1
|
Leandro TA, da Silva VM, Lopes MVDO, de Souza NMG, Lourenço Penaforte K, Gueiros EAT, Nascimento de Oliveira M. Analysis of etiological factors of nursing diagnosis of impaired comfort in children and adolescents with cancer. J Adv Nurs 2023; 79:3913-3922. [PMID: 37198978 DOI: 10.1111/jan.15695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 04/04/2023] [Accepted: 04/23/2023] [Indexed: 05/19/2023]
Abstract
AIM To analyse the etiological factors of the nursing diagnosis of impaired comfort in children and adolescents with cancer. DESIGN This cross-sectional study was carried out in the referral unit for the treatment of childhood cancer in a tertiary hospital located in northeastern Brazil. METHODS A total of 200 children and adolescents who were undergoing cancer treatment were included in this study. Data collection instruments and protocols were constructed with operational and conceptual definitions of clinical indicators and etiological factors for the nursing diagnosis of impaired comfort. A latent class model with adjusted random effects was used to determine impaired comfort and measures of sensitivity and specificity of clinical indicators. A univariate logistic regression analysis was performed for each etiological factor of impaired comfort. RESULTS The analysis of etiological factors for the nursing diagnosis of impaired comfort in children and adolescents with cancer showed the high prevalence of four factors: noxious environmental stimuli, insufficient situational control, insufficient resources and insufficient environmental control. Illness-related symptoms, noxious environmental stimuli, and insufficient environmental control increased the chance of impaired comfort occurring. CONCLUSION The etiological factors with the highest prevalence and most significant impact on the occurrence of impaired comfort were noxious environmental stimuli, insufficient situational control and illness-related symptoms. IMPACT The results obtained in this investigation can support more accurate nursing diagnostic inference of impaired comfort in children and adolescents with cancer. Moreover, the results can inform direct interventions for the modifiable factors that trigger this phenomenon to avoid or minimize the signs and symptoms of the nursing diagnosis.
Collapse
|
2
|
Kang D, Kim H, Cho J, Kim Z, Chung M, Lee JE, Nam SJ, Kim SW, Yu J, Chae BJ, Ryu JM, Lee SK. Prediction Model for Postoperative Quality of Life Among Breast Cancer Survivors Along the Survivorship Trajectory From Pretreatment to 5 Years: Machine Learning-Based Analysis. JMIR Public Health Surveill 2023; 9:e45212. [PMID: 37309655 PMCID: PMC10485708 DOI: 10.2196/45212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 05/02/2023] [Accepted: 06/13/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND Breast cancer is the most common cancer and the most common cause of cancer death in women. Although survival rates have improved, unmet psychosocial needs remain challenging because the quality of life (QoL) and QoL-related factors change over time. In addition, traditional statistical models have limitations in identifying factors associated with QoL over time, particularly concerning the physical, psychological, economic, spiritual, and social dimensions. OBJECTIVE This study aimed to identify patient-centered factors associated with QoL among patients with breast cancer using a machine learning (ML) algorithm to analyze data collected along different survivorship trajectories. METHODS The study used 2 data sets. The first data set was the cross-sectional survey data from the Breast Cancer Information Grand Round for Survivorship (BIG-S) study, which recruited consecutive breast cancer survivors who visited the outpatient breast cancer clinic at the Samsung Medical Center in Seoul, Korea, between 2018 and 2019. The second data set was the longitudinal cohort data from the Beauty Education for Distressed Breast Cancer (BEST) cohort study, which was conducted at 2 university-based cancer hospitals in Seoul, Korea, between 2011 and 2016. QoL was measured using European Organization for Research and Treatment of Cancer QoL Questionnaire Core 30 questionnaire. Feature importance was interpreted using Shapley Additive Explanations (SHAP). The final model was selected based on the highest mean area under the receiver operating characteristic curve (AUC). The analyses were performed using the Python 3.7 programming environment (Python Software Foundation). RESULTS The study included 6265 breast cancer survivors in the training data set and 432 patients in the validation set. The mean age was 50.6 (SD 8.66) years and 46.8% (n=2004) had stage 1 cancer. In the training data set, 48.3% (n=3026) of survivors had poor QoL. The study developed ML models for QoL prediction based on 6 algorithms. Performance was good for all survival trajectories: overall (AUC 0.823), baseline (AUC 0.835), within 1 year (AUC 0.860), between 2 and 3 years (AUC 0.808), between 3 and 4 years (AUC 0.820), and between 4 and 5 years (AUC 0.826). Emotional and physical functions were the most important features before surgery and within 1 year after surgery, respectively. Fatigue was the most important feature between 1 and 4 years. Despite the survival period, hopefulness was the most influential feature on QoL. External validation of the models showed good performance with AUCs between 0.770 and 0.862. CONCLUSIONS The study identified important factors associated with QoL among breast cancer survivors across different survival trajectories. Understanding the changing trends of these factors could help to intervene more precisely and timely, and potentially prevent or alleviate QoL-related issues for patients. The good performance of our ML models in both training and external validation sets suggests the potential use of this approach in identifying patient-centered factors and improving survivorship care.
Collapse
Affiliation(s)
- Danbee Kang
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
- Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Republic of Korea
| | - Hyunsoo Kim
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
- Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Republic of Korea
| | - Juhee Cho
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
- Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Republic of Korea
| | - Zero Kim
- Medical AI Research Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Myungjin Chung
- Medical AI Research Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Jeong Eon Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Seok Jin Nam
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Seok Won Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jonghan Yu
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Byung Joo Chae
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jai Min Ryu
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Se Kyung Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| |
Collapse
|
3
|
Hu YC, Chen SY, Chou WC, Chen JS, Weng LC, Tsay PK, Tang WR. The early predictive value of frailty for health-related quality of life among elderly patients with cancer receiving curative chemotherapy. PLoS One 2023; 18:e0287320. [PMID: 37531395 PMCID: PMC10395968 DOI: 10.1371/journal.pone.0287320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 06/02/2023] [Indexed: 08/04/2023] Open
Abstract
Changes in health-related quality of life (HRQOL) among elderly patients with cancer before and after receiving curative treatment, such as chemotherapy, have always been an important consideration in physician-patient treatment decision-making. Although frailty assessment can help predict the effects of chemotherapy, there is a lack of relevant literature on its effectiveness in predicting post-chemotherapy HRQOL. Therefore, this study investigated the early predictive value of pre-chemotherapy frailty assessment for post-chemotherapy HRQOL among elderly patients with cancer receiving curative chemotherapy. From September 2016 to November 2018, this study enrolled elderly patients with cancer aged ≥ 65 years (N = 178), who were expected to receive chemotherapy at three hospitals in Taiwan. The mean age of patients was 71.70 years (SD = 5.46 years) and half of them were female (n = 96, 53.9%). A comprehensive geriatric assessment was performed to measure frailty in 178 participants one week before receiving chemotherapy (T0). Further, the HRQOL of the elderly patients with cancer was assessed again, four weeks after chemotherapy (T1). After controlling for demographic variables, this study evaluated the predictive value of frailty for HRQOL using a hierarchical regression analysis. A total of 103 (57.9%) participants met the frailty criteria. The results showed that 31.1%-56.7% of the variance in the seven domains of HRQOL could be explained by demographic variables and the presence or absence of frailty. This suggests that the presence or absence of frailty is an important predictor of the illness burden domain (β = 9.5; p < .05) of HRQOL. Frailty affects the illness burden domain of HRQOL in elderly patients with cancer. Finally, the administration of frailty assessments before treatment is recommended as a reference for patient treatment decision-making.
Collapse
Affiliation(s)
- Yi-Cheng Hu
- Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan
- Department of Nursing, Ching Kuo Institute of Management and Health, Keelung, Taiwan
| | - Shih-Ying Chen
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Wen-Chi Chou
- Department of Hematology-Oncology and Cancer Center, Chang Gung Memorial Hospital Linkuo Branch, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Jen-Shi Chen
- Department of Hematology-Oncology and Cancer Center, Chang Gung Memorial Hospital Linkuo Branch, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Li-Chueh Weng
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of General Surgery, Chang Gung Memorial Hospital Linkuo Branch, Taoyuan, Taiwan
| | - Pei-Kwei Tsay
- Department of Public Health and Center of Biostatistics, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung University, Taoyuan, Taiwan
| | - Woung-Ru Tang
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Nephrology, Chang Gung Memorial Hospital Linkuo Branch, Taoyuan, Taiwan
| |
Collapse
|
4
|
Wang H, Tan JYB, Wang T, Liu XL, Bressington D, Zheng SL, Huang HQ. Feasibility and potential effects of breathing exercise for chronic pain management in breast cancer survivors: study protocol of a phase II randomised controlled trial. BMJ Open 2022; 12:e064358. [PMID: 36517097 PMCID: PMC9756203 DOI: 10.1136/bmjopen-2022-064358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Chronic pain is a common symptom significantly affecting the quality of life of breast cancer survivors. Despite the achievement of pharmacological interventions, the barriers associated with this approach such as inaccessibility, misuse and side effects drive research into effective non-pharmacological interventions to improve chronic pain management, quality of life, anxiety and depression. Breathing exercise (BE) can be a promising option, but research evidence is sparse. This pilot study aims to examine the feasibility and preliminary effect of using an evidence-based BE intervention for chronic pain management in breast cancer survivors. METHOD AND ANALYSIS This study will be a two-parallel-arm, open-labelled, phase II randomised controlled trial with 1:1 allocation. Seventy-two participants will be recruited from a tertiary hospital in China and randomly allocated to either a BE intervention group (n=36) or a control group (n=36). The participants in the intervention group will receive the usual care, a pain information booklet and a 4-week self-administered BE intervention; the participants in the control group will receive the usual care and the pain information booklet only. The assessment will be conducted at three time points: baseline (week 0), immediately after the intervention completion (week 5) and 4 weeks after the intervention completion (week 9). The primary outcomes will be the acceptability and feasibility assessment of the study protocol and methodological procedures. The secondary outcomes will be the effects of BE on pain, quality of life, anxiety and depression in breast cancer survivors. Descriptive statistics will be applied to present the primary outcomes and the Generalised Estimating Equation Model will be utilised to analyse the clinical outcomes. ETHICS AND DISSEMINATION This study has received ethical approvals from the Human Research Ethics Committee at Charles Darwin University (H21089) and the Clinical Trial Ethics Committee at the Affiliated Hospital of Southwest Medical University (KY2022107). Findings from this study will be presented at academic conferences and submitted to peer-reviewed journals for publication. TRIAL REGISTRATION NUMBER ClinicalTrials.gov: NCT05257876.
Collapse
Affiliation(s)
- Haiying Wang
- Faculty of Health, Charles Darwin University, Brisbane, Queensland, Australia
| | - Jing-Yu Benjamin Tan
- Faculty of Health, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Tao Wang
- Faculty of Health, Charles Darwin University, Brisbane, Queensland, Australia
| | - Xian-Liang Liu
- Faculty of Health, Charles Darwin University, Brisbane, Queensland, Australia
| | - Daniel Bressington
- Faculty of Health, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Si-Lin Zheng
- The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Hou-Qiang Huang
- The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| |
Collapse
|
5
|
Factors affecting the quality of life of gastric cancer survivors. Support Care Cancer 2022; 30:3215-3224. [PMID: 34973098 PMCID: PMC8857153 DOI: 10.1007/s00520-021-06683-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 11/03/2021] [Indexed: 12/30/2022]
Abstract
Background The number of gastric cancer survivors has been increasing, and such survivors experience various changes in their lives post-recovery. Adapting to these changes requires appropriate interventions that can improve their quality of life (QoL). This study was conducted to investigate the factors affecting the QoL of gastric cancer survivors and provide basic data for effective intervention. Methods Data were collected between September 8 and September 29, 2017, from the Gastric Cancer Center at a tertiary hospital. Questionnaire surveys were conducted using the EORTC QLQ-C30/STO22, Self-Efficacy-Scale, Multidimensional Scale of Perceived Social Support, and Quality of Life-Cancer Survivors Questionnaire on gastric cancer survivors who were followed up for 3 years after gastrectomy. Data were analyzed using descriptive statistics, t test, ANOVA, Pearson’s correlation coefficient, and multiple regression analysis. Results A total of 136 gastric cancer survivors completed the questionnaire survey. There were significant positive correlations of QoL with self-efficacy, functional status, and social support (r = .35, p < .001; r = .53, p < .001; r = .26, p < .001, respectively). There were significant negative correlations of QoL with general symptoms (r = − .39, p < .001) and gastric cancer-specific symptoms (r = − .51, p < .001). The regression model explained 48.3% of the QoL, and the affecting factors were gastric cancer-specific symptoms (β = − .397, p < .001), religious belief (β = .299, p < .001), functional status (β = .251, p = .003), and self-efficacy (β = .191, p = .004). Conclusion This study confirmed that gastric cancer-specific symptoms, spiritual well-being, self-efficacy, and functional status affect the QoL of gastric cancer survivors. Hence, these factors should be considered in the interventions to improve the QoL of gastric cancer survivors.
Collapse
|
6
|
Kang D, Bae KR, Lim J, Kim N, Shim S, Kweon SS, Seo HJ, Cho J. Impact of objective financial burden and subjective financial distress on spiritual well-being and quality of life among working-age cancer survivors. Support Care Cancer 2022; 30:4917-4926. [PMID: 35174421 DOI: 10.1007/s00520-022-06906-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 02/09/2022] [Indexed: 10/19/2022]
Abstract
PURPOSE To assess objective financial burden (OFB) and subjective financial distress (SFD) amikong working-age cancer survivors and evaluate their association with spiritual well-being and health-related quality of life (HRQoL). METHODS This is a multicenter cross-sectional survey of cancer survivors working at diagnosis between 2017 and 2018. OFB was defined as patients with high medical payments for individuals/households, debt due to cancer care costs, or bankruptcy. SFD was measured using a questionnaire. Fear of cancer recurrence (FCR), spiritual well-being, and HRQoL were also assessed. RESULTS Among 727 participants, 31% reported that they experienced financial toxicity, and 12% and 26% had OFB and SFD, respectively. The No-OFB-SFD, OFB-No-SFD, and OFB-SFD groups were 4.90, 1.82, and 7.81 times more likely to experience uncertainty than the No-OFB-No-SFD group. Furthermore, the No-OFB-SFD, OFB-No-SFD, and OFB-SFD groups were 1.92, 1.35, and 2.53 times more likely to report lost purpose of life, respectively. Overall QoL and health status in the No-OFB-No-SFD, No-OFB-SFD, OFB-No-SFD, and OFB-SFD groups were 63.1, 42.9, 57.0, and 41.2, respectively. Survivors who had SFD regardless of OFB had lower HRQoL and functioning, and higher symptoms than those of the survivors without SFD. CONCLUSION Financial toxicity was associated with FCR, uncertainty, loss of purpose, and loss of hope among working-age cancer survivors, even in a universal care setting. It is associated with FCR, uncertainty, loss of purpose, and loss of hope. It is necessary to inform survivors of the financial implications of cancer care to allow them to prepare financially as needed.
Collapse
Affiliation(s)
- Danbee Kang
- Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, 06355, Korea.,Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06355, South Korea
| | - Ka Ryeong Bae
- National Cancer Control Institute, National Cancer Center, Goyang, 10408, South Korea
| | - Jihyun Lim
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06355, South Korea
| | - Nayeon Kim
- Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, 06355, Korea.,Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, Korea
| | - Sungkeun Shim
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06355, South Korea.,Department of Digital Health, Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, 06355, South Korea
| | - Sun Seog Kweon
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, 34134, Korea
| | - Hwa Jeong Seo
- Medical Informatics and Health Technology (MIT), Department of Health Care Management, College of Social Science, Gachon University, Seongnam-si, Gyeonggi-do, 13120, South Korea.
| | - Juhee Cho
- Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, 06355, Korea. .,Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06355, South Korea. .,Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, Korea. .,Department of Digital Health, Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, 06355, South Korea.
| |
Collapse
|
7
|
Sezgin MG, Bektas H. The effect of decision support systems on pain in patients with cancer: A systematic review and meta-analysis of randomized controlled trials. J Nurs Scholarsh 2022; 54:578-588. [PMID: 35166032 DOI: 10.1111/jnu.12769] [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] [Received: 10/14/2021] [Revised: 01/19/2022] [Accepted: 01/28/2022] [Indexed: 01/19/2023]
Abstract
PURPOSE This study was conducted to systematically examine the effect of decision support systems (DSSs) applied to patients with cancer on pain severity. REVIEW METHODS Systematic review and meta-analysis. A search was done on Web of Science, Science Direct, PubMed, ProQuest, EBSCOhost/CINAHL Complete, Scopus, Springer Link, Cochrane Library, and Ovid databases, which covered a period until September 2021. Meta-analysis of the data was conducted on the CMA 3 software package. Comprehensive reviews were conducted by two independent researchers in line with the PICOS criteria. The study was conducted according to the PRISMA checklist. FINDINGS Five randomized controlled trials with 1.880 participants were included in this systematic review and meta-analysis. In the study, visits, consultations, simulation of patient outcomes, telephone support, and email applications were employed for periods ranging from 6 weeks to 6 months. The evaluation of the meta-analysis results indicated that DSSs had positive effects on pain severity in patients with cancer (Hedge's g = 0.22; p < 0.001). CONCLUSION The findings of this systematic review and meta-analysis show that DSSs can be used as an effective and comfortable technological application in reducing the severity of pain in patients with cancer. CLINICAL RELEVANCE The use of DSSs for pain severity in patients with cancer is an effective method. In line with the findings of this systematic review and meta-analysis, awareness and knowledge levels of all health disciplines about DSSs will increase. It is believed that the use of DSSs to improve patient-centered care will be guiding.
Collapse
Affiliation(s)
- Merve Gozde Sezgin
- Department of Internal Medicine Nursing, Akdeniz University Faculty of Nursing, Antalya, Turkey
| | | |
Collapse
|
8
|
Sezgin MG, Bektas H. The effect of web-based intervention programs on self-management and symptom management in patients with lymphoma: A systematic review of randomized controlled trials. Jpn J Nurs Sci 2021; 19:e12460. [PMID: 34738318 DOI: 10.1111/jjns.12460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 08/18/2021] [Accepted: 09/21/2021] [Indexed: 11/27/2022]
Abstract
AIM This systematic review aimed to systematically summarize studies obtained through a database search and examine the effect of web-based intervention programs on self-management and symptom management in patients with lymphoma. METHODS A systematic review of randomized controlled trials was carried out. Cochrane Central Register of Controlled Trials, Web of Science, PubMed, CINAHL, Scopus, ProQuest, Science Direct, and Ovid databases were reviewed until January 2021. The flow chart of the Preferred Reporting Items for Systematic Review and Meta-Analysis checklist was used in the search procedure without setting a year limit. Population, Intervention, Comparison, Outcomes and Study criteria were determined by two independent investigators and published randomized controlled studies in English with lymphoma diagnosis and web-based intervention programs for self-management and symptom management were included in the systematic review. The included studies were examined for their risk of bias with the help of the Cochrane Collaboration tool. A narrative synthesis of study findings was performed. RESULTS Six randomized controlled trials with 2382 participants were included in the systematic review. Web-based intervention programs in patients diagnosed with lymphoma were found to be generally implemented for determining the levels of self-management and symptom management. In all of the studies reviewed, it was found that the interventions had treatment outcomes. The risk of Bias 2 was evaluated as high risk in two studies that did not meet the criteria for blinding outcome evaluations. The included studies, while evaluating the effects of web-based intervention programs on patient outcomes, could not provide information about the underlying mechanisms by which these effects occur and how they occur. CONCLUSIONS All of the studies included were found to apply a technology designed to improve outcomes in patients with lymphoma. It is recommended that web-based intervention programs be individualized by adapting them to lymphoma types and stages, and serve as a guide for effective symptom management.
Collapse
Affiliation(s)
- Merve Gozde Sezgin
- Department of Internal Medicine Nursing, Akdeniz University Faculty of Nursing, Antalya, Turkey
| | - Hicran Bektas
- Department of Internal Medicine Nursing, Akdeniz University Faculty of Nursing, Antalya, Turkey
| |
Collapse
|
9
|
Song CM, Bang HS, Kim HG, Park HJ, Tae K. Health-related quality of life after transoral robotic thyroidectomy in papillary thyroid carcinoma. Surgery 2021; 170:99-105. [PMID: 33773821 DOI: 10.1016/j.surg.2021.02.042] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/12/2021] [Accepted: 02/16/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Health-related quality of life after transoral robotic thyroidectomy has not been evaluated thoroughly. The purpose of this study was to compare health-related quality of life after transoral robotic thyroidectomy and after conventional thyroidectomy. METHODS This study is a prospective, cross-sectional, and observational study of 114 patients who underwent transoral robotic thyroidectomy (57 patients) or conventional transcervical thyroidectomy (57 patients) for the treatment of papillary carcinoma. We used 2 questionnaires: the University of Washington Quality of Life questionnaire for head and neck cancer and the thyroid cancer-specific Quality of Life questionnaire (Thyroid Version). The survey was performed preoperatively, and 3 months and 1 year after thyroidectomy. RESULTS Mean scores for neck appearance were higher after surgery in the transoral robotic thyroidectomy group than the conventional group at both 3 months and 1 year. Anxiety was significantly improved after surgery in both groups. Total scores for health-related quality of life after surgery were similar in both groups. Health-related quality of life and overall quality of life over the previous 7 days as measured by the University of Washington Quality of Life questionnaire were significantly better at 1 year than in the preoperative period in both groups. Before surgery, patients in the both groups regarded anxiety and mood as the most important aspects of health-related quality of life. After surgery, patients in the transoral robotic thyroidectomy group identified anxiety, mood, and speech as the most significant issues, while patients in the conventional group selected anxiety, mood, and neck appearance. CONCLUSION Quality of life related to neck appearance is higher after transoral robotic thyroidectomy than after transcervical thyroidectomy. However, total scores for health-related quality of life did not differ in the 2 groups after surgery.
Collapse
Affiliation(s)
- Chang Myeon Song
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Hyang Sook Bang
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Hyung Gu Kim
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Hae Jin Park
- Department of Radiation Oncology, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Kyung Tae
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, Republic of Korea.
| |
Collapse
|
10
|
Bae KR, Kang D, Yi JY, Ahn Y, Kim IR, Kweon SS, Ahn JS, Nam SJ, Shim YM, Chun M, Heo J, Cho J. A return-to-work intervention protocol directed at cancer patients (self-assessment, tailored information & lifestyle management for returning to work among cancer patients, START): A multi-center, randomized controlled trial. Contemp Clin Trials Commun 2020; 19:100633. [PMID: 32885089 PMCID: PMC7451719 DOI: 10.1016/j.conctc.2020.100633] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 07/21/2020] [Accepted: 08/09/2020] [Indexed: 11/27/2022] Open
Abstract
Purpose This study describes the protocol for the design and evaluation of a self-assessment based educational program supporting cancer patients’ return-to-work (RTW), prior to its complete and ongoing implementation. Methods We designed a multi-center, randomized controlled trial with three follow-up points. The study population (N = 239) includes recently diagnosed cancer patients who plan to receive active treatment at two university hospitals in Korea. A pre-test is conducted at the point of enrollment for both groups. The intervention group receives a leaflet clarifying misconceptions about RTW and is shown a video clip of patient interviews concerning RTW. The control group receives a booklet about cancer and nutrition, and is not provided with further intervention. After active treatment, the intervention group receives a one-time, face-to-face education session with an oncology nurse. Following the education session, both groups receive three follow-up phone calls. The first follow-up call occurs at the end of intervention and at the end of active treatment for intervention and control groups, respectively. The next two follow-up calls will be conducted one month and a year following the post-test. The primary outcome is whether the patient has RTW or has plans to RTW, and the secondary outcome is knowledge of RTW. Results As of April 2020, 239 patients have been enrolled in the trial. Statistical analyses will be conducted upon trial completion in December 2020. Discussion We hypothesize that the provision of RTW education near diagnosis will not only enhance patients’ intentions to RTW, but also effectively encourage them to RTW.
Collapse
Affiliation(s)
- Ka Ryeong Bae
- Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea.,Cancer Education Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Danbee Kang
- Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea.,Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jae Yoon Yi
- Department of Public Health, Graduate School of Public Health, Seoul National University, South Korea
| | - Yeojin Ahn
- Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea.,Cancer Education Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Im-Ryung Kim
- Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea.,Cancer Education Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Sun-Seog Kweon
- Department of Preventive Medicine, Chonnam National University Medical School, Hwasun, South Korea
| | - Jin Seok Ahn
- Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea.,Department of Hematology & Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Seok Jin Nam
- Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea.,Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Young Mog Shim
- Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea.,Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Mison Chun
- Department of Radiation Oncology, Ajou University School of Medicine, Suwon, South Korea
| | - Jaesung Heo
- Department of Radiation Oncology, Ajou University School of Medicine, Suwon, South Korea
| | - Juhee Cho
- Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea.,Cancer Education Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| |
Collapse
|
11
|
Kim SJ, Kang D, Kim IR, Yoon SE, Kim WS, Butow PN, Guallar E, Cho J. Impact of fear of cancer recurrence on survival among lymphoma patients. Psychooncology 2020; 29:364-372. [PMID: 31654534 DOI: 10.1002/pon.5265] [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: 06/26/2019] [Revised: 10/09/2019] [Accepted: 10/17/2019] [Indexed: 11/05/2022]
Abstract
OBJECTIVE This study aimed to evaluate fear of cancer recurrence (FCR) among lymphoma patients who completed treatment and its impact on survival and quality of life (QOL). METHODS In this prospective cohort study, 467 lymphoma patients were included who completed treatment with curative intent between February 2012 and March 2017. FCR was measured using a question from the Korean version of the QOL in Cancer Survivors Questionnaire. QOL and general health and functioning were measured using the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30. Participants were actively followed up for all-cause and disease-specific mortality. RESULTS In total, 16.3% of the patients had severe FCR. The adjusted hazard ratio (HR) for all-cause mortality comparing participants with and without severe FCR was 2.52 (95% CI = 1.15-5.54), and the association was stronger in indolent non-Hodgkin lymphoma (NHL) (HR = 6.77; 95% CI = 1.04-43.92). Participants with severe FCR were also at higher risk of lymphoma-specific mortality (HR = 2.62; 95% CI = 1.13-6.05) than patients without severe FCR. Patients with severe FCR had significantly worse general health status (64.3 vs 71.0, P = .03) and physical (82.4 vs 76.7, P < .01), emotional (68.5 vs 84.8, P < .001), and social functioning (67.8 vs 84.2, P < .001) than patients without severe FCR. CONCLUSIONS A substantial number of participants with lymphoma experience FCR after treatment completion, even in the case of indolent lymphomas. Given the negative impact of severe FCR on survival and general health and functional status, active monitoring and appropriate management of FCR should be considered in clinical settings.
Collapse
Affiliation(s)
- Seok Jin Kim
- Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Korea.,Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Korea
| | - Danbee Kang
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Science and Technology, School of Medicine, Sungkyunkwan University, Seoul, Korea.,Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea.,Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Korea
| | - Im Ryung Kim
- Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Korea
| | - Sang Eun Yoon
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Korea
| | - Won Seog Kim
- Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Korea.,Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Korea
| | - Phyllis N Butow
- Centre for Medical Psychology and Evidence-based Decision-making, School of Psychology and Department of Medicine, University of Sydney, Sydney, NSW, Australia
| | - Eliseo Guallar
- Departments of Epidemiology and Medicine and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Juhee Cho
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Science and Technology, School of Medicine, Sungkyunkwan University, Seoul, Korea.,Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea.,Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Korea.,Departments of Epidemiology and Medicine and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, Maryland
| |
Collapse
|
12
|
Kang D, Cho J, Kim IR, Kim MK, Kim WS, Kim SJ. Health-Related Quality of Life in Non-Hodgkin Lymphoma Survivors: A Prospective Cohort Study. Cancer Res Treat 2017; 50:1051-1063. [PMID: 29121713 PMCID: PMC6192930 DOI: 10.4143/crt.2017.207] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Accepted: 11/07/2017] [Indexed: 01/10/2023] Open
Abstract
PURPOSE We evaluated health-related quality of life (HRQOL) in long-term survivors of indolent and aggressive non-Hodgkin lymphoma (NHL). Materials and Methods TheHRQOLwas assessed by the European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire Core 30 (EORTC QLQ-C30) at diagnosis in NHL patients between 2008 and 2011, and follow-up evaluation was conducted from June 2014 to February 2015 using EORTC QLQ-C30 and the quality of life in cancer survivors (QOL-CS) questionnaire. We used linear mixed models to compare changes in HRQOL between indolent and aggressive NHL over time. RESULTS The HRQOL of long-term survivors with aggressive NHL improved to the similar level of indolent NHL during the follow-up survey. However, survivors of NHL were found to fear the probability of relapse and second malignancy, and the degree of fear was not different between survivors with aggressive stage I/II or III/IV NHL (p > 0.05). Furthermore, a half of survivors reported impaired sense of psychosocial well-being regardless of aggressiveness and stage during follow-up survey. More than 65% of survivors thought they did not receive sufficient support from others, and patients who had financial difficulties at diagnosis were more frequently associated with suffering from insufficient support. Impaired physical and cognitive functioning at diagnosis was significantly associated with lack of life purpose in long-term survivors. CONCLUSION The HRQOL of aggressive NHL survivors improved to a similar level to that of indolent NHL. However, the majority of survivors still had fear of relapse, and psychosocial well-being remained unmet needs.
Collapse
Affiliation(s)
- Danbee Kang
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea
| | - Juhee Cho
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea.,Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Im Ryung Kim
- Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Mi Kyung Kim
- Samsung Biomedical Research Institute, Samsung Medical Center, Seoul, Korea
| | - Won Seog Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seok Jin Kim
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea.,Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| |
Collapse
|