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Albright L, Ko W, Buvanesh M, Haraldsson H, Polubriaginof F, Kuperman GJ, Levy M, Sterling MR, Dell N, Estrin D. Opportunities and Challenges for Augmented Reality in Family Caregiving: Qualitative Video Elicitation Study. JMIR Form Res 2024; 8:e56916. [PMID: 38814705 PMCID: PMC11176885 DOI: 10.2196/56916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/27/2024] [Accepted: 04/26/2024] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND Although family caregivers play a critical role in care delivery, research has shown that they face significant physical, emotional, and informational challenges. One promising avenue to address some of caregivers' unmet needs is via the design of digital technologies that support caregivers' complex portfolio of responsibilities. Augmented reality (AR) applications, specifically, offer new affordances to aid caregivers as they perform care tasks in the home. OBJECTIVE This study explored how AR might assist family caregivers with the delivery of home-based cancer care. The specific objectives were to shed light on challenges caregivers face where AR might help, investigate opportunities for AR to support caregivers, and understand the risks of AR exacerbating caregiver burdens. METHODS We conducted a qualitative video elicitation study with clinicians and caregivers. We created 3 video elicitations that offer ways in which AR might support caregivers as they perform often high-stakes, unfamiliar, and anxiety-inducing tasks in postsurgical cancer care: wound care, drain care, and rehabilitative exercise. The elicitations show functional AR applications built using Unity Technologies software and Microsoft Hololens2. Using elicitations enabled us to avoid rediscovering known usability issues with current AR technologies, allowing us to focus on high-level, substantive feedback on potential future roles for AR in caregiving. Moreover, it enabled nonintrusive exploration of the inherently sensitive in-home cancer care context. RESULTS We recruited 22 participants for our study: 15 clinicians (eg, oncologists and nurses) and 7 family caregivers. Our findings shed light on clinicians' and caregivers' perceptions of current information and communication challenges caregivers face as they perform important physical care tasks as part of cancer treatment plans. Most significant was the need to provide better and ongoing support for execution of caregiving tasks in situ, when and where the tasks need to be performed. Such support needs to be tailored to the specific needs of the patient, to the stress-impaired capacities of the caregiver, and to the time-constrained communication availability of clinicians. We uncover opportunities for AR technologies to potentially increase caregiver confidence and reduce anxiety by supporting the capture and review of images and videos and by improving communication with clinicians. However, our findings also suggest ways in which, if not deployed carefully, AR technologies might exacerbate caregivers' already significant burdens. CONCLUSIONS These findings can inform both the design of future AR devices, software, and applications and the design of caregiver support interventions based on already available technology and processes. Our study suggests that AR technologies and the affordances they provide (eg, tailored support, enhanced monitoring and task accuracy, and improved communications) should be considered as a part of an integrated care journey involving multiple stakeholders, changing information needs, and different communication channels that blend in-person and internet-based synchronous and asynchronous care, illness, and recovery.
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Affiliation(s)
- Liam Albright
- Department of Information Science, Cornell University, New York, NY, United States
| | - Woojin Ko
- Department of Computer Science, Cornell Tech, New York, NY, United States
| | - Meyhaa Buvanesh
- Department of Information Science, Jacobs Technion-Cornell Institute, Cornell Tech, New York, NY, United States
| | | | - Fernanda Polubriaginof
- Digital Informatics and Technology Solutions (DigITS), Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Gilad J Kuperman
- Digital Informatics and Technology Solutions (DigITS), Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Michelle Levy
- Digital Informatics and Technology Solutions (DigITS), Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Madeline R Sterling
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, NY, United States
| | - Nicola Dell
- Department of Information Science, Jacobs Technion-Cornell Institute, Cornell Tech, New York, NY, United States
| | - Deborah Estrin
- Department of Computer Science, Cornell Tech, New York, NY, United States
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Toni E, Ayatollahi H. An insight into the use of telemedicine technology for cancer patients during the Covid-19 pandemic: a scoping review. BMC Med Inform Decis Mak 2024; 24:104. [PMID: 38641567 PMCID: PMC11027268 DOI: 10.1186/s12911-024-02507-1] [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: 08/11/2023] [Accepted: 04/12/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND The use of telemedicine technology has significantly increased in recent years, particularly during the Covid-19 pandemic. This study aimed to investigate the use of telemedicine technology for cancer patients during the Covid-19 pandemic. METHODS This was a scoping review conducted in 2023. Various databases including PubMed, Web of Science, Scopus, Cochrane Library, Ovid, IEEE Xplore, ProQuest, Embase, and Google Scholar search engine were searched. All quantitative, qualitative, and mixed-method studies published in English between 2020 and 2022 were included. Finally, the needed data were extracted, and the results were synthesized and reported narratively. RESULTS A total of 29 articles were included in this review. The results showed that teleconsultation, televisit, and telerehabilitation were common telemedicine services, and video conferencing and telephone were common technologies used in these studies. In most cases, patients and healthcare providers preferred these services compared to the face-to-face consultations due to their convenience and advantages. Furthermore, the findings revealed that in terms of clinical outcomes, telemedicine could effectively reduce anxiety, pain, sleep disorders, and hospital admission rates. CONCLUSION The findings provided valuable insights into the various telemedicine technologies, services, users' perspectives, and clinical outcomes in cancer patients during the Covid-19 pandemic. Overall, the positive outcomes and users' satisfaction showed that the use of telemedicine technology can be expanded, particularly in cancer care. Future research needs to investigate both clinical and non-clinical effectiveness of using various telemedicine services and technologies for improving cancer care delivery, which can help to develop more successful strategies for implementing this technology.
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Affiliation(s)
- Esmaeel Toni
- Student Research Committee, Iran University of Medical Sciences, Tehran, Iran
| | - Haleh Ayatollahi
- Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran.
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Ren L, Chen M, Jiang H, Wang Y, Xia L, Dong C. Perceptions of adult patients with cancer towards telemedicine: A qualitative meta-synthesis. Asia Pac J Oncol Nurs 2024; 11:100360. [PMID: 38293602 PMCID: PMC10825605 DOI: 10.1016/j.apjon.2023.100360] [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: 10/14/2023] [Accepted: 12/01/2023] [Indexed: 02/01/2024] Open
Abstract
Objective This study aims to systematically identify, evaluate, and synthesize published qualitative research on the views and attitudes of adult cancer patients toward telemedicine and, consequently to better inform the future development of telemedicine technology and interventions. Methods A meta-synthesis review was conducted to identify qualitative studies that reported adult cancer patients' perceptions toward telemedicine applications using nine electronic databases, including PubMed, MEDLINE, Web of Science, the Cochrane Library, PsycINFO, CINAHL, Wan Fang, VIP, and CNKI, from inception to November 2022. Quality appraisal was guided by the Joanna Briggs Institute's (JBI) Critical Appraisal Checklist for Qualitative Research. Data were synthesized using "thematic synthesis" to identify themes and concepts. Results A total of 3518 articles were retrieved, of which 23 met the inclusion and exclusion criteria. These studies identified three key meta-themes and 11 key sub-themes: (1) Benefits of telemedicine: obtaining information and social support, maintaining the continuity of treatment, receiving professional assistance, having greater flexibility, and promoting physical and mental health; (2) Limitations of telemedicine: interference with normal life, privacy and security issues, auxiliary function issues, and increased psychological burden; (3) Expectations for future telemedicine: more personalized intervention, more specific and diverse information. Conclusions The study showed that the benefits and limitations coexisted in the process of telemedicine application among adult cancer patients. It is necessary to develop personalized applications that are better suited to the needs and characteristics of adult cancer patients. Future telemedicine interventions should focus on information diversification and provide patients with more diverse and effective information. Systematic review registration PROSPERO, CRD42022324528.
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Affiliation(s)
- Liya Ren
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Meijia Chen
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Hao Jiang
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Yuxin Wang
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Lin Xia
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Chaoqun Dong
- School of Nursing, Wenzhou Medical University, Wenzhou, China
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Rosell J, Araya AX, Miranda-Castillo C. Internet use by informal caregivers in Chile: An analysis including age and gender perspectives. Clin Gerontol 2024; 47:26-38. [PMID: 36773058 DOI: 10.1080/07317115.2023.2173692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
OBJECTIVES This study explored the relationship between Internet use and informal caregivers' characteristics. METHODS We used the Chilean Sociodemographic Characterization Survey. A total of 86,172 informal caregivers were identified. We conducted a weighted χ2 to test differences in 10 types of Internet use and weighted logistic regressions with caregivers' characteristics as predictors of Internet use. RESULTS Younger caregivers engaged in more types of use than the older ones. Education level was positively associated with all types of use, such as searching for information (OR = 3.52, CI 95% [2.34, 5.29]). Age was negatively related to Internet use. Women used the Internet more to communicate via social networks. Being single reduced the likelihood of performing certain types of use, such as information seeking. The number of people living in households has increased entertainment. CONCLUSIONS Older caregivers with lower education levels are at greater risk of digital exclusion. The same occurred in some types of use with single caregivers, where fewer people lived in the household. CLINICAL IMPLICATIONS The Internet can be a tool for coping with caregiving tasks and their negative consequences. Interventions should consider these characteristics when promoting online tools and performing online interventions to reach the broadest possible audience.
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Affiliation(s)
- Javiera Rosell
- Millennium Institute for Care Research (MICARE), Chile
- Escuela de Psicología, Facultad de Ciencias Sociales, Pontificia Universidad Católica de Chile, Chile
- Oxford Institute of Population Ageing, University of Oxford Oxford, UK
| | - Alejandra-Ximena Araya
- Millennium Institute for Care Research (MICARE), Chile
- Facultad de Enfermería, Universidad Andres Bello, Chile
| | - Claudia Miranda-Castillo
- Millennium Institute for Care Research (MICARE), Chile
- Facultad de Enfermería, Universidad Andres Bello, Chile
- Instituto Milenio para la Investigación en Depresión y Personalidad (MIDAP), Chile
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Jibb LA, Sivaratnam S, Hashemi E, Chu CH, Nathan PC, Chartrand J, Alberts NM, Masama T, Pease HG, Torres LB, Cortes HG, Zworth M, Kuczynski S, Fortier MA. Parent and clinician perceptions and recommendations on a pediatric cancer pain management app: A qualitative co-design study. PLOS DIGITAL HEALTH 2023; 2:e0000169. [PMID: 38019890 PMCID: PMC10686487 DOI: 10.1371/journal.pdig.0000169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 10/14/2023] [Indexed: 12/01/2023]
Abstract
Pain is one of the most prevalent and burdensome pediatric cancer symptoms for young children and their families. A significant proportion of pain episodes are experienced in environments where management options are limited, including at home. Digital innovations such as apps may have positive impacts on pain outcomes for young children in these environments. Our overall aim is to co-design such an app and the objective of this study was to explore the perceptions of children's parents about app utility, needed system features, and challenges. We recruited parents of young children with cancer and multidisciplinary pediatric oncology clinicians from two pediatric cancer care centers to participate in audio-recorded, semi-structured, co-design interviews. We conducted interviews structured around technology acceptance and family caregiving theories until data saturation was reached. Audio-recordings were then transcribed, coded, and analyzed using thematic analysis. Forty-two participants took part in the process. Participants endorsed the concept of an app as a useful, safe, and convenient way to engage caregivers in managing their young child's pain. Overall, the app was valued as a means to provide real-time, multimodal informational and procedural pain support to parents, while also reducing the emotional burden of pain care. Recommendations for intervention design included accessibility-focused features, comprehensive symptom tracking, and embedded scientific- and clinically-sound symptom assessments and management advice. Predicted challenges to app use included the workload burden it may place on parents and clinicians. The insights gathered will inform the design principles of our future childhood cancer pain digital research.
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Affiliation(s)
- Lindsay A. Jibb
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Canada
| | - Surabhi Sivaratnam
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Elham Hashemi
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Canada
| | - Charlene H. Chu
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - Paul C. Nathan
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Canada
- Division of Hematology/Oncology, Hospital for Sick Children, Toronto, Canada
| | - Julie Chartrand
- Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
- Research Institute, Children’s Hospital of Eastern Ontario, Ottawa, Canada
| | | | - Tatenda Masama
- Division of Hematology/Oncology, Hospital for Sick Children, Toronto, Canada
| | - Hannah G. Pease
- Sue and Bill Gross School of Nursing, University of California Irvine, Irvine, California, United States of America
| | - Lessley B. Torres
- Sue and Bill Gross School of Nursing, University of California Irvine, Irvine, California, United States of America
- Department of Pediatric Psychology, Children’s Hospital of Orange County, Orange, California, United States of America
- UCI Center on Stress and Health, University of California Irvine, Irvine, California, United States of America
| | - Haydee G. Cortes
- Sue and Bill Gross School of Nursing, University of California Irvine, Irvine, California, United States of America
- Department of Pediatric Psychology, Children’s Hospital of Orange County, Orange, California, United States of America
- UCI Center on Stress and Health, University of California Irvine, Irvine, California, United States of America
| | - Mallory Zworth
- Division of Hematology/Oncology, Hospital for Sick Children, Toronto, Canada
| | - Susan Kuczynski
- Ontario Parents Advocating for Children with Cancer, Toronto, Canada
| | - Michelle A. Fortier
- Sue and Bill Gross School of Nursing, University of California Irvine, Irvine, California, United States of America
- Department of Pediatric Psychology, Children’s Hospital of Orange County, Orange, California, United States of America
- UCI Center on Stress and Health, University of California Irvine, Irvine, California, United States of America
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Tan JYA, Ong GYQ, Cheng LJ, Pikkarainen M, He HG. Effectiveness of mHealth-based psychosocial interventions for breast cancer patients and their caregivers: A systematic review and meta-analysis. J Telemed Telecare 2023:1357633X231187432. [PMID: 37650270 DOI: 10.1177/1357633x231187432] [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: 09/01/2023]
Abstract
BACKGROUND Breast cancer causes significant distress in patient-caregiver dyads. While psychosocial and/or mHealth-based interventions have shown efficacy in improving their psychosocial well-being, no reviews have synthesised the effectiveness of such interventions delivered specifically to the breast cancer patient-caregiver dyad. OBJECTIVE To synthesise available evidence examining the effectiveness of mHealth-based psychosocial interventions among breast cancer patient-caregiver dyads in improving their psychosocial well-being (primary outcomes: dyadic adjustment, depression and anxiety; secondary outcomes: stress, symptom distress, social well-being and relationship quality), compared to active or non-active controls. DESIGN A systematic review and meta-analysis. METHODS Randomised controlled trials and quasi-experimental studies were comprehensively searched from seven electronic databases (PubMed, CENTRAL, CINAHL, Embase, PsycINFO, Scopus, Web of Science), ongoing trial registries (ClinicalTrials.gov, WHO ICTRP) and grey literature (ProQuest Dissertations and Theses Global) from inception of databases till 23 December 2022. Studies involving breast cancer patient-caregiver dyads participating in mHealth-based psychosocial interventions, compared to active or non-active controls, were included. Exclusion criteria were terminally ill patients and/or participants with psychiatric disorders or cognitive impairment and interventions collecting symptomatic data, promoting breast cancer screening or involving only physical activities. Screening, data extraction and quality appraisal of studies were conducted independently by two reviewers. Cochrane Risk of Bias Tool version 1 and JBI Critical Appraisal Checklist were used to appraise the randomised controlled trials and quasi-experimental studies, respectively. Meta-analyses using Review Manager 5.4.1 synthesised the effects of outcomes of interest. Sensitivity and subgroup analyses were conducted. The GRADE approach appraised the overall evidence quality. RESULTS Twelve trials involving 1204 breast cancer patient-caregiver dyads were included. Meta-analyses found statistically significant increase in caregiver anxiety (standardised mean difference (SMD) = 0.43, 95% confidence interval (CI) [0.09, 0.77], Z = 2.47, p = 0.01), involving 479 caregivers in 5 studies, and stress (SMD = 0.25, 95% CI [0.05, 0.45], Z = 2.44, p = 0.01), involving 387 caregivers in 4 studies post-intervention, favouring control groups. The intervention effects on the remaining outcomes were statistically insignificant. Beneficial effects of such interventions remain uncertain. The overall quality of evidence was very low for all primary outcomes. CONCLUSIONS Results of the effectiveness of mHealth-based psychosocial interventions on the psychosocial well-being of breast cancer patient-caregiver dyads are inconclusive. The high heterogeneity shown in the meta-analyses and very-low overall quality of evidence imply the need for cautious interpretation of findings. Higher-quality studies are needed to assess the effects of psychosocial interventions on dyadic outcomes and determine optimal intervention regimes.
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Affiliation(s)
- Jia Yu Amelia Tan
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Germaine Yi Qing Ong
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ling Jie Cheng
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- National University Health System, Singapore, Singapore
| | - Minna Pikkarainen
- Department of Occupational Therapy, Prosthetics and Orthoptics, Faculty of Health Sciences & Department of Product Design, Faculty of Technology, Art and Design, Oslo Metropolitan University, Oslo, Norway
- Martti Ahtisaari Institute, University of Oulu, Oulu, Finland
| | - Hong-Gu He
- National University Health System, Singapore, Singapore
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Tsagkaris C, Trygonis N, Spyrou V, Koulouris A. Telemedicine in Care of Sarcoma Patients beyond the COVID-19 Pandemic: Challenges and Opportunities. Cancers (Basel) 2023; 15:3700. [PMID: 37509361 PMCID: PMC10378403 DOI: 10.3390/cancers15143700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/15/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has created a challenging environment for sarcoma patients. Most oncology societies published guidelines or recommendations prioritizing sarcoma patients and established telehealth as an efficient method of approaching them. The aim of this review is the assessment of current evidence regarding the utilization of telemedicine in diagnosis, treatment modalities, telerehabilitation and satisfaction among sarcoma patients and healthcare providers (HP). METHODS This systematic review was carried out using the databases PubMed and Ovid MEDLINE according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). RESULTS The application of telemedicine to the management of sarcoma has yielded improved clinical and psychological outcomes. Specifically, significant progress has been demonstrated in the areas of tele-oncology and telerehabilitation during the last decade, and the COVID-19 outbreak has accelerated this transition toward them. Telehealth has been proven efficient in a wide spectrum of applications from consultations on physical therapy and psychological support to virtual care symptom management. Both HP and patients reported satisfaction with telehealth services at levels comparable to in-person visits. CONCLUSIONS Telehealth has already unveiled many opportunities in tailoring individualized care, and its role in the management of sarcoma patients has been established in the post-COVID-19 era, as well.
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Affiliation(s)
- Christos Tsagkaris
- European Student Think Tank, Public Health and Policy Working Group, 1058 DE Amsterdam, The Netherlands
| | - Nikolaos Trygonis
- Department of Orthopaedics, University Hospital of Heraklion, 70013 Heraklion, Greece
| | - Vasiliki Spyrou
- Post Covid Department, Theme Female Health, Karolinska University Hospital, 14157 Stockholm, Sweden
| | - Andreas Koulouris
- Department of Oncology-Pathology, Karolinska Institute, 17176 Stockholm, Sweden
- Thoracic Oncology Center, Theme Cancer, Karolinska University Hospital, 17177 Stockholm, Sweden
- Faculty of Medicine, University of Crete, 70013 Heraklion, Greece
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Wang XY, Wang J, Zhang S. Analysis of load status and management strategies of main caregivers of patients with malignant tumors of digestive tract. World J Gastrointest Oncol 2023; 15:973-978. [PMID: 37389114 PMCID: PMC10302986 DOI: 10.4251/wjgo.v15.i6.973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 04/12/2023] [Accepted: 04/23/2023] [Indexed: 06/14/2023] Open
Abstract
Caregiver load refers to the subjective and objective negative impact of caregivers in the care of patients, and excessive load will have a serious impact on patients and caregivers themselves and can reduce their quality of life. For the main caregivers, it not only needs to care for the patients in life and daily life, but also needs to pay the cost of treatment for the patients, coupled with the need to carry out their own original work, life, etc. excessive life pressure, economic pressure, work pressure, emotional pressure, etc. lead to heavy load of the main caregivers, which can easily cause caregivers to have different degrees of psychological problems, which will cause serious adverse effects on the caregivers themselves and cancer patients, not conducive to the construction of a harmonious family and society. This article analyzes the current situation of primary caregiver burden in patients with gastrointestinal malignant tumors, analyzes its influencing factors, and specifies specific treatment strategies. It is hoped to provide scientific guidance for later related research and application.
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Affiliation(s)
- Xiao-Yan Wang
- Emergency Department, West China Hospital of Sichuan University, Chengdu 610000, Sichuan Province, China
| | - Jing Wang
- ENT (Ear-Nose-Throat) Department, Chengdu Hospital of Combination of Chinese Traditional and Western Medicine, Chengdu 610000, Sichuan Province, China
| | - Shu Zhang
- Emergency Department, West China Hospital of Sichuan University, Chengdu 610000, Sichuan Province, China
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Shaffer KM, Turner KL, Siwik C, Gonzalez BD, Upasani R, Glazer JV, Ferguson RJ, Joshua C, Low CA. Digital health and telehealth in cancer care: a scoping review of reviews. Lancet Digit Health 2023; 5:e316-e327. [PMID: 37100545 PMCID: PMC10124999 DOI: 10.1016/s2589-7500(23)00049-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 01/06/2023] [Accepted: 02/23/2023] [Indexed: 04/28/2023]
Abstract
The COVID-19 pandemic necessitated remote cancer care delivery via the internet and telephone, rapidly accelerating an already growing care delivery model and associated research. This scoping review of reviews characterised the peer-reviewed literature reviews on digital health and telehealth interventions in cancer published from database inception up to May 1, 2022, from PubMed, Cumulated Index to Nursing and Allied Health Literature, PsycINFO, Cochrane Reviews, and Web of Science. Eligible reviews conducted a systematic literature search. Data were extracted in duplicate via a pre-defined online survey. Following screening, 134 reviews met the eligibility criteria. 77 of those reviews were published since 2020. 128 reviews summarised interventions intended for patients, 18 addressed family caregivers, and five addressed health-care providers. 56 reviews did not target a specific phase of the cancer continuum, whereas 48 reviews tended to address the active treatment phase. 29 reviews included a meta-analysis, with results showing positive effects on quality of life, psychological outcomes, and screening behaviours. 83 reviews did not report intervention implementation outcomes but when reported, 36 reported acceptability, 32 feasibility, and 29 fidelity outcomes. Several notable gaps were identified in these literature reviews on digital health and telehealth in cancer care. No reviews specifically addressed older adults, bereavement, or sustainability of interventions and only two reviews focused on comparing telehealth to in-person interventions. Addressing these gaps with rigorous systematic reviews might help guide continued innovation in remote cancer care, particularly for older adults and bereaved families, and integrate and sustain these interventions within oncology.
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Affiliation(s)
- Kelly M Shaffer
- Center for Behavioral Health and Technology, School of Medicine, University of Virginia, Charlottesville, VA, USA.
| | - Kea L Turner
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Chelsea Siwik
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA, USA
| | - Brian D Gonzalez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Rujula Upasani
- Center for Behavioral Health and Technology, School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Jillian V Glazer
- Center for Behavioral Health and Technology, School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Robert J Ferguson
- Division of Hematology/Oncology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Catherine Joshua
- Center for Behavioral Health and Technology, School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Carissa A Low
- Division of Hematology/Oncology, University of Pittsburgh, Pittsburgh, PA, USA
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Darley A, Coughlan B, Maguire R, McCann L, Furlong E. A bridge from uncertainty to understanding: The meaning of symptom management digital health technology during cancer treatment. Digit Health 2023; 9:20552076231152163. [PMID: 36714543 PMCID: PMC9880573 DOI: 10.1177/20552076231152163] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 01/03/2023] [Indexed: 01/24/2023] Open
Abstract
Objective Digital health technology is valued as a tool to provide person-centred care and improve health outcomes amongst people with cancer and their family caregivers. Although the evidence to date shows encouraging effectiveness, there is limited knowledge regarding the lived experience and personal meaning of using supportive technology during cancer treatment. The aim of this study was to explore the lived experiences of people with colorectal cancer receiving chemotherapy using digital health symptom management technology and their family caregivers. Methods A longitudinal and multi-perspective interpretative phenomenological analytical approach was adopted including three people with newly diagnosed colorectal cancer and four family caregivers. Findings Three superordinate themes and related subthemes were identified. The first theme (The 3 Cs of symptom management technology) centred on the continuity of care that participants felt while using the technology. The second theme (Digital health technology as a psychosocial support) offered insights into the psychological benefits using technology incurred as they navigated their cancer diagnosis including sense of control and psychological safety. The final theme (Impact of digital health technology on family caregivers) details the supportive effect the technology had on family caregivers' role, responsibilities and well-being during the cancer experience. Conclusion Digital health technology can act as a bridge from uncertainty to an understanding regarding a cancer diagnosis and its treatment. Digital health technology can support peoples' understanding of cancer and enhance self-management practices, while being a psychological support in navigating the uncertain and often worrying period of receiving cancer treatment.
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Affiliation(s)
- Andrew Darley
- School of Medicine, University College Dublin, Dublin, Ireland,Andrew Darley, School of Medicine,
University College Dublin, Belfield, Dublin 4, Ireland.
| | - Barbara Coughlan
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Roma Maguire
- Digital Health and Wellness Group, Department of Computing and
Information Sciences, University of Strathclyde, Glasgow, UK
| | - Lisa McCann
- Digital Health and Wellness Group, Department of Computing and
Information Sciences, University of Strathclyde, Glasgow, UK
| | - Eileen Furlong
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
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Söylemez BA, Özgül E, Küçükgüçlü Ö, Yener G. Telehealth applications used for self-efficacy levels of family caregivers for individuals with dementia: A systematic review and Meta-analysis. Geriatr Nurs 2023; 49:178-192. [PMID: 36565592 DOI: 10.1016/j.gerinurse.2022.12.001] [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: 09/02/2022] [Revised: 12/01/2022] [Accepted: 12/01/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND The effectiveness of telehealth applications for family caregivers of individuals with dementia remains unclear. The aim of this study is to investigate how telehealth-based interventions applied for family caregivers of individuals with dementia affect their self-efficacy levels, caregiving burden, stress, depression, and quality of life. MATERIALS AND METHODS This was a systematic review. Screening took place between April 30 and May 5, 2022, for the scope of the past 10 years (January 2012/May 2022). The related studies were screened over ten (10) databases and search engines both in English and Turkish, including CINAHL, Cochrane Library, MEDLINE, PsycINFO, PubMed and Web of Science, ULAKBIM, Turkish Medline, Türkiye Klinikleri, and YOK National Thesis Center. Keywords included in various medical topic titles identified upon consultation with literature review experts from a library. Methodological quality of the studies was evaluated using Critical Appraisal Checklists developed by the Joanna Briggs Institute for experimental and quasi-experimental studies. The data were synthesized by meta-analysis. RESULTS Two hundred and twelve (212) records were accessed in the databases. Of that, 12 studies (covering 1,013 caregivers) were selected for the meta-analysis. Statistically, the self-efficacy mean score was significantly higher in the intervention group than the control group after the intervention (SMD: 1.08, Z= 3.12, p= 0.002). The effectiveness of telehealth-based applications for caregivers' caregiving burden, stress, depression and quality of life -- except for self-efficacy - was evaluated. The results of the intervention and control groups were similar after the intervention (SMD: -0.17, Z= 0.82, p= 0.41; MD: -0.60, Z= 0.49, p= 0.63, SMD: -0.04, Z= 0.13, p= 0.98; SMD: 0.15, Z= 0.47, p= 0.64, respectively). CONCLUSIONS This systematic review and meta-analysis showed that telehealth applications were effective in elevating the self-efficacy levels of caregivers of individuals with dementia. However, no statistically significant difference was observed in terms of caregiving burden, stress, depression, or quality of life for caregivers.
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Affiliation(s)
- Burcu Akpınar Söylemez
- Department of Internal Medicine Nursing, Faculty of Nursing, Dokuz Eylul University, Izmir, Turkey
| | - Ecem Özgül
- Department of Internal Medicine Nursing, Faculty of Health Sciences, Izmir University of Economics, İzmir, Turkey.
| | - Özlem Küçükgüçlü
- Department of Internal Medicine Nursing, Faculty of Nursing, Dokuz Eylul University, Izmir, Turkey
| | - Görsev Yener
- Faculty of Medicine, Izmir University of Economics, İzmir, Turkey
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12
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Abstract
Public health measures associated with coronavirus disease (COVID-19) have accelerated the adoption of virtual health care across Canada. We explore the opportunities that virtual care presents in achieving the Quadruple Aim and challenges to navigate, through the lens of care for older adults. In particular, we recommend virtual care-related policies related to older adults that address (a) limited uptake among the socio-economically disadvantaged, (b) user-centered design of virtual care technologies, and (c) integration of iterative evaluations to ensure equitable and efficient achievement of desired outcomes. As virtual care accelerates forward, we must not leave older Canadians behind.
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13
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Teleoncology: A Solution for Everyone? A Single-Center Experience with Telemedicine during the Coronavirus Disease 2019 (COVID-19) Pandemic. Curr Oncol 2022; 29:8565-8578. [PMID: 36421328 PMCID: PMC9689494 DOI: 10.3390/curroncol29110675] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 11/03/2022] [Accepted: 11/08/2022] [Indexed: 11/13/2022] Open
Abstract
Since the beginning of the COVID-19 pandemic, the use of telehealth was rapidly implemented without previous evidence. The ONCOTELEMD study aimed to evaluate the opinion of patients attended via telemedicine during this period and to study factors that condition patient preferences on its use. Included patients had a confirmed cancer diagnosis and were contacted by telephone between 13 March and 30 April 2020, in the Medical Oncology Service of Hospital Parc Taulí, Sabadell. A 12-question survey was presented to them between 4 February and 19 April 2021. Statistical analysis was carried out using chi-square and multivariable logistic regression tests. Six hundred forty-six patients were included; 487 responded to the survey. The median age was 68 years (27-90), 55.2% were female. Most patients had a surveillance visit (65.3%) and were diagnosed with colorectal or breast cancer (43% and 26.5%, respectively); 91.8% of patients were satisfied, and 60% would accept the use of telemedicine beyond the pandemic. Patients aged more than 50 years (OR 0.40; 95% CI, 0.19-0.81; p = 0.01) and diagnosed with breast cancer (OR 0.45; 95% CI, 0.26-0.69; p < 0.001) were less predisposed to adopt telehealth in the future. Patients agreed to be informed via telehealth of scan or lab results (62% and 84%, respectively) but not of new oral or endovenous treatments (52% and 33.5%, respectively). Additionally, 75% of patients had a medium or low-null technologic ability, and 51.3% would only use the telephone or video call to contact health professionals. However, differences were found according to age groups (p < 0.0001). In total, patients surveyed were satisfied with telemedicine and believed telehealth could have a role following the COVID-19 pandemic. Moreover, our results remark on the importance of individualizing the use of telehealth, showing relevant data on patient preferences and digital literacy.
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Feasibility study of a self-guided internet-based intervention for family caregivers of patients with cancer (OAse). Sci Rep 2022; 12:16713. [PMID: 36202913 PMCID: PMC9537301 DOI: 10.1038/s41598-022-21157-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 09/23/2022] [Indexed: 12/05/2022] Open
Abstract
Despite high levels of distress, family caregivers of patients with cancer rarely seek psychosocial support and Internet-based interventions (IBIs) are a promising approach to reduce some access barriers. Therefore, we developed a self-guided IBI for family caregivers of patients with cancer (OAse), which, in addition to patients' spouses, also addresses other family members (e.g., adult children, parents). This study aimed to determine the feasibility of OAse (recruitment, dropout, adherence, participant satisfaction). Secondary outcomes were caregivers’ self-efficacy, emotional state, and supportive care needs. N = 41 family caregivers participated in the study (female: 65%), mostly spouses (71%), followed by children (20%), parents (7%), and friends (2%). Recruitment (47%), retention (68%), and adherence rates (76% completed at least 4 of 6 lessons) support the feasibility of OAse. Overall, the results showed a high degree of overall participant satisfaction (96%). There were no significant pre-post differences in secondary outcome criteria, but a trend toward improvement in managing difficult interactions/emotions (p = .06) and depression/anxiety (p = .06). Although the efficacy of the intervention remains to be investigated, our results suggest that OAse can be well implemented in caregivers’ daily lives and has the potential to improve family caregivers’ coping strategies.
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15
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Burrell A, Zrubka Z, Champion A, Zah V, Vinuesa L, Holtorf AP, Di Bidino R, Earla JR, Entwistle J, Boltyenkov AT, Braileanu G, Kolasa K, Roydhouse J, Asche C. How Useful Are Digital Health Terms for Outcomes Research? An ISPOR Special Interest Group Report. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2022; 25:1469-1479. [PMID: 36049797 DOI: 10.1016/j.jval.2022.04.1730] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 03/09/2022] [Accepted: 04/15/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES This study aimed to review definitions of digital health and understand their relevance for health outcomes research. Four umbrella terms (digital health, electronic health, mobile health, and telehealth/telemedicine) were summarized in this article. METHODS PubMed/MEDLINE, Embase, Cochrane Library, and EconLit were searched from January 2015 to May 2020 for systematic reviews containing key Medical Subject Headings terms for digital health (n = 38) and synonyms of "definition." Independent pairs of reviewers performed each stage of the review, with reconciliation by a third reviewer if required. A single reviewer consolidated each definition for consistency. We performed text analysis via word clouds and computed document frequency-and inverse corpus frequency scores. RESULTS The search retrieved 2610 records with 545 articles (20.9%) taken forward for full-text review. Of these, 39.3% (214 of 545) were eligible for data extraction, of which 134 full-text articles were retained for this analysis containing 142 unique definitions of umbrella terms (digital health [n = 4], electronic health [n = 36], mobile health [n = 50], and telehealth/telemedicine [n = 52]). Seminal definitions exist but have increasingly been adapted over time and new definitions were created. Nevertheless, the most characteristic words extracted from the definitions via the text analyses still showed considerable overlap between the 4 umbrella terms. CONCLUSIONS To focus evidence summaries for outcomes research purposes, umbrella terms should be accompanied by Medical Subject Headings terms reflecting population, intervention, comparator, outcome, timing, and setting. Ultimately a functional classification system is needed to create standardized terminology for digital health interventions denoting the domains of patient-level effects and outcomes.
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Affiliation(s)
| | - Zsombor Zrubka
- Health Economics Research Center, University Research and Innovation Center, Óbuda University, Budapest, Hungary; Corvinus Institute for Advanced Studies, Corvinus University of Budapest, Budapest, Hungary
| | | | - Vladimir Zah
- HEOR, Z Rx Outcomes Research Inc, Mississauga, ON, Canada
| | | | | | - Rosella Di Bidino
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | | | | | | | - George Braileanu
- National Institute for Health and Care Excellence, Manchester, England, UK
| | - Katarzyna Kolasa
- Health Economics and Healthcare Management, Kozminski University, Warszawa, Poland
| | - Jessica Roydhouse
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Carl Asche
- University of Illinois College of Medicine, Chicago, IL, USA
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16
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Pinnelli S. ICT Solutions in the D-Sys-Com Research: Analysis of the Needs and Attitudes of the Frail Elderly Person. Front Robot AI 2022; 9:851473. [PMID: 35694206 PMCID: PMC9174743 DOI: 10.3389/frobt.2022.851473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 04/04/2022] [Indexed: 11/13/2022] Open
Abstract
The introduction and use of innovative technological devices to support the aging of frail elderly people does not necessarily correspond to an improvement in people’s quality of life. The strong technical curvature resulting from the use of telemedicine models often highlights limits in the usability of technologies in responding to the real needs of users. The theoretical framework of special pedagogy allows the assumption of the bio-psycho-social perspective and the constructs of quality of life and participation and opens up to inclusive logics that implement a profound and questioning reflection on all contexts of life, with the goal of exposing the set of disabling processes and indicating a valid support in the use of technological resources. The study, retracing the research phases of the Data System Platform for Smart Communities project (project admitted for funding in the Innolabs 2018–2019 call), completed in 2020, investigates the needs of strategic stakeholders and explores the factors that influence the adoption and diffusion of telemedicine devices by frail elderly people.
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17
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Briggs LG, Labban M, Alkhatib K, Nguyen DD, Cole AP, Trinh QD. Digital technologies in cancer care: a review from the clinician's perspective. J Comp Eff Res 2022; 11:533-544. [PMID: 35416050 DOI: 10.2217/cer-2021-0263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Physicians are increasingly utilizing digital health technologies (DHT) such as smartphone applications, network-enabled wearable devices, web-based communication platforms, videoconferencing, chatbots, artificial intelligence and virtual reality to improve access to, and quality of, care. DHT aid in cancer screening, patient education, shared decision-making, promotion of positive health habits, symptom monitoring and intervention, patient-provider communication, provision of psychological support and delivery of effective survivorship care. This narrative review outlines how physicians may utilize digital health to improve or augment their delivery of cancer care. For the full potential of DHT to be realized, experts must develop appropriate solutions to issues surrounding the regulation, liability, quality, security, equity and reimbursement of DHT.
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Affiliation(s)
- Logan G Briggs
- Center for Surgery & Public Health, Brigham & Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Muhieddine Labban
- Center for Surgery & Public Health, Brigham & Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Khalid Alkhatib
- Center for Surgery & Public Health, Brigham & Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - David-Dan Nguyen
- Center for Surgery & Public Health, Brigham & Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Alexander P Cole
- Center for Surgery & Public Health, Brigham & Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Quoc-Dien Trinh
- Center for Surgery & Public Health, Brigham & Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
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18
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Pang NQ, Lau J, Fong SY, Wong CYH, Tan KK. Telemedicine Acceptance Among Older Adult Patients With Cancer: Scoping Review. J Med Internet Res 2022; 24:e28724. [PMID: 35348462 PMCID: PMC9006130 DOI: 10.2196/28724] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 10/11/2021] [Accepted: 02/19/2022] [Indexed: 12/11/2022] Open
Abstract
Background Cancer is likely to remain the most prevalent noncommunicable disease in high-income countries with an older population. Interestingly, no review of attitudes toward telemedicine among older adults has been performed. This is likely to be the group most affected by both cancer and the increasing use of technology in health care. Objective We aimed to map research on the acceptance of telemedicine among older adults who are cancer patients. Methods We conducted a scoping review. PubMed, EMBASE, PsycINFO, CINAHL, and the Cochrane Central Register of Controlled Trials were systematically searched from inception to September 2020. Articles were included if the study population had a mean or median age ≥65 years, with cancer diagnoses and if the study assessed patients’ acceptance of a telemedicine intervention. Quantitative, qualitative, and mixed method studies were included. Results Out of a total of 887 articles that were identified, 19 were included in the review. Interventions were delivered via telephone, videoconference, web portal, mobile app, wearable technology, and text messaging and included teleconsultation, monitoring and follow-up, psychosocial support and nursing care, and prompts. The most often cited facilitating factor was convenience. Other facilitators included an increase in telemedicine care accessibility, previous positive experiences of telemedicine, appropriate technical knowledge and support, decreased cost, physician recommendations, and privacy conferred by the telemedicine intervention. Barriers include a preference for conventional care along with negative perceptions of telemedicine, concerns about technical difficulties, and confidentiality concerns in the adoption of telemedicine. Conclusions None of the studies explored the ability of tailored interventions to address facilitators and barriers of the acceptance of telemedicine in order to increase its adoption by older adults. Facilitators and barriers will likely differ across different cultural contexts and by type of telemedicine; however, this is a gap in current knowledge. In-depth studies are necessary to determine if interventions could potentially address the barriers identified in this review, to increase acceptability.
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Affiliation(s)
- Ning-Qi Pang
- Division of Hepatobiliary & Pancreatic Surgery and Liver Transplantation, National University of Singapore, Singapore, Singapore
| | - Jerrald Lau
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Si-Ying Fong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Celine Yu-Hui Wong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ker-Kan Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Division of Colorectal Surgery, University Surgical Cluster, National University Hospital, Singapore, Singapore
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19
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Wong AKC, Bayuo J, Wong FKY, Yuen WS, Lee AYL, Chang PK, Lai JTC. Effects of a Nurse-Led Telehealth Self-care Promotion Program on the Quality of Life of Community-Dwelling Older Adults: Systematic Review and Meta-analysis. J Med Internet Res 2022; 24:e31912. [PMID: 35311680 PMCID: PMC8981017 DOI: 10.2196/31912] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 10/18/2021] [Accepted: 01/18/2022] [Indexed: 01/14/2023] Open
Abstract
Background In recent years, telehealth has become a common channel for health care professionals to use to promote health and provide distance care. COVID-19 has further fostered the widespread use of this new technology, which can improve access to care while protecting the community from exposure to infection by direct personal contact, and reduce the time and cost of traveling for both health care users and providers. This is especially true for community-dwelling older adults who have multiple chronic diseases and require frequent hospital visits. Nurses are globally recognized as health care professionals who provide effective community-based care to older adults, facilitating their desire to age in place. However, to date, it is unclear whether the use of telehealth can facilitate their work of promoting self-care to community-dwelling older adults. Objective This review aims to summarize findings from randomized controlled trials on the effect of nurse-led telehealth self-care promotion programs compared with the usual on-site or face-to-face services on the quality of life (QoL), self-efficacy, depression, and hospital admissions among community-dwelling older adults. Methods A search of 6 major databases was undertaken of relevant studies published from May 2011 to April 2021. Standardized mean differences (SMDs) and their 95% CIs were calculated from postintervention outcomes for continuous data, while the odds ratio was obtained for dichotomous data using the Mantel–Haenszel test. Results From 1173 possible publications, 13 trials involving a total of 4097 participants were included in this meta-analysis. Compared with the control groups, the intervention groups of community-dwelling older adults significantly improved in overall QoL (SMD 0.12; 95% CI 0.03 to 0.20; P=.006; I2=21%), self-efficacy (SMD 0.19; 95% CI 0.08 to 0.30; P<.001; I2=0%), and depression level (SMD –0.22; 95% CI –0.36 to –0.08; P=.003; I2=89%). Conclusions This meta-analysis suggests that employing telehealth in nurse-led self-care promotion programs may have a positive impact on older adults, although more studies are needed to strengthen the evidence base, particularly regarding organization and delivery. Trial Registration PROSPERO (Prospective International Register of Systematic Reviews) CRD42021257299; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=257299
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Affiliation(s)
| | - Jonathan Bayuo
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | | | - Wing Shan Yuen
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Athena Yin Lam Lee
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Pui King Chang
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Jojo Tsz Chui Lai
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
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20
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Bodschwinna D, Lorenz I, Bauereiß N, Gündel H, Baumeister H, Hönig K. A psycho-oncological online intervention supporting partners of patients with cancer (PartnerCARE): Results from a randomized controlled feasibility trial. Psychooncology 2022; 31:1230-1242. [PMID: 35233880 DOI: 10.1002/pon.5917] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 02/18/2022] [Accepted: 02/27/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Partners of cancer patients are the primary supporters and burdened at the same time. Support for partners is hitherto scarce and existing offers are rarely used. The PartnerCARE online intervention was specifically developed to address the caregiving partners' needs. This two-arm parallel randomized controlled trial evaluates the feasibility, acceptability, and potential efficacy of PartnerCARE. METHODS Sixty German-speaking partners of patients with various cancer entities were randomized into two conditions: intervention group with PartnerCARE (N=30) or waitlist-control group (N=30). Participants completed online questionnaires at baseline (T0), post-treatment (T1) and four-months follow-up (T2). Feasibility and acceptability outcomes included dropout rates, use and acceptance of PartnerCARE, individual user/e-coach feedback as well as negative effects. Relevant efficacy outcomes were assessed to test for potential intervention effects. RESULTS Recruitment success illustrates demand for and acceptability of PartnerCARE. Satisfaction with the intervention was high (CSQ-I, T1: M=24.66, SD=6.42) and 73.3 % of participants completed the intervention. Study dropout rate was low (T1: 17%, T2: 29%). More positive than negative side effects of the intervention were identified, and negative ones were mainly related to 'intrapersonal change'. For efficacy outcomes we found effects over time, with strongest effects within the intervention group from T0 to T1 in psychological distress (d=0.73, 95%-CI: [0.34; 1.12]) and anxiety (0.66, [0.26; 1.04]), but no group effects were significant at T1 and T2. CONCLUSIONS PartnerCARE is feasible, acceptable and potentially efficacious. Based on received feedback, PartnerCARE is currently undergoing further development and subsequently efficacy will be investigated in a randomized controlled trial. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Daniela Bodschwinna
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Ulm, Germany.,Comprehensive Cancer Center Ulm (CCCU), Germany
| | - Inga Lorenz
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Ulm, Germany
| | - Natalie Bauereiß
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Germany
| | - Harald Gündel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Ulm, Germany
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Germany
| | - Klaus Hönig
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Ulm, Germany.,Comprehensive Cancer Center Ulm (CCCU), Germany
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21
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Christiansen MG, Pappot H, Pedersen C, Jarden M, Mirza MR, Piil K. Patient perspectives and experiences of the rapid implementation of digital consultations during COVID-19 - a qualitative study among women with gynecological cancer. Support Care Cancer 2021; 30:2545-2554. [PMID: 34796401 PMCID: PMC8601371 DOI: 10.1007/s00520-021-06651-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 10/24/2021] [Indexed: 11/25/2022]
Abstract
Purpose Due to the first COVID-19 outbreak and subsequent restrictions, standard practice for gynecological cancer quickly evolved to include additional digital consultations. Women with gynecological cancer have a high need for information and experience a high symptom burden. We aimed to explore the experiences and perspectives of the rapid implementation of digital consultations during COVID-19. Methods We conducted individual telephone interviews with patients with gynecological cancer 1–4 days after a telephone or video consultation during the COVID-19 outbreak in April and May 2020. We applied Braun and Clarke’s thematic analysis to analyze the qualitative data. Results Thirty-two patients with ovarian (50%), cervical (35%), vulvar (12%), and vaginal cancer (3%) participated in the study. The patients experienced that, combined, cancer and COVID-19 restrictions made their situation twice as challenging. In general, the patients valued face-to-face consultations, recommending that they were ideal for the initial appointment to build trust. Overall, there was a willingness to participate in digital consultations because of the restrictions, but the results also showed varying degrees of openness and that individual solutions were favored. Conclusion The findings of this study show that digital consultations were an accepted alternative during COVID-19. Even though this temporary solution was deemed to be beneficial for practical reasons, patients also experienced digital consultations to be impersonal. A key message is that face–to–face encounters create the foundation to establish a trusting relationship from where a valuable dialogue arises. Digital consultations should therefore be implemented with caution since no one-size-fits-all model is recommended. Among patients with gynecological cancer, however, digital technologies represent a promising and flexible method depending on the purpose of consultations, patient preferences, and needs.
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Affiliation(s)
| | - Helle Pappot
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Charlotte Pedersen
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Mary Jarden
- Department of Haematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mansoor Raza Mirza
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Karin Piil
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Public Health, Faculty of Health, University of Aarhus, Aarhus, Denmark
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22
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Su Z, Li X, McDonnell D, Fernandez AA, Flores BE, Wang J. Technology-Based Interventions for Cancer Caregivers: Concept Analysis. JMIR Cancer 2021; 7:e22140. [PMID: 34783664 PMCID: PMC8663574 DOI: 10.2196/22140] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 12/01/2020] [Accepted: 10/13/2021] [Indexed: 01/16/2023] Open
Abstract
Background Cancer is a taxing chronic disease that demands substantial care, most of which is shouldered by informal caregivers. As a result, cancer caregivers often have to manage considerable challenges that could result in severe physical and psychological health consequences. Technology-based interventions have the potential to address many, if not all, of the obstacles caregivers encounter while caring for patients with cancer. However, although the application of technology-based interventions is on the rise, the term is seldom defined in research or practice. Considering that the lack of conceptual clarity of the term could compromise the effectiveness of technology-based interventions for cancer caregivers, timely research is needed to bridge this gap. Objective This study aims to clarify the meaning of technology-based interventions in the context of cancer caregiving and provide a definition that can be used by cancer caregivers, patients, clinicians, and researchers to facilitate evidence-based research and practice. Methods The 8-step concept analysis method by Walker and Avant was used to analyze the concept of technology-based interventions in the context of cancer caregiving. PubMed, PsycINFO, CINAHL, and Scopus were searched for studies that examined technology-based interventions for cancer caregivers. Results The defining attributes of technology-based interventions were recognized as being accessible, affordable, convenient, and user-friendly. On the basis of insights gained on the defining attributes, antecedents to, and consequences of technology-based interventions through the concept analysis process, technology-based interventions were defined as the use of technology to design, develop, and deliver health promotion contents and strategies aimed at inducing or improving positive physical or psychological health outcomes in cancer caregivers. Conclusions This study clarified the meaning of technology-based interventions in the context of cancer caregiving and provided a clear definition that can be used by caregivers, patients, clinicians, and researchers to facilitate evidence-based oncology practice. A clear conceptualization of technology-based interventions lays foundations for better intervention design and research outcomes, which in turn have the potential to help health care professionals address the needs and preferences of cancer caregivers more cost-effectively.
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Affiliation(s)
- Zhaohui Su
- Center on Smart and Connected Health Technologies, School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Xiaoshan Li
- Program of Public Relations and Advertising, Beijing Normal University-Hong Kong Baptist University United International College, Zhuhai, China
| | - Dean McDonnell
- Department of Humanities, Institute of Technology, Carlow, Ireland
| | - Andrea A Fernandez
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Bertha E Flores
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Jing Wang
- Florida State University College of Nursing, Tallahassee, FL, United States
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Marzorati C, Pizzoli SFM, Grasso R, Pravettoni G. Remote Relaxation and Acceptance Training for the Management of Stress in Cancer Patients: A Study Protocol. Front Psychol 2021; 12:710861. [PMID: 34721155 PMCID: PMC8548685 DOI: 10.3389/fpsyg.2021.710861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 09/15/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Cancer patients are now facing a double distinctive challenge of survival against both the disease and fear of contracting COVID-19. This challenge has resulted in the forced adoption of social distancing measures and reorganization of the delivery of medical and psychological treatments. The perceived loneliness and uncertainty increased distress and symptoms burden. In the current period, eHealth interventions might provide valuable benefits in the field of cancer care. Objective: The overall goal of the study protocol will be to provide an innovative intervention for cancer patients based on an online platform, to help them manage and prevent psychological problems related to social isolation. Specifically, the efficacy of two web-based interventions aimed at lowering stress in cancer patients will be tested and compared. Methods: One hundred and fifty participants (75 per group) will be enrolled in a two-group randomized trial. The two interventions will be composed either by exercises on relaxation and meditation practices, presented in both automated online content and interactive group sessions or by fixed psychoeducational online content. Stress, anxiety, and depressive symptoms, distress, resilience, and perceived social isolation will be measured before the start of the interventions (T0), 2 weeks (T1), 4 weeks (T2), and 2 months (T3) after the beginning of the interventions in both groups. A repeated measures ANOVA will be performed to test differences in the questionnaires' scores between groups across the four-time points. Expected Results: We hypothesized greater improvement in the specific domain of stress symptoms (IES-R) assessed in the group receiving the interactive intervention, compared to the group which will receive only fully automated psychoeducational content. Secondarily, we expect the same trend of improvement across all the psychological variables in the blended intervention group. Conclusions: Implementing these practices on people who are forced into mandatory social isolation may help them become more aware of their mind-body condition and reduce negative effects. Moreover, relaxation techniques help individuals in achieving a greater state of well-being, increasing the ability to cope with stressful situations (resilience), and strengthening the immune system.
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Affiliation(s)
- Chiara Marzorati
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy
| | | | - Roberto Grasso
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Gabriella Pravettoni
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
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24
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McGrowder DA, Miller FG, Vaz K, Anderson Cross M, Anderson-Jackson L, Bryan S, Latore L, Thompson R, Lowe D, McFarlane SR, Dilworth L. The Utilization and Benefits of Telehealth Services by Health Care Professionals Managing Breast Cancer Patients during the COVID-19 Pandemic. Healthcare (Basel) 2021; 9:1401. [PMID: 34683081 PMCID: PMC8535379 DOI: 10.3390/healthcare9101401] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/05/2021] [Accepted: 10/13/2021] [Indexed: 12/20/2022] Open
Abstract
Telehealth is the delivery of many health care services and technologies to individuals at different geographical areas and is categorized as asynchronously or synchronously. The coronavirus disease 2019 (COVID-19) pandemic has caused major disruptions in health care delivery to breast cancer (BCa) patients and there is increasing demand for telehealth services. Globally, telehealth has become an essential means of communication between patient and health care provider. The application of telehealth to the treatment of BCa patients is evolving and increasingly research has demonstrated its feasibility and effectiveness in improving clinical, psychological and social outcomes. Two areas of telehealth that have significantly grown in the past decade and particularly since the beginning of the COVID-19 pandemic are telerehabilitation and teleoncology. These two technological systems provide opportunities at every stage of the cancer care continuum for BCa patients. We conducted a literature review that examined the use of telehealth services via its various modes of delivery among BCa patients particularly in areas of screening, diagnosis, treatment modalities, as well as satisfaction among patients and health care professionals. The advantages of telehealth models of service and delivery challenges to patients in remote areas are discussed.
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Affiliation(s)
- Donovan A. McGrowder
- Department of Pathology, Faculty of Medical Sciences, The University of the West Indies, Kingston 7, Jamaica; (K.V.); (L.A.-J.); (L.L.); (R.T.); (D.L.); (L.D.)
| | - Fabian G. Miller
- Department of Physical Education, Faculty of Education, The Mico University College, 1A Marescaux Road, Kingston 5, Jamaica;
- Department of Biotechnology, Faculty of Science and Technology, The University of the West Indies, Kingston 7, Jamaica
| | - Kurt Vaz
- Department of Pathology, Faculty of Medical Sciences, The University of the West Indies, Kingston 7, Jamaica; (K.V.); (L.A.-J.); (L.L.); (R.T.); (D.L.); (L.D.)
| | - Melisa Anderson Cross
- School of Allied Health and Wellness, College of Health Sciences, University of Technology, Kingston 7, Jamaica;
| | - Lennox Anderson-Jackson
- Department of Pathology, Faculty of Medical Sciences, The University of the West Indies, Kingston 7, Jamaica; (K.V.); (L.A.-J.); (L.L.); (R.T.); (D.L.); (L.D.)
| | - Sophia Bryan
- Department of Basic Medical Sciences, Faculty of Medical Sciences, The University of the West Indies, Kingston 7, Jamaica;
| | - Lyndon Latore
- Department of Pathology, Faculty of Medical Sciences, The University of the West Indies, Kingston 7, Jamaica; (K.V.); (L.A.-J.); (L.L.); (R.T.); (D.L.); (L.D.)
| | - Rory Thompson
- Department of Pathology, Faculty of Medical Sciences, The University of the West Indies, Kingston 7, Jamaica; (K.V.); (L.A.-J.); (L.L.); (R.T.); (D.L.); (L.D.)
| | - Dwight Lowe
- Department of Pathology, Faculty of Medical Sciences, The University of the West Indies, Kingston 7, Jamaica; (K.V.); (L.A.-J.); (L.L.); (R.T.); (D.L.); (L.D.)
| | - Shelly R. McFarlane
- Caribbean Institute for Health Research, Faculty of Medical Sciences, The University of the West Indies, Kingston 7, Jamaica;
| | - Lowell Dilworth
- Department of Pathology, Faculty of Medical Sciences, The University of the West Indies, Kingston 7, Jamaica; (K.V.); (L.A.-J.); (L.L.); (R.T.); (D.L.); (L.D.)
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25
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Taylor J, Fradgley EA, Clinton-McHarg T, Hall A, Paul CL. Referral and uptake of services by distressed callers to the Cancer Council Information and Support telephone service. Asia Pac J Clin Oncol 2021; 18:303-310. [PMID: 34185960 DOI: 10.1111/ajco.13604] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 04/10/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Patient-centered cancer care includes emotional, informational, and practical support that is personalised to the needs of patients and inclusive of family and friends. However, when supportive care referrals are offered in hospital settings, distressed patients and carers do not consistently act on those referrals, which can prolong patient suffering. The degree to which sub-optimal referral uptake also occurs in Australian telephone support services is unknown. AIMS To report, among a sample of distressed patients and caregivers who called a cancer information and support service: 1) the types of services used; 2) proportion who received and actioned a referral (uptake); 3) associations between referral to a service and callers' characteristics); and, 4) associations between uptake of a referred service and callers' characteristics. METHODS This study used cross-sectional data collected at 3-month post-baseline from control participants (usual care group) enrolled in the Structured Triage and Referral by Telephone (START) trial. The START trial recruited distressed adult cancer patients and caregivers from the Cancer Council Information and Support Service (CIS). A research assistant conducted a 30-45 min telephone interview with participants, which included recall of referrals provided by CIS staff and reported uptake of referral(s) to the offered service types. RESULTS Most patients (98%) and caregivers (97%) reported receiving a referral to a service. For patients and caregivers respectively, information materials (71%, 77%), CIS call-back (51%, 43%), practical services (52%, 45%), and group peer support (49%, 51%) were the services most frequently offered. For callers receiving a referral, uptake was highest for information materials (91%) and CIS call-backs (89%) and lowest for specialist psychological services (30%). Significant association was found between older age and reduced uptake of services (p = 0.03). CONCLUSION The high uptake rate of CIS call-backs suggests it is a potentially more acceptable form of support compared to specialist psychological services. Efforts to reduce the barriers to telephone-based psychological services are required. Specifically, older age peoples' and caregivers' preferences for support and priorities who may benefit from a referral coordinator.
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Affiliation(s)
- Jo Taylor
- School of Medicine and Public health, University of Newcastle, Callaghan, New South Wales, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia.,Priority Research Centre for Cancer Research Innovation and Translation, University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton Heights, Newcastle, New South Wales, Australia
| | - Elizabeth A Fradgley
- School of Medicine and Public health, University of Newcastle, Callaghan, New South Wales, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia.,Priority Research Centre for Cancer Research Innovation and Translation, University of Newcastle, Callaghan, New South Wales, Australia.,Cancer Institute New South Wales, Cancer Institute New South Wales, Eveleigh, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton Heights, Newcastle, New South Wales, Australia
| | - Tara Clinton-McHarg
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia.,Priority Research Centre for Cancer Research Innovation and Translation, University of Newcastle, Callaghan, New South Wales, Australia.,School of Psychology, University of Newcastle, Callaghan, New South Wales, Australia
| | - Alix Hall
- School of Medicine and Public health, University of Newcastle, Callaghan, New South Wales, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia.,Hunter New England Population Health, Hunter New England Area Health Service, Newcastle, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton Heights, Newcastle, New South Wales, Australia
| | - Christine L Paul
- School of Medicine and Public health, University of Newcastle, Callaghan, New South Wales, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia.,Priority Research Centre for Cancer Research Innovation and Translation, University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton Heights, Newcastle, New South Wales, Australia
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26
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Cheung YT, Zhang H, Cai J, Au-Doung LWP, Yang LS, Yan C, Zhou F, Chen X, Guan X, Pui CH, Hudson MM, Li CK. Identifying Priorities for Harmonizing Guidelines for the Long-Term Surveillance of Childhood Cancer Survivors in the Chinese Children Cancer Group (CCCG). JCO Glob Oncol 2021; 7:261-276. [PMID: 33591820 PMCID: PMC8081494 DOI: 10.1200/go.20.00534] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/24/2020] [Accepted: 12/16/2020] [Indexed: 12/11/2022] Open
Abstract
PURPOSE Survivors of childhood cancer often experience treatment-related chronic health conditions. Given its vast population, China shares a large proportion of the global childhood cancer burden. Yet, screening and treatment of late effects in survivors of childhood cancer remain underaddressed in most regions of China. This study aimed to identify high-priority late effects for harmonizing screening guidelines within the Chinese Children's Cancer Group (CCCG), as well as barriers and enablers of the implementation of surveillance recommendations in local practice. METHODS To establish clinical consensus, 12 expert panelists who represent major institutions within the CCCG completed a Delphi survey and participated in a focus group discussion. The survey solicited ratings of the prevalence, severity, and priority for screening of 45 late effects. Major themes identified from the focus group were analyzed using thematic analysis. RESULTS The Delphi survey identified eight high-priority late effects for harmonization within CCCG: osteonecrosis, osteoporosis, left ventricular dysfunction, secondary brain tumors, treatment-related myeloid leukemia, gonadal dysfunction, growth hormone deficiency, and neurocognitive deficits. The common barriers to implementing survivorship programs include lack of support and resources for clinicians to provide follow-up care. Patients were also concerned about privacy issues and lacked awareness of late effects. Many institutions also lacked rehabilitation expertise and referral pathways. CONCLUSION By identifying obstacles related to the professional setting, patient behavior, and organization of care, our study identified resources and a framework for establishing collaborative strategies to facilitate follow-up care of childhood cancer survivors in China.
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Affiliation(s)
- Yin Ting Cheung
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Hui Zhang
- Department of Hematology and Oncology, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Jiaoyang Cai
- Key Laboratory of Pediatric Hematology and Oncology Ministry of Health, Department of Hematology and Oncology, Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | | | - Lok Sum Yang
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Cuixia Yan
- Department of Hematology and Oncology, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Fen Zhou
- Pediatric Department, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaojuan Chen
- State Key Laboratory of Experimental Hematology, Department of Paediatrics Haematology, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xianmin Guan
- Division of Hematology, Children's Hospital, Chongqing Medical University, Chongqing, China
| | - Ching-Hon Pui
- Department of Oncology, St Jude Children's Research Hospital, Memphis, TN
| | - Melissa M. Hudson
- Department of Oncology, St Jude Children's Research Hospital, Memphis, TN
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN
| | - Chi-kong Li
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong
- Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong
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27
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Thiessen M, Soriano AM, Loewen HJ, Decker KM. Impact of Telemedicine Use by Oncology Physicians on the Patient and Informal Caregiver Experience of Receiving Care: Protocol for a Scoping Review in the Context of COVID-19. JMIR Res Protoc 2020; 9:e25501. [PMID: 33290243 PMCID: PMC7744149 DOI: 10.2196/25501] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 11/23/2020] [Accepted: 12/01/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND During the COVID-19 pandemic, the use of telemedicine by oncology physicians in Manitoba, Canada, has increased to limit the risk of exposure to the virus for both patients and health care providers. It is not clear how telemedicine impacts the information needs of patients or the experience of receiving cancer care. OBJECTIVE The objective of this study is to describe how the use of telemedicine impacts the information needs and experience of patients with cancer and their informal caregivers (ie, family and friends) and identify directions for future research. METHODS This review will include all studies addressing telemedicine in the cancer context including those using quantitative, qualitative, and mixed methods approaches. This scoping review will be conducted using the methodology described by the Joanna Briggs Institute. In collaboration with a librarian scientist specializing in health sciences, a comprehensive search will be undertaken to identify and retrieve relevant reports published in English from 1990 to the present. Databases searched will include MEDLINE, CINAHL, EMBASE, Scopus, Cochrane Library, and PsycINFO. Data will be extracted by two independent reviewers, synthesized, and reported in a summary table and in a narrative format describing what has been reported regarding the impact of telemedicine by physicians in oncology on the experience of patients and their informal caregivers and their receipt of information. RESULTS The results from this scoping review are expected to be available by late spring 2021. CONCLUSIONS The results from this scoping review will be useful for informing practice as well as directing future research, both in the context of COVID-19 and beyond. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/25501.
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Affiliation(s)
- Maclean Thiessen
- Research Institute of Oncology and Hematology, CancerCare Manitoba, Winnipeg, MB, Canada.,Department of Internal Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.,Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | - Andrea Michelle Soriano
- Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Hal John Loewen
- Neil John Maclean Health Science Library, University of Manitoba, Winnipeg, MB, Canada
| | - Kathleen Margaret Decker
- Research Institute of Oncology and Hematology, CancerCare Manitoba, Winnipeg, MB, Canada.,Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
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28
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Shin JY, Chaar D, Kedroske J, Vue R, Chappell G, Mazzoli A, Hassett AL, Hanauer DA, Park SY, Debra B, Choi SW. Harnessing mobile health technology to support long-term chronic illness management: exploring family caregiver support needs in the outpatient setting. JAMIA Open 2020; 3:593-601. [PMID: 33758797 PMCID: PMC7969961 DOI: 10.1093/jamiaopen/ooaa053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 08/18/2020] [Accepted: 09/24/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Family caregiving is an important public health issue, particularly with the aging population. In recent years, mobile health (mHealth) technology has emerged as a potential low-cost, scalable platform to address caregiver support needs, and thereby alleviate the burden on caregivers. This study sought to examine the support needs of family caregivers in their lived experiences of outpatient care to inform the development of a future mHealth intervention. MATERAILS AND METHODS We conducted 20 semi-structured interviews in 2 outpatient hematopoietic cell transplant (HCT) clinics at a large academic medical center in the Midwestern United States. A thematic analysis was performed to define emerging themes. RESULTS Qualitative data analysis identified 5 primary themes that HCT caregivers faced: (I) lifestyle restrictions due to the patient's immunocompromised state; (II) Unmet needs due to limitations in the current resources, including unfamiliar medical tasks without necessary trainings; and (III) caregivers' adaptive strategies, including reformation of social relationships with family and friends. Based on these findings, we suggest 3 design considerations to guide the development of a future mHealth intervention. CONCLUSIONS The findings herein captured the family caregiver's lived experiences during outpatient care. There was broad agreement that caregiving was challenging and stressful. Thus, effective and scalable interventions to support caregivers are needed. This study provided data to guide the content and design of a future mHealth intervention in the outpatient setting.
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Affiliation(s)
- Ji Youn Shin
- Department of Media and Information, College of Communication Arts and Sciences, Michigan State University, East Lansing, Michigan, USA
| | - Dima Chaar
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
- School of Information, University of Michigan, Ann Arbor, Michigan, USA
| | - Jacob Kedroske
- Department of Pediatrics, Blood and Marrow Transplantation Program, University of Michigan, Ann Arbor, Michigan, USA
| | - Rebecca Vue
- Department of Pediatrics, Blood and Marrow Transplantation Program, University of Michigan, Ann Arbor, Michigan, USA
| | - Grant Chappell
- Department of Pediatrics, Blood and Marrow Transplantation Program, University of Michigan, Ann Arbor, Michigan, USA
| | - Amanda Mazzoli
- Department of Pediatrics, Blood and Marrow Transplantation Program, University of Michigan, Ann Arbor, Michigan, USA
| | - Afton L Hassett
- Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan, USA
| | - David A Hanauer
- Michigan Institute for Clinical and Health Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Sun Young Park
- School of Information, University of Michigan, Ann Arbor, Michigan, USA
- Stamps School of Arts and Design, University of Michigan, Ann Arbor, Michigan, USA
| | - Barton Debra
- School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
| | - Sung Won Choi
- Department of Pediatrics, Blood and Marrow Transplantation Program, University of Michigan, Ann Arbor, Michigan, USA
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29
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Acceptability and Usefulness of a Dyadic, Tailored, Web-Based, Psychosocial and Physical Activity Self-Management Program (TEMPO): A Qualitative Study. J Clin Med 2020; 9:jcm9103284. [PMID: 33066225 PMCID: PMC7650635 DOI: 10.3390/jcm9103284] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/08/2020] [Accepted: 10/10/2020] [Indexed: 12/11/2022] Open
Abstract
Caregivers of men with prostate cancer report high burden, and there is a need to develop cost-effective programs to support them in their roles. This study reports on the acceptability of a dyadic, Tailored, wEb-based, psychosocial and physical activity (PA) self-Management PrOgram called TEMPO. TEMPO was accessed by a convenience sample of 19 men with prostate cancer and their caregivers (n = 18), as well as six health care professionals (HCPs). User feedback was gathered via semi-structured qualitative interviews. Data were analyzed using thematic analysis. Most dyads were satisfied with TEMPO, particularly with the dyadic feature of TEMPO, the focus on goal setting to integrate self-management, and the extensive health library. The patients and caregivers motivated each other as they worked through TEMPO. Most goals to achieve during TEMPO pertained to increasing PA, followed by learning physical symptom management. One unanticipated benefit of TEMPO for the dyads was improved communication. HCPs agreed that TEMPO was a novel approach to online cancer self-management and they echoed the benefits reported by dyads. Key suggestions for improving TEMPO were to reduce repetition, tailor content, add more exercise ideas, and have more printing options. This study provides a strong foundation on which to plan a larger trial.
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30
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Taylor J, Fradgley E, Clinton-McHarg T, Byrnes E, Paul C. What are the sources of distress in a range of cancer caregivers? A qualitative study. Support Care Cancer 2020; 29:2443-2453. [PMID: 32929537 DOI: 10.1007/s00520-020-05742-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 09/04/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Caring for a person diagnosed with cancer is associated with elevated distress that may impact on caregiver health and patient outcomes. However, caregivers' distress is relatively under-researched. This Australian study explored a range of caregivers' reported sources of distress. METHODS The grounded theory approach informed semi-structured interviews that were conducted with a purposive and broad range sample of distressed caregivers identified through the 'Structured Triage And Referral by Telephone' (START) trial. A grounded theory framework was used to generate themes with data analysed by two independent coders using the NVivo software. RESULTS Caregivers (n = 14) were aged from 25 to 80 years, including two bereaved caregivers. The relationships of the caregivers to the patients were as follows: partner (n = 8), parent (n = 1), child (n = 3), sibling (n = 1), and friend (n = 1). Six major themes emerged in relation to sources of distress: (1) a lack of sufficient and timely information; (2) uncertainty; (3) the role and duties of caregiving; (4) lack of family-centred services; (5) practical challenges; and (6) impact of distress. CONCLUSION Caregivers face a number of specific challenges beyond those experienced by patients. It is essential to ensure that caregivers are actively well-informed and well-supported alongside the person who is diagnosed with cancer.
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Affiliation(s)
- Jo Taylor
- School of Medicine and Public Health, University of Newcastle, Level 4 West, HMRI Building, Callaghan, NSW, 2308, Australia. .,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia. .,Priority Research Centre for Cancer Research Innovation and Translation, University of Newcastle, Callaghan, Australia.
| | - Elizabeth Fradgley
- School of Medicine and Public Health, University of Newcastle, Level 4 West, HMRI Building, Callaghan, NSW, 2308, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia.,Priority Research Centre for Cancer Research Innovation and Translation, University of Newcastle, Callaghan, Australia.,Cancer Institute New South Wales, Eveleigh, Australia
| | - Tara Clinton-McHarg
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia.,Priority Research Centre for Cancer Research Innovation and Translation, University of Newcastle, Callaghan, Australia.,School of Psychology, University of Newcastle, Callaghan, Australia
| | - Emma Byrnes
- School of Medicine and Public Health, University of Newcastle, Level 4 West, HMRI Building, Callaghan, NSW, 2308, Australia.,Priority Research Centre for Generational Health and Aging, University of Newcastle, Callaghan, Australia
| | - Christine Paul
- School of Medicine and Public Health, University of Newcastle, Level 4 West, HMRI Building, Callaghan, NSW, 2308, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia.,Priority Research Centre for Cancer Research Innovation and Translation, University of Newcastle, Callaghan, Australia.,Hunter Research Cancer Alliance, HMRI Building, New Lambton Heights, Australia
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31
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Broom A, Kenny K, Page A, Cort N, Lipp ES, Tan AC, Ashley DM, Walsh KM, Khasraw M. The Paradoxical Effects of COVID-19 on Cancer Care: Current Context and Potential Lasting Impacts. Clin Cancer Res 2020; 26:5809-5813. [PMID: 32816894 DOI: 10.1158/1078-0432.ccr-20-2989] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 08/03/2020] [Accepted: 08/14/2020] [Indexed: 11/16/2022]
Abstract
Coronavirus disease 2019 (COVID-19) has fundamentally disrupted the practice of oncology, shifting care onto virtual platforms, rearranging the logistics and economics of running a successful clinical practice and research, and in some contexts, redefining what treatments patients with cancer should and can receive. Since the start of the pandemic in early 2020, there has been considerable emphasis placed on the implications for patients with cancer in terms of their vulnerability to the virus and potential exposure in healthcare settings. But little emphasis has been placed on the significant, and potentially enduring, consequences of COVID-19 for how cancer care is delivered. In this article, we outline the importance of a focus on the effects of COVID-19 for oncology practice during and potentially after the pandemic, focusing on key shifts that are already evident, including: the pivot to online consultations, shifts in access to clinical trial and definitions of "essential care," the changing economics of practice, and the potential legacy effects of rapidly implemented changes in cancer care. COVID-19 is reshaping oncology practice, clinical trials, and delivery of cancer care broadly, and these changes might endure well beyond the short- to mid-term of the active pandemic. Therefore, shifts in practice brought about by the pandemic must be accompanied by improved training and awareness, enhanced infrastructure, and evidence-based support if they are to harness the positives and offset the potential negative consequences of the impacts of COVID-19 on cancer care.
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Affiliation(s)
- Alex Broom
- The University of Sydney, Sydney, New South Wales, Australia
| | - Katherine Kenny
- The University of Sydney, Sydney, New South Wales, Australia
| | - Alexander Page
- The University of Sydney, Sydney, New South Wales, Australia
| | - Nicole Cort
- Duke University Medical Center, Duke University, Durham, North Carolina
| | - Eric S Lipp
- Duke University Medical Center, Duke University, Durham, North Carolina
| | - Aaron C Tan
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - David M Ashley
- Duke University Medical Center, Duke University, Durham, North Carolina
| | - Kyle M Walsh
- Duke University Medical Center, Duke University, Durham, North Carolina
| | - Mustafa Khasraw
- The University of Sydney, Sydney, New South Wales, Australia. .,Duke University Medical Center, Duke University, Durham, North Carolina
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32
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Crotty BH, Asan O, Holt J, Tyszka J, Erickson J, Stolley M, Pezzin LE, Nattinger AB. Qualitative Assessment of Unmet Information Management Needs of Informal Cancer Caregivers: Four Themes to Inform Oncology Practice. JCO Clin Cancer Inform 2020; 4:521-528. [PMID: 32530708 DOI: 10.1200/cci.19.00159] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Family and friends often provide informal care for patients with cancer, coordinating care and supporting patients at home. Stress, depression, and burnout are increasingly recognized among these informal caregivers. Although past research has described a range of needs, including the need for information, details about unmet informational needs for caregivers have not been fully described. We sought to assess unmet information management needs for informal caregivers in the digital era. METHODS This was a qualitative research study with semistructured interviews and focus groups of nonprofessional caregivers for patients with cancer, facilitated using a discussion guide. Eligible caregivers supported patients in the community who were in treatment (chemotherapy or radiotherapy) or completed treatment within 3 years. Participants were recruited using informational flyers at an academic cancer center and in the local community of metropolitan Milwaukee, Wisconsin. Sessions were transcribed verbatim and analyzed inductively to identify themes. RESULTS Thirteen caregivers participated, the majority between 41 and 60 years of age: seven of 13, 53.8%, were predominantly women; 10 of 13 (76.9%) were educated, 10 of 13 (76.9%) had graduated from college; and of modest means, six of 13 (46.2%) had household incomes < $35,000. Four themes emerged: (1) the information overload paradox, where caregivers felt overloaded by information yet had unmet informational needs; (2) navigating volatility as a caregiver, with changing or unknown expectations; (3) caregivers as information brokers, which placed new burdens on caregivers to seek, share, and protect information; and (4) care for the caregiver, including unmet information needs related to self-care. CONCLUSION This study identified several informational challenges affecting caregivers. Caregivers have dynamic and evolving informational needs, and strategies that support caregivers through just-in-time information availability or dedicated caregiver check-ins may provide relief within the stress of caregiving.
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Affiliation(s)
| | - Onur Asan
- Stevens Institute of Technology, Hoboken, NJ
| | - Jeana Holt
- Medical College of Wisconsin, Milwaukee, WI
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Shaw SE, Hughes G, Hinder S, Carolan S, Greenhalgh T. Care organising technologies and the post-phenomenology of care: An ethnographic case study. Soc Sci Med 2020; 255:112984. [PMID: 32315872 PMCID: PMC7262591 DOI: 10.1016/j.socscimed.2020.112984] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 04/08/2020] [Accepted: 04/09/2020] [Indexed: 11/15/2022]
Abstract
Care organising technologies are software applications that are intended primarily for informal carers, to help organise, document and coordinate caring work. These may be purchased privately or provided as part of state support. Take-up to date remains low. Based on empirical case studies of three such technologies and drawing on post-phenomenology and political science, we examined people's experience of caring when caring technologies find a way into their lives. Our findings show how care organising technologies have evolved in a political context that assumes informal support will supplement and sometimes substitute for state support. Technologies were largely designed to foreground the technical and organisational aspects of care such as planning meals, coordinating medication, and allocating and monitoring tasks among carers. For carers, the result was often a flattening of the landscape of care such that the socio-emotional work of caring was rendered invisible and relations between cared-for and caregiver were configured in narrow transactional terms. For a small number of carers, the focus on tasks was out of tune with their (often emotionally charged) experiences of care and led to active rejection of the technology. However, we also found examples of caregivers and the individuals they cared for using technologies adaptively to facilitate and embed existing care relationships. In these examples, the material/technical, socio-emotional and bodily aspects of caring were interwoven with the situated context of close, unique and evolving relationships. We conclude that the design and development of caring technologies would benefit by being informed by a broader orientation of caring as a relational practice. Care organising technologies are applications that aim to help coordinate caring. Post-phenomenology invites examination of people's experience of such technologies. Perceptions of caring (e.g. as material problem) shape technology design and use. Flexible technology, that supports relationships, has potential to enhance caring. Take-up remains low. Co-design and orientation to caring relations can help.
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Affiliation(s)
- Sara E Shaw
- Nuffield Department of Primary Care Health Sciences, University of Oxford, United Kingdom.
| | - Gemma Hughes
- Nuffield Department of Primary Care Health Sciences, University of Oxford, United Kingdom
| | | | - Stephany Carolan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, United Kingdom
| | - Trisha Greenhalgh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, United Kingdom
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Shin JY, Choi SW. Online interventions geared toward increasing resilience and reducing distress in family caregivers. Curr Opin Support Palliat Care 2020; 14:60-66. [PMID: 31842019 PMCID: PMC6996606 DOI: 10.1097/spc.0000000000000481] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW Family caregivers of patients with cancer often spend a great deal of effort on physically and emotionally demanding work while taking care of patients. However, the majority of caregivers are not properly equipped for their role as caregivers, which may lead to increased distress in both caregivers and patients. Herein, we reviewed the recent literature (last 3 years) examining online interventions that seek to support caregiver resilience and decrease distress. RECENT FINDINGS Our search identified interventions involving three main themes: informational support, positive activities, and social support. These are mostly in the form of web-based tools and mobile apps targeting both usability and quality of life. Social network services are also considered in this review as a new environment for caregivers to connect with other individuals with lived experience in similar circumstances. SUMMARY Existing studies on online interventions to support caregivers is still at a formative development stage and pilot tests of feasibility, rather than a substantive body of randomized controlled trials to assess the impact in different user populations, or to determine specific factors that impact caregiver distress level or resilience. More research is needed to further assess the long-term effects of online interventions on caregiver stress and resilience. Also, the role of different types of social network services and new forms of interaction, such as conversational agents, has not yet been fully investigated in caregiver populations. Future research should strive to seek new modes of providing services that may present novel opportunities to enhance caregiver resilience and reduce distress.
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Affiliation(s)
- Ji Youn Shin
- College of Communication Arts and Sciences, Michigan State University, East Lansing, MI
| | - Sung Won Choi
- Blood and Marrow Transplantation Program, University of Michigan, Ann Arbor, MI
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Hong YA, Hossain MM, Chou WS. Digital interventions to facilitate patient‐provider communication in cancer care: A systematic review. Psychooncology 2020; 29:591-603. [DOI: 10.1002/pon.5310] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 11/12/2019] [Accepted: 12/01/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Y. Alicia Hong
- Department of Health Administration and Policy, College of Health and Human ServicesGeorge Mason University Fairfax Virginia
| | - Md Mahbub Hossain
- Department of Health Promotion and Community Health Sciences, School of Public HealthTexas A&M University College Station Texas
| | - Wen‐Ying Sylvia Chou
- Health Communication and Informatics Research Branch, Division of Cancer Control and Population ScienceNational Cancer Institute Bethesda Maryland
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Bertucci F, Le Corroller-Soriano AG, Monneur A, Fluzin S, Viens P, Maraninchi D, Goncalves A. [E-health and "Cancer outside the hospital walls", Big Data and artificial intelligence]. Bull Cancer 2019; 107:102-112. [PMID: 31543271 DOI: 10.1016/j.bulcan.2019.07.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 06/15/2019] [Accepted: 07/04/2019] [Indexed: 12/25/2022]
Abstract
To heal otherwise in oncology has become an imperative of Public Health and an economic imperative in France. Patients can therefore receive live most of their care outside of hospital with more ambulatory care. This ambulatory shift will benefit from the digital revolution and the development of digital health or e-health. Cancer research will also benefit with Big Data and artificial intelligence, which gather and analyze a huge amount of data. In this synthesis, we describe the different e-health tools and their potential impacts in oncology, at the levels of education and information of patients and caregivers, prevention, screening and diagnosis, treatment, follow-up, and research. A few randomized studies have already demonstrated clinical benefits. Large Big Data projects such as ConSoRe and Health Data Hub have been launched in France. We also discuss the issues and limitations of "cancer outside the hospital walls and e-health" from the point of view of patients, health care professionals, health facilities and government. This new organization will have to provide remote support "outside the walls" with care and follow-up of quality, continuous and prolonged in total safety and equity. Ongoing and future randomized clinical trials will need to definitively demonstrate areas of interest, advantages and drawbacks not only for patients, but also for caregivers, health facilities and governments.
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Affiliation(s)
- François Bertucci
- Institut Paoli-Calmettes, département d'oncologie médicale, 13009 Marseille, France; Aix-Marseille université, Centre de recherche en cancérologie de Marseille, Inserm U1068-CNRS U7258, 13009 Marseille, France.
| | - Anne-Gaëlle Le Corroller-Soriano
- Aix-Marseille université, SESSTIM, Sciences économiques & sociales de la santé & traitement de l'information médicale, Inserm UMR912, 13009 Marseille, France
| | - Audrey Monneur
- Institut Paoli-Calmettes, département d'oncologie médicale, 13009 Marseille, France
| | - Sylvain Fluzin
- Institut Paoli-Calmettes, direction du système d'information et de l'organisation, 13009 Marseille, France
| | - Patrice Viens
- Institut Paoli-Calmettes, département d'oncologie médicale, 13009 Marseille, France; Aix-Marseille université, Centre de recherche en cancérologie de Marseille, Inserm U1068-CNRS U7258, 13009 Marseille, France
| | - Dominique Maraninchi
- Institut Paoli-Calmettes, département d'oncologie médicale, 13009 Marseille, France; Aix-Marseille université, Centre de recherche en cancérologie de Marseille, Inserm U1068-CNRS U7258, 13009 Marseille, France
| | - Anthony Goncalves
- Institut Paoli-Calmettes, département d'oncologie médicale, 13009 Marseille, France; Aix-Marseille université, Centre de recherche en cancérologie de Marseille, Inserm U1068-CNRS U7258, 13009 Marseille, France
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Outpatient Cancer Care Delivery in the Context of E-Oncology: A French Perspective on "Cancer outside the Hospital Walls". Cancers (Basel) 2019; 11:cancers11020219. [PMID: 30769858 PMCID: PMC6406853 DOI: 10.3390/cancers11020219] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 01/06/2019] [Accepted: 02/10/2019] [Indexed: 01/21/2023] Open
Abstract
In oncology, the treatment of patients outside of hospitals has become imperative due to an increasing number of patients who are older and live longer, along with issues such as medical desertification, oncologist hyperspecialization, and difficulties in financing mounting health expenditures. Treatments have become less "invasive", with greater precision and efficiency. Patients can therefore receive most of their care outside of hospitals. The development of e-health can address these new imperatives. In this letter, we describe the different e-health tools and their potential clinical impacts in oncology, as already reported at every level of care, including education, prevention, diagnosis, treatment, and monitoring. A few randomized studies have yet demonstrated the clinical benefit. We also comment on issues and limits of "cancer outside the hospital walls" from the point of view of patients, health care professionals, health facilities, and public authorities. Care providers in hospitals and communities will have to adapt to these changes within well-coordinated networks in order to better meet patient expectations regarding increasing education and personalizing management. Ultimately, controlled studies should aim to definitively demonstrate areas of interest, benefits, and incentives, for not only patients, but also caregivers (formal and informal) and health care providers, health care facilities, and the nation.
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