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Paulsen A, Vistad I, Fegran L. Gynecological cancer survivors' experiences with sexual health communication in nurse-led follow-up consultations. Acta Obstet Gynecol Scand 2024; 103:551-560. [PMID: 38062675 PMCID: PMC10867355 DOI: 10.1111/aogs.14749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 11/19/2023] [Accepted: 11/21/2023] [Indexed: 02/16/2024]
Abstract
INTRODUCTION Gynecological cancer and its treatment may cause sexual difficulties in terms of physical and psychosocial health. Considering the essential role that nurses play in cancer care, they are well positioned to be ideal providers for addressing sexual health concerns in the follow-up phase of gynecological cancer. The aim of this study was to gain in-depth knowledge of how gynecological cancer survivors experience sexual health communication in nurse-led follow-up consultations. MATERIAL AND METHODS Using a qualitative hermeneutic approach, we conducted individual semi-structured interviews with 17 women from five different hospitals in Norway between April 4, 2022, and June 2, 2022. The women participated in a large intervention study on cancer follow-up that included sexual health as one of several topics addressed by trained nurses in three consultations in the first year of follow-up. A five-stage Gadamerian-inspired research method was utilized for data collection and analysis. RESULTS We identified three themes: (1) the importance of nurses listening to the women's own perceptions of sexuality, (2) post-treatment sexual challenges influence the women's need to communicate about sexual health, and (3) nursing communication can help women regain their sexual health. CONCLUSIONS Women who have undergone treatment for gynecological cancer find communication with trained nurses regarding sexual health beneficial. We recommend integration of trained nurses in the follow-up team. The nurses should adjust communication according to each gynecological cancer survivor's unique understanding of sexuality and inform women with sexual health concerns at that end of treatment, that sexual health can improve during follow-up.
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Affiliation(s)
- Anita Paulsen
- Department of ResearchSorlandet HospitalKristiansandNorway
- Department of Health and Nursing SciencesUniversity of AgderKristiansandNorway
| | - Ingvild Vistad
- Department of Gynecology and ObstetricsSorlandet HospitalKristiansandNorway
- Institute of Clinical Medicine, University of OsloOsloNorway
| | - Liv Fegran
- Department of Health and Nursing SciencesUniversity of AgderKristiansandNorway
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Western B, Ivarsson A, Vistad I, Demmelmaier I, Aaronson NK, Radcliffe G, van Beurden M, Bohus M, Courneya KS, Daley AJ, Galvão DA, Garrod R, Goedendorp MM, Griffith KA, van Harten WH, Hayes SC, Herrero-Roman F, Hiensch AE, Irwin ML, James E, Kenkhuis MF, Kersten MJ, Knoop H, Lucia A, May AM, McConnachie A, van Mechelen W, Mutrie N, Newton RU, Nollet F, Oldenburg HS, Plotnikoff R, Schmidt ME, Schmitz KH, Schulz KH, Short CE, Sonke GS, Steindorf K, Stuiver MM, Taaffe DR, Thorsen L, Velthuis MJ, Wenzel J, Winters-Stone KM, Wiskemann J, Berntsen S, Buffart LM. Dropout from exercise trials among cancer survivors-An individual patient data meta-analysis from the POLARIS study. Scand J Med Sci Sports 2024; 34:e14575. [PMID: 38339809 DOI: 10.1111/sms.14575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 01/04/2024] [Accepted: 01/25/2024] [Indexed: 02/12/2024]
Abstract
INTRODUCTION The number of randomized controlled trials (RCTs) investigating the effects of exercise among cancer survivors has increased in recent years; however, participants dropping out of the trials are rarely described. The objective of the present study was to assess which combinations of participant and exercise program characteristics were associated with dropout from the exercise arms of RCTs among cancer survivors. METHODS This study used data collected in the Predicting OptimaL cAncer RehabIlitation and Supportive care (POLARIS) study, an international database of RCTs investigating the effects of exercise among cancer survivors. Thirty-four exercise trials, with a total of 2467 patients without metastatic disease randomized to an exercise arm were included. Harmonized studies included a pre and a posttest, and participants were classified as dropouts when missing all assessments at the post-intervention test. Subgroups were identified with a conditional inference tree. RESULTS Overall, 9.6% of the participants dropped out. Five subgroups were identified in the conditional inference tree based on four significant associations with dropout. Most dropout was observed for participants with BMI >28.4 kg/m2 , performing supervised resistance or unsupervised mixed exercise (19.8% dropout) or had low-medium education and performed aerobic or supervised mixed exercise (13.5%). The lowest dropout was found for participants with BMI >28.4 kg/m2 and high education performing aerobic or supervised mixed exercise (5.1%), and participants with BMI ≤28.4 kg/m2 exercising during (5.2%) or post (9.5%) treatment. CONCLUSIONS There are several systematic differences between cancer survivors completing and dropping out from exercise trials, possibly affecting the external validity of exercise effects.
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Affiliation(s)
- Benedikte Western
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
| | - Andreas Ivarsson
- Centre of Research on Welfare, Health and Sport, Halmstad University, Halmstad, Sweden
| | - Ingvild Vistad
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Obstetrics and Gynecology, Sørlandet Hospital, Kristiansand, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Demmelmaier
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Neil K Aaronson
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Gillian Radcliffe
- Lane Fox Respiratory Research Unit, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Marc van Beurden
- Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Martin Bohus
- Institute of Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health, Mannheim, Germany
- Heidelberg University, Heidelberg, Germany
- Faculty of Health, University of Antwerp, Antwerp, Belgium
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
| | - Amanda J Daley
- Centre for Lifestyle Medicine and Behaviour (CLiMB), The School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Daniel A Galvão
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Rachel Garrod
- Department of Respiratory Medicine, King's College London, London, UK
| | - Martine M Goedendorp
- Department of Psychology, University of Groningen, Groningen, Netherlands
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | - Wim H van Harten
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
- University of Twente, Enschede, The Netherlands
| | - Sandi C Hayes
- School of Public Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | | | - Anouk E Hiensch
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | | | - Erica James
- School of Medicine & Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Marlou-Floor Kenkhuis
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marie José Kersten
- Department of Hematology, Amsterdam University Medical Centers, Cancer Center Amsterdam and LYMMCARE, Amsterdam, The Netherlands
| | - Hans Knoop
- Department of Medical Psychology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Anne M May
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Alex McConnachie
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Willem van Mechelen
- Department of Public and Occupational Health, Amsterdam University Medical Centers, Amsterdam, The Netherlands
- Faculty of Health and Behavioural Sciences, School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia
- Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- UCD School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Nanette Mutrie
- Physical Activity for Health Research Center, University of Edinburgh, Edinburgh, UK
| | - Robert U Newton
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Frans Nollet
- Department of Rehabilitation Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, The Netherlands
| | - Hester S Oldenburg
- Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Ron Plotnikoff
- Priority Research Centre for Physical Activity and Nutrition, the University of Newcastle, Callaghan, New South Wales, Australia
| | - Martina E Schmidt
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany
| | | | - Karl-Heinz Schulz
- Competence Center for Sports- and Exercise Medicine (Athleticum) and Institute for Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Camille E Short
- Melbourne Centre for Behaviour Change, Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
- Cancer and Exercise Recovery Research Group (CanRex), Melbourne School of Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Gabe S Sonke
- Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Karen Steindorf
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany
| | - Martijn M Stuiver
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Dennis R Taaffe
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Lene Thorsen
- National Advisory Unit on Late Effects after Cancer Treatment, Department of Oncology, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
- Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
| | - Miranda J Velthuis
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Jennifer Wenzel
- Johns Hopkins School of Nursing, Johns Hopkins School of Medicine, Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland, USA
| | | | - Joachim Wiskemann
- Department of Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg and Heidelberg University Clinic, Heidelberg, Germany
| | - Sveinung Berntsen
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
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Jeppesen MM, Bergholdt SH, Bentzen AG, de Rooij BH, Skorstad M, Ezendam NPM, van de Poll-Franse LV, Vistad I, Jensen PT. Cancer worry is associated with increased use of supportive health care-results from the multinational InCHARGE study. J Cancer Surviv 2024; 18:165-175. [PMID: 36705796 DOI: 10.1007/s11764-023-01337-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 01/17/2023] [Indexed: 01/28/2023]
Abstract
PURPOSE To assess use of health care following a diagnosis of endometrial, cervical, and ovarian cancer in the Netherlands, Norway, and Denmark. Furthermore, to analyze the association between cancer worry and use of supportive care. METHODS An international multicenter cross-sectional questionnaire study was undertaken among female cancer survivors with endometrial, cervical, or ovarian cancer 1-7 years post diagnosis. We investigated different aspects of cancer survivorship and follow-up care. Health care use included information on the use of supportive health care, general practitioner (GP), and follow-up visits to the department of gynecology. Cancer worry was assessed with the Impact of Cancer (IoCv2) questionnaire. RESULTS A total of 1433 women completed the questionnaire. Health care use decreased from time of diagnosis and was higher among cervical and ovarian cancer survivors than endometrial cancer survivors. Twenty-five percent of the women with ovarian cancer reported severe cancer worry, in contrast to 10 and 15% of women diagnosed with endometrial and cervical cancer, respectively. Women with severe worry had significantly higher use of supportive care activities. In a multivariable regression analysis, cancer worry remained a significant correlate for use of supportive health care services irrespective of disease severity or prognosis. The strongest association was found for use of a psychologist (OR 2.1 [1.71-2.58]). CONCLUSION Cancer worry is associated with increased use of supportive care. IMPLICATIONS FOR CANCER SURVIVORS Targeted, timely, and accessible psychological support aimed at severe cancer worry may improve survivorship care and ensure optimal referral of patients in need of additional care.
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Affiliation(s)
- M M Jeppesen
- Department of Gynecology and Obstetrics, Lillebaelt Hospital, Kolding, Denmark.
- OPEN, Odense Patient Data Explorative Network, Odense University Hospital, Odense, Denmark.
| | - S H Bergholdt
- OPEN, Odense Patient Data Explorative Network, Odense University Hospital, Odense, Denmark
- Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark
| | - A G Bentzen
- Department of Oncology, University Hospital of Northern Norway, Tromsø, Norway
| | - B H de Rooij
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
- Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - M Skorstad
- Department of Obstetrics and Gynaecology, Sørlandet Hospital, Kristiansand, Norway
| | - N P M Ezendam
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
- Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - L V van de Poll-Franse
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
- Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - I Vistad
- Department of Obstetrics and Gynaecology, Sørlandet Hospital, Kristiansand, Norway
- Clinical Institute II, Medical Department, University of Bergen, Bergen, Norway
| | - P T Jensen
- Department of Gynecology and Obstetrics, Aarhus University Hospital, Aarhus, Denmark
- Faculty of Health, Institute for Clinical Medicine, Aarhus University, Aarhus, Denmark
- Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
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Meltzer‐Gunnes CJ, Lie AK, Jonassen CGM, Rangberg A, Nystrand CF, Småstuen MC, Vistad I. Time trends in human papillomavirus prevalence and genotype distribution in vulvar carcinoma in Norway. Acta Obstet Gynecol Scand 2024; 103:153-164. [PMID: 37904590 PMCID: PMC10755140 DOI: 10.1111/aogs.14702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 09/11/2023] [Accepted: 10/07/2023] [Indexed: 11/01/2023]
Abstract
INTRODUCTION Approximately 25%-43% of all vulvar carcinomas are associated with human papillomavirus (HPV). In many countries, vulvar carcinoma incidence rates are increasing, possibly due to greater HPV exposure. However, studies exploring changes in HPV prevalence and genotype distribution in vulvar carcinoma over time are scarce. Our aim was to evaluate time trends in HPV prevalence and genotype distribution in vulvar squamous cell carcinoma in an unselected, nationwide sample of Norwegian women. Further, we explored clinical and histopathological aspects in relation to HPV status and investigated whether HPV status was associated with survival. MATERIAL AND METHODS All vulvar squamous cell carcinoma cases from 1970-1975 and 2000-2005 were extracted from the Cancer Registry of Norway and corresponding tissue blocks were retrieved. After detailed histology review, HPV testing was conducted using real-time TaqMan PCR. Overall survival rates were calculated using the Kaplan-Meier method. Multivariable Cox regression analysis was performed to estimate hazard ratios adjusted for age at diagnosis, stage and diagnostic period. RESULTS Histological review was performed on 352 vulvar squamous cell carcinoma cases. We were able to obtain valid HPV analysis results for 282 cases, Overall, 29.8% (95% CI 24.5%-35.5%) of cases were high-risk HPV (hrHPV)-positive. When comparing the two periods, we found that the percentage of hrHPV-positive tumors increased significantly from 23% (95% CI 16.0%-31.4%) in 1970-1975 to 35.3% (95% CI 27.8%-43.3%) in 2000-2005 (P = 0.025). The predominant genotypes were HPV 16 (73%), HPV 33 (21%), and HPV 18 (6%), with similar distributions in both periods. In the more recent cohort, several additional genotypes were detected: HPV 6, 11, 39, 45, 52, 58 and 66 were found in smaller percentages, ranging from 1.8% to 3.6%. In univariate analysis, patients with HPV-positive tumors showed improved overall survival compared with patients with HPV-negative tumors (hazard ratio [HR] 0.65, 95% CI 0.48-0.86). CONCLUSIONS The prevalence of HPV in vulvar squamous cell carcinomas in Norway was significantly higher in 2000-2005 than in 1970-1975. The three predominant genotypes were HPV 16, 33 and 18 in both time periods. However, several other HPV genotypes have emerged over the last decades. HPV-positivity was associated with better overall survival.
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Affiliation(s)
| | - Agnes Kathrine Lie
- Department of PathologyThe Norwegian Radium Hospital, Oslo University HospitalOsloNorway
- Center for Laboratory MedicineOstfold Hospital HFFredrikstadNorway
| | | | - Anbjørg Rangberg
- Center for Laboratory MedicineOstfold Hospital HFFredrikstadNorway
| | | | - Milada Cvancarova Småstuen
- Department of Nursing and Health PromotionOslo and Akershus University College of Applied SciencesOsloNorway
| | - Ingvild Vistad
- Department of Obstetrics and GynecologySorlandet Hospital HFKristiansandNorway
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Vilming B, Fallås Dahl J, Bentzen AG, Ingebrigtsen VA, Berge Nilsen E, Vistad I, Dørum A, Solheim O, Bjørge L, Zucknick M, Aune G, Lindemann K. Real-world data on niraparib maintenance treatment in patients with non-gBRCA mutated platinum-sensitive recurrent ovarian cancer. Int J Gynecol Cancer 2023; 33:1898-1905. [PMID: 38000795 PMCID: PMC10803952 DOI: 10.1136/ijgc-2023-004484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 09/06/2023] [Indexed: 11/26/2023] Open
Abstract
OBJECTIVES The aim of this study was to provide real-world efficacy and safety data on niraparib maintenance treatment in patients with non-germline (gBRCA)1/2 mutated platinum-sensitive recurrent ovarian cancer. METHODS This retrospective multi-center cohort study included 94 platinum-sensitive recurrent ovarian cancer patients without known gBRCA1/2 mutation treated in an individual patient access program in Norway. The primary outcome was time from start of niraparib treatment to first subsequent treatment. Secondary endpoints included progression-free survival, safety, and tolerability. RESULTS After median follow-up of 13.4 months (95% confidence interval (CI) 10.0 to 16.8), 68.1% had progressed and 22.3% had died. Of the entire cohort, 61.7% had commenced a new line of treatment, and 24.5% were still receiving niraparib. The median duration of niraparib treatment was 5.0 months (range 0.4 to 27.3), and the median time to first subsequent treatment was 10.7 months (95% CI 8.4 to 13.0). Patients with elevated CA125 prior to start of niraparib had shorter time to first subsequent treatment (7.3 months, 95% CI 4.2 to 10.3) than patients with normalized CA125 (12.2 months, 95% CI 10.9 to 13.7 (p=0.002). Patients who started on individual dose based on weight and platelet counts had fewer dose reductions (p<0.001) and interruptions (p=0.02). CONCLUSION In a real-world setting, niraparib maintenance treatment in patients with non-gBRCA1/2 mutated recurrent platinum-sensitive ovarian cancer showed effectiveness comparable with published phase III studies and acceptable safety. Individualized dosing is essential to minimize adverse events. CA125 levels at start of niraparib treatment may help to estimate the individual prognosis.
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Affiliation(s)
- Bente Vilming
- Department of Gynecological Oncology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Jørgen Fallås Dahl
- Department of Clinical and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Anne Gry Bentzen
- Department of Gynecological Oncology, University Hospital of North Norway, Tromsø, Norway
| | | | - Elisabeth Berge Nilsen
- Department of Obstetrics and Gynecology, Stavanger University Hospital, Stavanger, Norway
| | - Ingvild Vistad
- Department of Gynaecology and Obstetrics, Hospital of Southern Norway, Kristiansand, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Anne Dørum
- Department of Gynecological Oncology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Olesya Solheim
- Department of Gynecological Oncology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Line Bjørge
- Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway
- Centre for Cancer Biomarkers, Department of Clinical Science, University of Bergen, Bergen, Norway
| | | | - Guro Aune
- Department of Clinical and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Gynecological Oncology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Kristina Lindemann
- Department of Gynecological Oncology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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Paulsen A, Vistad I, Fegran L. Nurse-patient sexual health communication in gynaecological cancer follow-up: A qualitative study from nurses' perspectives. J Adv Nurs 2023; 79:4648-4659. [PMID: 37358051 DOI: 10.1111/jan.15755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 05/18/2023] [Accepted: 06/15/2023] [Indexed: 06/27/2023]
Abstract
AIM To explore nurse-patient sexual health communication from the perspectives of nurses trained to address sexual health in gynaecological cancer follow-up. DESIGN A qualitative hermeneutic approach. METHODS Individual semi-structured interviews with 10 nurses at five different hospitals in Norway were conducted in March and April 2021. A Gadamerian-inspired research method was used in the analysis. RESULTS Three main themes with six sub-themes were identified. The three main themes were: (1) building relationships through communication, (2) practice makes perfect-the importance of experience and knowledge, and (3) personal attitudes as promoters or inhibiters of sexual health communication. CONCLUSION This study provides valuable insights into nurse-patient sexual health communication from the perspectives of nurses. The nurses in this study experienced the importance of having a good, respectful nurse-patient relationship as the foundation for sexual health communication. The professional confidence gained through experience and knowledge was emphasized, including the significance of how attitudes and taboos can influence sexual health communication. IMPACT The main findings of this study indicate that training in sexual health communication and the possibility of addressing sexual health repeatedly give nurses skills and professional confidence to address sexual health in cancer follow-up. Our study indicates that sexual health communication can be achieved in a clinical setting without being overly resource demanding. Our results may also motivate nurses to enhance their knowledge about sexual health in cancer follow-ups. PATIENT OR PUBLIC CONTRIBUTION A patient representative from the Norwegian Gynaecological Cancer Society have been involved in the planning of this study. She has given valuable contributions from the view of a gynaecological cancer patient.
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Affiliation(s)
- Anita Paulsen
- Department of Research, Sorlandet Hospital, University of Agder, Kristiansand, Norway
- Department of Health and Nursing Sciences, University of Agder, Kristiansand, Norway
| | - Ingvild Vistad
- Department of Gynaecology and Obstetrics, Sorlandet Hospital, Kristiansand, Norway
| | - Liv Fegran
- Department of Health and Nursing Sciences, University of Agder, Kristiansand, Norway
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van Leeuwen M, Kieffer JM, Young TE, Annunziata MA, Arndt V, Arraras JI, Autran D, Hani HB, Chakrabarti M, Chinot O, Cho J, da Costa Vieira RA, Darlington AS, Debruyne PR, Dirven L, Doege D, Eller Y, Eichler M, Fridriksdottir N, Gioulbasanis I, Hammerlid E, van Hemelrijck M, Hermann S, Husson O, Jefford M, Johansen C, Kjaer TK, Kontogianni M, Lagergren P, Lidington E, Lisy K, Morag O, Nordin A, Al Omari ASH, Pace A, De Padova S, Petranovia D, Pinto M, Ramage J, Rammant E, Reijneveld J, Serpentini S, Sodergren S, Vassiliou V, Leeuw IVD, Vistad I, Young T, Aaronson NK, van de Poll-Franse LV. Phase III study of the European Organisation for Research and Treatment of Cancer Quality of Life cancer survivorship core questionnaire. J Cancer Surviv 2023; 17:1111-1130. [PMID: 35088246 DOI: 10.1007/s11764-021-01160-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 12/22/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of this study is to develop a European Organisation for Research and Treatment of Cancer Quality of Life Group (EORTC QLG) questionnaire that captures the full range of physical, mental, and social health-related quality of life (HRQOL) issues relevant to disease-free cancer survivors. In this phase III study, we pretested the provisional core questionnaire (QLQ-SURV111) and aimed to identify essential and optional scales. METHODS We pretested the QLQ-SURV111 in 492 cancer survivors from 17 countries with one of 11 cancer diagnoses. We applied the EORTC QLG decision rules and employed factor analysis and item response theory (IRT) analysis to assess and, where necessary, modify the hypothesized questionnaire scales. We calculated correlations between the survivorship scales and the QLQ-C30 summary score and carried out a Delphi survey among healthcare professionals, patient representatives, and cancer researchers to distinguish between essential and optional scales. RESULTS Fifty-four percent of the sample was male, mean age was 60 years, and, on average, time since completion of treatment was 3.8 years. Eleven items were excluded, resulting in the QLQ-SURV100, with 12 functional and 9 symptom scales, a symptom checklist, 4 single items, and 10 conditional items. The essential survivorship scales consist of 73 items. CONCLUSIONS The QLQ-SURV100 has been developed to assess comprehensively the HRQOL of disease-free cancer survivors. It includes essential and optional scales and will be validated further in an international phase IV study. IMPLICATIONS FOR CANCER SURVIVORS The availability of this questionnaire will facilitate a standardized and robust assessment of the HRQOL of disease-free cancer survivors.
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Affiliation(s)
- Marieke van Leeuwen
- Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, the Netherlands.
| | - Jacobien M Kieffer
- Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Teresa E Young
- Lynda Jackson Macmillan Centre, North Hertfordshire NHS Trust Including Mount Vernon Cancer Centre, East &, Northwood, UK
| | | | - Volker Arndt
- Unit of Cancer Survivorship Research, Division of Clinical Epidemiology and Aging Research & Epidemiological Cancer Registry Baden-Wurttemberg, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Didier Autran
- Pole Neurosciences Cliniques, Service de Neuro-Oncologie, Aix-Marseille Universite, Marseille, France
| | | | | | - Olivier Chinot
- Pole Neurosciences Cliniques, Service de Neuro-Oncologie, Aix-Marseille Universite, Marseille, France
| | - Juhee Cho
- Center for Clinical Epidemiology and Cancer Education Center, Samsung Medical Center, School of Medicine Sungkyunkwan University, Seoul, Korea
| | | | | | - Philip R Debruyne
- Kortrijk Cancer Centre, General Hospital Groeninge, Kortrijk, Belgium
| | - Linda Dirven
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands
| | - Daniela Doege
- Unit of Cancer Survivorship Research, Division of Clinical Epidemiology and Aging Research & Epidemiological Cancer Registry Baden-Wurttemberg, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Yannick Eller
- Centre for Medical Education, University of Dundee, Dundee, UK
| | - Martin Eichler
- National Center for Tumor Diseases (NCT/UCC), University Hospital Carl Gustav Carus Dresden, Dresden, Germany
| | - Nanna Fridriksdottir
- National University Hospital of Iceland, Ugo De Giorgi, Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, 47014, Italy
| | | | - Eva Hammerlid
- Department of Otolaryngology, Head and Neck Surgery, Sahlgrenska University Hospital, Goteborg, Sweden
| | - Mieke van Hemelrijck
- Translational Oncology & Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Silke Hermann
- Epidemiological Cancer Registry Baden-Wurttemberg, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Olga Husson
- Division of Clinical Studies, Institute of Cancer Research, London, UK
| | - Michael Jefford
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Christoffer Johansen
- Oncology Clinic, Finsen Center, Copenhagen Colin Johnson, University Surgical Unit, University Hospitals Southampton, Southampton, UK
| | - Trille Kristina Kjaer
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Meropi Kontogianni
- Department of Nutrition & Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Pernilla Lagergren
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | | | - Karolina Lisy
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Ofir Morag
- Oncology Institute, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Andy Nordin
- East Kent Gynaecological Oncology Centre, Margate, UK
| | | | - Andrea Pace
- Neuroncology Unit, National Cancer Institute Regina Elena, Rome, Italy
| | - Silvia De Padova
- Psycho-Oncology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, 47014, Italy
| | - Duska Petranovia
- Hematology Department, University Clinical Hospital Center Rijeka, Medical Faculty University of Rijeka, Rijeka, Croatia
| | - Monica Pinto
- Rehabilitation Medicine Unit, Department of Strategic Health Services, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Naples, Italy
| | - John Ramage
- Department of Gastroenterology and Hepatology, Hampshire Hospitals NHS Foundation Trust, Basingstoke, UK
| | - Elke Rammant
- Translational Oncology & Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Jaap Reijneveld
- Department of Neurology and Brain Tumor Center Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Samantha Serpentini
- Unit of Psychoncology-Breast Unit, Istituto Oncologico Veneto (IOV)-IRCCS, Padua, Italy
| | - Sam Sodergren
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Vassilios Vassiliou
- Department of Radiation Oncology, Bank of Cyprus Oncology Centre, Nicosia, Cyprus
| | - Irma Verdonck-de Leeuw
- Department of Otolaryngology / Head & Neck Surgery, Amsterdam UMC, Amsterdam, The Netherlands
| | - Ingvild Vistad
- Department of Gynecology and Obstetrics, Sorlandet Hospital Kristiansand, Kristiansand, Norway
| | - Teresa Young
- Lynda Jackson Macmillan Centre, Mount Vernon Cancer Centre, Northwood, UK
| | - Neil K Aaronson
- Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
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8
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Vistad I, Bjørge L. Advanced endometrial cancer: New medical treatment options on the horizon. Acta Obstet Gynecol Scand 2023; 102:128-129. [PMID: 36721075 PMCID: PMC9889320 DOI: 10.1111/aogs.14499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 12/06/2022] [Indexed: 02/02/2023]
Affiliation(s)
- Ingvild Vistad
- Department of Gynecology and Obstetrics, Sørlandet Hospital, Kristiansand, Norway.,Clinical Department, University of Bergen, Bergen, Norway
| | - Line Bjørge
- Centre for Cancer Biomarkers CCBIO, Department of Clinical Science, University of Bergen, Bergen, Norway.,Department of Obstetrics, Gynecology Haukeland University Hospital, Bergen, Norway
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9
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Western B, Demmelmaier I, Vistad I, Hansen BH, Stenling A, Henriksen HB, Nordin K, Blomhoff R, Berntsen S. How many days of continuous physical activity monitoring reliably represent time in different intensities in cancer survivors. PLoS One 2023; 18:e0284881. [PMID: 37093874 PMCID: PMC10124860 DOI: 10.1371/journal.pone.0284881] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 04/10/2023] [Indexed: 04/25/2023] Open
Abstract
BACKGROUND Physical activity (PA) monitoring is applied in a growing number of studies within cancer research. However, no consensus exists on how many days PA should be monitored to obtain reliable estimates in the cancer population. The objective of the present study was to determine the minimum number of monitoring days required for reliable estimates of different PA intensities in cancer survivors when using a six-days protocol. Furthermore, reliability of monitoring days was assessed stratified on sex, age, cancer type, weight status, and educational level. METHODS Data was obtained from two studies where PA was monitored for seven days using the SenseWear Armband Mini in a total of 984 cancer survivors diagnosed with breast, colorectal or prostate cancer. Participants with ≥22 hours monitor wear-time for six days were included in the reliability analysis (n = 736). The intra-class correlation coefficient (ICC) and the Spearman Brown prophecy formula were used to assess the reliability of different number of monitoring days. RESULTS For time in light PA, two monitoring days resulted in reliable estimates (ICC >0.80). Participants with BMI ≥25, low-medium education, colorectal cancer, or age ≥60 years required one additional monitoring day. For moderate and moderate-to-vigorous PA, three monitoring days yielded reliable estimates. Participants with BMI ≥25 or breast cancer required one additional monitoring day. Vigorous PA showed the largest within subject variations and reliable estimates were not obtained for the sample as a whole. However, reliable estimates were obtained for breast cancer survivors (4 days), females, BMI ≥30, and age <60 years (6 days). CONCLUSION Shorter monitoring periods may provide reliable estimates of PA levels in cancer survivors when monitored continuously with a wearable device. This could potentially lower the participant burden and allow for less exclusion of participants not adhering to longer protocols.
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Affiliation(s)
- Benedikte Western
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
| | - Ingrid Demmelmaier
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Ingvild Vistad
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Obstetrics and Gynecology, Sørlandet Hospital, Kristiansand, Norway
| | - Bjørge Herman Hansen
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
| | - Andreas Stenling
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
- Department of Psychology, Umeå University, Umeå, Sweden
| | - Hege Berg Henriksen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Karin Nordin
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Rune Blomhoff
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
| | - Sveinung Berntsen
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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10
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Skorstad M, Vistad I, Fegran L, Berntsen S, Johannessen B. Nurse-led consultations reinforced with eHealth technology: a qualitative study of the experiences of patients with gynecological cancer. BMC Nurs 2022; 21:326. [PMID: 36434602 PMCID: PMC9701034 DOI: 10.1186/s12912-022-01104-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 11/14/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND During the last decade, the health care profession has moved toward personalized care and has focused on the diversity of survivorship needs after initial cancer treatment. Health care providers encourage empowering patients to participate actively in their own health management and survivorship. Consequently, we developed and piloted a new follow-up model for patients at a Norwegian hospital, referred to as the Lifestyle and Empowerment Techniques in Survivorship of Gynecologic Oncology (LETSGO) model. Using LETSGO, a dedicated nurse replaces the physician in every second follow-up consultation, providing patients who have undergone cancer treatment with self-management techniques that are reinforced with eHealth technology via a specially designed app. Encouraging behavioral change and evaluating the late effects of treatment and recurrence symptoms are central components of self-management techniques. In addition, the app encourages physical activity and positive lifestyle changes, helps identify recurrence-related symptoms, and provides reminders of activity goals. This study aims to investigate experiences with nurse-led consultations supported by eHealth technology among the patients who piloted the LETSGO intervention. METHODS Semi-structured qualitative interviews were conducted to analyze the participants' experiences with the LETSGO intervention after six to seven months. RESULTS The participants in the LETSGO pilot felt safe and well cared for. They thought the nurse was less busy than the doctors appear to be, which made it easy for them to share any cancer-related challenges. Many participants reported increased empowerment and confidence in recognizing symptoms of cancer recurrence, and participants who used the app regularly were motivated to increase their physical activity levels. However, the participants also experienced some limitations and technical errors with the app. CONCLUSIONS Generally, the participants positively received the nurse-led consultations and eHealth technology, but an intervention study is required for further evaluation. In addition, the reported technical app errors should be resolved and tested prior to eHealth application implementation. Regardless, this study may be useful in planning personalized survivorship care studies. TRIAL REGISTRATION ClinicalTrials.gov, NCT03453788 . Registration March 5, 2018.
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Affiliation(s)
- Mette Skorstad
- grid.417290.90000 0004 0627 3712Department of Gynecology and Obstetrics, Sorlandet Hospital HF, Egsveien 100, 4615 Kristiansand, Norway ,grid.7914.b0000 0004 1936 7443Clinical Institute II, Medical Department, University of Bergen, Haukelandsveien 28, 5009 Bergen, Norway
| | - Ingvild Vistad
- grid.417290.90000 0004 0627 3712Department of Gynecology and Obstetrics, Sorlandet Hospital HF, Egsveien 100, 4615 Kristiansand, Norway ,grid.7914.b0000 0004 1936 7443Clinical Institute II, Medical Department, University of Bergen, Haukelandsveien 28, 5009 Bergen, Norway
| | - Liv Fegran
- grid.23048.3d0000 0004 0417 6230Department of Health and Nursing Science, University of Agder, Universitetsveien 25, 4630 Kristiansand, Norway
| | - Sveinung Berntsen
- grid.23048.3d0000 0004 0417 6230Department of Sport Science and Physical Education, University of Agder, Universitetsveien 25, 4630 Kristiansand, Norway
| | - Berit Johannessen
- grid.23048.3d0000 0004 0417 6230Department of Health and Nursing Science, University of Agder, Universitetsveien 25, 4630 Kristiansand, Norway
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11
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Reinertsen MP, Liland H, Haug AJ, Martinez JD, Stockler MR, Aune G, Kiely BE, Paulsen T, Vistad I, Lindemann K. 2022-RA-854-ESGO Giving prognostic information by using scenarios – attitudes of women with gynecological cancer. Palliat Care 2022. [DOI: 10.1136/ijgc-2022-esgo.781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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12
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Lindemann K, Liland H, Paus Reinertsen M, Jabri Haug A, Deu Martinez J, Stockler M, Aune G, Kiely B, Vistad I, Paulsen T. 602P Using scenarios to explain survival times – attitudes of women with gynaecological cancer. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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13
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Madland K, Bjorge L, Småstuen MC, Dørum A, Vistad I. Symptomatic or asymptomatic recurrence of ovarian cancer: does it influence survival? Int J Gynecol Cancer 2022; 32:ijgc-2022-003361. [PMID: 35680138 DOI: 10.1136/ijgc-2022-003361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The survival benefit of monitoring CA125 in ovarian cancer patients after primary treatment is debated due to findings varying from insignificant survival differences to prolonged median overall survival in favor of asymptomatic patients. Hence we aimed to compare ovarian cancer patients with and without symptoms at the time of the first diagnosed recurrence in terms of post-recurrence survival and overall survival, and to explore time to recurrence and common symptoms at recurrence. METHODS We included 421 women with ovarian cancer from a prospective multi-institutional Norwegian study of first recurrence of gynecological cancer over the period from March 2012 to April 2016. Patients were interviewed by clinicians at participating hospitals, and patient reported and clinical variables were recorded in a standardized questionnaire. The Kaplan-Meier method and the multivariate Cox model were used to evaluate post-recurrence survival and overall survival. RESULTS Of the 406 patients included, 183 (45%) patients were diagnosed with asymptomatic recurrence, and 223 (55%) patients had symptoms at recurrence. Asymptomatic patients had their recurrence detected 2 months later than symptomatic patients (14 vs 12 months, respectively, p=0.17). Median post-recurrence survival was significantly longer in asymptomatic patients compared with patients with symptoms at recurrence (33.9 vs 26.2 months, respectively, p=0.002). The post-recurrence survival rate remained higher for symptomatic patients in the adjusted analysis (hazard ratio (HR)=1.42, p=0.001). Median overall survival was 47.8 months for asymptomatic patients versus 44.0 months for symptomatic patients in the unadjusted analyses (p=0.056). Asymptomatic patients had a significantly longer survival in the adjusted analysis (HR=1.24, p=0.046). Pain was the most common symptom at recurrence (54%). CONCLUSION Patients with asymptomatic recurrence had a better prognosis based on post-recurrence data and the multivariate Cox regression analysis of overall survival. However, a closer exploration of differences in development of recurrence is needed as these results may give rise to more individualized follow-up for ovarian cancer patients.
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Affiliation(s)
| | - Line Bjorge
- Haukeland University Hospital, Bergen, Norway
- Department of Obstetrics and Gynecology, University of Bergen Center for Cancer Biomarkers, Bergen, Norway
| | | | - Anne Dørum
- Department of Gynecologic Oncology, Oslo University Hospital, Oslo, Norway
| | - Ingvild Vistad
- Gynecologic, Sorlandet Hospital Kristiansand, Kristiansand, Norway
- Department of Clinical Science, University of Bergen Faculty of Medicine and Dentistry, Bergen, Norway
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14
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Forsse D, Barbero ML, Werner HMJ, Woie K, Nordskar N, Berge Nilsen E, Ellstrøm Engh M, Vistad I, Rege A, Sævik-Lode M, Andreasen S, Haldorsen IS, Trovik J, Krakstad C. Longitudinal effects of adjuvant chemotherapy and lymph node staging on patient-reported outcomes in endometrial cancer survivors: a prospective cohort study. Am J Obstet Gynecol 2022; 226:90.e1-90.e20. [PMID: 34400137 DOI: 10.1016/j.ajog.2021.08.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 08/06/2021] [Accepted: 08/10/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Most patients with endometrial cancer with localized disease are effectively treated and survive for a long time. The primary treatment is hysterectomy, to which surgical staging procedures may be added to assess the need for adjuvant therapy. Longitudinal data on patient-reported outcomes comparing different levels of primary treatment are lacking, especially when adjuvant radiotherapy is omitted. OBJECTIVE We assessed the impact of lymphadenectomy and adjuvant chemotherapy on patient-reported symptoms, function, and quality of life. We hypothesized that these treatment modalities would substantially affect patient-reported outcomes at follow-up. STUDY DESIGN We prospectively included patients with endometrial cancer enrolled in the ongoing MoMaTEC2 study (ClinicalTrials.gov Identifier: NCT02543710). Patients were asked to complete the patient-reported outcome questionnaires European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire EN24 preoperatively and at 1 and 2 years of follow-up. Functional domains and symptoms were analyzed for the whole cohort and by treatment received. To assess the effect of the individual treatment modifications, we used mixed regression models. RESULTS Baseline data were available for 448 patients. Of these patients, 339 and 219 had reached 1-year follow-up and 2-year follow-up, respectively. Treatment included hysterectomy (plus bilateral salpingo-oophorectomy) alone (n=177), hysterectomy and lymph node staging without adjuvant therapy (n=133), or adjuvant chemotherapy irrespective of staging procedure (n=138). Overall, patients reported improved global health status and quality of life (+9 units; P<.001), increased emotional and social functioning, and increased sexual interest and activity (P<.001 for all) from baseline to year 1, and these outcomes remained stable at year 2. Means of functional scales and quality of life were similar to age- and sex-weighted reference cohorts. Mean tingling and numbness and lymphedema increased after treatment. The group who received adjuvant chemotherapy had a larger mean reduction in physical functioning (-6 vs +2; P=.002) at year 1, more neuropathy (+30 vs +5; P<.001; year 1) at years 1 and 2, and more lymphedema at year 1 (+11 vs +2; P=.007) than the group treated with hysterectomy and salpingo-oophorectomy only. In patients not receiving adjuvant chemotherapy, patient-reported outcomes were similar regardless of lymph node staging procedures. Adjuvant chemotherapy independently increased fatigue, lymphedema, and neuropathy in mixed regression models. CONCLUSION Patients with endometrial cancer receiving adjuvant chemotherapy reported significantly reduced functioning and more symptoms up to 2 years after treatment. For patients treated by surgery alone, surgical staging did not seem to affect the quality of life or symptoms to a measurable degree at follow-up. Therefore, subjecting patients to lymph node removal to tailor adjuvant therapy seems justified from the patient's viewpoint; however, efforts should increase to find alternatives to traditional chemotherapy.
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Affiliation(s)
- David Forsse
- Centre for Cancer Biomarkers, Department of Clinical Science, University of Bergen, Bergen, Norway; Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway
| | - Mark L Barbero
- Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway
| | - Henrica M J Werner
- Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway
| | - Kathrine Woie
- Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway
| | - Nina Nordskar
- Department of Gynecology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Elisabeth Berge Nilsen
- Department of Obstetrics and Gynecology, Helse Stavanger-Stavanger University Hospital, Stavanger, Norway
| | - Marie Ellstrøm Engh
- Department of Obstetrics and Gynaecology, Akershus University Hospital, Lørenskog, Norway; Faculty Division Akershus University Hospital, University of Oslo
| | - Ingvild Vistad
- Department of Obstetrics and Gynecology, Sørlandet Hospital, Kristiansand, Norway; Clinical Institute II, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Astri Rege
- Department of Obstetrics and Gynecology, District General Hospital of Førde, Førde, Norway
| | - Margaret Sævik-Lode
- Department of Obstetrics and Gynecology, Helse Møre and Romsdal Hospital Trust, Ålesund, Norway
| | - Stine Andreasen
- Department of Obstetrics and Gynecology, Nordland Hospital, Bodø, Norway
| | - Ingfrid S Haldorsen
- Department of Radiology, Mohn Medical Imaging and Visualization Centre, Helse Bergen, Haukeland University Hospital, Bergen, Norway; Section for Radiology, Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Jone Trovik
- Centre for Cancer Biomarkers, Department of Clinical Science, University of Bergen, Bergen, Norway; Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway
| | - Camilla Krakstad
- Centre for Cancer Biomarkers, Department of Clinical Science, University of Bergen, Bergen, Norway; Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway.
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15
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Utne I, Løyland B, Grov EK, Rasmussen HL, Torstveit AH, Paul SM, Ritchie C, Lindemann K, Vistad I, Rodríguez-Aranda C, Miaskowski C. Age-related differences in self-report and objective measures of cognitive function in older patients prior to chemotherapy. Nurs Open 2021; 9:1040-1051. [PMID: 34878233 PMCID: PMC8859071 DOI: 10.1002/nop2.1141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 10/01/2021] [Accepted: 11/16/2021] [Indexed: 12/27/2022] Open
Abstract
Aim Evaluate for differences in demographic and clinical characteristics and subjective and objective measures of cognitive function (CF) between younger older adults (YOA, 60–69 years) and older adults (OA, ≥70 years). Design Cross‐sectional. Methods Older oncology patients (n = 139) completed subjective (Attentional Function Index, European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC) CF scale) and objective (Montreal Cognitive Assessment, Trail Making Test (TMT) A & B) measures of CF prior to chemotherapy. Data were analyzed using parametric and nonparametric tests. Results No differences were found between the two groups for any of the subjective or objective CF measures, except that OA patients had higher TMT B scores. Compared with the general population, OAs had significantly higher EORTC CF scores and YOAs had significantly worse scores for all of the objective tests. Clinically meaningful difference between group differences was found for the TMT B test.
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Affiliation(s)
- Inger Utne
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Borghild Løyland
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Ellen Karine Grov
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Hege Lund Rasmussen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Ann Helen Torstveit
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Steven M Paul
- School of Nursing, University of California, San Francisco, California, USA
| | - Christine Ritchie
- Division of Palliative Care and Geriatric Medicine, Massachusetts General Hospital Morgan Institute, Boston, Massachusetts, USA
| | - Kristina Lindemann
- Department of Gynecological Oncology, Oslo University Hospital, Oslo, Norway
| | - Ingvild Vistad
- Department of Obstetrics and Gynecology, Hospital of Southern Norway, Kristiansand, Norway.,Clinical Institute II, Medical department, University of Bergen, Bergen, Norway
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16
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Oommen H, Oddbjørn Tveit T, Eskedal LT, Myr R, Swanson DM, Vistad I. The association between intrapartum opioid fentanyl and early breastfeeding: A prospective observational study. Acta Obstet Gynecol Scand 2021; 100:2294-2302. [PMID: 34622936 DOI: 10.1111/aogs.14268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 08/23/2021] [Accepted: 08/30/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Intrapartum opioids in labor may interfere with the early breastfeeding phase and cause breastfeeding difficulties. This study examines the effects of intrapartum fentanyl given intravenously (IV) or through epidural analgesia (EDA) on early breastfeeding. MATERIAL AND METHODS This is a prospective observational study conducted in a regional maternity unit. We included 1101 healthy mothers of term singleton babies in vertex presentation born between 2016 and 2018 (468 nulliparous and 633 multiparous). The main data were collected prospectively, and additional data were retrieved from hospital records. The main outcome measures were exclusive breastfeeding at discharge, spontaneous suckling, and breastfeeding problems after birth. We assessed the outcomes in four groups categorized by intrapartum opioid exposure: none, IV fentanyl, EDA fentanyl and IV+EDA fentanyl. We also analyzed the dose-response relation of fentanyl administered by epidural or IV and early breastfeeding. Ultimately, we dichotomized the IV fentanyl group into two groups (≤200 µg and >200 µg) to further study the effect on early breastfeeding. RESULTS The odds of non-exclusive breastfeeding were doubled with EDA fentanyl (odds ratio [OR] 2.45, 95% CI 1.34-4.48, p = 0.004) and four times higher with IV+EDA fentanyl (OR 4.20, 95% CI 2.49-7.09, p < 0.001) compared with no opioid exposure. Spontaneous suckling was negatively associated with intrapartum fentanyl use (p < 0.001) irrespective of mode of administration. When the IV fentanyl doses exceeded 200 µg compared with less than 200 µg, we found a reduction in exclusive breastfeeding (81% vs. 89%; p = 0.014) and spontaneous suckling (68% vs. 83%; p < 0.001) and an increase in breastfeeding problems (41% vs. 27%; p = 0.004). CONCLUSIONS Fentanyl in labor is associated with breastfeeding difficulties. However, IV fentanyl in low doses (≤200 µg) seems to affect breastfeeding less than EDA fentanyl and is therefore a viable alternative when labor analgesia is needed. This could be most relevant for multiparous women, where a shorter labor is expected. More research is needed to determine the optimal dose and route of administration of fentanyl for labor analgesia.
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Affiliation(s)
- Hanna Oommen
- Department of Obstetrics and Gynecology, Sørlandet Hospital Kristiansand, Kristiansand, Norway.,Department of Life Science and Education, University of South Wales, Pontypridd, UK
| | - Tor Oddbjørn Tveit
- Department of Anesthesiology and Intensive Care, Sørlandet Hospital, Kristiansand, Norway.,Research Department, Sørlandet Hospital, Kristiansand, Norway.,Faculty of Health and Sport Science, University of Agder, Kristiansand, Norway
| | - Leif T Eskedal
- Research Department, Sørlandet Hospital, Kristiansand, Norway
| | - Rachel Myr
- Department of Obstetrics and Gynecology, Sørlandet Hospital Kristiansand, Kristiansand, Norway
| | - David M Swanson
- Oslo Center for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Ingvild Vistad
- Department of Obstetrics and Gynecology, Sørlandet Hospital Kristiansand, Kristiansand, Norway.,Research Department, Sørlandet Hospital, Kristiansand, Norway.,Faculty of Health and Sport Science, University of Agder, Kristiansand, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
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17
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Greimel E, Nagele E, Lanceley A, Oberguggenberger AS, Nordin A, Kuljanic K, Arraras JI, Wei-Chu C, Jensen PT, Tomaszewski KA, Creutzberg CL, Galalae R, Toelen H, Zimmermann K, Bjelic-Radisic V, Costantini A, Almont T, Serpentini S, Paskeviciute Frøding L, Vistad I, Schmalz C. Psychometric validation of the European Organisation for Research and Treatment of Cancer-Quality of Life Questionnaire Sexual Health (EORTC QLQ-SH22). Eur J Cancer 2021; 154:235-245. [PMID: 34298374 DOI: 10.1016/j.ejca.2021.06.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 06/01/2021] [Accepted: 06/08/2021] [Indexed: 11/12/2022]
Abstract
BACKGROUND The European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Group developed a questionnaire to assess sexual health in patients with cancer and cancer survivors. This study evaluates the psychometric properties of the questionnaire. METHODS The 22-item EORTC sexual health questionnaire (EORTC QLQ-SH22) was administered with the EORTC QLQ-C30 to 444 patients with cancer. The hypothesised scale structure, reliability and validity were evaluated through standardised psychometric procedures. RESULTS The cross-cultural field study showed that the majority of patients (94.7%) were able to complete the QLQ-SH22 in less than 20 min; 89% of the study participants did not need any help to fill in the questionnaire. Multi-item multi-trait scaling analysis confirmed the hypothesised scale structure with two multi-item scales (sexual satisfaction, sexual pain) and 11 single items (including five conditional items and four gender-specific items). The internal consistency yielded acceptable Cronbach's alpha coefficients (.90 for the sexual satisfaction scale, .80 for the sexual pain scale). The test-retest correlations (Pearson's r) ranged from .70 to .93 except for the scale communication with professionals (.67) and male body image (.69). The QLQ-SH22 discriminates well between subgroups of patients differing in terms of their performance and treatment status. CONCLUSION The study supports the reliability, the content and construct validity of the QLQ-SH22. The newly developed questionnaire is clinically applicable to assess sexual health of patients with cancer at different treatment stages and during survivorship for clinical trials and for clinical practice.
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Affiliation(s)
| | - Eva Nagele
- Medical University of Graz, Graz Austria
| | | | | | - Andy Nordin
- East Kent Hospitals University Foundation NHS Trust, Kent, United Kingdom
| | | | | | - Chie Wei-Chu
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taiwan
| | | | - Krzysztof A Tomaszewski
- Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Kraków University, Kraków, Poland; Scanmed St. Raphael Hospital, Kraków, Poland
| | - Carien L Creutzberg
- Leiden University Medical Center, Department of Radiation Oncology, Leiden, Netherlands
| | - Razvan Galalae
- Evangelische Kliniken Gelsenkirchen GmbH, Gelsenkirchen, Germany
| | - Hilde Toelen
- University Hospitals Leuven, UZ Campus Gasthuisberg, Belgium
| | - Kristin Zimmermann
- Bundeswehrzentralkrankenhaus Koblenz, Klinik für Urologie, Koblenz, Germany
| | | | - Anna Costantini
- Psychoncology Unit, Sant'Andrea Universitary Hospital, Rome, Italy
| | | | - Samantha Serpentini
- Unit of Psycho-oncology/Breast Unit, Veneto Institute of Oncology IOV-IRCCS Comprehensive Cancer Centre, Padova, Italy
| | | | | | - Claudia Schmalz
- Department for Radiation Oncology, University Clinic Schleswig-Holstein, Kiel, Germany
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Vistad I, Skorstad M, Demmelmaier I, Småstuen MC, Lindemann K, Wisløff T, van de Poll-Franse LV, Berntsen S. Lifestyle and Empowerment Techniques in Survivorship of Gynaecologic Oncology (LETSGO study): a study protocol for a multicentre longitudinal interventional study using mobile health technology and biobanking. BMJ Open 2021; 11:e050930. [PMID: 34253678 PMCID: PMC8276283 DOI: 10.1136/bmjopen-2021-050930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION The number of gynaecological cancer survivors is increasing and there is a need for a more sustainable model of follow-up care. Today's follow-up model is time-consuming and patients have reported unmet needs regarding information about their cancer and strategies for managing the consequences of treatment. The main aim of this study is to assess health-related empowerment-in terms of patient education, psychosocial support, and promotion of physical activity-in a new follow-up model by comparing it to standard follow-up in a quasi-randomised study involving intervention hospitals and control hospitals. METHODS AND ANALYSIS At the intervention hospitals, patients will be stratified by risk of recurrence and late effects to either 1 or 3 years' follow-up. Nurses will replace doctors in half of the follow-up visits and focus in particular on patient education, self-management and physical activity. They will provide patients with information and guide them in goal setting and action planning. These measures will be reinforced by a smartphone application for monitoring symptoms and promoting physical activity. At the control hospitals, patients will be included in the standard follow-up programme. All patients will be asked to complete questionnaires at baseline and after 3, 6, 12, 24 and 36 months. Blood samples will be collected for biobanking at 3, 12 and 36 months. The primary outcome is health-related empowerment. Secondary outcomes include health-related quality of life, adherence to physical activity recommendations, time to recurrence, healthcare costs and changes in biomarkers. Changes in these outcomes will be analysed using generalised linear mixed models for repeated measures. Type of hospital (intervention or control), time (measurement point), and possible confounders will be included as fixed factors. ETHICS AND DISSEMINATION The study is approved by the Regional Committee for Medical Research Ethics (2019/11093). Dissemination of findings will occur at the local, national and international levels. TRIAL REGISTRATION NUMBER NCT04122235.
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Affiliation(s)
- Ingvild Vistad
- Department of Gynaecology and Obstetrics, Sorlandet Hospital Kristiansand, Kristiansand, Norway
- Clinical Department 2, University of Bergen, Bergen, Hordaland, Norway
| | - Mette Skorstad
- Department of Gynaecology and Obstetrics, Sorlandet Hospital Kristiansand, Kristiansand, Norway
| | - Ingrid Demmelmaier
- Department of Public Health and Caring Sciences, Lifestyle and Rehabilitation in Long-term Illness, Uppsala Universitet, Uppsala, Sweden
| | | | - Kristina Lindemann
- Department of Gynaecologic Oncology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Torbjørn Wisløff
- Department of Community Medicine, UiT The Arctic University of Norway, Tromso, Norway
| | - Lonneke V van de Poll-Franse
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Sveinung Berntsen
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Vest-Agder, Norway
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19
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Vilming B, Fallås-Dahl J, Bentzen AG, Ingebrigtsen VA, Berge Nilsen E, Vistad I, Dørum A, Solheim O, Bjørge L, Aune G, Lindemann K. Real-life data of niraparib maintenance treatment in patients with recurrent platinum-sensitive ovarian cancer. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.5560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5560 Background: PARP (poly adenosine diphosphate [ADP]–ribose polymerase) inhibitors are the new standard for maintenance treatment in platinum sensitive recurrent ovarian cancer (PSROC), independent of germline (g-BRCA) or somatic BRCA mutation status. Real-life data after the introduction of new anti-neoplastic agents are needed to evaluate whether the benefit observed in phase III trials can be translated into clinical practice. The aim of this study was to provide real-life data on efficacy and safety of niraparib in non-gBRCA PSROC. Methods: This retrospective multi-center cohort study included patients with PSROC who were enrolled in a national individual patient access program in Norway. Efficacy and safety data were collected from the patients´ electronic medical records. The primary outcome was time from start of niraparib treatment to first subsequent treatment (TFST). Secondary endpoints included prevalence of dose interruption and -reduction, as well as adverse events. Results: The study included 106 patients with median age of 64 years (range 38-81). After median follow up of 15.3 months (95% CI 12.1-18.5), 71 patients (67%) had progressed, 64 (60%) had started a new line of treatment, and 25 (24%) had died. 25 (24%) patients were still receiving niraparib. Median duration of niraparib treatment was 7.6 months (0.4 to 27.3 months). Median TFST was 11.7 months (95% CI 9.2 -14.2). Patients with elevated CA125 after chemotherapy prior to start of niraparib had shorter progression-free survival (PFS) compared to patients with complete serological response (6.5 months (95% CI 5.7 – 7.3) vs 12 months (95% CI 6.2 – 17.9, (p < 0.001)). Grade 3-4 hematologic and non-hematologic events occurred in 25% and 17% of the patients, respectively. The most common grade 3/4 hematologic events were anemia (15%), thrombocytopenia (11%) and neutropenia (8%). Adverse events led to dose interruption in 38% and dose reduction in 44% of the patients. Patients with individualized dosing based on baseline weight and platelet counts had fewer dose reductions (p < 0.001) and -interruptions (p = 0.042) than patients whose dose was not adjusted to those baseline values. Conclusions: In a real-life setting, niraparib maintenance treatment in patients with non-gBRCA PSROC showed efficacy comparable with the published phase III data and an acceptable safety profile. Individualized dosing at start of treatment minimized adverse events. The prolonged PFS in patients with CA125 normalization after last chemotherapy, suggests that these patients in particular benefit from maintenance treatment but warrants confirmation in a larger sample.[Table: see text]
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Affiliation(s)
| | - Jørgen Fallås-Dahl
- Department of Clinical and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Anne-Gry Bentzen
- Department of Oncology, University Hospital of North Norway, Tromsø, Norway
| | | | | | - Ingvild Vistad
- Department of Gynecology, Sørlandet Hospital Trust, Kristiansand, Norway
| | - Anne Dørum
- Department of Gynecologic Oncology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Olesya Solheim
- Department of Gynecologic Oncology, Oslo University Hospital, Oslo, Norway
| | - Line Bjørge
- Haukeland University Hospital, Bergen, Norway
| | - Guro Aune
- Department of Gynecological Oncology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Kristina Lindemann
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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20
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Skorstad M, de Rooij BH, Jeppesen MM, Bergholdt SH, Ezendam NPM, Bohlin T, Jensen PT, Lindemann K, van de Poll L, Vistad I. Self-management and adherence to recommended follow-up after gynaecological cancer: results from the international InCHARGE study. Int J Gynecol Cancer 2021; 31:1106-1115. [PMID: 33858949 DOI: 10.1136/ijgc-2020-002377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 03/24/2021] [Accepted: 03/24/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To assess the relationship between self-management skills and adherence to follow-up guidelines among gynecological cancer survivors in the Netherlands, Norway, and Denmark, and to assess the relationship between adherence to follow-up programs and use of additional healthcare services. METHODS For this international, multicenter, cross-sectional study, we recruited gynecological cancer survivors 1-5 years after completion of treatment. Information on follow-up visits, use of healthcare resources, self-management (measured by the Health Education Impact Questionnaire), clinical characteristics, and demographics were obtained by validated questionnaires. Participants were categorized as adherent if they attended the number of follow-up visits recommended by national guidelines, non-adherent if they had fewer visits than recommended, or over-users if they had more visits than recommended. RESULTS Of 4455 invited survivors, 2428 (55%) returned the questionnaires, and 911 survivors were included in the analyses. Survivors with high self-management most frequently adhered to recommended follow-up. Non-adherent survivors showed lower self-management in the health-directed activity domain (OR 1.54, 95% CI 1.03 to 2.32) than adherent survivors. No other associations between self-management and follow-up adherence were revealed. Non-adherent survivors tended to have endometrial cancer, surgical treatment only, be older, and be Danish residents. Over-users reported more follow-up visits and also used additional healthcare services more frequently than adherent survivors. CONCLUSION Low self-management appears to reduce the likelihood of adherence to national guidelines for gynecological cancer follow-up. Focusing on patient education for survivors at risk of low self-management to ensure adherence to recommended follow-up may improve personalization of follow-up.
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Affiliation(s)
- Mette Skorstad
- Department of Gynaecology and Obstetrics, Sorlandet Hospital Kristiansand, Kristiansand, Norway
| | - Belle H de Rooij
- Department of Medical and Clinical Psychology, IKNL, Utrecht, Utrecht, Netherlands.,Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands
| | - Mette Moustgaard Jeppesen
- Department of Gynaecology and Obstetrics, Hospital Lillebaelt Middelfart Hospital, Middelfart, Denmark.,OPEN, Odense Patient data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Stinne Holm Bergholdt
- Department of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark
| | - Nicole Paulina Maria Ezendam
- Department of Medical and Clinical Psychology, IKNL, Utrecht, Utrecht, Netherlands.,Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands
| | - Tonje Bohlin
- Department of Gynaecology and Obstetrics, Vestfold Hospital Trust, Tonsberg, Norway
| | - Pernille Tine Jensen
- Faculty of Health Science, Aarhus University, Aarhus, Denmark.,Department of Gynecology and Obstetrics, Aarhus Universitetshospital, Aarhus, Denmark
| | - Kristina Lindemann
- Department of Gynecological Oncology, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Lonneke van de Poll
- Department of Medical and Clinical Psychology, IKNL, Utrecht, Utrecht, Netherlands.,Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands.,Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Ingvild Vistad
- Department of Gynaecology and Obstetrics, Sorlandet Hospital Kristiansand, Kristiansand, Norway.,Department of Clinical Science, University of Bergen Faculty of Medicine and Dentistry, Bergen, Norway
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21
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Forsse D, Werner H, Alræk Iversen G, Nordskar N, Engh M, Berge Nilsen E, Vistad I, Rege A, Sævik-Lode M, Andreassen S, Trovik J, Krakstad C. 859P Impact of treatment modalities on quality of life for endometrial cancer patients in Norway. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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22
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Vistad I, Lindemann K, Bentzen AG, Dahl AA, Steen R, Kiserud C. Preferences for follow up in long-term survivors after cervical cancer. Acta Obstet Gynecol Scand 2020; 99:1253-1259. [PMID: 32232835 DOI: 10.1111/aogs.13855] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 02/21/2020] [Accepted: 03/19/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION An increasing number of cervical cancer survivors combined with lack of data on the efficacy of long-term surveillance, challenges existing follow-up models. However, before introducing new follow-up models, cervical cancer survivors' own views on follow up are important. We aimed to explore preferences for follow up in long-term cervical cancer survivors and their associations with self-reported late-effects. MATERIAL AND METHODS In 2013, we mailed 974 Norwegian long-term cervical cancer survivors treated during 2000-2007 a questionnaire with items covering preferences for follow up after treatment, clinical variables and validated questionnaires covering anxiety, neuroticism and depression. RESULTS We included 471 cervical cancer survivors (response rate 57%) with a median follow up of 11 years. In all, 77% had FIGO stage I disease, and 35% were attending a follow-up program at the time of survey. Of the patients, 55% preferred more than 5 years of follow up. This was also preferred by 57% of cervical cancer survivors who were treated with conization only. In multivariable analyses, chemo-radiotherapy or surgery with radiation and/or chemotherapy (heavy treatment) and younger age were significantly associated with a preference for more than 5 years' follow up. Late effects were reported by more than 70% of the cervical cancer survivors who had undergone heavy treatment. CONCLUSIONS Our study reveals the need for targeted patient education about the benefits and limitations of follow up. To meet increasing costs of cancer care, individualized follow-up procedures adjusted to risk of recurrence and late-effects in cervical cancer survivors are warranted.
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Affiliation(s)
- Ingvild Vistad
- Department of Obstetrics and Gynecology, Sørlandet Hospital Kristiansand, Kristiansand, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Kristina Lindemann
- Department of Gynecologic Oncology, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, Norway.,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Anne G Bentzen
- Department of Gynecologic Oncology, University Hospital of North Norway, Tromsø, Norway
| | - Alv A Dahl
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,National Advisory Unit on Late Effects after Cancer Treatment, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, Norway
| | - Rita Steen
- Department of Clinical Service, The Cancer Clinic, Oslo University Hospital, Oslo, Norway.,Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
| | - Cecilie Kiserud
- National Advisory Unit on Late Effects after Cancer Treatment, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, Norway
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23
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Andenæs R, Småstuen MC, Misvær N, Ribu L, Vistad I, Helseth S. Associations between menopausal hormone therapy and sleep disturbance in women during the menopausal transition and post-menopause: data from the Norwegian prescription database and the HUNT study. BMC Womens Health 2020; 20:64. [PMID: 32228557 PMCID: PMC7106897 DOI: 10.1186/s12905-020-00916-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 02/28/2020] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Impaired sleep is common in menopausal women. The aim was to examine associations between uses of systemic menopausal hormone therapy (MHT) and sleep disturbance in a large population sample. METHODS Female participants aged 45 to 75 years were selected from the Norwegian Health Study in Nord-Trøndelag (HUNT3, 2006-2008) (N = 13,060). Data were linked to the Norwegian Prescription Database, identifying use of prescribed MHT and use of sleep medication. Data were analyzed using multiple linear regression. RESULTS In total, 996 women used systemic MHT (7.6%), with the highest prevalence of 10.3% among women 55 to 64 years of age. Despite high reports of frequent nocturnal awakening (24.7%) and high reports of hot flashes, use of MHT was low in this large population based survey. Although MHT use was associated with more sleep disturbance in unadjusted analyses, the association was not significant after adjusting for relevant covariates. Using sleep medication, reporting poor health, tobacco and alcohol use, doing daily exercise, having higher levels of anxiety, and being less satisfied with life were factors showing the strongest associations with sleep disturbance. CONCLUSION The lack of association between MHT and sleep disturbance suggests that other factors, such as self-perceived good health, a healthy lifestyle and anxiety/depression, are more relevant to sleep than MHT.
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Affiliation(s)
- Randi Andenæs
- Faculty of Health Sciences. Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Milada Cvancarova Småstuen
- Faculty of Health Sciences. Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Nina Misvær
- Faculty of Health Sciences. Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Lis Ribu
- Faculty of Health Sciences. Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway.
| | - Ingvild Vistad
- Sørlandet Hospital, Kristiansand, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Sølvi Helseth
- Faculty of Health Sciences. Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
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Vistad I, Bjørge L, Skeie-Jensen T. Kreftoppfølgingen bør endres. Tidsskriftet 2020; 140:20-0281. [DOI: 10.4045/tidsskr.20.0281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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25
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Affiliation(s)
- Ingvild Vistad
- Department of Clinical Science University of Bergen BergenNorway
- Department of Obstetrics and Gynecology Sørlandet Hospital Kristiansand Norway
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26
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Fidjeland HL, Vistad I, Gjelstad S, Brekke M. Exploring why patients with cancer consult GPs: a 1-year data extraction. BJGP Open 2019; 3:bjgpopen19X101663. [PMID: 31581120 PMCID: PMC6995854 DOI: 10.3399/bjgpopen19x101663] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 06/23/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Survival rates of patients with cancer are increasing owing to improvements in diagnostics and therapies. The traditional hospital-based follow-up model faces challenges because of the consequent increasing workload, and it has been suggested that selected patients with cancer could be followed up by GPs.The hypothesis of the study was that, regardless of the hospital-based follow-up care, GPs see their patients with cancer both for cancer-related problems as well as for other reasons. Thus, a formalised follow-up by GPs would not mean too large a change in GPs' workloads. AIM To explore to what extent patients with cancer consult their GPs, and for what reasons. DESIGN & SETTING A 1-year explorative study was undertaken, based on data from 91 Norwegian GPs from 2016-2017. METHOD The data were electronically extracted from GPs' electronic medical records (EMR). RESULTS Data were collected from 91 GPs. There were 11 074 consultations in total, generated by 1932 patients with cancer. The mean consultation rate was higher among the patients with cancer compared with Norwegian patients in general. In one-third of the consultations, cancer was the main diagnosis. Apart from cancer, cardiovascular and musculoskeletal diagnoses were common. Patients with cancer who had multiple diagnoses or psychological diagnoses did not consult their GP significantly more often than patients with cancer without such comorbidity. CONCLUSION This study confirms that patients with cancer consult their GP more often than other patients, both for cancer-related reasons and for various comorbidities. A formalised follow-up by GPs would probably be feasible, and GPs should prepare for this responsibility.
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Affiliation(s)
- Heidi Lidal Fidjeland
- Doctoral Research Fellow, General Practice Research Unit (AFE), Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
- Doctoral Research Fellow, Department of Obstetrics and Gynecology, Sørlandet Hospital Kristiansand, Kristiansand, Norway
| | - Ingvild Vistad
- Consultant, Department of Obstetrics and Gynecology, Sørlandet Hospital Kristiansand, Kristiansand, Norway
| | - Svein Gjelstad
- Associate Professor, General Practice Research Unit (AFE), Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Mette Brekke
- Professor, General Practice Research Unit (AFE), Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
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27
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O'Brien EC, Segurado R, Geraghty AA, Alberdi G, Rogozinska E, Astrup A, Barakat Carballo R, Bogaerts A, Cecatti JG, Coomarasamy A, de Groot CJM, Devlieger R, Dodd JM, El Beltagy N, Facchinetti F, Geiker N, Guelfi K, Haakstad L, Harrison C, Hauner H, Jensen DM, Khan K, Kinnunen TI, Luoto R, Willem Mol B, Mørkved S, Motahari-Tabari N, Owens JA, Perales M, Petrella E, Phelan S, Poston L, Rauh K, Rayanagoudar G, Renault KM, Ruifrok AE, Sagedal L, Salvesen KÅ, Scudeller TT, Shen G, Shub A, Stafne SN, Surita FG, Thangaratinam S, Tonstad S, van Poppel MNM, Vinter C, Vistad I, Yeo S, McAuliffe FM. Impact of maternal education on response to lifestyle interventions to reduce gestational weight gain: individual participant data meta-analysis. BMJ Open 2019; 9:e025620. [PMID: 31375602 PMCID: PMC6688690 DOI: 10.1136/bmjopen-2018-025620] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES To identify if maternal educational attainment is a prognostic factor for gestational weight gain (GWG), and to determine the differential effects of lifestyle interventions (diet based, physical activity based or mixed approach) on GWG, stratified by educational attainment. DESIGN Individual participant data meta-analysis using the previously established International Weight Management in Pregnancy (i-WIP) Collaborative Group database (https://iwipgroup.wixsite.com/collaboration). Preferred Reporting Items for Systematic reviews and Meta-Analysis of Individual Participant Data Statement guidelines were followed. DATA SOURCES Major electronic databases, from inception to February 2017. ELIGIBILITY CRITERIA Randomised controlled trials on diet and physical activity-based interventions in pregnancy. Maternal educational attainment was required for inclusion and was categorised as higher education (≥tertiary) or lower education (≤secondary). RISK OF BIAS Cochrane risk of bias tool was used. DATA SYNTHESIS Principle measures of effect were OR and regression coefficient. RESULTS Of the 36 randomised controlled trials in the i-WIP database, 21 trials and 5183 pregnant women were included. Women with lower educational attainment had an increased risk of excessive (OR 1.182; 95% CI 1.008 to 1.385, p =0.039) and inadequate weight gain (OR 1.284; 95% CI 1.045 to 1.577, p =0.017). Among women with lower education, diet basedinterventions reduced risk of excessive weight gain (OR 0.515; 95% CI 0.339 to 0.785, p = 0.002) and inadequate weight gain (OR 0.504; 95% CI 0.288 to 0.884, p=0.017), and reduced kg/week gain (B -0.055; 95% CI -0.098 to -0.012, p=0.012). Mixed interventions reduced risk of excessive weight gain for women with lower education (OR 0.735; 95% CI 0.561 to 0.963, p=0.026). Among women with high education, diet based interventions reduced risk of excessive weight gain (OR 0.609; 95% CI 0.437 to 0.849, p=0.003), and mixed interventions reduced kg/week gain (B -0.053; 95% CI -0.069 to -0.037,p<0.001). Physical activity based interventions did not impact GWG when stratified by education. CONCLUSIONS Pregnant women with lower education are at an increased risk of excessive and inadequate GWG. Diet based interventions seem the most appropriate choice for these women, and additional support through mixed interventions may also be beneficial.
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Affiliation(s)
- Eileen C O'Brien
- UCD Perinatal Research Centre, Obstetrics and Gynaecology, UCD School of Medicine, University College Dublin, Dublin, Ireland
| | - Ricardo Segurado
- Centre for Support and Training in Analysis and Research (CSTAR), School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Aisling A Geraghty
- UCD Perinatal Research Centre, Obstetrics and Gynaecology, UCD School of Medicine, University College Dublin, Dublin, Ireland
| | - Goiuri Alberdi
- UCD Perinatal Research Centre, Obstetrics and Gynaecology, UCD School of Medicine, University College Dublin, Dublin, Ireland
| | - Ewelina Rogozinska
- Women's Health Research Unit, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- Multidisciplinary Evidence Synthesis Hub (mEsh), Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Arne Astrup
- Department of Nutrition, Exercise and Sports, Univesity of Copenhagen, Copenhagen, Denmark
| | - Rubenomar Barakat Carballo
- Facultad de Ciencias de la Actividad Fısica y del Deporte (INEF), Universidad Politecnica de Madrid, Madrid, Spain
| | - Annick Bogaerts
- Department of Development and Regeneration KU Leuven, University of Leuven, Leuven, Belgium
- Faculty of Health and Social Work, UC Leuven-Limburg, Leuven, Belgium
- Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care (CRIC), University of Antwerp, Belgium
| | - Jose Guilherme Cecatti
- Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Arri Coomarasamy
- School of Clinical and Experimental Medicine, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Christianne J M de Groot
- Obstetrics and Gynaecology, Faculty of Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Roland Devlieger
- Department of Development and Regeneration KU Leuven, University of Leuven, Leuven, Belgium
- Department of Obstetrics and Gynecology, Universitaire Ziekenhuizen Leuven, Leuven, Belgium
| | - Jodie M Dodd
- Obstetrics and Gynaecology, School of Paediatrics and Reproductive Health, The Unversity of Adelaide, Adelaide, Australia
| | - Nermeen El Beltagy
- Department of Obstetrics and Gynecology, Alexandria University, Alexandria, Egypt
| | - Fabio Facchinetti
- Mother-Infant Department, University of Modena and Reggio Emilia, Modena, Italy
| | - Nina Geiker
- Clinical Nutrition Research, Copenhagen University Hospital Herlev-Gentofte, Gentofte, Denmark
| | - Kym Guelfi
- School of Human Sciences, The University of Western Australia, Perth, Australia
| | - Lene Haakstad
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Cheryce Harrison
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Hans Hauner
- Else Kroener-Fresenius-Center for Nutritional Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Dorte M Jensen
- Department of Endocrinology, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Khalid Khan
- Women's Health Research Unit, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- Multidisciplinary Evidence Synthesis Hub (mEsh), Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Tarja Inkeri Kinnunen
- Health Sciences, Faculty of Social Sciences, University of Tampere, Tampere, Finland
| | - Riitta Luoto
- Health Sciences, Faculty of Social Sciences, University of Tampere, Tampere, Finland
| | - Ben Willem Mol
- Robinson Institute, School of Paediatrics and Reproductive Health, The University of Adelaide, Adelaide, Australia
| | - Siv Mørkved
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Clinical Services, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Narges Motahari-Tabari
- Midwifery Department, Faculty of Nursing and Midwifery, Mazandaran University of Medical Science, Sari, Iran
| | - Julie A Owens
- Obstetrics and Gynaecology, School of Paediatrics and Reproductive Health, The Unversity of Adelaide, Adelaide, Australia
| | - Maria Perales
- Facultad de Ciencias de la Actividad Fısica y del Deporte (INEF), Universidad Politecnica de Madrid, Madrid, Spain
| | - Elisabetta Petrella
- Mother-Infant Department, University of Modena and Reggio Emilia, Modena, Italy
| | - Suzanne Phelan
- Kinesiology Department, College of Science and Mathematics, California Polytechnic State University, San Luis Obispo, California, USA
| | - Lucilla Poston
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - Kathrin Rauh
- Nutrition Information and Knowledge Transfer, Competence Centre for Nutrition (KErn), Freising, Germany
| | - Girish Rayanagoudar
- Women's Health Research Unit, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Kristina M Renault
- Department of Obstetrics and Gynecology, Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark
- Obstetric Clinic, Juliane Marie Centret, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Anneloes E Ruifrok
- Department of Obstetrics and Gynaecology, Academisch Medisch Centrum Universiteit van Amsterdam, Amsterdam, The Netherlands
| | - Linda Sagedal
- Department of Obstetrics and Gynecology, Sorlandet Hospital, Kristiansand, Norway
| | - Kjell Å Salvesen
- Department of Obstetrics and Gynaecology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Laboratory Medicine Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Tania T Scudeller
- Department of Management and Health Care, Universidade Federal de Sao Paulo, São Paulo, Brazil
| | - Gary Shen
- Department of Internal Medicine, University of Manitoba College of Medicine, Winnipeg, Canada
| | - Alexis Shub
- Obstetrics and Gynaecology, University of Melbourne, Victoria, Australia
| | - Signe N Stafne
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Clinical Services, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Fernanda G Surita
- Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Shakila Thangaratinam
- Women's Health Research Unit, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- Multidisciplinary Evidence Synthesis Hub (mEsh), Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Serena Tonstad
- Department of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway
| | - Mireille N M van Poppel
- Department of Public and Occupational Health, VU University Medical Center, Amsterdam, The Netherlands
| | - Christina Vinter
- Department of Obstetrics and Gynecology, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Ingvild Vistad
- Department of Obstetrics and Gynecology, Sorlandet Hospital, Kristiansand, Norway
| | - SeonAe Yeo
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Fionnuala M McAuliffe
- UCD Perinatal Research Centre, Obstetrics and Gynaecology, UCD School of Medicine, University College Dublin, Dublin, Ireland
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Rohde G, Söderhamn U, Vistad I. Reflections on communication of disease prognosis and life expectancy by patients with colorectal cancer undergoing palliative care: a qualitative study. BMJ Open 2019; 9:e023463. [PMID: 30850402 PMCID: PMC6429716 DOI: 10.1136/bmjopen-2018-023463] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES Patients with colorectal cancer undergoing palliative treatment receive extensive treatment-related information throughout their disease trajectory. We aimed to explore the experiences of patients with incurable colorectal cancer while in palliative care and their reflections on the information provided by physicians and nurses. Our main focus was the patients' thoughts about how information about disease status and life expectancy was communicated, from the first time that they were informed about the incurable nature of their disease through to postsurgery palliative treatment. SETTINGS Patients with colorectal cancer receiving palliative chemotherapy. RESEARCH DESIGN We used a qualitative approach, and the data were analysed by qualitative content analysis. PARTICIPANTS 20 patients (34-75 years of age) were included in the study; 12 received first-line chemotherapy and 8 received second-line chemotherapy. Eleven patients were treated by oncologists, and nine were treated by junior physicians. RESULTS Data-driven empirical analysis identified three themes: (1) inadequate information during the initial phase of the disease trajectory; (2) hope and information further into the disease trajectory and (3) personal, professional and organisational factors that influenced information and communication throughout the disease trajectory. CONCLUSION The participants' experience of being told for the first time that they had an incurable disease was perceived as inadequate, while postsurgery palliative chemotherapy, physicians and nurses offered hope. The participants preferred customised information about their treatment and likely future prospects and physicians and nurses who took a holistic and compassionate approach focusing on their lifeworld. To be a sensitive, holistic and compassionate physician or nurse requires knowledge and confidence. To achieve this requires training and guidance at universities and in hospitals.
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Affiliation(s)
- Gudrun Rohde
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
- Department of Clinical Research, Sorlandet Hospital, Kristiansand, Norway
| | - Ulrika Söderhamn
- Department of Health and Nursing Sciences, Faculty of Health and Sport Sciences, University of Agder, Centre for Caring Research–Southern Norway, Grimstad, Norway
| | - Ingvild Vistad
- Department of Obstetric and Gynaecology, Sorlandet Hospital Kristiansand, Kristiansand, Norway
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Hillesund ER, Bere E, Sagedal LR, Vistad I, Seiler HL, Torstveit MK, Øverby NC. Pre-pregnancy and early pregnancy dietary behavior in relation to maternal and newborn health in the Norwegian Fit for Delivery study - a post hoc observational analysis. Food Nutr Res 2018; 62:1273. [PMID: 30108471 PMCID: PMC6085578 DOI: 10.29219/fnr.v62.1273] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 07/18/2018] [Accepted: 07/19/2018] [Indexed: 12/16/2022] Open
Abstract
Background Randomized controlled trials targeting maternal dietary and physical activity behaviors during pregnancy have generally failed to accomplish reductions in the prevalence of adverse maternal and neonatal outcomes. Interventions carried out during pregnancy could thus be missing the mark in maximizing intervention health benefit. Objective To investigate whether pre-pregnancy and early pregnancy dietary behavior as reported at inclusion into the Norwegian Fit for Delivery (NFFD) trial was associated with maternal and neonatal outcomes irrespective of subsequent randomization assignment. Design The study is a post-hoc observational analysis of data from a randomized controlled lifestyle intervention. We constructed two diet scores from participant responses to a 43-item questionnaire that addressed dietary behavior in retrospect (pre-pregnancy diet score) and dietary behavior at inclusion (early pregnancy diet score), respectively. The diet scores ranged from 0 to 10, with higher score reflecting healthier dietary behavior. Associations between diet scores and maternal and neonatal health outcomes were estimated in multivariate logistic regression models. Results A total of 591 women were eligible for analysis. A one-point increase in pre-pregnancy diet score was associated with lower odds of excessive gestational weight gain (GWG) (odds ratio [OR]adj: 0.92; 95% confidence interval [CI]: 0.84-1.00, p = 0.050), preterm delivery (ORadj: 0.81; 95% CI: 0.68-0.97, p = 0.019), and birthweight ≥ 4,000 g (ORadj: 0.88; 95% CI: 0.78-0.99, p = 0.038). A one-point increase in early pregnancy diet score was associated with lower odds of excessive GWG (ORadj: 0.88; 95% CI: 0.79-0.97, p = 0.009), preterm delivery (ORadj: 0.82; 95% CI: 0.67-0.99, p = 0.038), and preeclampsia (ORadj: 0.78; 95% CI: 0.62-0.99, p = 0.038). Discussion Higher diet score either pre-pregnancy or in early pregnancy was protectively associated with excessive GWG and preterm delivery, whereas the protective association with high birthweight was confined to pre-pregnancy diet and with preeclampsia to early pregnancy diet. Conclusions Both pre-pregnancy and early pregnancy dietary behavior was associated with important maternal and neonatal health outcomes in the NFFD dataset.
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Affiliation(s)
- Elisabet R Hillesund
- Department of Public Health, Sports and Nutrition, University of Agder, Kristiansand, Norway
| | - Elling Bere
- Department of Public Health, Sports and Nutrition, University of Agder, Kristiansand, Norway
| | - Linda R Sagedal
- Department of Obstetrics and Gynecology, Sørlandet Hospital HF, Kristiansand, Norway.,Department of Research, Sørlandet Hospital HF, Kristiansand, Norway
| | - Ingvild Vistad
- Department of Obstetrics and Gynecology, Sørlandet Hospital HF, Kristiansand, Norway.,Department of Research, Sørlandet Hospital HF, Kristiansand, Norway
| | - Hilde L Seiler
- Department of Public Health, Sports and Nutrition, University of Agder, Kristiansand, Norway
| | - Monica K Torstveit
- Department of Public Health, Sports and Nutrition, University of Agder, Kristiansand, Norway
| | - Nina C Øverby
- Department of Public Health, Sports and Nutrition, University of Agder, Kristiansand, Norway
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30
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Fidjeland HL, Brekke M, Stokstad T, Vistad I. Gynecological cancer patients' attitudes toward follow-up care after cancer treatment: Do preferences reflect patients' experience? A cross-sectional questionnaire study. Acta Obstet Gynecol Scand 2018; 97:1325-1331. [PMID: 29893058 DOI: 10.1111/aogs.13396] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Accepted: 06/06/2018] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Due to an increasing number of cancer patients, new follow-up models are being debated, among them follow-up by general practitioners. Before changing surveillance, it is important to explore patients' views. The purpose of this study was to compare attitudes toward follow-up care among patients treated for gynecological cancer who had not yet started a follow-up regimen, with those who had been attending a hospital-based follow-up regimen for more than one year. MATERIAL AND METHODS We conducted a cross-sectional survey among gynecological cancer patients recruited from three Norwegian hospitals in 2013-2015: Sørlandet Hospital Kristiansand, Sørlandet Hospital Arendal and St. Olavs Hospital, Trondheim. RESULTS In all, 239 patients agreed to participate, 100 who had not yet started follow-up and 139 who had been attending more than one year of follow-up. Patients reported that they preferred to be followed up by a gynecologist rather than by their GP, whom they viewed as less competent for this purpose. However, patients who had not yet started follow-up were more willing to be followed up by a GP. Overall, patients rated detection of recurrence as the most important aspect of follow-up visits. CONCLUSIONS The gynecological cancer patients in our study preferred a hospital-based follow-up model. However, patients who had not yet started follow-up were more willing to be followed up by a GP. If follow-up is to be provided by GPs for selected patients, it is important that these patients are informed early of the value and limitations of follow-up visits, to ensure that they feel safe.
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Affiliation(s)
- Heidi L Fidjeland
- General Practice Research Unit (AFE), Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway.,Department of Obstetrics and Gynecology, Sørlandet Hospital Kristiansand, Kristiansand, Norway
| | - Mette Brekke
- General Practice Research Unit (AFE), Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Trine Stokstad
- Department of Clinical and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Gynecology, St. Olavs Hospital - Trondheim University Hospital, Trondheim, Norway
| | - Ingvild Vistad
- Department of Obstetrics and Gynecology, Sørlandet Hospital Kristiansand, Kristiansand, Norway
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31
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van Leeuwen M, Husson O, Alberti P, Arraras JI, Chinot OL, Costantini A, Darlington AS, Dirven L, Eichler M, Hammerlid EB, Holzner B, Johnson CD, Kontogianni M, Kjær TK, Morag O, Nolte S, Nordin A, Pace A, Pinto M, Polz K, Ramage J, Reijneveld JC, Serpentini S, Tomaszewski KA, Vassiliou V, Verdonck-de Leeuw IM, Vistad I, Young TE, Aaronson NK, van de Poll-Franse LV. Understanding the quality of life (QOL) issues in survivors of cancer: towards the development of an EORTC QOL cancer survivorship questionnaire. Health Qual Life Outcomes 2018; 16:114. [PMID: 29866185 PMCID: PMC5987570 DOI: 10.1186/s12955-018-0920-0] [Citation(s) in RCA: 108] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 04/30/2018] [Indexed: 11/12/2022] Open
Abstract
BACKROUND The number of cancer survivors is growing steadily and increasingly, clinical trials are being designed to include long-term follow-up to assess not only survival, but also late effects and health-related quality of life (HRQOL). Therefore it is is essential to develop patient-reported outcome measures (PROMs) that capture the full range of issues relevant to disease-free cancer survivors. The objectives of this project are: 1) to develop a European Organisation for Research and Treatment of Cancer (EORTC) questionnaire that captures the full range of physical, mental and social HRQOL issues relevant to disease-free cancer survivors; and 2) to determine at which minimal time since completion of treatment the questionnaire should be used. METHODS We reviewed 134 publications on cancer survivorship and interviewed 117 disease-free cancer survivors with 11 different types of cancer across 14 countries in Europe to generate an exhaustive, provisional list of HRQOL issues relevant to cancer survivors. The resulting issue list, the EORTC core questionnaire (QLQ-C30), and site-specific questionnaire modules were completed by a second group of 458 survivors. RESULTS We identified 116 generic survivorship issues. These issues covered body image, cognitive functioning, health behaviors, negative and positive outlook, health distress, mental health, fatigue, sleep problems, physical functioning, pain, several physical symptoms, social functioning, and sexual problems. Patients rated most of the acute symptoms of cancer and its treatment (e.g. nausea) as no longer relevant approximately one year after completion of treatment. CONCLUSIONS Compared to existing cancer survivorship questionnaires, our findings underscore the relevance of assessing issues related to chronic physical side effects of treatment such as neuropathy and joint pain. We will further develop a core survivorship questionnaire and three site-specific modules for disease-free adult cancer survivors who are at least one year post-treatment.
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Affiliation(s)
- Marieke van Leeuwen
- Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
| | - Olga Husson
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Paola Alberti
- Experimental Neurology Unit, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
- Milan Center for Neuroscience, Milan, Italy
| | | | - Olivier L Chinot
- Pôle Neurosciences Cliniques, Service de Neuro-Oncologie, Aix-Marseille Université, Marseille, France
| | - Anna Costantini
- Departmental Psychoncology Unit, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | | | - Linda Dirven
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Neurology, Haaglanden Medical Center, The Hague, the Netherlands
| | - Martin Eichler
- Division of Epidemiology and Health Services Research at Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), Mainz, Germany
| | - Eva B Hammerlid
- Department of Otolaryngology Head and Neck Surgery, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Bernhard Holzner
- Department of Psychiatry and Psychotheraphy, Division of Psychooncology, Innsbruck Medical University, Innsbruck, Austria
| | - Colin D Johnson
- University Surgical Unit, University Hospitals Southampton, Southampton, UK
| | - Meropi Kontogianni
- Department of Nutrition & Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Trille Kristina Kjær
- Unit of Survivorship Research, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Ofir Morag
- Oncology Institute, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Sandra Nolte
- Department of Psychosomatic Medicine Center for Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Andrew Nordin
- East Kent Gynaecological Oncology Centre, Margate, UK
| | - Andrea Pace
- Neuroncology Unit, National Cancer Institute Regina Elena, Rome, Italy
| | - Monica Pinto
- Rehabilitation Unit, Department of Supportive Care, Istituto Nazionale Tumori - IRCCS- Fondazione G. Pascale, Naples, Italy
| | - Katja Polz
- Evangelische Kliniken Gelsenkirchen, Gelsenkirchen, Germany
| | - John Ramage
- Department of Gastroenterology and Hepatology, Hampshire Hospitals NHS Foundation Trust, Basingstoke, UK
| | - Jaap C Reijneveld
- Department of Neurology and Brain Tumor Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Samantha Serpentini
- Unit of Psychoncology - Breast Unit, Istituto Oncologico Veneto (IOV)-IRCCS, Padua, Italy
| | - Krzysztof A Tomaszewski
- Health Outcomes Research Unit, Department of Geriatrics, Gerontology, and Social Work, Faculty of Education, Ignatianum Academy, Krakow, Poland
| | - Vassilios Vassiliou
- Department of Radiation Oncology, Bank of Cyprus Oncology Centre, Nicosia, Cyprus
| | - Irma M Verdonck-de Leeuw
- Department of Otolaryngology / Head & Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands
| | - Ingvild Vistad
- Department of Gynecology and Obstetrics, Sorlandet Hospital Kristiansand, Kristiansand, Norway
| | - Teresa E Young
- Lynda Jackson Macmillan Centre, East & North Hertfordshire NHS Trust including Mount Vernon Cancer Centre, Northwood, UK
| | - Neil K Aaronson
- Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Lonneke V van de Poll-Franse
- Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Comprehensive Cancer Centre South (CCCS), Eindhoven Cancer Registry, Eindhoven, The Netherlands
- Tilburg University, Tilburg, The Netherlands
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32
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Rogozińska E, Marlin N, Jackson L, Rayanagoudar G, Ruifrok AE, Dodds J, Molyneaux E, van Poppel MN, Poston L, Vinter CA, McAuliffe F, Dodd JM, Owens J, Barakat R, Perales M, Cecatti JG, Surita F, Yeo S, Bogaerts A, Devlieger R, Teede H, Harrison C, Haakstad L, Shen GX, Shub A, Beltagy NE, Motahari N, Khoury J, Tonstad S, Luoto R, Kinnunen TI, Guelfi K, Facchinetti F, Petrella E, Phelan S, Scudeller TT, Rauh K, Hauner H, Renault K, de Groot CJ, Sagedal LR, Vistad I, Stafne SN, Mørkved S, Salvesen KÅ, Jensen DM, Vitolo M, Astrup A, Geiker NR, Kerry S, Barton P, Roberts T, Riley RD, Coomarasamy A, Mol BW, Khan KS, Thangaratinam S. Effects of antenatal diet and physical activity on maternal and fetal outcomes: individual patient data meta-analysis and health economic evaluation. Health Technol Assess 2018; 21:1-158. [PMID: 28795682 DOI: 10.3310/hta21410] [Citation(s) in RCA: 178] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Diet- and physical activity-based interventions in pregnancy have the potential to alter maternal and child outcomes. OBJECTIVES To assess whether or not the effects of diet and lifestyle interventions vary in subgroups of women, based on maternal body mass index (BMI), age, parity, Caucasian ethnicity and underlying medical condition(s), by undertaking an individual patient data (IPD) meta-analysis. We also evaluated the association of gestational weight gain (GWG) with adverse pregnancy outcomes and assessed the cost-effectiveness of the interventions. DATA SOURCES MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Database of Abstracts of Reviews of Effects and Health Technology Assessment database were searched from October 2013 to March 2015 (to update a previous search). REVIEW METHODS Researchers from the International Weight Management in Pregnancy Collaborative Network shared the primary data. For each intervention type and outcome, we performed a two-step IPD random-effects meta-analysis, for all women (except underweight) combined and for each subgroup of interest, to obtain summary estimates of effects and 95% confidence intervals (CIs), and synthesised the differences in effects between subgroups. In the first stage, we fitted a linear regression adjusted for baseline (for continuous outcomes) or a logistic regression model (for binary outcomes) in each study separately; estimates were combined across studies using random-effects meta-analysis models. We quantified the relationship between weight gain and complications, and undertook a decision-analytic model-based economic evaluation to assess the cost-effectiveness of the interventions. RESULTS Diet and lifestyle interventions reduced GWG by an average of 0.70 kg (95% CI -0.92 to -0.48 kg; 33 studies, 9320 women). The effects on composite maternal outcome [summary odds ratio (OR) 0.90, 95% CI 0.79 to 1.03; 24 studies, 8852 women] and composite fetal/neonatal outcome (summary OR 0.94, 95% CI 0.83 to 1.08; 18 studies, 7981 women) were not significant. The effect did not vary with baseline BMI, age, ethnicity, parity or underlying medical conditions for GWG, and composite maternal and fetal outcomes. Lifestyle interventions reduce Caesarean sections (OR 0.91, 95% CI 0.83 to 0.99), but not other individual maternal outcomes such as gestational diabetes mellitus (OR 0.89, 95% CI 0.72 to 1.10), pre-eclampsia or pregnancy-induced hypertension (OR 0.95, 95% CI 0.78 to 1.16) and preterm birth (OR 0.94, 95% CI 0.78 to 1.13). There was no significant effect on fetal outcomes. The interventions were not cost-effective. GWG, including adherence to the Institute of Medicine-recommended targets, was not associated with a reduction in complications. Predictors of GWG were maternal age (summary estimate -0.10 kg, 95% CI -0.14 to -0.06 kg) and multiparity (summary estimate -0.73 kg, 95% CI -1.24 to -0.23 kg). LIMITATIONS The findings were limited by the lack of standardisation in the components of intervention, residual heterogeneity in effects across studies for most analyses and the unavailability of IPD in some studies. CONCLUSION Diet and lifestyle interventions in pregnancy are clinically effective in reducing GWG irrespective of risk factors, with no effects on composite maternal and fetal outcomes. FUTURE WORK The differential effects of lifestyle interventions on individual pregnancy outcomes need evaluation. STUDY REGISTRATION This study is registered as PROSPERO CRD42013003804. FUNDING The National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
- Ewelina Rogozińska
- Women's Health Research Unit, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,Multidisciplinary Evidence Synthesis Hub, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Nadine Marlin
- Pragmatic Clinical Trials Unit, Blizard Institute, Barts and the London School of Medicine and Dentistry, London, UK
| | - Louise Jackson
- Health Economics Unit, School of Health and Population Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Girish Rayanagoudar
- Women's Health Research Unit, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Anneloes E Ruifrok
- Department of Obstetrics and Gynecology, Academic Medical Centre, Amsterdam, the Netherlands.,Department of Obstetrics and Gynaecology, Faculty of Medicine, VU University Medical Center, Amsterdam, the Netherlands
| | - Julie Dodds
- Women's Health Research Unit, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Emma Molyneaux
- Section of Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, King's College London, London, UK
| | - Mireille Nm van Poppel
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research (EMGO+), VU University Medical Center, Amsterdam, the Netherlands.,Institute of Sport Science, University of Graz, Graz, Austria
| | - Lucilla Poston
- Division of Women's Health, Women's Health Academic Centre, King's College London, St Thomas' Hospital, London, UK
| | - Christina A Vinter
- Department of Obstetrics and Gynecology, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Fionnuala McAuliffe
- School of Medicine & Medical Science, UCD Institute of Food and Health, Dublin, Ireland
| | - Jodie M Dodd
- The Robinson Research Institute, School of Medicine, Department of Obstetrics & Gynaecology, University of Adelaide, SA, Australia.,Women's and Children's Health Network, Women's and Babies Division, North Adelaide, SA, Australia
| | - Julie Owens
- The Robinson Research Institute, School of Medicine, Department of Obstetrics & Gynaecology, University of Adelaide, SA, Australia
| | - Ruben Barakat
- Facultad de Ciencias de la Actividad Física y del Deporte, Universidad Politecnica de Madrid, Madrid, Spain
| | - Maria Perales
- Facultad de Ciencias de la Actividad Física y del Deporte, Universidad Politecnica de Madrid, Madrid, Spain
| | - Jose G Cecatti
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Fernanda Surita
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, Brazil
| | - SeonAe Yeo
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Annick Bogaerts
- Research Unit Healthy Living, University Colleges Leuven-Limburg, Leuven, Belgium.,Centre for Research and Innovation in Care, University of Antwerp, Antwerp, Belgium
| | - Roland Devlieger
- Division of Mother and Child, Department of Obstetrics and Gynaecology, University Colleges Leuven-Limburg, Hasselt and University Hospitals KU Leuven, Leuven, Belgium
| | - Helena Teede
- Monash Centre for Health Research and Implementation, School of Public Health, Monash University, Melbourne, VIC, Australia
| | - Cheryce Harrison
- Monash Centre for Health Research and Implementation, School of Public Health, Monash University, Melbourne, VIC, Australia
| | - Lene Haakstad
- Norwegian School of Sport Sciences, Department of Sports Medicine, Oslo, Norway
| | - Garry X Shen
- Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Alexis Shub
- Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, VIC, Australia
| | - Nermeen El Beltagy
- Department of Obstetrics and Gynecology, Alexandria University, Alexandria, Egypt
| | - Narges Motahari
- Department of Sport Physiology, Faculty of Physical Education and Sport Sciences, Mazandaran University, Babolsar, Iran
| | - Janette Khoury
- Department of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway
| | - Serena Tonstad
- Department of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway
| | - Riitta Luoto
- UKK Institute for Health Promotion Research, Tampere, Finland
| | - Tarja I Kinnunen
- School of Health Sciences, University of Tampere, Tampere, Finland
| | - Kym Guelfi
- School of Sport Science, Exercise and Health, University of Western Australia, Perth, WA, Australia
| | - Fabio Facchinetti
- Mother-Infant Department, University of Modena and Reggio Emilia, Modena, Italy
| | - Elisabetta Petrella
- Mother-Infant Department, University of Modena and Reggio Emilia, Modena, Italy
| | - Suzanne Phelan
- Kinesiology Department, California Polytechnic State University, San Luis Obispo, CA, USA
| | - Tânia T Scudeller
- Department of Management and Health Care, São Paulo Federal University, Santos, Brazil
| | - Kathrin Rauh
- Else Kröner-Fresenius-Center for Nutritional Medicine, Technische Universität München, Munich, Germany.,Competence Centre for Nutrition, Freising, Germany
| | - Hans Hauner
- Else Kröner-Fresenius-Center for Nutritional Medicine, Technische Universität München, Munich, Germany
| | - Kristina Renault
- Department of Obstetrics and Gynecology, Odense University Hospital, University of Southern Denmark, Odense, Denmark.,Departments of Obstetrics and Gynecology, Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Christianne Jm de Groot
- Department of Obstetrics and Gynaecology, Faculty of Medicine, VU University Medical Center, Amsterdam, the Netherlands
| | - Linda R Sagedal
- Department of Obstetrics and Gynecology, Sorlandet Hospital Kristiansand, Kristiansand, Norway
| | - Ingvild Vistad
- Department of Obstetrics and Gynecology, Sorlandet Hospital Kristiansand, Kristiansand, Norway
| | - Signe Nilssen Stafne
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Clinical Services, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Siv Mørkved
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Clinical Services, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Kjell Å Salvesen
- Department of Obstetrics and Gynaecology, Clinical Sciences, Lund University, Lund, Sweden.,Department of Laboratory Medicine Children's and Women's Health, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Dorte M Jensen
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
| | - Márcia Vitolo
- Department of Nutrition and the Graduate Program in Health Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Arne Astrup
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Nina Rw Geiker
- Nutritional Research Unit, Copenhagen University Hospital Herlev, Copenhagen, Denmark
| | - Sally Kerry
- Pragmatic Clinical Trials Unit, Blizard Institute, Barts and the London School of Medicine and Dentistry, London, UK
| | - Pelham Barton
- Health Economics Unit, School of Health and Population Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Tracy Roberts
- Health Economics Unit, School of Health and Population Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Richard D Riley
- Research Institute for Primary Care and Health Sciences, Keele University, Keele, UK
| | - Arri Coomarasamy
- School of Clinical and Experimental Medicine, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Ben Willem Mol
- The South Australian Health and Medical Research Institute, Adelaide, SA, Australia
| | - Khalid S Khan
- Women's Health Research Unit, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,Multidisciplinary Evidence Synthesis Hub, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Shakila Thangaratinam
- Women's Health Research Unit, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,Multidisciplinary Evidence Synthesis Hub, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Sanda B, Vistad I, Sagedal LR, Haakstad LA, Lohne-Seiler H, Torstveit MK. What is the effect of physical activity on duration and mode of delivery? Secondary analysis from the Norwegian Fit for Delivery trial. Acta Obstet Gynecol Scand 2018; 97:861-871. [DOI: 10.1111/aogs.13351] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 03/20/2018] [Indexed: 01/26/2023]
Affiliation(s)
- Birgitte Sanda
- Faculty of Health and Sport Sciences; University of Agder; Kristiansand Norway
- Department of Obstetrics and Gynecology; Southern Norway Hospital Trust; Kristiansand Norway
| | - Ingvild Vistad
- Department of Obstetrics and Gynecology; Southern Norway Hospital Trust; Kristiansand Norway
| | - Linda R. Sagedal
- Department of Obstetrics and Gynecology; Southern Norway Hospital Trust; Kristiansand Norway
| | | | - Hilde Lohne-Seiler
- Faculty of Health and Sport Sciences; University of Agder; Kristiansand Norway
| | - Monica K. Torstveit
- Faculty of Health and Sport Sciences; University of Agder; Kristiansand Norway
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Hillesund ER, Seland S, Bere E, Sagedal LR, Torstveit MK, Lohne-Seiler H, Vistad I, Øverby NC. Preeclampsia and gestational weight gain in the Norwegian Fit for Delivery trial. BMC Res Notes 2018; 11:282. [PMID: 29739447 PMCID: PMC5941786 DOI: 10.1186/s13104-018-3396-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 05/03/2018] [Indexed: 11/30/2022] Open
Abstract
Objective Excessive gestational weight gain is linked to risk of preeclampsia, but it is not clear whether the association is causal. The purpose of this paper was to examine gestational weight gain in the Norwegian Fit for Delivery study among women who developed preeclampsia compared to those who did not, and to further explore associations between weight gain and preeclampsia by including data on body composition (bioimpedance) assessed in the last trimester of pregnancy. Results A total of 550 women were eligible for the study. Women who developed preeclampsia gained more weight than women who did not (difference 3.7 kg, p = 0.004), with a 3.5 kg difference in total body water observed in week 36 (p = 0.040). Adjusted for age, education, pre-pregnancy body mass index (BMI), randomization, and fat mass, a one kg increase in GWG was associated with 1.3 times higher odds of preeclampsia (OR: 1.31, 95% CI 1.15–1.49, p < 0.001). An independent inverse association between fat mass in week 36 and odds of preeclampsia was observed (OR: 0.79, 95% CI 0.68–0.92, p = 0.002). Given the observed difference in total body water, these findings point to excess fluid as the component driving the association between gestational weight gain and preeclampsia in the present study. Trial registration The NFFD trial has the Clinical Trials registration: clinicaltrial.gov NCT0100168
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Affiliation(s)
- E R Hillesund
- Department of Public Health, Sport and Nutrition, University of Agder, Serviceboks 422, 4604, Kristiansand, Norway.
| | - S Seland
- Department of Public Health, Sport and Nutrition, University of Agder, Serviceboks 422, 4604, Kristiansand, Norway.,Department of Obstetrics and Gynecology, Sørlandet Hospital HF, Serviceboks 416, 4604, Kristiansand, Norway
| | - E Bere
- Department of Public Health, Sport and Nutrition, University of Agder, Serviceboks 422, 4604, Kristiansand, Norway
| | - L R Sagedal
- Department of Obstetrics and Gynecology, Sørlandet Hospital HF, Serviceboks 416, 4604, Kristiansand, Norway.,Department of Research, Sørlandet Hospital HF, Serviceboks 416, 4604, Kristiansand, Norway
| | - M K Torstveit
- Department of Public Health, Sport and Nutrition, University of Agder, Serviceboks 422, 4604, Kristiansand, Norway
| | - H Lohne-Seiler
- Department of Public Health, Sport and Nutrition, University of Agder, Serviceboks 422, 4604, Kristiansand, Norway
| | - I Vistad
- Department of Obstetrics and Gynecology, Sørlandet Hospital HF, Serviceboks 416, 4604, Kristiansand, Norway.,Department of Research, Sørlandet Hospital HF, Serviceboks 416, 4604, Kristiansand, Norway
| | - N C Øverby
- Department of Public Health, Sport and Nutrition, University of Agder, Serviceboks 422, 4604, Kristiansand, Norway
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Sanda B, Vistad I, Sagedal LR, Haakstad LAH, Lohne-Seiler H, Torstveit MK. Effect of a prenatal lifestyle intervention on physical activity level in late pregnancy and the first year postpartum. PLoS One 2017; 12:e0188102. [PMID: 29176762 PMCID: PMC5703566 DOI: 10.1371/journal.pone.0188102] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 10/26/2017] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Despite documented health benefits for mother and baby, physical activity (PA)-level tends to decline in pregnancy. Overweight/obese and physically inactive women are two selected groups at increased risk of pregnancy complications. Thus, efficient strategies to maintain or increase PA-level in pregnancy and the postpartum period, especially among these women, are warranted. This secondary analysis examined the effect of a prenatal lifestyle-intervention on PA-level in late pregnancy and the first year postpartum, with subanalysis on initially physically active versus inactive and normal-weight versus overweight/obese women. METHOD The Norwegian Fit for Delivery (NFFD) randomized controlled trial included healthy primiparous women with singleton pregnancies and body mass index (BMI) ≥19 kg/m2 assigned to an intervention group, n = 303 (twice weekly group-exercises and dietary counseling) or a control group, n = 303 (standard prenatal care). The International Physical Activity Questionnaire short-form was used to assess PA-levels at inclusion (mean gestational week (GW) 16), GW 36, and six and 12 months postpartum. RESULTS At GW 36, a positive intervention-effect with a significant between-group difference in total PA-level compared to time of inclusion was found for the total group (530 MET-min/week, p = 0.001) and the subgroups of normal-weight (533 MET-min/week, p = 0.003) and initially active women (717 MET-min/week, p<0.001). Intervention-effect was dependent on exercise-adherence among overweight/obese and inactive women. Compared to time of inclusion, the intervention groups maintained total PA-level at GW 36, while total PA-level decreased in the control groups. The PA-levels increased postpartum, but with no significant differences between the randomization groups. CONCLUSION The NFFD prenatal combined lifestyle intervention had a significant effect on TPA-level in late pregnancy among women entering pregnancy normal-weight or physically active, thereby preventing the downward trend typically seen during pregnancy. Intervention-effect among overweight/obese and physically inactive women was, however, dependent on exercise-adherence. Long-term intervention-effect was not observed in the postpartum period.
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Affiliation(s)
- Birgitte Sanda
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
- Department of Obstetrics and Gynecology, Southern Norway Hospital Trust, Kristiansand, Norway
| | - Ingvild Vistad
- Department of Obstetrics and Gynecology, Southern Norway Hospital Trust, Kristiansand, Norway
| | - Linda Reme Sagedal
- Department of Obstetrics and Gynecology, Southern Norway Hospital Trust, Kristiansand, Norway
| | | | - Hilde Lohne-Seiler
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
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36
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Vistad I, Bjørge L, Solheim O, Fiane B, Sachse K, Tjugum J, Skrøppa S, Bentzen AG, Stokstad T, Iversen GA, Salvesen HB, Kristensen GB, Dørum A. A national, prospective observational study of first recurrence after primary treatment for gynecological cancer in Norway. Acta Obstet Gynecol Scand 2017; 96:1162-1169. [PMID: 28795770 DOI: 10.1111/aogs.13199] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 07/23/2017] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Gynecological cancer patients are routinely followed up for five years after primary treatment. However, the value of such follow up has been debated, as retrospective studies indicate that first recurrence is often symptomatic and occurs within two to three years of primary treatment. We prospectively investigated time to first recurrence, symptoms at recurrence, diagnostic procedures, and recurrence treatment in gynecological cancer patients after primary curative treatment. MATERIAL AND METHODS Clinicians from 21 hospitals in Norway interviewed 680 patients with first recurrence of gynecological cancer (409 ovarian, 213 uterine, and 58 cervical cancer patients) between 2012 and 2016. A standardized questionnaire was used to collect information on self-reported and clinical variables. RESULTS Within two years of primary treatment, 72% of ovarian, 64% of uterine, and 66% of cervical cancer patients were diagnosed with first recurrence, and 54, 67, and 72%, respectively, had symptomatic recurrence. Of symptomatic patients, 25-50% failed to make an appointment before their next scheduled follow-up visit. Computer tomography was the most common diagnostic procedure (89% of ovarian, 76% of uterine, and 62% of cervical cancer patients), and recurrence treatment in terms of chemotherapy was most frequently planned (86% of ovarian, 46% of uterine, and 62% of cervical cancer patients). CONCLUSIONS A majority of patients experienced symptomatic recurrence, but many patients failed to make an appointment earlier than scheduled. Most first recurrences occurred within two years of primary treatment; the mean annual incidence rate for years 3-5 after primary treatment was <7%. New models for follow up of gynecological cancer patients could be considered.
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Affiliation(s)
- Ingvild Vistad
- Department of Obstetrics and Gynecology, Sørlandet Hospital, Kristiansand, Norway
| | - Line Bjørge
- Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway.,Departments of Global Public Health and Primary Care and Clinical Medicine, Haukeland University Hospital, Bergen, Norway.,Centre for Cancer Biomarkers, University of Bergen, Bergen, Norway
| | - Olesya Solheim
- Department of Gynecologic Oncology, Oslo University Hospital, Norwegian Radium Hospital, Oslo, Norway
| | - Bent Fiane
- Department of Obstetrics and Gynecology, Stavanger University Hospital, Stavanger, Norway
| | - Kurt Sachse
- Department of Obstetrics and Gynecology, Akershus University Hospital, Lørenskog, Norway
| | - Jostein Tjugum
- Department of Obstetrics and Gynecology, Førde Central Hospital, Førde, Norway
| | - Siri Skrøppa
- Department of Obstetrics and Gynecology, Vestfold Hospital Trust, Tønsberg, Norway
| | - Anne G Bentzen
- Department of Gynecologic Oncology, University Hospital of Tromsø, Tromsø, Norway
| | - Trine Stokstad
- Department of Obstetrics and Gynecology, St. Olav's University Hospital, Trondheim, Norway
| | - Grete A Iversen
- Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway
| | - Helga B Salvesen
- Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway
| | - Gunnar B Kristensen
- Department of Gynecologic Oncology, Oslo University Hospital, Norwegian Radium Hospital, Oslo, Norway.,Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo, Norway
| | - Anne Dørum
- Department of Gynecologic Oncology, Oslo University Hospital, Norwegian Radium Hospital, Oslo, Norway
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Rohde G, Kersten C, Vistad I, Mesel T. Spiritual Well-being in Patients With Metastatic Colorectal Cancer Receiving Noncurative Chemotherapy: A Qualitative Study. Cancer Nurs 2017; 40:209-216. [PMID: 27101099 PMCID: PMC5402710 DOI: 10.1097/ncc.0000000000000385] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2016] [Indexed: 12/04/2022]
Abstract
BACKGROUND Spiritual well-being (SWB) is an important quality-of-life dimension for cancer patients in the palliative phase. Therefore, it is important for healthcare professionals to recognize the concept of SWB from the patient's point of view. A deeper understanding of how patients experience and reflect upon these issues might influence patient care. OBJECTIVES The aim of this study was to explore SWB in colorectal cancer patients receiving chemotherapy in the palliative phase. METHODS We used a qualitative method of in-depth interviews and a hermeneutic editing approach for the analyses and interpretations. RESULTS Twenty colorectal cancer patients in the palliative phase, aged 34 to 75 years, were included: 12 patients were receiving first-line chemotherapy, and 8 patients were receiving second-line chemotherapy. Through empirical analyses, we identified subthemes according to the SWB dimensions defined by the European Organisation for Research and Treatment of Cancer quality-of-life group. Under the SWB dimension, (i) relationships with self and others, we identified the subthemes: (a) strategies for inner harmony and (b) sharing feelings with significant others. Under the dimension, (ii) existential issues, we identified the subtheme (c) coping with end-of-life thoughts. Under the dimension, (iii) specifically religious and/or spiritual beliefs and practices, we identified the subtheme (d) seeking faith as inner support. CONCLUSION Knowledge about cancer patients' use of different strategies to increase their SWB may help healthcare professionals to guide patients through this vulnerable phase. IMPLICATION FOR PRACTICE Healthcare professionals need sufficient courage and willingness to share their patients' thoughts, beliefs, and grief to be able to guide patients toward improving their SWB.
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Affiliation(s)
- Gudrun Rohde
- Author Affiliations: Faculty of Health and Sport Sciences, University of Agder (Dr Rohde); Department of Clinical Research (Dr Rohde), Center for Cancer Treatment (Dr Kersten), and Department of Obstetrics and Gynecology (Dr Vistad), Sorlandet Hospital HF; and Department of Religion, Philosophy, and History, University of Agder (Dr Mesel), Kristiansand, Norway
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Abstract
OBJECTIVES Internationally, the 10-Group Classification System (TGCS) has been used to report caesarean section rates, but analysis of other outcomes is also recommended. We now aim to present the TGCS as a method to assess outcomes of labour and delivery using routine collection of perinatal information. DESIGN This research is a methodological study to describe the use of the TGCS. SETTING Stavanger University Hospital (SUH), Norway, National Maternity Hospital Dublin, Ireland and Slovenian National Perinatal Database (SLO), Slovenia. PARTICIPANTS 9848 women from SUH, Norway, 9250 women from National Maternity Hospital Dublin, Ireland and 106 167 women, from SLO, Slovenia. MAIN OUTCOME MEASURES All women were classified according to the TGCS within which caesarean section, oxytocin augmentation, epidural analgesia, operative vaginal deliveries, episiotomy, sphincter rupture, postpartum haemorrhage, blood transfusion, maternal age >35 years, body mass index >30, Apgar score, umbilical cord pH, hypoxic-ischaemic encephalopathy, antepartum and perinatal deaths were incorporated. RESULTS There were significant differences in the sizes of the groups of women and the incidences of events and outcomes within the TGCS between the three perinatal databases. CONCLUSIONS The TGCS is a standardised objective classification system where events and outcomes of labour and delivery can be incorporated. Obstetric core events and outcomes should be agreed and defined to set standards of care. This method provides continuous and available observations from delivery wards, possibly used for further interpretation, questions and international comparisons. The definition of quality may vary in different units and can only be ascertained when all the necessary information is available and considered together.
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Affiliation(s)
- Janne Rossen
- Department of Obstetrics and Gynecology, Sørlandet Hospital HF Kristiansand, Kristiansand, Norway
- Department of Laboratory Medicine, Children’s and Women’s Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Miha Lucovnik
- Department of Perinatology, Division of Obstetrics and Gynecology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Torbjørn Moe Eggebø
- Department of Laboratory Medicine, Children’s and Women’s Health, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Obstetrics and Gynecology, Stavanger University Hospital, Stavanger, Norway
- National Center for Fetal Medicine, Trondheim University Hospital, St Olavs Hospital, Trondheim, Norway
| | - Natasa Tul
- Department of Perinatology, Division of Obstetrics and Gynecology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | | | - Ingvild Vistad
- Department of Obstetrics and Gynecology, Sørlandet Hospital HF Kristiansand, Kristiansand, Norway
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Sagedal LR, Vistad I, Øverby NC, Bere E, Torstveit MK, Lohne-Seiler H, Hillesund ER, Pripp A, Henriksen T. The effect of a prenatal lifestyle intervention on glucose metabolism: results of the Norwegian Fit for Delivery randomized controlled trial. BMC Pregnancy Childbirth 2017; 17:167. [PMID: 28577545 PMCID: PMC5457543 DOI: 10.1186/s12884-017-1340-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 05/23/2017] [Indexed: 12/03/2022] Open
Abstract
Background The effectiveness of prenatal lifestyle intervention to prevent gestational diabetes and improve maternal glucose metabolism remains to be established. The Norwegian Fit for Delivery (NFFD) randomized, controlled trial studied the effect of a combined lifestyle intervention provided to a general population, and found significantly lower gestational weight gain among intervention participants but no improvement in obstetrical outcomes or the proportion of large infants. The aim of the present study is to examine the effect of the NFFD intervention on glucose metabolism, including an assessment of the subgroups of normal-weight and overweight/obese participants. Methods Healthy, non-diabetic women expecting their first child, with pre-pregnancy body mass index (BMI) ≥19 kg/m2, age ≥ 18 years and a singleton pregnancy of ≤20 gestational-weeks were enrolled from healthcare clinics in southern Norway. Gestational weight gain was the primary endpoint. Participants (n = 606) were individually randomized to intervention (two dietary consultations and access to twice-weekly exercise groups) or control group (routine prenatal care). The effect of intervention on glucose metabolism was a secondary endpoint, measuring glucose (fasting and 2-h following 75-g glucose load), insulin, homeostatic assessment of insulin resistance (HOMA-IR) and leptin levels at gestational-week 30. Results Blood samples from 557 (91.9%) women were analyzed. For the total group, intervention resulted in reduced insulin (adj. Mean diff −0.91 mU/l, p = 0.045) and leptin levels (adj. Mean diff -207 pmol/l, p = 0.021) compared to routine care, while glucose levels were unchanged. However, the effect of intervention on both fasting and 2-h glucose was modified by pre-pregnancy BMI (interaction p = 0.030 and p = 0.039, respectively). For overweight/obese women (n = 158), intervention was associated with increased risk of at least one glucose measurement exceeding International Association of Pregnancy and Diabetes Study Group thresholds (33.7% vs. 13.9%, adj. OR 3.89, p = 0.004). Conclusions The Norwegian Fit for Delivery intervention lowered neither glucose levels nor GDM incidence, despite reductions in insulin and leptin. Prenatal combined lifestyle interventions designed for a general population may be unsuited to reduce GDM risk, particularly among overweight/obese women, who may require earlier and more targeted interventions. Trial registration ClinicalTrials.gov ID NCT01001689, registered July 2, 2009, confirmed completed October 26, 2009 (retrospectively registered).
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Affiliation(s)
- Linda R Sagedal
- Department of Obstetrics and Gynecology/Department of Research, Sørlandet Hospital, Postbox 416, 4604, Kristiansand, Norway.
| | - Ingvild Vistad
- Department of Obstetrics and Gynecology/Department of Research, Sørlandet Hospital, Postbox 416, 4604, Kristiansand, Norway
| | - Nina C Øverby
- Department of Public Health, Sports and Nutrition, University of Agder, Postbox 422, 4604, Kristiansand, Norway
| | - Elling Bere
- Department of Public Health, Sports and Nutrition, University of Agder, Postbox 422, 4604, Kristiansand, Norway
| | - Monica K Torstveit
- Department of Public Health, Sports and Nutrition, University of Agder, Postbox 422, 4604, Kristiansand, Norway
| | - Hilde Lohne-Seiler
- Department of Public Health, Sports and Nutrition, University of Agder, Postbox 422, 4604, Kristiansand, Norway
| | - Elisabet R Hillesund
- Department of Public Health, Sports and Nutrition, University of Agder, Postbox 422, 4604, Kristiansand, Norway
| | - Are Pripp
- Department of Biostatistics and Epidemiology, Oslo University Hospital, Postbox 4950, Nydalen, 0424, Oslo, Norway
| | - Tore Henriksen
- Section of Obstetrics, Women and Children's Division, Oslo University Hospital and University of Oslo, Postbox 4950, Nydalen, 0424, Oslo, Norway
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40
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Skreden M, Bere E, Sagedal LR, Vistad I, Øverby NC. Changes in fruit and vegetable consumption habits from pre-pregnancy to early pregnancy among Norwegian women. BMC Pregnancy Childbirth 2017; 17:107. [PMID: 28376732 PMCID: PMC5381088 DOI: 10.1186/s12884-017-1291-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 03/24/2017] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND A healthy diet is important for pregnancy outcome and the current and future health of woman and child. The aims of the study were to explore the changes from pre-pregnancy to early pregnancy in consumption of fruits and vegetables (FV), and to describe associations with maternal educational level, body mass index (BMI) and age. METHODS Healthy nulliparous women were included in the Norwegian Fit for Delivery (NFFD) trial from September 2009 to February 2013, recruited from eight antenatal clinics in southern Norway. At inclusion, in median gestational week 15 (range 9-20), 575 participants answered a food frequency questionnaire (FFQ) where they reported consumption of FV, both current intake and recollection of pre-pregnancy intake. Data were analysed using a linear mixed model. RESULTS The percentage of women consuming FV daily or more frequently in the following categories increased from pre-pregnancy to early pregnancy: vegetables on sandwiches (13 vs. 17%, p <0.01), other vegetables (11 vs. 14%, p = 0.01), fruits (apples, pears, oranges or bananas) (24 vs. 41%, p < 0.01), other fruits and berries (8 vs. 15%, p < 0.01) and fruits and vegetables as snacks (14 vs. 28%, p < 0.01). The percentage of women who reported at least daily consumption of vegetables with dinner (22% at both time points) was stable. A higher proportion of older women increased their consumption of vegetables and fruits as snacks from pre-pregnancy to early pregnancy compared to younger women (p=0.04). CONCLUSIONS We found an increase in the proportion of women consuming FV daily or more frequently from pre-pregnancy to early pregnancy. TRIAL REGISTRATION ClinicalTrials.gov database, NCT01001689 . https://clinicaltrials.gov/ct2/show/NCT01001689?term=NCT01001689&rank=1 .
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Affiliation(s)
- Marianne Skreden
- Department of Public Health, Sports and Nutrition, University of Agder, PO Box 422, 4604, Kristiansand, Norway.
| | - Elling Bere
- Department of Public Health, Sports and Nutrition, University of Agder, PO Box 422, 4604, Kristiansand, Norway
| | - Linda R Sagedal
- Department of Obstetrics and Gynaecology, Sørlandet Hospital HF, PO Box 416, 4604, Kristiansand, Norway.,Department of Research, Sørlandet Hospital HF, PO Box 416, 4604, Kristiansand, Norway
| | - Ingvild Vistad
- Department of Obstetrics and Gynaecology, Sørlandet Hospital HF, PO Box 416, 4604, Kristiansand, Norway.,Department of Research, Sørlandet Hospital HF, PO Box 416, 4604, Kristiansand, Norway
| | - Nina C Øverby
- Department of Public Health, Sports and Nutrition, University of Agder, PO Box 422, 4604, Kristiansand, Norway
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Sanda B, Vistad I, Haakstad LAH, Berntsen S, Sagedal LR, Lohne-Seiler H, Torstveit MK. Reliability and concurrent validity of the International Physical Activity Questionnaire short form among pregnant women. BMC Sports Sci Med Rehabil 2017; 9:7. [PMID: 28316789 PMCID: PMC5351171 DOI: 10.1186/s13102-017-0070-4] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 02/17/2017] [Indexed: 11/23/2022]
Abstract
ABSTRACT Sanda B, Vistad I, Haakstad LAH, Berntsen S, Sagedal LR, Lohne-Seiler H, Torstveit MK. Reliability and concurrent validity of the International Physical Activity Questionnaire short form among pregnant women. BACKGROUND The International Physical Activity Questionnaire short-form (IPAQ-SF) is frequently used to assess physical activity (PA) level in the general adult population including pregnant women. However, the reliability and validity of the questionnaire in pregnancy is unknown. Therefore, the aims of the present study were to investigate test-retest reliability and concurrent validity of IPAQ-SF among pregnant women, and whether PA is reported differently among those who fulfill (active) vs. do not fulfill (inactive) recommendations of ≥150 min of weekly moderate intensity PA in pregnancy. METHOD Test-retest reliability was examined by answering IPAQ-SF twice, two weeks apart (n = 88). To assess validity, IPAQ-SF was compared to the physical activity monitor SenseWear Armband® (SWA) (n = 64). The participants wore SWA for 8 consecutive days before answering IPAQ-SF. PA level was reported as time spent in moderate-, vigorous- and moderate-to-vigorous intensity PA (MPA, VPA and MVPA) corresponding to the cut-off points 3-6, >6 and >3 Metabolic Equivalents (METs), respectively. RESULTS Test-retest intraclass-correlation of MPA, VPA and MVPA ranged from 0.81-0.84 (95% Confidence Intervals: 0.69,0.90). Comparing time spent performing PA at various intensities; the mean differences and limits of agreement (±1.96 Standard Deviation) from Bland-Altman plots were-84 ± 402 min/week for MPA,-85 ± 452 min/week for MVPA and 26 ± 78 min/week for VPA, illustrating that the total group under-reported MPA by 72% and MVPA by 52%, while VPA was over-reported by 1400%. For the inactive group corresponding numbers were 44 ± 327 min/week for MPA, 52 ± 355 min/week for MVPA and 16 ± 33 min/week for VPA, illustrating that the inactive group over-reported MPA by 13% and MVPA by 49%, while VPA was not detected by SWA, but participants reported 16 min of VPA/week. In contrast, corresponding numbers for the active group were-197 ± 326 min/week for MPA,-205 ± 396 min/week for MVPA and 35 ± 85 min/week for VPA, illustrating that the active group under-reported MPA by 81% and MVPA by 60%, while they over-reported VPA by 975%. CONCLUSION IPAQ-SF had good test-retest reliability, but low to fair concurrent validity for MPA, VPA and MVPA compared to an objective criterion measure among pregnant women. Further, women fulfilling PA guidelines in pregnancy under-reported, while inactive women over-reported PA level.
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Affiliation(s)
- Birgitte Sanda
- Faculty of Health and Sport Sciences, University of Agder, P.O. Box 422, 4604 Kristiansand, Norway
- Department of Obstetrics and Gynaecology, Southern Norway Hospital Trust, Kristiansand, Norway
| | - Ingvild Vistad
- Department of Obstetrics and Gynaecology, Southern Norway Hospital Trust, Kristiansand, Norway
| | | | - Sveinung Berntsen
- Faculty of Health and Sport Sciences, University of Agder, P.O. Box 422, 4604 Kristiansand, Norway
| | - Linda Reme Sagedal
- Department of Obstetrics and Gynaecology, Southern Norway Hospital Trust, Kristiansand, Norway
| | - Hilde Lohne-Seiler
- Faculty of Health and Sport Sciences, University of Agder, P.O. Box 422, 4604 Kristiansand, Norway
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Astrup GL, Hofsø K, Bjordal K, Guren MG, Vistad I, Cooper B, Miaskowski C, Rustøen T. Patient factors and quality of life outcomes differ among four subgroups of oncology patients based on symptom occurrence. Acta Oncol 2017; 56:462-470. [PMID: 28077018 DOI: 10.1080/0284186x.2016.1273546] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
CONTEXT Reviews of the literature on symptoms in oncology patients undergoing curative treatment, as well as patients receiving palliative care, suggest that they experience multiple, co-occurring symptoms and side effects. OBJECTIVES The purposes of this study were to determine if subgroups of oncology patients could be identified based on symptom occurrence rates and if these subgroups differed on a number of demographic and clinical characteristics, as well as on quality of life (QoL) outcomes. METHODS Latent class analysis (LCA) was used to identify subgroups (i.e. latent classes) of patients with distinct symptom experiences based on the occurrence rates for the 13 most common symptoms from the Memorial Symptom Assessment Scale. RESULTS In total, 534 patients with breast, head and neck, colorectal, or ovarian cancer participated. Four latent classes of patients were identified based on probability of symptom occurrence: all low class [i.e. low probability for all symptoms (n = 152)], all high class (n = 149), high psychological class (n = 121), and low psychological class (n = 112). Patients in the all high class were significantly younger compared with patients in the all low class. Furthermore, compared to the other three classes, patients in the all high class had lower functional status and higher comorbidity scores, and reported poorer QoL scores. Patients in the high and low psychological classes had a moderate probability of reporting physical symptoms. Patients in the low psychological class reported a higher number of symptoms, a lower functional status, and poorer physical and total QoL scores. CONCLUSION Distinct subgroups of oncology patients can be identified based on symptom occurrence rates. Patient characteristics that are associated with these subgroups can be used to identify patients who are at greater risk for multiple co-occurring symptoms and diminished QoL, so that these patients can be offered appropriate symptom management interventions.
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Affiliation(s)
- Guro Lindviksmoen Astrup
- Department of Oncology, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Kristin Hofsø
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
- Lovisenberg Diaconal University College, Oslo, Norway
| | - Kristin Bjordal
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Research Support Services, Oslo University Hospital, Oslo, Norway
| | - Marianne Grønlie Guren
- Department of Oncology and K.G. Jebsen Colorectal Cancer Research Centre, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
| | - Ingvild Vistad
- Department of Obstetrics and Gynecology, Division of Surgery, Sørlandet Hospital HF, Kristiansand, Norway
| | - Bruce Cooper
- School of Nursing, University of California, San Francisco, CA, USA
| | | | - Tone Rustøen
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
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Cameron MG, Kersten C, Vistad I, van Helvoirt R, Weyde K, Undseth C, Mjaaland I, Skovlund E, Fosså SD, Guren MG. Palliative pelvic radiotherapy for symptomatic rectal cancer - a prospective multicenter study. Acta Oncol 2016; 55:1400-1407. [PMID: 27332723 DOI: 10.1080/0284186x.2016.1191666] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND AND PURPOSE Palliative pelvic radiotherapy (PPRT) is used to treat locally advanced rectal cancer (RC) although symptomatic effects and toxicities are poorly documented. Aims were to evaluate symptom severity, quality of life (QOL) and toxicity after PPRT. MATERIAL AND METHODS Fifty-one patients with symptomatic primary or recurrent RC prescribed PPRT with fractions of 3 Gy to 30-39 Gy were included. Primary outcome was severity of target symptoms (TS) 12 weeks after PPRT. Pelvic symptom burden, toxicity, and QOL were assessed. Response was defined as patient-reported TS improvement or resolution. RESULTS Pain (n = 24), rectal dysfunction (n = 16), and hematochezia (n = 9) were the most common TSs. Overall response rate among evaluable patients 12 weeks after PPRT was 28/33 (85%). Eighteen patients did not complete the study follow-up, 16 due to deteriorating health. TS responses were 10/13 (77%) for pain, 9/10 (90%) for rectal dysfunction, and 8/8 for hematochezia. Non-target pelvic symptom severity decreased and median QOL scores remained stable. There was no grade 4 toxicity. Median survival was nine months. CONCLUSIONS In the majority of patients with symptomatic primary or recurrent RC, PPRT with 30-39 Gy contributes to pelvic symptom relief, with little toxicity. Patients prescribed PPRT of RC have limited life expectancy. Future studies should investigate simplification of PPRT.
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Affiliation(s)
- Marte G. Cameron
- Center for Cancer Treatment, Sørlandet Hospital, Kristiansand, Norway
| | - Christian Kersten
- Center for Cancer Treatment, Sørlandet Hospital, Kristiansand, Norway
| | - Ingvild Vistad
- Department of Obstetrics and Gynecology, Sørlandet Hospital, Kristiansand, Norway
| | - Rene van Helvoirt
- Center for Cancer Treatment, Sørlandet Hospital, Kristiansand, Norway
| | - Kjetil Weyde
- Department of Oncology, Innlandet Hospital, Gjøvik, Norway
| | | | - Ingvil Mjaaland
- Department of Oncology, Stavanger University Hospital, Stavanger, Norway
| | - Eva Skovlund
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim and the Norwegian Institute of Public Health, Oslo, Norway
| | - Sophie D. Fosså
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Marianne G. Guren
- Department of Oncology, Oslo University Hospital, Oslo, Norway
- K. G. Jebsen Colorectal Cancer Research Centre, Oslo University Hospital, Oslo, Norway
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Cameron M, Kersten C, Vistad I, Van Helvoirt R, Weyde K, Undseth C, Mjaaland I, Skovlund E, Fosså S, Guren M. PO-0779: Multicenter study of palliative pelvic radiation for symptomatic primary and recurrent rectal cancer. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32029-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Skreden M, Øverby NC, Sagedal LR, Vistad I, Torstveit MK, Lohne-Seiler H, Bere E. Change in active transportation and weight gain in pregnancy. Int J Behav Nutr Phys Act 2016; 13:10. [PMID: 26818593 PMCID: PMC4730776 DOI: 10.1186/s12966-016-0332-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 01/14/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pregnancy is characterised by large weight gain over a short period, and often a notable change in mode of transportation. This makes pregnancy suitable for examining the plausible, but in the scientific literature still unclear, association between active transportation and weight gain. We hypothesize that women continuing an active mode of transportation to work or school from pre- to early pregnancy will have a lower gestational weight gain (GWG) than those who change to a less active mode of transportation. METHODS We analysed prospective data from the Norwegian Fit for Delivery (NFFD) trial. Between September 2009 and February 2013 606 women were consecutively enrolled in median gestational week 16 (range; 8-20). Of 219 women who used an active mode of transportation (biking, walking, public transportation) pre-pregnancy, 66 (30%) converted to a less active mode in early pregnancy ("active-less active" group), and 153 (70%) continued with active transportation ("active-active" group). Pre-pregnancy weight was self-reported. Weight at gestational (GA) weeks 16, 30, 36, and at term delivery was objectively measured. Weight gain was compared between the two groups. Linear mixed effects analysis of the repeated weight measures was performed including the group*time interaction. RESULTS A significant overall group effect was observed for the four time points together ("active-active" group: 77.3 kg vs. "active-less active" group: 78.8 kg, p = 0.008). The interaction term group*time was significant indicating different weight gain throughout pregnancy for the two groups; the mean differences between the groups were 0.7 kg at week 16, 1.4 kg at week 30, 2.1 kg at week 36, and 2.2 kg at term delivery, respectively. CONCLUSION The findings indicate that active transportation is one possible approach to prevent excessive weight gain in pregnancy.
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Affiliation(s)
- Marianne Skreden
- Department of Public Health, Sports and Nutrition, University of Agder, Kristiansand, Norway.
| | - Nina C Øverby
- Department of Public Health, Sports and Nutrition, University of Agder, Kristiansand, Norway.
| | - Linda R Sagedal
- Department of Obstetrics and Gynaecology, Sørlandet Hospital, Kristiansand, Norway.
| | - Ingvild Vistad
- Department of Obstetrics and Gynaecology, Sørlandet Hospital, Kristiansand, Norway.
| | - Monica K Torstveit
- Department of Public Health, Sports and Nutrition, University of Agder, Kristiansand, Norway.
| | - Hilde Lohne-Seiler
- Department of Public Health, Sports and Nutrition, University of Agder, Kristiansand, Norway.
| | - Elling Bere
- Department of Public Health, Sports and Nutrition, University of Agder, Kristiansand, Norway.
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Sagedal LR, Sanda B, Øverby NC, Bere E, Torstveit MK, Lohne-Seiler H, Hillesund ER, Pripp AH, Henriksen T, Vistad I. The effect of prenatal lifestyle intervention on weight retention 12 months postpartum: results of the Norwegian Fit for Delivery randomised controlled trial. BJOG 2016; 124:111-121. [DOI: 10.1111/1471-0528.13863] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2015] [Indexed: 11/28/2022]
Affiliation(s)
- LR Sagedal
- Department of Obstetrics and Gynecology; Sørlandet Hospital; Kristiansand Norway
- Department of Research; Sørlandet Hospital; Kristiansand Norway
| | - B Sanda
- Department of Obstetrics and Gynecology; Sørlandet Hospital; Kristiansand Norway
- Department of Public Health, Sports and Nutrition; University of Agder; Kristiansand Norway
| | - NC Øverby
- Department of Public Health, Sports and Nutrition; University of Agder; Kristiansand Norway
| | - E Bere
- Department of Public Health, Sports and Nutrition; University of Agder; Kristiansand Norway
| | - MK Torstveit
- Department of Public Health, Sports and Nutrition; University of Agder; Kristiansand Norway
| | - H Lohne-Seiler
- Department of Public Health, Sports and Nutrition; University of Agder; Kristiansand Norway
| | - ER Hillesund
- Department of Public Health, Sports and Nutrition; University of Agder; Kristiansand Norway
| | - AH Pripp
- Oslo Centre of Biostatistics and Epidemiology; Research Support Services; Oslo University Hospital; Oslo Norway
| | - T Henriksen
- Section of Obstetrics, Women and Children's Division; Oslo University Hospital; University of Oslo; Oslo Norway
| | - I Vistad
- Department of Obstetrics and Gynecology; Sørlandet Hospital; Kristiansand Norway
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Sagedal LR, Øverby NC, Bere E, Torstveit MK, Lohne-Seiler H, Småstuen M, Hillesund ER, Henriksen T, Vistad I. Lifestyle intervention to limit gestational weight gain: the Norwegian Fit for Delivery randomised controlled trial. BJOG 2016; 124:97-109. [DOI: 10.1111/1471-0528.13862] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2015] [Indexed: 12/30/2022]
Affiliation(s)
- LR Sagedal
- Department of Obstetrics and Gynaecology/Department of Research; Sørlandet Hospital; Kristiansand Norway
| | - NC Øverby
- Department of Public Health, Sports and Nutrition; University of Agder; Kristiansand Norway
| | - E Bere
- Department of Public Health, Sports and Nutrition; University of Agder; Kristiansand Norway
| | - MK Torstveit
- Department of Public Health, Sports and Nutrition; University of Agder; Kristiansand Norway
| | - H Lohne-Seiler
- Department of Public Health, Sports and Nutrition; University of Agder; Kristiansand Norway
| | - M Småstuen
- Department of Medicine; University of Oslo; Blindern Oslo Norway
| | - ER Hillesund
- Department of Public Health, Sports and Nutrition; University of Agder; Kristiansand Norway
| | - T Henriksen
- Section of Obstetrics; Women and Children's Division; Oslo University Hospital and University of Oslo; Nydalen Oslo Norway
| | - I Vistad
- Department of Obstetrics and Gynaecology/Department of Research; Sørlandet Hospital; Kristiansand Norway
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Szczesny W, Vistad I, Kaern J, Nakling J, Tropé C, Paulsen T. Impact of hospital type and treatment on long-term survival among patients with FIGO Stage IIIC epithelial ovarian cancer: follow-up through two recurrences and three treatment lines in search for predictors for survival. EUR J GYNAECOL ONCOL 2016; 37:305-311. [PMID: 27352555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The purpose of this study was to investigate the impact of hospital type determined at primary treatment and find possible predictors of survival in a cohort of patients with advanced epithelial ovarian cancer (EOC) who recurred twice and received three lines of treatment during eight-year follow-up. Using the Norwegian Cancer Registry, the authors identified 174 women with FIGO Stage IIIC EOC diagnosed in 2002. First-line treatment consisted of up-front debulking surgery and chemotherapy, received in either a teaching hospital (TH, n = 84) or a non-teaching hospital (NTH, n = 90). After recurrence all patients in Norway are equally consulted at TH. Survival determined for three time intervals (TI): TI-1, from end date of first-line treatment to first recurrence or death, TI-2, from beginning of second-line treatment until second recurrence or death, and TI-3, from beginning of third-line treatment to death or end of follow-up. Extensive surgery carried out in TH followed by at least six cycles of platinol-taxan chemotherapy resulted in longer survival in the TH group during TI-1. Altogether, the majority of those who receive treatment for recurrences were primary better debulked with following platinol-taxane chemotherapy. Survival in TI-2 was influenced by platinol-sensitivity. During TI-3 the majority (96%) had good performance status and their mean age at primary diagnosis at either hospital type was 57 years. Extensive primary surgery at TH, platinol sensitivity, age, and performance status were predictors of survival in this cohort.
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Ruifrok AE, Rogozinska E, van Poppel MNM, Rayanagoudar G, Kerry S, de Groot CJM, Yeo S, Molyneaux E, Barakat Carballo R, Perales M, Bogaerts A, Cecatti JG, Surita F, Dodd J, Owens J, El Beltagy N, Devlieger R, Teede H, Harrison C, Haakstad L, Shen GX, Shub A, Motahari N, Khoury J, Tonstad S, Luoto R, Kinnunen TI, Guelfi K, Facchinetti F, Petrella E, Phelan S, Scudeller TT, Rauh K, Hauner H, Renault K, Sagedal LR, Vistad I, Stafne SN, Mørkved S, Salvesen KÅ, Vinter C, Vitolo M, Astrup A, Geiker NRW, McAuliffe F, Poston L, Roberts T, Riley RD, Coomarasamy A, Khan KS, Mol BW, Thangaratinam S. Erratum to: Study protocol: differential effects of diet and physical activity based interventions in pregnancy on maternal and fetal outcomes: individual patient data (IPD) meta-analysis and health economic evaluation. Syst Rev 2015; 4:101. [PMID: 26272207 PMCID: PMC4535827 DOI: 10.1186/s13643-015-0079-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 06/12/2015] [Indexed: 11/10/2022] Open
Affiliation(s)
- Anneloes E Ruifrok
- Department of Obstetrics and Gynecology, Academic Medical Centre, Amsterdam, The Netherlands. .,Department of Obstetrics and Gynaecology, Faculty of Medicine, VU University Medical Center, Amsterdam, The Netherlands.
| | - Ewelina Rogozinska
- Women's Health Research Unit, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK. .,Multidisciplinary Evidence Synthesis Hub (mEsh), Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
| | - Mireille N M van Poppel
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
| | - Girish Rayanagoudar
- Women's Health Research Unit, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
| | - Sally Kerry
- Multidisciplinary Evidence Synthesis Hub (mEsh), Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
| | - Christianne J M de Groot
- Department of Obstetrics and Gynaecology, Faculty of Medicine, VU University Medical Center, Amsterdam, The Netherlands.
| | - SeonAe Yeo
- University of North Carolina at Chapel Hill, School of Nursing, Chapel Hill, NC, USA.
| | - Emma Molyneaux
- Section of Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, King's College London, London, UK.
| | - Ruben Barakat Carballo
- Facultad de Ciencias de la Actividad Fısica y del Deporte-INEF, Universidad Politecnica de Madrid, Madrid, Spain.
| | - Maria Perales
- Facultad de Ciencias de la Actividad Fısica y del Deporte-INEF, Universidad Politecnica de Madrid, Madrid, Spain.
| | - Annick Bogaerts
- Division of Mother and Child, Department of Obstetrics and Gynaecology, University Colleges Leuven-Limburg, Hasselt and University Hospitals KU Leuven, Leuven, Belgium.
| | - Jose G Cecatti
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil.
| | - Fernanda Surita
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil.
| | - Jodie Dodd
- Discipline of Obstetrics and Gynaecology, School of Paediatrics and Reproductive Health, The University of Adelaide, Adelaide, Australia.
| | - Julie Owens
- Discipline of Obstetrics and Gynaecology, School of Paediatrics and Reproductive Health, The University of Adelaide, Adelaide, Australia.
| | - Nermeen El Beltagy
- Department of Obstetrics and Gynecology, Alexandria University, Alexandria, Egypt.
| | - Roland Devlieger
- Division of Mother and Child, Department of Obstetrics and Gynaecology, University Colleges Leuven-Limburg, Hasselt and University Hospitals KU Leuven, Leuven, Belgium.
| | - Helena Teede
- Monash Centre for Health Research and Implementation -MCHRI, School of Public Health Monash University, Melbourne, Australia.
| | - Cheryce Harrison
- Monash Centre for Health Research and Implementation -MCHRI, School of Public Health Monash University, Melbourne, Australia.
| | - Lene Haakstad
- Norwegian School of Sport Sciences, Department of Sports Medicine, Oslo, Norway.
| | - Garry X Shen
- Department of Internal Medicine, University of Manitoba, Winnipeg, Canada.
| | - Alexis Shub
- Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Australia.
| | - Narges Motahari
- Department of Sport Physiology, Faculty of Physical Education and Sport Sciences, Mazandaran University, Babolsar, Iran.
| | - Janette Khoury
- Department of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway.
| | - Serena Tonstad
- Department of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway.
| | - Riitta Luoto
- UKK Institute for Health Promotion Research, Tampere, Finland.
| | - Tarja I Kinnunen
- School of Health Sciences, University of Tampere, Tampere, Finland.
| | - Kym Guelfi
- School of Sport Science, Exercise and Health, The University of Western Australia, Perth, Australia.
| | - Fabio Facchinetti
- Mother-Infant Department, University of Modena and Reggio Emilia, Modena, Italy.
| | - Elisabetta Petrella
- Mother-Infant Department, University of Modena and Reggio Emilia, Modena, Italy.
| | - Suzanne Phelan
- Kinesiology Department, California Polytechnic State University, San Luis Obispo, USA.
| | - Tânia T Scudeller
- Department of Health Sciences, Physical Therapy Course, São Paulo Federal University/Unifesp, Santos, Brazil.
| | - Kathrin Rauh
- Else Kroener-Fresenius-Center for Nutritional Medicine, Chair of Nutritional Medicine, Technische Universität München, Munich, Germany. .,Competence Centre for Nutrition (KErn), Freising, Germany.
| | - Hans Hauner
- Else Kroener-Fresenius-Center for Nutritional Medicine, Chair of Nutritional Medicine, Technische Universität München, Munich, Germany.
| | - Kristina Renault
- Departments of Obstetrics and Gynecology, Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark. .,Department of Obstetrics and Gynecology, Odense University Hospital, University of Southern Denmark, Odense, Denmark.
| | - Linda Reme Sagedal
- Department of Obstetrics and Gynecology, Sorlandet Hospital, Kristiansand, Norway.
| | - Ingvild Vistad
- Department of Obstetrics and Gynecology, Sorlandet Hospital, Kristiansand, Norway.
| | - Signe Nilssen Stafne
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway. .,Clinical Services, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
| | - Siv Mørkved
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway. .,Clinical Services, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
| | - Kjell Åsmund Salvesen
- Department of Obstetrics and Gynaecology, Clinical Sciences, Lund University, Lund, Sweden. .,Department of Laboratory Medicine Children's and Women's Health, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Christina Vinter
- Department of Obstetrics and Gynecology, Odense University Hospital, University of Southern Denmark, Odense, Denmark.
| | - Marcia Vitolo
- Department of Nutrition and the Graduate Program in Health Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil.
| | - Arne Astrup
- Department of Human Nutrition, Faculty of Life Science, Copenhagen University Copenhagen, Copenhagen, Denmark.
| | | | - Fionnuala McAuliffe
- School of Medicine & Medical Science, UCD Institute of Food and Health, Dublin, Ireland.
| | - Lucilla Poston
- Division of Women's Health, Women's Health Academic Centre, King's College London, St. Thomas' Hospital, London, UK.
| | - Tracy Roberts
- Health Economics Unit, School of Health and Population Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
| | - Richard D Riley
- School of Health and Population Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
| | - Arri Coomarasamy
- School of Clinical and Experimental Medicine, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
| | - Khalid S Khan
- Women's Health Research Unit, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK. .,Multidisciplinary Evidence Synthesis Hub (mEsh), Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
| | - Ben Willem Mol
- Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, Australia.
| | - Shakila Thangaratinam
- Women's Health Research Unit, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK. .,Multidisciplinary Evidence Synthesis Hub (mEsh), Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
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Vistad I, Klungsøyr K, Albrechtsen S, Skjeldestad FE. Neonatal outcome of singleton term breech deliveries in Norway from 1991 to 2011. Acta Obstet Gynecol Scand 2015; 94:997-1004. [DOI: 10.1111/aogs.12684] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 05/22/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Ingvild Vistad
- Department of Obstetrics and Gynecology; Sorlandet Hospital HF; Kristiansand Norway
| | - Kari Klungsøyr
- Department of Global Public Health and Primary Care; University of Bergen; Bergen Norway
- Medical Birth Registry of Norway; Norwegian Institute of Public Health; Bergen Norway
| | - Susanne Albrechtsen
- Department of Obstetrics and Gynecology; Haukeland University Hospital; Bergen Norway
- Department of Clinical Medicine; University of Bergen; Bergen Norway
| | - Finn E. Skjeldestad
- Faculty of Health Sciences; Department of Community Medicine; Research Group Epidemiology of Chronic Diseases; UiT; the Arctic University of Norway; Tromsø Norway
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