1
|
Klafke N, Bossert J, Boltenhagen U, Froehlich D, Mahler C, Joos S, Wensing M. Counseling lifestyle medicine in oncology: A qualitative analysis of interprofessional patient-nurse-physician interactions. PATIENT EDUCATION AND COUNSELING 2024; 127:108352. [PMID: 38905751 DOI: 10.1016/j.pec.2024.108352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 05/23/2024] [Accepted: 06/14/2024] [Indexed: 06/23/2024]
Abstract
OBJECTIVES Counseling plays a key role in promoting health behaviors, providing evidence-based information, and supporting patients with cancer during and after treatment. This study aimed to evaluate an interprofessional counseling service on Complementary and Integrative Health (CIH) for patients being treated at Comprehensive Cancer Centers (CCCs) in Southern Germany. METHODS Patients participating in the CCC-Integrativ study received three CIH counseling sessions within three months in addition to their conventional cancer treatment. Medical and nursing staff participated in a study-specific blended learning training program before conducting the counseling. As part of the process evaluation, 30 audio-recorded counseling sessions were transcribed verbatim and analyzed by conducting a content analysis using MAXQDA 2020. RESULTS Throughout the counseling, patients were conceded to address various health issues, which mainly revolved around symptom management interlaced with the areas of nutrition, exercise, and relaxation. The interprofessional teams conducted the counseling in a structured and patient-oriented manner. They worked together to motivate the patients to apply procedures from the CIH field independently, even if patients sometimes experienced difficulties in implementation. CONCLUSIONS Interprofessional collaboration improved healthcare quality, as patients received comprehensive and evidence-based advice on their supportive needs and lifestyle issues. Both professions could equally contribute their areas of knowledge and expertise and apply them to the benefit of the patients. PRACTICE IMPLICATIONS Providing an integrative counseling service and adequate training on interpersonal communication and CIH for healthcare professionals will improve patient-centered care.
Collapse
Affiliation(s)
- Nadja Klafke
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany.
| | - Jasmin Bossert
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Ursula Boltenhagen
- Institute of Health Sciences, Department of Nursing Science, University Hospital Tuebingen, Tuebingen, Germany
| | - Daniela Froehlich
- Institute for General Practice and Interprofessional Care, University Hospital Tuebingen, Tuebingen, Germany
| | - Cornelia Mahler
- Institute of Health Sciences, Department of Nursing Science, University Hospital Tuebingen, Tuebingen, Germany
| | - Stefanie Joos
- Institute for General Practice and Interprofessional Care, University Hospital Tuebingen, Tuebingen, Germany
| | - Michel Wensing
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| |
Collapse
|
2
|
Osowiecka K, Dolińska A, Szwiec M, Działach E, Nowakowski JJ, Rucińska M. Validation of the Standardized Needs Evaluation Questionnaire in Polish Cancer Patients. Cancers (Basel) 2024; 16:1451. [PMID: 38672533 PMCID: PMC11048258 DOI: 10.3390/cancers16081451] [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: 02/29/2024] [Revised: 04/05/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Cancer influences various aspects of patients' functioning. Cancer patients face not only medical problems but also organizational, socio-psychological, and spiritual problems. Their needs often seem to be unrecognized because patients do not express their concerns and clinicians do not ask appropriate questions. Unmet needs impact patients' quality of life. The aim of this study was to select, adapt, validate, and introduce a simple instrument for estimating cancer patients' unmet needs in Poland. METHODS The Needs Evaluation Questionnaire (NEQ) was chosen for validation in a Polish population. The Polish version of the NEQ was developed with a back-translation procedure, as approved by a psycho-oncologist and a public health specialist. The psychometric properties of the NEQ (content analysis, reliability, construct validity, comprehensibility, and acceptability) were measured. RESULTS This study was performed on a group of 121 cancer patients. The median time of completion for the NEQ was 10 min. The form, length, and font size of the NEQ were accepted by the respondents. Overall, the meaning of the questions was well understood, with only a few cases of discreetly heterogeneous interpretation of the content. The questionnaire showed good reliability and internal factor structure validity. CONCLUSION The NEQ is a simple, easy-to-administer instrument with good psychometric properties and seems to be useful in assessing the unexpressed needs of cancer patients.
Collapse
Affiliation(s)
- Karolina Osowiecka
- Department of Psychology and Sociology of Health and Public Health, School of Public Health, University of Warmia and Mazury in Olsztyn, Warszawska 30, 10-082 Olsztyn, Poland
| | - Anna Dolińska
- Psychology Outpatient Clinic, University Hospital in Zielona Gora, Zyty 26, 65-046 Zielona Gora, Poland;
| | - Marek Szwiec
- Department of Surgery and Oncology, Faculty of Medicine and Health Sciences, University of Zielona Gora, Zyty 28, 65-046 Zielona Gora, Poland;
| | - Eliza Działach
- Department of Public Health, Faculty of Sciences in Bytom, Medical University of Silesia in Katowice, Piekarska 18, 41-902 Bytom, Poland;
| | - Jacek J. Nowakowski
- Department of Botany and Evolutionary Ecology, Faculty of Biology and Biotechnology, University of Warmia and Mazury in Olsztyn, Plack Łódzki 3, 10-727 Olsztyn, Poland;
| | - Monika Rucińska
- Department of Oncology, Collegium Medicum University of Warmia and Mazury in Olsztyn, Wojska Polskiego 37, 10-228 Olsztyn, Poland;
| |
Collapse
|
3
|
Osowiecka K, Szwiec M, Dolińska A, Gwara A, Kurowicki M, Kołb-Sielecki J, Działach E, Radecka W, Nawrocki S, Rucińska M. Unmet non-medical needs of cancer patients in Poland: a quantitative and qualitative study. Support Care Cancer 2024; 32:183. [PMID: 38388767 PMCID: PMC10884169 DOI: 10.1007/s00520-024-08387-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 02/16/2024] [Indexed: 02/24/2024]
Abstract
PURPOSE Cancer itself and its treatment have a multifaceted impact on patients' daily lives. The aim of the study was to determine unmet non-medical needs among Polish cancer patients. METHODS Survey research using a 23-item Needs Evaluation Questionnaire (NEQ) was carried out among 1062 cancer patients from different regions of Poland. Quantitative and qualitative analyses were performed. RESULTS The quantitative analysis showed that 48% of the NEQ items (11/23) were expressed as unmet needs by at least half of patients. Unmet information needs were indicated by patients most often: information about their diagnosis, exams, treatment, future condition, funding and economic support. Cancer patients would like to get more attention from medical staff. Unmet needs were most frequently expressed by respondents who were men, with a lower level of education, living in village, pensioners. Qualitative analysis showed that each need may be understood in a variety of different ways across the cohort. Some patients added comments that the completing NEQ helped them to notice their non-medical needs. CONCLUSION Polish cancer patients have some unmet non-medical needs, especially informative needs.
Collapse
Affiliation(s)
- Karolina Osowiecka
- Department of Psychology and Sociology of Health and Public Health, School of Public Health, University of Warmia and Mazury in Olsztyn, Warszawska 30, 10-082, Olsztyn, Poland.
| | - Marek Szwiec
- Department of Surgery and Oncology, Faculty of Medicine and Health Sciences, University of Zielona Gora, Zyty 28, 65-046, Zielona Gora, Poland
| | - Anna Dolińska
- Psychology Outpatient Clinic, University Hospital in Zielona Gora, Zyty 26, 65-046, Zielona Gora, Poland
| | - Anna Gwara
- Department of Nursing, Institute of Health Science, University of Zielona Gora, Zyty 28, 65-046, Zielona Gora, Poland
| | - Marcin Kurowicki
- NU-MED Radiotherapy Center in Elblag, Królewiecka 146, 82-300, Elblag, Poland
| | - Jarosław Kołb-Sielecki
- Department of Oncology, The Center for Pulmonary Diseases in Olsztyn, Jagiellońska 78, 10-357, Olsztyn, Poland
| | - Eliza Działach
- Departament of Public Health, Faculty of Sciences in Bytom, Medical University of Silesia in Katowice, Piekarska 18, 41-902, Bytom, Poland
| | - Weronika Radecka
- Department of Anatomy, University of Opole, Kopernika 11a, 45-040, Opole, Poland
| | - Sergiusz Nawrocki
- Department of Oncology, Collegium Medicum University of Warmia and Mazury in Olsztyn, Wojska Polskiego 37, 10-228, Olsztyn, Poland
| | - Monika Rucińska
- Department of Oncology, Collegium Medicum University of Warmia and Mazury in Olsztyn, Wojska Polskiego 37, 10-228, Olsztyn, Poland
| |
Collapse
|
4
|
Arends SAM, van Rossum CE, Eeltink CM, Robertus JE, Schoonmade LJ, Francke AL, Jongerden IP. Feasibility and effectiveness of communication tools for addressing intimacy and sexuality in patients with cancer: a systematic review. Support Care Cancer 2024; 32:109. [PMID: 38231322 PMCID: PMC10794301 DOI: 10.1007/s00520-024-08308-6] [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: 09/12/2023] [Accepted: 01/05/2024] [Indexed: 01/18/2024]
Abstract
PURPOSE Patients diagnosed with cancer might experience changes in intimacy and sexuality due to the illness itself, treatment, or psychological and social factors. Healthcare professionals (HCPs) often feel reluctant to discuss these changes. This study aimed to provide an overview of the feasibility and effectiveness of communication tools that support communication regarding changes in intimacy or sexuality among patients with cancer. METHODS This is a systematic review. Databases are PubMed, Embase, CINAHL, PsycInfo, Web of Science and Cochrane Library from inception to June 2023. The Mixed Methods Appraisal Tool was used to assess included studies. Data were summarized in data charting forms. RESULTS In total 35 studies were included, published between 2001 and 2023. Most had a quantitative design and moderate methodological quality. In 11 studies, the PLISSIT model (Permission, Limited Information, Specific Suggestions, Intensive Therapy) was used. Tools were integrated in counselling sessions or training programmes for individual patients, couples, groups of patients, or HCPs. All tools were considered feasible by patients or HCPs. Twenty studies reported significant improvement in sexual functioning, quality of life, quality of care or combined outcomes. CONCLUSION Tools to support communication about changes in intimacy and sexuality among patients with cancer seem feasible and effective. The most commonly used tool, the PLISSIT model, proved to be feasible for HCPs and to have a positive effect on patients' and partners' sexual functioning and quality of life. Giving attention to changes in intimacy and sexuality seems to be important in itself, regardless of the communication tool or approach used.
Collapse
Affiliation(s)
- Susanne A M Arends
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Van Der Boechorststraat 7, NL-1081 BT, Amsterdam, the Netherlands.
- Amsterdam Public Health Research Institute, Van Der Boechorststraat 7, NL-1081 BT, Amsterdam, the Netherlands.
- Center of Expertise in Palliative Care, VU University Medical Center, Amsterdam, the Netherlands.
| | - Carlijn E van Rossum
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Van Der Boechorststraat 7, NL-1081 BT, Amsterdam, the Netherlands
| | - Corien M Eeltink
- Oncology Daycare Center, Dijklander Hospital, Hoorn, the Netherlands
| | - Jantien E Robertus
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Van Der Boechorststraat 7, NL-1081 BT, Amsterdam, the Netherlands
| | | | - Anneke L Francke
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Van Der Boechorststraat 7, NL-1081 BT, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Van Der Boechorststraat 7, NL-1081 BT, Amsterdam, the Netherlands
- Center of Expertise in Palliative Care, VU University Medical Center, Amsterdam, the Netherlands
- NIVEL. Netherlands Institute for Health Services Research, Utrecht, the Netherlands
| | - Irene P Jongerden
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Van Der Boechorststraat 7, NL-1081 BT, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Van Der Boechorststraat 7, NL-1081 BT, Amsterdam, the Netherlands
- Center of Expertise in Palliative Care, VU University Medical Center, Amsterdam, the Netherlands
| |
Collapse
|
5
|
Kleisiaris C, Maniou M, Karavasileiadou S, Togas C, Konstantinidis T, Papathanasiou IV, Tsaras K, Almegewly WH, Androulakis E, Alshehri HH. Psychological Distress and Concerns of In-Home Older People Living with Cancer and Their Impact on Supportive Care Needs: An Observational Survey. Curr Oncol 2023; 30:9569-9583. [PMID: 37999112 PMCID: PMC10670276 DOI: 10.3390/curroncol30110692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/24/2023] [Accepted: 10/26/2023] [Indexed: 11/25/2023] Open
Abstract
(1) Background: Cancer patients are experiencing psychological problems after diagnosis, such as emotional distress and social anxiety, which may increase their demands for emotional and supportive care. This study aimed to assess the influence of both emotional distress and concerns on the supportive care needs of cancer patients receiving home-based healthcare. (2) Methods: In this door-to-door screening program, 97 cancer patients were approached, with a mean age of 73 years old (mean = 73.43; SD = 6.60). (3) Results: As expected, 42.3% of patients highlighted their treatment as their main psychological priority, with 20.6% identifying concerns about the future of their family in this regard. No significant associations with respect to sex were identified in terms of focus, though females reported the need for more frequent psychological support (58.7% vs. 37.3%, respectively, p = 0.035) compared to males. Patients who had experienced an increased number of concerns during the last weeks (IRR = 1.02; 95% CI: 1.00-1.03, p = 0.007) had a significantly greater risk of presenting an increased rate of supportive care needs. Notably, male patients with bone cancer presented a significantly greater number of supportive care needs (mean rank 45.5 vs. 9.0, p = 0.031) respectively, in comparison to those with other types of cancer. (4) Conclusions: Supportive care needs arise from a greater concern and specific type of cancer, highlighting the need for supportive care, such as psychosocial and psychological support. This may have significant implications for treatment and patient outcomes in home care settings.
Collapse
Affiliation(s)
- Christos Kleisiaris
- Department of Nursing, Faculty of Health Sciences, Hellenic Mediterranean University, 71410 Heraklion, Greece; (C.K.); (M.M.); (T.K.)
| | - Maria Maniou
- Department of Nursing, Faculty of Health Sciences, Hellenic Mediterranean University, 71410 Heraklion, Greece; (C.K.); (M.M.); (T.K.)
| | - Savvato Karavasileiadou
- Department of Community Health Nursing, College of Nursing, Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia;
| | - Constantinos Togas
- Department of Social Service, Ministry of Public Order, 22100 Tripolis, Greece;
| | - Theocharis Konstantinidis
- Department of Nursing, Faculty of Health Sciences, Hellenic Mediterranean University, 71410 Heraklion, Greece; (C.K.); (M.M.); (T.K.)
| | | | - Konstantinos Tsaras
- Department of Nursing, University of Thessaly, 41500 Larissa, Greece; (I.V.P.); (K.T.)
| | - Wafa Hamad Almegewly
- Department of Community Health Nursing, College of Nursing, Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia;
| | - Emmanouil Androulakis
- Department of Statistics and Insurance Science, University of Piraeus, 18534 Piraeus, Greece;
| | - Hanan Hamdan Alshehri
- Department of Medical-Surgical Nursing, College of Nursing, Princess Nourah bint Abdulrahman University, Riyadh 116711, Saudi Arabia;
| |
Collapse
|
6
|
Bonacchi A, Chiesi F, Marunic G, Campani C, Gitto S, Lau C, Tagliaferro C, Forte P, Tarocchi M, Marra F. Needs evaluation questionnaire for liver disease: a novel assessment of unmet needs in patients with chronic liver disease. Hepatol Commun 2023; 7:e0007. [PMID: 36706170 PMCID: PMC9988321 DOI: 10.1097/hc9.0000000000000007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 09/05/2022] [Accepted: 09/17/2022] [Indexed: 01/29/2023] Open
Abstract
Patients with chronic liver disease face debilitating complications in their daily living and constantly report several types of unmet needs, but there is a paucity of validated questionnaires to assess these needs. In this study, we present the development of the Needs Evaluation Questionnaire for Liver Diseases (NEQ-LD) for the assessment of unmet needs in patients with chronic liver disease. Two hundred eighty-six outpatients with chronic liver diseases from a single tertiary referral center completed the NEQ-LD and related validity measures. Item response theory analyses were performed and demonstrated the strong psychometric properties of the questionnaire. Differential item functioning analyses showed that the scale functions equally across groups differing for age, sex, and presence of cirrhosis, suggesting the large applicability of the NEQ-LD for the assessment of unmet needs and between-group comparisons. Criterion validity measures provided evidence that unmet needs were positively associated with measures of depression and anxiety and negatively associated with measures of subjective well-being and physical and mental health. Unmet needs were expressed by a high percentage of patients, especially in the areas of information and dialogue with clinicians. One third of the sample reported material needs. Most of the items describing unmet needs were reported more frequently by patients with cirrhosis. Conclusion: We developed a reliable, valid, and largely employable instrument that can promote patient-centered care and facilitate support services in Hepatology.
Collapse
Affiliation(s)
- Andrea Bonacchi
- Clinical Epidemiology Unit, Oncological Network, Prevention and Research Institute—ISPRO, Florence, Italy
- Centro Studi e Ricerca Synthesis, Associazione Promozione Sociale Sul Sentiero, Florence, Italy
| | - Francesca Chiesi
- Department of Neuroscience, Psychology, Drug, and Child’s Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Georgia Marunic
- Department of Neuroscience, Psychology, Drug, and Child’s Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Claudia Campani
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Stefano Gitto
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Chloe Lau
- Department of Psychology, Western University, London, Ontario, Canada
| | | | - Paolo Forte
- Clinical Gastroenterology Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Mirko Tarocchi
- Clinical Gastroenterology Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
- Department of Biomedical Sciences ‘Mario Serio,’ University of Florence, Florence, Italy
| | - Fabio Marra
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| |
Collapse
|
7
|
Nicoll I, Lockwood G, Longo CJ, Loiselle CG, Fitch MI. Relationships between Canadian adult cancer survivors' annual household income and emotional/practical concerns, help-seeking and unmet needs. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e1290-e1301. [PMID: 34390067 DOI: 10.1111/hsc.13536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/26/2021] [Accepted: 07/27/2021] [Indexed: 06/13/2023]
Abstract
The objective of this study was to explore the relationship among income and emotional/practical concerns, help-seeking and unmet needs for cancer survivors aged 18 to 64 years one to three years after treatment. A cross-sectional survey was mailed in 2016 to 40,790 survivors randomly selected from 10 Canadian provincial cancer registries. Thirty-three percent responded. A trend analysis was conducted for survivors most likely to be in the workforce exploring the relationship across four income levels and emotional/practical concerns, whether help was sought for identified concerns, and whether help was received. A total of 4,264 respondents, aged 18-64, provided useable data with breast (34.4%) and colo-rectal (15.0%) accounting for the primary cancer type and 32.0% reporting annual household incomes of <$50,000. More than 94% of respondents indicated having emotional or practical concerns. Between one-third and one-half of the respondents sought help for their concerns and, of those, between one-third and one-half experienced difficulty finding help or did not obtain assistance. Significant trends across income categories indicated greater percentages of those in lower income categories experienced emotional and practical concerns, rated their concerns as 'big', sought help, and had difficulty finding help to address their concerns. Clearly adult cancer survivors experience emotional and practical concerns. Healthcare professionals have important roles monitoring these concerns and connecting those who desire help to relevant services. Opportunities should be given to individuals, regardless of income level, to indicate if they have concerns and if they would like assistance.
Collapse
Affiliation(s)
- Irene Nicoll
- Health Care Independent Consultant, Toronto, ON, Canada
| | - Gina Lockwood
- Biostatistician Independent Consultant, Toronto, ON, Canada
| | - Christopher J Longo
- Health Policy and Management, DeGroote School of Business, McMaster University, Hamilton, ON, Canada
| | - Carmen G Loiselle
- Department of Oncology and Ingram School of Nursing, Christine and Hershel Victor/Hope & Cope Chair in Psychosocial Oncology, McGill University, Montreal, QC, Canada
- Segal Cancer Centre, Jewish General Hospital, CIUSSS Centre-Ouest, Montreal, QC, Canada
| | - Margaret I Fitch
- Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
8
|
Chen M, Li R, Ding G, Jin C. Needs of cancer patients during the SARS-CoV-2 Omicron lockdown: A population-based survey in Shanghai, China. Biosci Trends 2022; 16:230-237. [PMID: 35718468 DOI: 10.5582/bst.2022.01251] [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: 11/05/2022]
Abstract
The aim of this study was to investigate the medical and healthcare needs of cancer patients during the Shanghai lockdown due to the SARS-CoV-2 Omicron pandemic. From April 15 to April 21, 2022, 4,195 cancer patients from every district in Shanghai were surveyed using quota sampling via an online platform. The questionnaire consisted of three main parts: demographic and sociological data, disease diagnosis, and different dimensions of patients' needs. Correlation analysis was used to examine the relationship between participants' need scores in each dimension, and generalized linear regression models were used to analyze the factors influencing patients' need scores. The mean age of participants was 63.23 years (SD: 7.43 years), with more female than male participants (80.38% vs. 19.62%). Among participants, the three leading groups of patients were those with breast cancer (39.02%), colorectal cancer (12.82%), or tracheal and bronchial lung cancer (10.23%). Social support, dietary/nutritional support, and psychological counselling ranked as the top three needs of cancer patients. In addition, vaccination against SARS-CoV-2 may reduce psychological anxiety in cancer patients. Compared to participants who had never received the SARS-CoV-2 vaccine, participants who had received one, two, or three doses of the vaccine were respectively 36% (odds ratio (OR): 0.64, 95% confidence interval (CI): 0.56-0.73), 38% (OR: 0.62, 95% CI: 0.59-0.54), and 37% (OR: 0.63, 95% CI: 0.60-0.66) less likely to have an increased need for psychological counseling. In light of constraints on offline medical resources for cancer patients during the lockdown, the current authors have begun to re-examine the universal accessibility and spread of telemedicine in the future. In addition, immune barriers can be established for cancer patients and vaccination guidelines for different disease stages, tumor types, and treatment regimens can be explored in detail.
Collapse
Affiliation(s)
- Minxing Chen
- Shanghai Health Development Research Center, Shanghai Medical Information Center, Shanghai, China
| | - Ruijia Li
- Shanghai Health Development Research Center, Shanghai Medical Information Center, Shanghai, China
| | - Gang Ding
- Oncology Department, Shanghai International Medical Center, Shanghai, China
| | - Chunlin Jin
- Shanghai Health Development Research Center, Shanghai Medical Information Center, Shanghai, China
| |
Collapse
|
9
|
Hart NH, Crawford-Williams F, Crichton M, Yee J, Smith TJ, Koczwara B, Fitch MI, Crawford GB, Mukhopadhyay S, Mahony J, Cheah C, Townsend J, Cook O, Agar MR, Chan RJ. Unmet supportive care needs of people with advanced cancer and their caregivers: a systematic scoping review. Crit Rev Oncol Hematol 2022; 176:103728. [PMID: 35662585 DOI: 10.1016/j.critrevonc.2022.103728] [Citation(s) in RCA: 67] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 05/24/2022] [Accepted: 05/26/2022] [Indexed: 01/11/2023] Open
Abstract
Examining and addressing unmet care needs is integral to improving the provision and quality of cancer services. This review explored the prevalence of unmet supportive care needs, and factors associated with unmet need, in adults with advanced cancers (solid and hematological malignancies) and their caregivers. Electronic databases (PubMed, CINAHL, EMBASE) were searched, producing 85 papers representing 81 included studies. People with advanced cancer reported the highest unmet needs in financial, health system and information, psychological, and physical and daily living domains, whereas caregivers reported the highest unmet needs in psychological, and patient care and support domains. Distress, depression, and anxiety were associated with higher unmet needs across all unmet need domains for people with advanced cancer and their caregivers. Substantial heterogeneity in study populations and methods was observed. Findings from this review can inform targeted strategies and interventions to address these unmet needs in people with advanced cancer.
Collapse
Affiliation(s)
- Nicolas H Hart
- Caring Futures Institute, College of Nursing and Health Science, Flinders University, SA, Australia; Exercise Medicine Research Institute, School of Medical and Health Sciences, Edith Cowan University, WA, Australia; Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, QLD, Australia; Institute for Health Research, University of Notre Dame Australia, WA, Australia.
| | - Fiona Crawford-Williams
- Caring Futures Institute, College of Nursing and Health Science, Flinders University, SA, Australia; Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, QLD, Australia
| | - Megan Crichton
- Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, QLD, Australia; Nutrition and Dietetics Research Group, Bond University, QLD, Australia
| | - Jasmine Yee
- Centre for Medical Psychology and Evidence-Based Decision-Making, Faculty of Medicine and Health, University of Sydney, NSW, Australia
| | - Thomas J Smith
- Division of General Internal Medicine, John Hopkins Medical Institutions, Baltimore, MD, USA
| | - Bogda Koczwara
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, SA, Australia; Flinders Cancer and Innovation Centre, Flinders Medical Centre, SA, Australia
| | - Margaret I Fitch
- School of Graduate Studies, Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Gregory B Crawford
- Discipline of Medicine, University of Adelaide, SA, Australia; Northern Adelaide Local Health Network, SA, Australia
| | - Sandip Mukhopadhyay
- Burdwan Medical College, West Bengal, Kolkata, India; Indian Council of Medical Research, National Institute of Cholera and Enteric Diseases, Kolkata, India
| | | | - Chan Cheah
- Internal Medicine, UWA Medical School, University of Western Australia, WA, Australia; Department of Haematology, Sir Charles Gairdner Hospital, WA, Australia; Department of Haematology, Hollywood Private Hospital, WA, Australia
| | | | - Olivia Cook
- McGrath Foundation, NSW, Australia; School of Nursing and Midwifery, Monash University, VIC, Australia
| | - Meera R Agar
- IMPACCT Centre, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Raymond J Chan
- Caring Futures Institute, College of Nursing and Health Science, Flinders University, SA, Australia; Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, QLD, Australia
| |
Collapse
|
10
|
Bağçivan G, Seven M, Paşalak Şİ, Bilmiç E, Aydın Y, Öz G, Selçukbiricik F. Palliative care needs of the cancer patients receiving active therapy. Support Care Cancer 2021; 30:749-756. [PMID: 34370103 DOI: 10.1007/s00520-021-06485-2] [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: 08/07/2020] [Accepted: 08/04/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE To identify cancer patients' palliative care needs with problem burden, problem intensity, and felt needs related to these problems while receiving cancer treatment. METHODS This is a descriptive survey study conducted at a tertiary hospital with no palliative care services in Istanbul, Turkey, from September 2019 to February 2020. Data were collected using the Patient Information Form and the Three Levels of Needs Questionnaire (3LNQ). Descriptive statistics (frequency and percentage) were used to present data. RESULTS The mean age of patients was 60.2 ± 13.0, and the mean duration since the diagnosis was 11.6 ± 21.4 months. Of the patients, 40.4% were diagnosed with gastrointestinal (GI) cancer, and 34.4% had stage 4 cancer. Patients mostly received help for their pain (85.7%), lack of appetite (64.8%), and nausea (73/7%). The most frequent unmet needs were problems with concentration (70%), worrying (68%), difficulties with sex life (63.6%), problems with being limited in work and daily activities (61.4%), and being depressed (58.5%) among patients who reported to have these symptoms. CONCLUSION This study shows that patients with cancer require supportive and palliative care along with medical treatment for cancer and its treatment-induced physical and psychological symptoms. The study results have the potential to guide the development of palliative care services, especially for outpatient oncology settings in countries where palliative care services mostly focus on the end-of-life care. Further studies are also needed to focus on interventions to meet cancer patients' palliative care needs during the medical cancer treatment process with tailored palliative care delivery models.
Collapse
Affiliation(s)
- Gülcan Bağçivan
- School of Nursing, Koç University, Koç Üniversitesi Sağlık Bilimleri Kampüsü, Davutpaşa Cad. No:4, Topkapı, 34010, Istanbul, Turkey.
| | - Memnun Seven
- School of Nursing, Koç University, Koç Üniversitesi Sağlık Bilimleri Kampüsü, Davutpaşa Cad. No:4, Topkapı, 34010, Istanbul, Turkey.,Amherst College of Nursing, University of Massachusetts, Amherst, MA, USA
| | - Şeyma İnciser Paşalak
- School of Nursing, Koç University, Koç Üniversitesi Sağlık Bilimleri Kampüsü, Davutpaşa Cad. No:4, Topkapı, 34010, Istanbul, Turkey.,Graduate School of Health Sciences, Koç University, Istanbul, Turkey
| | - Ezgi Bilmiç
- School of Nursing, Koç University, Koç Üniversitesi Sağlık Bilimleri Kampüsü, Davutpaşa Cad. No:4, Topkapı, 34010, Istanbul, Turkey.,Graduate School of Health Sciences, Koç University, Istanbul, Turkey
| | - Yasemin Aydın
- Medical Oncology, Koç University Hospital, Istanbul, Turkey
| | - Gözde Öz
- Medical Oncology, Koç University Hospital, Istanbul, Turkey
| | - Fatih Selçukbiricik
- Medical Oncology, Koç University Hospital, Istanbul, Turkey.,Medical School, Koç University, Istanbul, Turkey
| |
Collapse
|
11
|
Thiessen M, Sinclair S, Tang PA, Raffin Bouchal S. Information Access and Use by Patients With Cancer and Their Friends and Family: Development of a Grounded Theory. J Med Internet Res 2020; 22:e20510. [PMID: 33118940 PMCID: PMC7661235 DOI: 10.2196/20510] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 08/29/2020] [Accepted: 09/17/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Information has been identified as a commonly unmet supportive care need for those living with cancer (ie, patients and their friends and family). The information needed to help individuals plan their lives around the consequences of cancer, such as the receipt of health care, is an example of an important informational need. A suitable theory to guide the development of interventions designed to meet this informational need has not been identified by the authors. OBJECTIVE The aim of this study is to generate a grounded theory capable of guiding the development of interventions designed to assist those living with cancer in meeting their informational needs. METHODS Classic grounded theory was used to analyze data collected through digitally recorded one-on-one audio interviews with 31 patients with cancer and 29 friends and family members. These interviews focused on how the participants had accessed and used information to plan their lives and what barriers they faced in obtaining and using this information. RESULTS The theory that emerged consisted of 4 variables: personal projects, cancer as a source of disruption to personal projects, information as the process of accessing and interpreting cancer-related data (CRD) to inform action, and CRD quality as defined by accessibility, credibility, applicability, and framing. CRD quality as a moderator of personal project disruption by cancer is the core concept of this theory. CONCLUSIONS Informational resources providing accessible, credible, applicable, and positively framed CRD are likely key to meeting the information needs of those affected by cancer. Web-based informational resources delivering high-quality CRD focused on assisting individuals living with cancer in maintaining and planning their personal projects are predicted to improve quality of life. Research is needed to develop and integrate resources informed by this theoretical framework into clinical practice.
Collapse
Affiliation(s)
- Maclean Thiessen
- Research Institute in 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
| | - Shane Sinclair
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Patricia A Tang
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | | |
Collapse
|
12
|
Rha SY, Lee HJ, Lee J. Unmet needs in the physical and daily living domain mediates the influence of symptom experience on the quality of life of gastric cancer patients. Support Care Cancer 2019; 28:1419-1431. [PMID: 31267280 DOI: 10.1007/s00520-019-04954-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Accepted: 06/18/2019] [Indexed: 12/31/2022]
Abstract
PURPOSE Gastric cancer patients are expected to have considerable supportive care needs; however, few studies have been conducted. This study aimed to understand the unmet needs of gastric cancer patients at different phases of the cancer journey, identify factors contributing to their unmet needs and quality of life (QOL) and explore the relationships among unmet needs, symptom experience, anxiety, depression, and QOL. METHODS A correlational study was conducted using data from 223 gastric cancer patients. The instruments include the SCNS-SF 34, HADS, MDASI, and EORTC QLQ-C 30 (Korean version). Descriptive statistics, t test/ANOVA, Pearson's correlation, multiple regression, and path analyses were used to analyze the data. RESULTS Unmet needs in the health system and information domain were the highest. The phase of the cancer journey had a significant association only with physical and daily living unmet needs (p = 0.027). Physical and daily living unmet needs, symptom severity, symptom interference, and depression demonstrated direct effects on QOL. The physical and daily living unmet needs mediated the association between symptom experience (symptom severity and interference with daily living caused by symptoms) and QOL. The overall paths explained 51.6% of the variance in the QOL of gastric cancer patients (p < 0.001). CONCLUSION The health system and information unmet needs of gastric cancer patients should be fulfilled by reinforcing the continuity of care, professional counseling, and self-care education. Unmet needs in the physical and daily living domain have to be appraised to facilitate improved symptom management to minimize the negative influence on QOL. Factors contributing to the unmet needs and QOL of gastric cancer patients need to be reflected in supportive care planning.
Collapse
Affiliation(s)
- Sun Young Rha
- College of Medicine and Yonsei Cancer Center, Yonsei University, Seoul, South Korea
| | - Hyo Jin Lee
- College of Medicine, Chungnam National University, Daejeon, South Korea
| | - Jiyeon Lee
- College of Nursing, Chungnam National University, Munhwa-ro 266, Jung-gu, Daejeon, South Korea.
| |
Collapse
|
13
|
Konstantinidis TI, Spinthouri M, Ramoutsaki A, Marnelou A, Kritsotakis G, Govina O. Assessment of Unmet Supportive Care Needs in Haematological Cancer Survivors. Asian Pac J Cancer Prev 2019; 20:1487-1495. [PMID: 31127913 PMCID: PMC6857858 DOI: 10.31557/apjcp.2019.20.5.1487] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background: Health needs assessment is crucial for the provision of individualized nursing care. However, many patients report a significant number of unmet needs. The aim of the present study was the assessment of self-reported unmet supportive care needs among haematological cancer survivors in Greece. Methods: 102 patients (mean age 66.2 years old) diagnosed with haematological cancer were included in a cross-sectional study, conducted in two major Greek public hospitals, between October and December 2016. Patients’ needs were assessed using the ‘Needs Evaluation Questionnaire’ (NEQ). Data analysis was conducted using the Statistical Package for Social Sciences software for Windows. Alfa-level (p-value) selected was 5%, bootstrap techniques were used for 95% CI estimation, χ2 was used for differentiation control and Kuder-Richardson coefficient for reliability score assessment (ρ = 0.922). Results: Patients reported higher needs levels “to receive less commiseration from other people” (48%), “more information about my future condition” (44.1%) and “to feel more useful within my family” (42.2%). In contrast, patients reported lower levels to the needs “to speak with a spiritual advisor” (11.8%), “to have more help with eating, dressing and going to the bathroom” (13.7%) and “better attention from nurses” (18.6%). The mean score of satisfied patients (≥8/10) was 8.9 (SD 1.7). Associations between socio-demographic, hospitalization data and unmet needs groups were identified. The less satisfied patients (<8/10) reported more informational needs about their diagnosis and their future condition (p-value=0.002), about their exams and treatments (p-value=0.001), communicative (p-value <0.001), assistance and treatment (p-value<0.001) and hospital infrastructure (p-value <0.001). Conclusion: Various factors seem to be associated to the prevalent unmet care needs among haematological cancer patients. Establishing NEQ as a routine needs assessment tool could aid health professionals to early identify patients’ needs in a busy clinical setting and implement more individualized and patient-centered quality care.
Collapse
Affiliation(s)
| | | | | | | | - George Kritsotakis
- Department of Nursing, Technological Educational Institute of Crete, Heraklion, Greece.
| | - Ourania Govina
- Faculty of Nursing, University of West Attica, Athens, Greece
| |
Collapse
|
14
|
Bonacchi A, Fazzini E, Messina S, Muraca MG, Pacetti P, Di Miceli S, Miccinesi G. Sociodemographic, clinical, and psychological characteristics identify groups of Italian cancer patients with high rates of unmet needs. TUMORI JOURNAL 2018; 105:288-295. [PMID: 30185126 DOI: 10.1177/0300891618792458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Although an optimal goal remains the routine assessment of unmet needs of all patients with cancer, particular attention should be paid to those groups of patients with characteristics known to be more frequently associated with unmet needs in general or with specific areas of need. This report aims to describe the sociodemographic, clinical, and psychological characteristics associated with higher unmet needs in Italian cancer patients. METHODS A total of 835 cancer patients from different care settings (ward, day hospital, follow-up ambulatory, rehabilitation unit, and palliative care) filled out the Needs Evaluation Questionnaire (NEQ), the Psychological Distress Inventory, and the Sense of Coherence Scale. Association of NEQ scores with the clinical and demographic variables were tested using analysis of variance. RESULTS Higher NEQ total score was associated with lower educational level, inpatient care setting, radiotherapy treatment, psychological distress, and lower resilience trait sense of coherence. Different predictors were identified for different areas of unmet needs. Care setting, psychological distress, and resilience trait were the strongest indicators of unmet needs in every area: information/communication, assistance/care, material needs, relational needs, and psychoemotional support. CONCLUSIONS Clinicians should consider that inpatients with a high distress and a low resilience trait sense of coherence represent a group of cancer patients to be investigated with particular attention regarding unmet needs.
Collapse
Affiliation(s)
- Andrea Bonacchi
- 1 Clinical and Descriptive Epidemiology Unit, Institute for Cancer Research and Prevention-ISPO, Florence, Italy.,2 Centro Studi e Ricerca Synthesis, Florence, Italy
| | | | | | - Maria Grazia Muraca
- 3 Centro Riabilitazione Oncologica, Institute for Cancer Research and Prevention-ISPO, Florence, Italy
| | - Paola Pacetti
- 4 Azienda USL Nordovest, Oncologia Ambito Territoriale di Massa Carrara, Carrara, Italy
| | - Stefania Di Miceli
- 5 Rete di Cure Palliative, Zona Nord Ovest, USL Centro Firenze, Florence, Italy
| | - Guido Miccinesi
- 1 Clinical and Descriptive Epidemiology Unit, Institute for Cancer Research and Prevention-ISPO, Florence, Italy
| |
Collapse
|