poikonen-Saksela
- Helsinki University Hospital Comprehensive Cancer Center, Helsinki University, Helsinki, Finland
| | - Ketti Mazzocco
- Department of Oncology and Hemato-oncology, University of Milan, Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy
| | - Berta Sousa
- Breast Unit, Champalimaud Clinical Centre/Champalimaud Foundation, Champalimaud Research, Lisboa, Portugal
| | - Ruth Pat-Horenczyk
- Paul Baerwald School of Social Work and Social Welfare, Hebrew University of Jerusalem, Israel.
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15
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Song CV, Yip CH, Mohd Taib NA, See MH, Teoh LY, Monninkhof EM, Saad M, Uiterwaal CSPM, Bhoo-Pathy N. Association Between Adherence to Clinical Practice Guidelines for Adjuvant Therapy for Breast Cancer and Survival in a Resource-Limited Setting. JCO Glob Oncol 2022; 8:e2100314. [PMID: 35245099 PMCID: PMC8920448 DOI: 10.1200/go.21.00314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE Addressing unwarranted clinical variation in oncology practices is expected to lead to improved cancer outcomes. Particularly, the application and impact of treatment guidelines on breast cancer outcomes are poorly studied in resource-limited settings. We measured adherence to a set of locally developed adjuvant treatment guidelines in a middle-income setting. Importantly, the impact of guidelines adherence on survival following breast cancer was determined. METHODS Data of 3,100 Malaysian women with nonmetastatic breast cancer diagnosed between 2010 and 2017 were analyzed. Adherence to the Malaysian Clinical Practice Guidelines for Management of Breast Cancer second Edition was measured. Outcomes comprised overall survival and event-free survival. RESULTS Guideline adherence for chemotherapy, radiotherapy, hormonal therapy, and targeted therapy were 61.7%, 79.2%, 85.1%, and 26.2%, respectively. Older age was generally associated with lower adherence to guidelines. Compared with patients who were treated according to treatment guidelines, overall survival and event-free survival were substantially lower in patients who were not treated accordingly; hazard ratios for all-cause mortality were 1.69 (95% CI, 1.29 to 2.22), 2.59 (95% CI, 1.76 to 3.81), 3.08 (95% CI, 1.94 to 4.88), and 4.48 (95% CI, 1.98 to 10.13) for chemotherapy, radiotherapy, hormone therapy, and targeted therapy, respectively. Study inferences remain unchanged following sensitivity analyses. CONCLUSION Our study findings appear to suggest that adherence to treatment guidelines that have been adapted for resource-limited settings may still provide effective guidance in improving breast cancer outcomes. Non-adherence to local breast cancer CPG worsens survival in Malaysia.![]()
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Affiliation(s)
- Chin Vern Song
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Lembah Pantai, Kuala Lumpur, Malaysia.,Julius Center for Health Sciences and Primary Care, UMC Utrecht, Utrecht University, Heidelberglaan, Utrecht, the Netherlands
| | - Cheng-Har Yip
- Ramsay Sime Darby Health Care, Subang Jaya, Malaysia
| | | | - Mee Hoong See
- Department of Surgery, Universiti Malaya, Lembah Pantai, Kuala Lumpur, Malaysia
| | - Li Ying Teoh
- Department of Surgery, Universiti Malaya, Lembah Pantai, Kuala Lumpur, Malaysia
| | - Evelyn M Monninkhof
- Julius Center for Health Sciences and Primary Care, UMC Utrecht, Utrecht University, Heidelberglaan, Utrecht, the Netherlands
| | - Marniza Saad
- Department of Clinical Oncology, Universiti Malaya, Lembah Pantai, Kuala Lumpur, Malaysia
| | - Cuno S P M Uiterwaal
- Julius Center for Health Sciences and Primary Care, UMC Utrecht, Utrecht University, Heidelberglaan, Utrecht, the Netherlands
| | - Nirmala Bhoo-Pathy
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Lembah Pantai, Kuala Lumpur, Malaysia
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16
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Syam Y, Prihantono P, Sjattar EL, Puspitha A, Majid S. The effect of Apis dorsata honey as complementary therapy on IL-37 levels and fatigue in breast cancer patients undergoing chemotherapy. Breast Dis 2021; 40:S129-S133. [PMID: 34092586 DOI: 10.3233/bd-219020] [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: 12/24/2022]
Abstract
OBJECTIVE The purpose of this study is to determine the effect of Apis dorsata Honey as a complementary therapy on IL-37 levels and fatigue in breast cancer patients undergoing chemotherapy. METHOD The study used a quasi-experimental pretest-posttest design with a control group. A total of 30 subjects were recruited using a concurrent sampling technique. The intervention group consisted of 15 subjects who received oral honey at a dose of 13 ml (1 tablespoon × 3) for 15 days, and the control group consisted of 15 subjects. The groups' samples were chosen at random. The Fatigue Symptom Inventory (FSI) was used to assess the side effects of chemotherapy. RESULTS Although the effect of Apis dorsata Honey on IL-37 levels was not statistically significant (p > 0.05), the group given honey experienced a clinically significant increase in IL-37 levels, with a mean before (632.37514.93) and post (632.37514.93). (1,003.021,248.88). Fatigue decreased statistically significantly in the group given mean honey values prior to 13.205.59 and after 11.805.07 (p = 0.004). CONCLUSION Honey administration increases IL-37 levels clinically, though the increase is not statistically significant. Giving honey to patients with breast cancer can help alleviate fatigue caused by chemotherapy.
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Affiliation(s)
- Yuliana Syam
- Nursing Study Program, Nursing Faculty, Universitas Hasanuddin, Indonesia
| | - Prihantono Prihantono
- Department of Medical Sciences, Faculty of Medicine, Universitas Hasanuddin, Indonesia
| | - Elly L Sjattar
- Nursing Study Program, Nursing Faculty, Universitas Hasanuddin, Indonesia
| | - Arnis Puspitha
- Nursing Study Program, Nursing Faculty, Universitas Hasanuddin, Indonesia
| | - Sintawati Majid
- Master of Nursing Program, Universitas Hasanuddin, Indonesia
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17
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Mendonça AB, Pereira ER, Magnago C, Medeiros AYBBV, Silva RMCRA, Martins ADO, Meira KC. Suffering experiences of people with cancer undergoing chemotherapy: A meta-ethnographic study. Nurs Health Sci 2021; 23:586-610. [PMID: 33817939 DOI: 10.1111/nhs.12839] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/30/2021] [Accepted: 03/31/2021] [Indexed: 12/14/2022]
Abstract
This meta-ethnography had the objectives of identifying, evaluating, and summarizing the findings of qualitative studies regarding the suffering experiences of people undergoing chemotherapy, as well as developing an explanatory conceptual structure regarding what affects these experiences. A systematic literature review was carried out, covering the past 10 years, in the following databases: CINAHL, Embase, Medline, LILACS and Scopus. By using meta-ethnographic synthesis methods, the following themes were found: the pain of loss; evaluating, measuring, and neutralizing the threat; and social contours of suffering. The experience of living with cancer and undergoing chemotherapy was synthesized into a theoretical-explanatory model with a structure that resembles barbed-wire loops. The model expresses people's suffering experiences as marked by the feeling of loss, restraint of emotions, and resilience. While transcendent movements broke the cycle of suffering, resilience emerged as a learning experience that made patients more resistant to the pain of loss. The results indicated a complex and diverse set of factors that influence suffering, which confirmed that experiences are individual, comprehensive, and continuously reinterpreted.
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Affiliation(s)
- Angelo Braga Mendonça
- Healthcare Sciences Program, School of Nursing, Universidade Federal Fluminense, Niterói, Brazil
| | - Eliane Ramos Pereira
- Healthcare Sciences Program, School of Nursing, Universidade Federal Fluminense, Niterói, Brazil
| | - Carinne Magnago
- Public Health Faculty, Universidade de São Paulo, Niterói, Brazil
| | | | | | | | - Karina Cardoso Meira
- Health Sciences School, Universidade Federal do Rio Grande do Norte, Natal, Brazil
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18
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Grupińska J, Budzyń M, Brzeziński JJ, Gryszczyńska B, Kasprzak MP, Kycler W, Leporowska E, Iskra M. Association between clinicopathological features of breast cancer with adipocytokine levels and oxidative stress markers before and after chemotherapy. Biomed Rep 2021; 14:30. [PMID: 33585032 PMCID: PMC7873584 DOI: 10.3892/br.2021.1406] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 12/22/2020] [Indexed: 12/15/2022] Open
Abstract
Adipocytokines and markers of oxidative stress have been shown to exhibit potential for detection of advanced stage, HER2/neu status and lymph node metastases in patients with breast cancer, as well as in determining the efficiency of anti-cancer treatments. In the present study, blood concentrations of apelin (APLN), retinol-binding protein 4 (RBP4), 8-hydroxydeoxyguanosine (8-oxo-dG) and total antioxidant capacity (TAC) in women with breast cancer with different clinicopathological features were measured prior to and following adjuvant chemotherapy. The study included 60 women with breast cancer stratified according to tumor grade and size, HER-2/neu expression, and lymph node and hormone receptor status. Blood samples were taken before and after two cycles of adjuvant chemotherapy. None of the clinicopathological features were associated with the baseline concentrations of RBP4, 8-oxo-dG or TAC. An increased baseline concentration of APLN was observed in HER-2/neu positive patients. Moreover, through multivariate logistical regression analysis, APLN was shown to be independently associated with a positive HER/neu status. Chemotherapy treatment did not affect the levels of RBP4 or APLN, or TAC values when assessing all the patients, and when assessing the stratified groups of patients. Only 8-oxo-dG was found to be significantly decreased following drug administration (P=0.0009). This preliminary study demonstrated that APLN is a significant and independent predictor of HER-2/neu positive breast cancer. A significant reduction in 8-oxo-dG levels following chemotherapy may indicate its potential clinical utility in monitoring the effects of chemotherapy in breast cancer patients.
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Affiliation(s)
- Joanna Grupińska
- Chair and Department of Medical Chemistry and Laboratory Medicine, Poznan University of Medical Sciences, 60-806 Poznań, Poland.,Nutrition Laboratory, Hospital Pharmacy, Greater Poland Cancer Centre, 61-866 Poznań, Poland
| | - Magdalena Budzyń
- Chair and Department of Medical Chemistry and Laboratory Medicine, Poznan University of Medical Sciences, 60-806 Poznań, Poland
| | - Jacek J Brzeziński
- Gastrointestinal Surgical Oncology Department, Greater Poland Cancer Centre, 61-866 Poznań, Poland
| | - Bogna Gryszczyńska
- Chair and Department of Medical Chemistry and Laboratory Medicine, Poznan University of Medical Sciences, 60-806 Poznań, Poland
| | - Magdalena P Kasprzak
- Chair and Department of Medical Chemistry and Laboratory Medicine, Poznan University of Medical Sciences, 60-806 Poznań, Poland
| | - Witold Kycler
- Gastrointestinal Surgical Oncology Department, Greater Poland Cancer Centre, 61-866 Poznań, Poland
| | - Ewa Leporowska
- Department of Laboratory Diagnostics, Greater Poland Cancer Centre, 61-866 Poznań, Poland
| | - Maria Iskra
- Chair and Department of Medical Chemistry and Laboratory Medicine, Poznan University of Medical Sciences, 60-806 Poznań, Poland
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19
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Epstein RS, Basu Roy UK, Aapro M, Salimi T, Moran D, Krenitsky J, Leone-Perkins ML, Girman C, Schlusser C, Crawford J. Cancer Patients' Perspectives and Experiences of Chemotherapy-Induced Myelosuppression and Its Impact on Daily Life. Patient Prefer Adherence 2021; 15:453-465. [PMID: 33658769 PMCID: PMC7920579 DOI: 10.2147/ppa.s292462] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 01/19/2021] [Indexed: 01/10/2023] Open
Abstract
PURPOSE To evaluate which side effects of chemotherapy are considered most burdensome by patients with cancer, identify which health care professionals pay most attention to symptoms associated with chemotherapy-induced myelosuppression (CIM) from the patient perspective, and capture the "patient voice" describing how CIM impacts their daily lives. PARTICIPANTS AND METHODS Online survey of participants with breast, lung, or colorectal cancer who had received chemotherapy within the past 12 months and experienced ≥1 episode of CIM in the past year. Participants were asked to answer close-ended questions and provide qualitative responses to: "In your own words, please describe how side effects from myelosuppression have impacted your life." RESULTS Among 301 survey participants, fatigue was the most frequently reported side effect of chemotherapy; 55% of participants rated fatigue as highly bothersome (9 or 10 on a 1-10 scale of "bothersomeness"). Participants rated symptoms associated with CIM, including fatigue, weakened immune system (infections), bleeding and/or bruising, and shortness of breath, as being as bothersome as other side effects of chemotherapy, including alopecia, neuropathy, and nausea/vomiting. Overall, 24-43% of participants thought that CIM and its symptoms had a negative impact on their daily lives, including their ability to complete tasks at home and work, and to socialize. Qualitative responses supported these findings; participants highlighted that CIM-related symptoms, particularly fatigue and fear of infections, affected their ability to be physically active, complete work, or continue meaningful relationships with friends and family. CONCLUSION Participants described a real-world impact of CIM that often isolates them from family and friends, and means that they are unable to work or perform tasks of daily living. Using measures that help patients to recognize and communicate the signs and symptoms of CIM might increase the likelihood of maintaining daily lives as close to normal as possible, during and after chemotherapy treatment.
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Affiliation(s)
- Robert S Epstein
- Epstein Health, LLC., Woodcliff Lake, NJ, USA
- Correspondence: Robert S Epstein Epstein Health, LLC., Woodcliff Lake, NJ, 07677, USATel +1 201-285-5800 Email
| | | | | | | | - Donald Moran
- G1 Therapeutics Ltd., Research Triangle Park, NC, USA
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20
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Heydarzadeh L, Alilu L, Habibzadeh H, Rasouli J. The effect of peer education on management of chemotherapy side effects in patients with cancer. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2021; 26:81-84. [PMID: 33954103 PMCID: PMC8074735 DOI: 10.4103/ijnmr.ijnmr_227_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 12/18/2019] [Accepted: 09/28/2020] [Indexed: 11/26/2022]
Abstract
Background: Chemotherapy drugs may have numerous side effects for patients. Thus, this study was conducted with the aim to determine the effect of peer education on the management of chemotherapy side effects in patients with cancer. Materials and Methods: This randomized, controlled trial was conducted on 80 patients with cancer in 2018. They were allocated to two groups of intervention and control. The self-care education on chemotherapy side effects was provided by the peers to the individuals in the intervention group. The data collection tools included a demographic characteristics form and the Self-Care Diary (SCD). Data analysis was performed using independent t-test and Chi-square test in SPSS software. Results: The results showed that the mean scores of the effectiveness of self-care behaviors were significantly higher in the intervention group compared to the control group after the intervention (p < 0.05). Conclusions: Peer education is recommended for cancer patients undergoing chemotherapy.
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21
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Magalhães B, Fernandes C, Lima L, Martinez-Galiano JM, Santos C. Cancer patients’ experiences on self-management of chemotherapy treatment-related symptoms: A systematic review and thematic synthesis. Eur J Oncol Nurs 2020; 49:101837. [DOI: 10.1016/j.ejon.2020.101837] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 09/10/2020] [Accepted: 09/16/2020] [Indexed: 01/12/2023]
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22
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Rathbone AP, Jamie K, Todd A, Husband A. A qualitative study exploring the lived experience of medication use in different disease states: Linking experiences of disease symptoms to medication adherence. J Clin Pharm Ther 2020; 46:352-362. [PMID: 33151549 DOI: 10.1111/jcpt.13288] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 09/08/2020] [Accepted: 09/15/2020] [Indexed: 12/25/2022]
Abstract
WHAT IS KNOWN Medication non-adherence leads to negative health outcomes. Medication adherence is predicted if patients understand the necessity of medication use to control disease symptoms and progression. It could be expected then, that patients with diseases with symptoms which are managed with medications, such as chronic obstructive pulmonary disorder or gout, or diseases with high-mortality rates, such as cancer, would have higher adherence rates than asymptomatic diseases, such as hypertension. However, poor medication adherence remains problematic in both symptomatic and asymptomatic diseases. Further work is needed to explore patient experiences of medication adherence to understand the link between adherence and symptom control. OBJECTIVE To explore patients' lived experiences of medication adherence. METHODS Participants were recruited from community pharmacies and general practices. Forty-one semi-structured interviews and three focus groups were used to collect data from patients with disease states that had different symptomatic and asymptomatic profiles. Inductive thematic analysis was used to identify key parts of the experience of using medications. RESULTS Participants reported similar experiences of medication adherence despite having different disease symptoms. Participants said that they used medications because it was an expected part of everyday life and that medications 'must be needed' because they had been supplied, rather than being used for a particular symptom. Participants reported short-term episodes of non-adherence were unlikely to lead to negative health outcomes but may result in negative social consequences. DISCUSSION The findings broaden our understanding of patient experiences of medication use by indicating patients with symptomatic and asymptomatic diseases share similar experiences of medication use. The necessity to use medications appeared to come from 'the system' of healthcare professionals, family and friends that supply and recommend medications. WHAT IS NEW There were key similarities in experiences of medication adherence in patients with different disease states. The negative consequences of short-term episodes of non-adherence were normalized by healthcare professionals. CONCLUSION Patients with symptomatic and asymptomatic diseases share similar experiences of medication adherence.
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Affiliation(s)
- Adam Pattison Rathbone
- School of Pharmacy, Newcastle University Faculty of Medical Sciences, Newcastle upon Tyne, UK.,Pharmacy Department, Newcastle Upon Tyne Hospitals NHS, Foundation Trust, Newcastle upon Tyne, UK
| | | | - Adam Todd
- School of Pharmacy, Newcastle University Faculty of Medical Sciences, Newcastle upon Tyne, UK.,Pharmacy Department, Newcastle Upon Tyne Hospitals NHS, Foundation Trust, Newcastle upon Tyne, UK
| | - Andy Husband
- School of Pharmacy, Newcastle University Faculty of Medical Sciences, Newcastle upon Tyne, UK.,Pharmacy Department, Newcastle Upon Tyne Hospitals NHS, Foundation Trust, Newcastle upon Tyne, UK
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23
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Chua GP, Ng QS, Tan HK, Ong WS. Determining the Concerns of Breast Cancer Survivors to Inform Practice. Asia Pac J Oncol Nurs 2020; 7:319-327. [PMID: 33062826 PMCID: PMC7529018 DOI: 10.4103/apjon.apjon_26_20] [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: 01/20/2020] [Accepted: 04/07/2020] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE Breast cancer is the most common cancer in women across all ethnicities, accounting for almost one in three incident cancers in female, and the leading cause of mortality in Singapore. Literature reveals that survivors of breast cancer have many concerns, and these concerns can linger on for decades. The primary aim of this secondary analysis was to establish the concerns of breast cancer survivors and use the data to inform practice. METHODS The present report was part of a bigger data designed to evaluate the concerns of cancer survivors (top six cancers) across the survivorship trajectory. Data of 438 breast cancer survivors were derived from a cross-sectional survey of the self-reported concerns of 1107 cancer survivors, using the questionnaire adopted from the Mayo Clinic Cancer Centre's Cancer Survivors Survey of Needs. Logistic regression models were fitted to estimate the odds ratios to assess the association of various variables with the presence of ≥1 concerned or very concerned issue among patients. Linear regression models were fitted to identify the variables associated with quality of life (QOL). RESULTS A total of 438 breast cancer survivors responded to this survey. The top five concerns were cancer treatment and recurrence risk (55.5%), followed by fear of recurrence (FOR) (54.6%), long-term effects of treatment (53.4%), osteoporosis/bone health (39.0%), and keeping primary care physicians informed (37.4%). Cancer treatment and recurrence risk, FOR, and long-term treatment effects were among the top concerns across the survivorship trajectory. The mean QOL was 7.5 on a scale of 0-10. CONCLUSIONS Irrespective of the cancer trajectory, survivors of breast cancer have serious concerns that warrant attention. Designing patient care delivery that addresses these concerns identified is critical in assisting them in their coping process and enhancing their QOL.
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Affiliation(s)
- Gek Phin Chua
- Cancer Education and Information Service (Research and Data), National Cancer Centre Singapore, Singapore
| | - Quan Sing Ng
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - Hiang Khoon Tan
- Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore
| | - Whee Sze Ong
- Division of Clinic Trials and Epidemiological Sciences, National Cancer Centre Singapore, Singapore
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ÖCALAN S, ÜZAR ÖZÇETİN YS. Kanser Deneyiminde Ruminasyon, Tükenmişlik ve Psikolojik Sağlamlık. PSIKIYATRIDE GUNCEL YAKLASIMLAR 2020. [DOI: 10.18863/pgy.664396] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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25
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Chan CMH, Blanch-Hartigan D, Taib NA, Wee LH, Krupat E, Meyer F. Preferences for patient-centered care among cancer survivors 5 years post-diagnosis. PATIENT EDUCATION AND COUNSELING 2020; 103:1601-1605. [PMID: 32143985 DOI: 10.1016/j.pec.2020.02.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 02/21/2020] [Accepted: 02/22/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Our primary objective was to identify predictors associated with preferences for patient-centered care among cancer survivors and the association between cancer health literacy and patient-centered care preferences. METHODS Cross sectional analyses of N = 345 adult cancer survivors (5 years post cancer diagnosis) attending follow-ups at University Malaya Medical Centre, Malaysia. Face-to face-interviews were conducted using the 30-item Cancer Health Literacy Test and the Patient-Practitioner Orientation Scale to determine preference for patient-centered care. RESULTS Cancer survivors' preference for patient-centered care was associated with a higher cancer health literacy score, higher educational level, being employed, breast cancer diagnosis, and not desiring psychological support [F (14, 327) = 11.25, p < 0.001, R2 = 0.325]. CONCLUSION Findings from this study provide insights into preferences for patient-centered care among cancer survivors during receipt of follow-up care, which remains an understudied phase of cancer care delivery. PRACTICE IMPLICATIONS Efforts are needed to ensure different preferences for care are taken into account particularly in the setting of variable cancer health literacy.
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Affiliation(s)
| | | | | | - Lei Hum Wee
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Malaysia.
| | - Edward Krupat
- Beth Israel Deaconess Medical Centre, Boston, MA, USA
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