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McCloy K, Hughes C, Dunwoody L, Marley J, Cleland I, Cruciani F, Saunders C, Gracey J. Evaluating the effectiveness of mindfulness alone compared to exercise and mindfulness on fatigue in women with gynaecology cancer (GEMS): Protocol for a randomised feasibility trial. PLoS One 2023; 18:e0278252. [PMID: 37883461 PMCID: PMC10602305 DOI: 10.1371/journal.pone.0278252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 05/30/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND In 2020 Globocan reported nearly 1.4 million new cases of gynaecology cancer worldwide. Cancer related fatigue has been identified as a symptom that can be present for gynaecology cancer patients many years after treatment. The current evidence around the management of this symptom suggests that exercise has the most positive outcome. However, some ambiguity remains around the evidence and whether it can address all areas of fatigue effectively. More recently, other interventions such as mindfulness have begun to show a favourable response to the management of symptoms for cancer patients. To date there has been little research that explores the feasibility of using both these interventions together in a gynaecology cancer population. This study aims to explore the feasibility of delivering an intervention that involves mindfulness and mindfulness and exercise and will explore the effect of this on fatigue, sleep, mood and quality of life. METHODS/DESIGN This randomised control trial will assess the interventions outcomes using a pre and post design and will also include a qualitative process evaluation. Participants will be randomised into one of 2 groups. One group will undertake mindfulness only and the other group will complete exercise and mindfulness. Both groups will use a mobile application to complete these interventions over 8 weeks. The mobile app will be tailored to reflect the group the participants have drawn during randomisation. Self-reported questionnaire data will be assessed at baseline prior to commencing intervention and at post intervention. Feasibility will be assessed through recruitment, adherence, retention and attrition. Acceptability and participant perspective of participation (process evaluation), will be explored using focus groups. DISCUSSION This trial will hope to evidence and demonstrate that combination of two interventions such as mindfulness and exercise will further improve outcomes of fatigue and wellbeing in gynaecology cancer. The results of this study will be used to assess (i) the feasibility to deliver this type of intervention to this population of cancer patients using a digital platform; (ii) assist this group of women diagnosed with cancer to manage fatigue and other symptoms of sleep, mood and impact their quality of life. TRIAL REGISTRATION NCT05561413.
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Affiliation(s)
- Kairen McCloy
- Institute of Nursing and Health Research, Ulster University, Newtownabbey, United Kingdom
| | - Ciara Hughes
- Institute of Nursing and Health Research, Ulster University, Newtownabbey, United Kingdom
| | - Lynn Dunwoody
- Psychology Research Institute, Ulster University, Coleraine, United Kingdom
| | - Joanne Marley
- Institute of Nursing and Health Research, Ulster University, Newtownabbey, United Kingdom
| | - Ian Cleland
- School of Computing, Ulster University, Newtownabbey, United Kingdom
| | - Federico Cruciani
- School of Computing, Ulster University, Newtownabbey, United Kingdom
| | | | - Jackie Gracey
- Institute of Nursing and Health Research, Ulster University, Newtownabbey, United Kingdom
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Mullan LJ, Blackburn NE, Gracey J, Dunwoody L, Lorimer J, Semple CJ. Evaluating the effects of lymphoedema management strategies on functional status and health-related quality of life following treatment for head and neck cancer: a systematic review. J Cancer Surviv 2023:10.1007/s11764-023-01453-7. [PMID: 37648875 DOI: 10.1007/s11764-023-01453-7] [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: 08/07/2023] [Accepted: 08/17/2023] [Indexed: 09/01/2023]
Abstract
PURPOSE Patients living with head and neck lymphoedema (HNL) after completion of head and neck cancer (HNC) often can experience long-term functional challenges and overall poorer health-related quality of life (HRQOL). This systematic review aims to explore components of effective HNL interventions through identification and synthesising literature on existing HNL management interventions. METHODS Five electronic databases (MEDLINE via Ovid and PubMed, CINAHL, CENTRAL, and Scopus) were systematically searched using Medical Subject Headings and free text, as well as citation tracking and Google Scholar for grey literature. RESULTS A total of 1910 studies were screened, with 12 studies meeting the inclusion criteria. Findings indicated vast heterogeneity within HNL interventions. Patients' adherence to intervention strategies was reported as low and partially adhered to, particularly at home. This impacted on function domains and overall HRQOL during the post-treatment HNC phase, as well as further increasing the demands placed on healthcare professionals. CONCLUSIONS Synthesis of the research findings highlighted a need to provide and educate patients with individualised HNL self-management intervention strategies. Promoting adherence was reported as being essential, with self-efficacy and behaviour change techniques being emphasised as a critical element to enhance motivation and therefore effective intervention delivery. Further work is important to address barriers to adherence and promote both motivation and behaviour change, to develop individualised self-management interventions for this cancer population. IMPLICATIONS FOR CANCER SURVIVORS The findings from this systematic review will provide guidance in the development and delivery of individualised self-management HNL interventions for patients who have completed HNC treatment.
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Affiliation(s)
- Lauren J Mullan
- School of Nursing, Institute of Nursing and Health Research, Ulster University, Belfast, UK.
| | - Nicole E Blackburn
- School of Health Sciences, Institute of Nursing and Health Research, Ulster University, Londonderry, UK
| | - Jackie Gracey
- School of Health Sciences, Institute of Nursing and Health Research, Ulster University, Londonderry, UK
| | - Lynn Dunwoody
- School of Psychology, Faculty of Life and Health Sciences, Ulster University, Londonderry, UK
| | - Jill Lorimer
- Physiotherapy Department, Cancer Centre, Belfast Health and Social Care Trust, Belfast, UK
| | - Cherith J Semple
- School of Nursing, Institute of Nursing and Health Research, Ulster University, Belfast, UK
- Cancer Services, South Eastern Health and Social Care Trust, Belfast, UK
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McCloy K, Hughes C, Dunwoody L, Marley J, Gracey J. Effects of mindfulness-based interventions on fatigue and psychological wellbeing in women with cancer: A systematic review and meta-analysis of randomised control trials. Psychooncology 2022; 31:1821-1834. [PMID: 36221152 PMCID: PMC9828570 DOI: 10.1002/pon.6046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 09/01/2022] [Accepted: 09/27/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND Cancer diagnosis and treatment can cause fatigue, stress and anxiety which can have a detrimental effect on patients, families and the wider community. Mindfulness-based interventions appear to have positive effects on managing these cancer-related symptoms. OBJECTIVE To investigate the efficacy of mindfulness on cancer related fatigue (CRF) and psychological well-being in female cancer patients. METHODS Five databases (CINHAL, Ovid Medline, Ovid Psych Info, Scopus, and Cochrane), and two trial registers (WHO and Clinicaltrials.gov) were searched for randomised control trials from inception to April 2021 and updated in August 2022. Meta-analysis was performed using Review Manager 5.4. The standardised mean difference (SMD) and 95% confidence intervals (CI) were used to determine the intervention effect. Subgroup analysis was performed for adaptation to types of mindfulness, length of intervention and types of comparator used. RESULTS Twenty-one studies with a total of 2326 participants were identified. Mindfulness significantly improved CRF (SMD -0.81, 95% CI -1.17 to -0.44), depression (SMD-0.74, 95% CI -1.08 to -0.39) and anxiety (SMD -0.92, 95% CI -1.50 to -0.33). No effect was observed for quality of life (SMD 0.32, 95% CI -0.13-0.87) and sleep (SMD -0.65, 95% CI -1.34-0.04). Subgroup analysis revealed that there was little difference in SMD for adapted type of mindfulness (p = 0.42), wait list control compared to active comparator (p = 0.05) or length of intervention (p = 0.29). CONCLUSION Mindfulness appears to be effective in reducing CRF and other cancer related symptoms in women. Adaptations to mindfulness delivery did not have negative impact on results which may aid delivery in the clinical settings.
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Al Maqbali M, Gracey J, Rankin J, Dunwoody L, Hacker E, Hughes C. Cross-Cultural Adaptation and Psychometric Properties of Quality of Life Scales for Arabic-Speaking Adults: A systematic review. Sultan Qaboos Univ Med J 2020; 20:e125-e137. [PMID: 32655904 PMCID: PMC7328836 DOI: 10.18295/squmj.2020.20.02.002] [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: 07/22/2019] [Revised: 09/30/2019] [Accepted: 12/09/2019] [Indexed: 11/16/2022] Open
Abstract
This review aimed to explore the psychometric properties of quality of life (QOL) scales to identify appropriate tools for research and clinical practice in Arabic-speaking adults. A systematic search of the Cumulative Index to Nursing and Allied Health Literature® (EBSCO Information Services, Ipswich, Massachusetts, USA), MEDLINE® (National Library of Medicine, Bethesda, Maryland, USA), EMBASE (Elsevier, Amsterdam, Netherlands) and PsycINFO (American Psychological Association, Washington, District of Columbia, USA) databases was conducted according to Preferred Reporting Items Systematic Reviews and Meta-Analysis guidelines. Quality assessment criteria were then utilised to evaluate the psychometric properties of identified QOL scales. A total of 27 studies relating to seven QOL scales were found. While these studies provided sufficient information regarding the scales' validity and reliability, not all reported translation and cross-cultural adaptation processes. Researchers and clinicians should consider whether the psychometric properties, subscales and characteristics of their chosen QOL scale are suitable for use in their population of interest.
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Affiliation(s)
- Mohammed Al Maqbali
- Institute of Nursing and Health Research, Ulster University, Shore Road, Jordanstown Campus, Newtownabbey, UK.,Ministry of Health, Al Buraimi Hospital, Oman
| | - Jackie Gracey
- Institute of Nursing and Health Research, Ulster University, Shore Road, Jordanstown Campus, Newtownabbey, UK
| | - Jane Rankin
- Physiotherapy Department, Cancer Centre, Belfast Health and Social Care Trust, Belfast, UK
| | - Lynn Dunwoody
- Psychology Research Institute, Ulster University, Coleraine, UK
| | - Eileen Hacker
- School of Nursing, Indiana University, Indianapolis, USA
| | - Ciara Hughes
- Institute of Nursing and Health Research, Ulster University, Shore Road, Jordanstown Campus, Newtownabbey, UK
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Davies CC, Gracey J. Thinking outside the box, bespoke cancer rehabilitation moving forward, what matters? Physical Therapy Reviews 2020. [DOI: 10.1080/10833196.2020.1822141] [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] [Indexed: 10/22/2022]
Affiliation(s)
- Claire C. Davies
- Nursing and Allied Health Research Office, Baptist Health Lexington, Lexington, KY, USA;
| | - Jackie Gracey
- School of Health Science, Ulster University, Coleraine, UK
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Al Maqbali M, Gracey J, Dunwoody L, Rankin J, Hacker E, Hughes C. Healthcare professionals knowledge on cancer-related fatigue: A cross-sectional survey in Oman. Nurs Health Sci 2020; 22:732-740. [PMID: 32270899 DOI: 10.1111/nhs.12720] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 03/26/2020] [Accepted: 04/01/2020] [Indexed: 11/27/2022]
Abstract
Cancer-related fatigue is a common and distressing cancer symptom that negatively affects quality of life. The main objective of this study was to determine health professionals' knowledge relating to cancer patients' fatigue in Oman and identify current management practices of cancer-related fatigue. A cross-sectional survey design using Qualtrics® software was performed. The survey had five sections and comprised 32 items. A total of 138 healthcare professionals working in Oman participated in the study (response rate 63.9%). Nearly three quarters of the participants were nurses (74.6%, n = 103). The mean level of knowledge of cancer-related fatigue was 16.6/23, with 50% of participants having the expected level of knowledge above 12. The result indicated that professional discipline and work experience each were significantly associated with overall level of knowledge. Participants identified the need for guidelines, assessment tools, and training for the oncology staff to help improve the quality of life of patients with cancer-related fatigue.
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Affiliation(s)
- Mohammed Al Maqbali
- Institute of Nursing and Health Research, Ulster University, Newtownabbey, UK
| | - Jackie Gracey
- Institute of Nursing and Health Research, Ulster University, Newtownabbey, UK
| | - Lynn Dunwoody
- Psychology Research Institute, Ulster University, Coleraine, UK
| | - Jane Rankin
- Physiotherapy Department, Cancer Centre, Belfast Health and Social Care Trust, Belfast, UK
| | | | - Ciara Hughes
- Institute of Nursing and Health Research, Ulster University, Newtownabbey, UK
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Al Maqbali M, Hughes C, Gracey J, Rankin J, Hacker E, Dunwoody L. Psychometric Properties of the Arabic Version of the Functional Assessment of Chronic Illnesses Therapy-Fatigue in Arabic Cancer Patients. J Pain Symptom Manage 2020; 59:130-138.e2. [PMID: 31647976 DOI: 10.1016/j.jpainsymman.2019.10.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 10/04/2019] [Accepted: 10/04/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND The Functional Assessment of Chronic Illness Therapy (FACIT) is a measurement system that was developed to assess the health-related quality of life among patients with cancer and other chronic illnesses. The Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) is a 40-item questionnaire, and it is one of the most frequently used instruments to assess fatigue in cancer populations. The aim of this study was to evaluate the psychometric properties of the Arabic FACIT-F among patients diagnosed with cancer. METHODS Following a translated and cross-cultural evaluation procedure of the FACIT-F Arabic version, a cross-sectional and descriptive correlational design was conducted. A total of 369 patients with cancer completed the FACIT-F, which consists of the 27-item Functional Assessment of Cancer Therapy-General (FACT-G) and the 13-item Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F). The scale was assessed in terms of acceptability, internal consistency, and validity. Construct validity was explored through confirmatory factor analysis. RESULTS The FACT-G had acceptable fit in the four-factor model, whereas the FACIT-Fatigue was found to be acceptable for the one-factor model in Arabic patients diagnosed with cancer. The Cronbach's alpha coefficient for the Arabic FACIT-Fatigue was 0.92, whereas the total score for FACT-G was 0.92, which showed good reliability. There was evidence that discriminated validity analysis was generally very good for the FACIT-Fatigue and FACT-G Arabic versions. CONCLUSION The Arabic versions of the FACIT-Fatigue and FACT-G demonstrated good reliability and validity for assessing fatigue and quality of life in patients diagnosed with cancer.
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Affiliation(s)
- Mohammed Al Maqbali
- Institute of Nursing and Health Research , Ulster University, Newtownabbey, UK.
| | - Ciara Hughes
- Institute of Nursing and Health Research , Ulster University, Newtownabbey, UK
| | - Jackie Gracey
- Institute of Nursing and Health Research , Ulster University, Newtownabbey, UK
| | - Jane Rankin
- Physiotherapy Department, Cancer Centre , Belfast Health and Social Care Trust, Belfast, UK
| | - Eileen Hacker
- School of Nursing , Indiana University, Indianapolis, USA
| | - Lynn Dunwoody
- Psychology Research Institute , Ulster University, Coleraine, UK
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Al Maqbali M, Hughes C, Gracey J, Rankin J, Dunwoody L, Hacker E. Quality assessment criteria: psychometric properties of measurement tools for cancer related fatigue. Acta Oncol 2019; 58:1286-1297. [PMID: 31204538 DOI: 10.1080/0284186x.2019.1622773] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Background: Fatigue is a common and distressing cancer symptom that negatively affects the quality of life. Many scales have been developed to assess cancer-related fatigue. The properties of the scales vary in terms of dimensionality, reliability, validity, length and method of administration. Insufficient of psychometric properties may affect the accuracy of scales findings, that may lead result obtained questionable. The main objective of this review was to conduct a quality assessment of the psychometric properties of cancer-related fatigue scales to identify appropriate scales that could be used in research and clinical practice. Method: A systematic search was carried out to identify validated scales that measure cancer-related fatigue. Five databases were searched: CINAHL, MEDLINE, EMBASE, PsycINFO, Cochrane Library. This review was conducted following the PRISMA and Terwee et al.'s quality assessment guidelines to evaluate the psychometric properties of the studies. Result: Seventy-one different studies published between 1970 and 2018 met the inclusion criteria. Twenty-five scales were identified. Of these, eighteen were multidimensional and seven were uni-dimensional, containing between 4 and 72 items. Reliability and/or validity information was missing for many scales. Four scales met the quality assessment criteria and were reported as the most appropriate for measuring fatigue in cancer patients. Conclusion: Further psychometric testing is required for other scales. Developing a universally-defined tool kit for the assessment of cancer-related fatigue may help clarify the concept of fatigue and promote a systematic approach to fatigue measurement.
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Affiliation(s)
- Mohammed Al Maqbali
- Institute of Nursing and Health Research, Ulster University, Newtownabbey, UK
| | - Ciara Hughes
- Institute of Nursing and Health Research, Ulster University, Newtownabbey, UK
| | - Jackie Gracey
- Institute of Nursing and Health Research, Ulster University, Newtownabbey, UK
| | - Jane Rankin
- Physiotherapy Department, Cancer Centre, Belfast Health and Social Care Trust, Belfast, UK
| | - Lynn Dunwoody
- Psychology Research Institute, Ulster University, Coleraine, UK
| | - Eileen Hacker
- School of Nursing, Indiana University, Indianapolis, USA
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Maqbali M, Hughes C, Dunwoody L, Rankin JP, Hacker ED, Gracey J. Exercise Interventions to Manage Fatigue in Women With Gynecologic Cancer: A Systematic Review. Oncol Nurs Forum 2019; 46:71-82. [PMID: 30547952 DOI: 10.1188/19.onf.71-82] [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: 11/17/2022]
Abstract
PROBLEM IDENTIFICATION Fatigue has a negative impact on the quality of life of patients with cancer. The aim of this review is to evaluate studies on the effectiveness of exercise interventions in reducing fatigue in women with gynecologic cancer. LITERATURE SEARCH The review was conducted according to the PRISMA guidelines using the CINAHL®, MEDLINE®, EMBASE, PsycINFO®, and Cochrane Library databases. The Critical Appraisal Skills Programme was used for quality assessment. DATA EVALUATION Five studies met the inclusion criteria. SYNTHESIS Evidence suggests that exercise interventions result in significant reductions in fatigue in women with gynecologic cancer. However, the current evidence is limited. Additional studies are required to address the dose-dependent outcomes of exercise interventions on fatigue in women with gynecologic cancer. IMPLICATIONS FOR NURSING Findings support the positive effects of exercise interventions in reducing fatigue in women with gynecologic cancer, suggesting that healthcare professionals may consider including exercise programs into management plans for this population.
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Al Maqbali M, Dunwoody L, Rankin J, Hacker E, Hughes C, Gracey J. Psychometric properties and cultural adaptation of sleep disturbance measures in Arabic-speaking populations: A systematic review. J Sleep Res 2019; 29:e12877. [PMID: 31180174 DOI: 10.1111/jsr.12877] [Citation(s) in RCA: 5] [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: 01/19/2019] [Revised: 04/26/2019] [Accepted: 04/27/2019] [Indexed: 12/25/2022]
Abstract
The aim of this review was to evaluate the psychometric properties and cross-cultural adaptation of sleep disturbance scales that have been translated into Arabic or originally developed in Arabic, and to identify appropriate scales that can be used in research and clinical practice intended for Arabic-speaking participants. The following databases were searched: CINAHL (2003-2019), MEDLINE (1946-2019), EMBASE (1980-2019), PsycINFO (1806-2019) and Cochrane Library (1806-2019). This review was conducted following PRISMA guidelines. Terwee et al. (J. Clin. Epidemiol., 60, 2007, 34) quality assessment was used to evaluate the psychometric properties of the studies, and cross-cultural adaptation was assessed using criteria from Guillemin, Bombardier, and Beaton (J. Clin. Epidemiol., 46, 1993, 1417). Seven studies met the inclusion criteria, which included four scales: the Epworth Sleepiness Scale, Insomnia Severity Index, Pittsburgh Sleep Quality Index, and Arabic Scale of Insomnia. Cross-cultural adaptations scored between good and poor; psychometric properties information was missing for most scales. The review suggested that Pittsburgh Sleep Quality Index may be a useful scale to measure sleep disturbance, as the scale showed good cultural adaptation and acceptable psychometric properties in an Arabic population. Furthermore, the scales measure seven different aspects of sleep quality. This review provides options to help researchers and clinicians select the most appropriate instrument for their practice. Further psychometric testing and cultural adaptation is required for sleep scales used in Arabic clinical populations to ensure validity and reliability in outcome measurement for research studies.
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Affiliation(s)
- Mohammed Al Maqbali
- Institute of Nursing and Health Research, Ulster University, Newtownabbey, UK
| | - Lynn Dunwoody
- Psychology Research Institute, Ulster University, Coleraine, UK
| | - Jane Rankin
- Physiotherapy Department, Cancer Centre, Belfast Health and Social Care Trust, Belfast, UK
| | - Eileen Hacker
- School of Nursing, Indiana University, Indianapolis, USA
| | - Ciara Hughes
- Institute of Nursing and Health Research, Ulster University, Newtownabbey, UK
| | - Jackie Gracey
- Institute of Nursing and Health Research, Ulster University, Newtownabbey, UK
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Payne C, McIlfatrick S, Larkin P, Dunwoody L, Gracey J. A qualitative exploration of patient and healthcare professionals' views and experiences of palliative rehabilitation during advanced lung cancer treatment. Palliat Med 2018; 32:1624-1632. [PMID: 30180786 DOI: 10.1177/0269216318794086] [Citation(s) in RCA: 14] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Limited evidence exists on the impact of palliative rehabilitation during systemic treatment of advanced cancer. AIM To explore the experiences and perceptions of patients and healthcare professionals on the feasibility and acceptability of palliative rehabilitation during advanced lung cancer treatment. DESIGN Qualitative design using individual semi-structured interviews transcribed verbatim and analysed thematically. SETTING/PARTICIPANTS Eight patients and six healthcare professionals were recruited from a regional cancer centre in the United Kingdom following completion of a 6-week individualised behaviour change study which combined physical activity and nutritional guidance. RESULTS Palliative rehabilitation and study participation were positively viewed by both participants and healthcare professionals. Five themes were identified from patient interviews within an overarching theme of living with and beyond an advanced cancer diagnosis: (1) challenges of living with incurable cancer, (2) personal and altruistic reasons for participating in rehabilitation, (3) applicability of palliative rehabilitation content, (4) barriers and facilitators to adherence and (5) positive impact on self and others. Three themes were identified from healthcare professionals, within an overarching theme of palliative rehabilitation: exploring the concept (1) pre-study-mixed perceptions of palliative rehabilitation, (2) perceived benefits for patients and families and (3) lessons for future research. CONCLUSION Patients described personal benefits associated with setting their own goals for physical activity and dietary intake. Healthcare professionals who initially expressed a negative or indifferent stance towards palliative rehabilitation, displayed a mind-set change and were keen to explore further opportunities to expand the evidence base.
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Affiliation(s)
- Cathy Payne
- 1 Institute of Nursing and Health Research, Ulster University, Newtownabbey, UK
| | - Sonja McIlfatrick
- 1 Institute of Nursing and Health Research, Ulster University, Newtownabbey, UK.,2 School of Nursing, Institute of Nursing and Health Research, Ulster University, Newtownabbey, UK
| | - Philip Larkin
- 3 School of Nursing, Midwifery and Health Systems, Health Sciences Centre, University College Dublin and Our Lady's Hospice and Care Services, Dublin, Ireland
| | - Lynn Dunwoody
- 4 Psychology Research Institute, Ulster University, Newtownabbey, UK
| | - Jackie Gracey
- 1 Institute of Nursing and Health Research, Ulster University, Newtownabbey, UK.,5 Institute of Nursing and Health Research, School of Health Sciences, Ulster University, Newtownabbey, UK
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Hubbard G, Campbell A, Fisher A, Harvie M, Maltinsky W, Mullen R, Banks E, Gracey J, Gorely T, Munro J, Ozakinci G. Physical activity referral to cardiac rehabilitation, leisure centre or telephone-delivered consultations in post-surgical people with breast cancer: a mixed methods process evaluation. Pilot Feasibility Stud 2018; 4:108. [PMID: 29881639 PMCID: PMC5984397 DOI: 10.1186/s40814-018-0297-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 05/15/2018] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Physical activity (PA) programmes effective under 'research' conditions may not be effective under 'real-world' conditions. A potential solution is to refer patients to existing PA community-based PA services. METHODS A process evaluation of referral of post-surgical patients with early-stage breast cancer to cardiac rehabilitation exercise classes, leisure centre with 3-month free leisure centre membership or telephone-delivered PA consultations for 12 weeks. Quantitative data were collected about PA programme uptake and reach, patient engagement with the PA programme, delivery and fidelity and PA dose. Qualitative data were collected about patient experiences of taking part in the PA programmes. Audio-recorded qualitative interviews of participants about the programmes were analysed thematically. Quantitative data were reported descriptively using means and SD. RESULTS In Phase I, 30% (n = 20) of eligible patients (n = 20) consented, 85% (n = 17) chose referral to leisure centre, and 15% (n = 3) chose cardiac rehabilitation. In Phase II, 32% (n = 12) consented, 25% (n = 3) chose leisure centre and 75% (n = 9) chose telephone-delivered PA consultations. Walking at light intensity for about an hour was the most common PA. All Phase I participants received an induction by a cardiac rehabilitation physiotherapist or PA specialist from the leisure centre but only 50% of Phase II participants received an induction by a PA specialist from the leisure centre. Four themes were identified from qualitative interviews about programme choice: concerns about physical appearance, travel distance, willingness to socialise and flexibility in relation to doing PA. Four themes were identified about facilitators and barriers for engaging in PA: feeling better, feeling ill, weight management, family and friends. CONCLUSIONS The current community-based PA intervention is not yet suitable for a definitive effectiveness randomised controlled trial. Further work is needed to optimise PR programme reach, PA dose and intervention fidelity. TRIAL REGISTRATION ISRCTN11183372.
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Affiliation(s)
- Gill Hubbard
- Department of Nursing, University of the Highlands and Islands, Centre for Health Sciences, Old Perth Road, Inverness, IV2 3JH Scotland UK
| | - Anna Campbell
- School of Life Science, Sport and Social Science, Edinburgh Napier University, Edinburgh, EH11 4B Scotland UK
| | - Abi Fisher
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 6BT England UK
| | - Michelle Harvie
- Prevent Breast Cancer Research Unit, The Nightingale Centre, Wythenshawe Hospital, Manchester, England UK
| | - Wendy Maltinsky
- Division of Health Research, Rural Health & Wellbeing, University of the Highlands and Islands, An Lòchran, Inverness Campus, Inverness, IV2 5NA Scotland UK
| | - Russell Mullen
- Highland Breast Centre, NHS Highland, Raigmore Hospital, Old Perth Road, Inverness, IV2 3UJ Scotland UK
| | - Elspeth Banks
- National Cancer Research Institute, Clinical Studies Group, Angel Building, 407 St John Street, London, EC1V 4AD England UK
| | - Jackie Gracey
- School of Health Sciences, Ulster University, Jordanstown campus, Shore Road, 7, Newtown Abbey, County Antrim, BT37 OQB Northern Ireland UK
| | - Trish Gorely
- Department of Nursing, University of the Highlands and Islands, Centre for Health Sciences, Old Perth Road, Inverness, IV2 3JH Scotland UK
| | - Julie Munro
- Department of Nursing, University of the Highlands and Islands, Centre for Health Sciences, Old Perth Road, Inverness, IV2 3JH Scotland UK
| | - Gozde Ozakinci
- School of Medicine, Medical & Biological Sciences, University of St Andrews, North Haugh, St Andrews, KY16 9TF Scotland UK
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Hubbard G, Taylor C, Beeken B, Campbell A, Gracey J, Grimmett C, Fisher A, Ozakinci G, Slater S, Gorely T. Research priorities about stoma-related quality of life from the perspective of people with a stoma: A pilot survey. Health Expect 2017; 20:1421-1427. [PMID: 28675608 PMCID: PMC5689233 DOI: 10.1111/hex.12585] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [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] [Accepted: 05/16/2017] [Indexed: 12/21/2022] Open
Abstract
Background There is a recognized need to include patients in setting research priorities. Research priorities identified by people with a stoma are rarely elicited. Objectives To improve the quality of life of people with a stoma through use of evidence‐based practice based on research priorities set by patients. Design and Methods Online pilot survey publicized in 2016 via United Kingdom stoma charities. People ranked nine stoma‐related quality of life topics in order of research priority. Participants People 16 years of age and over who currently have or have had a stoma for treatment for any medical condition. Analysis Distributions of the priority scores for each of the nine research topics were examined. Group differences were explored using either the Mann–Whitney U‐test or the Kruskal–Wallis test depending on the number of groups. Results In total, 225 people completed the survey. The most important research priority was pouch leak problems and stoma bag/appliance problems followed by hernia risk. There were statistically significant differences in ranking research priorities between males and females, age, underlying disease that led to a stoma, stoma type and length of time with a stoma. Conclusion People with a stoma are willing to engage in and set research priorities. The results should contribute towards future research about setting the research agenda for the study of stoma‐related concerns that impact quality of life.
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Musameh MD, Nelson CP, Gracey J, Tobin M, Tomaszewski M, Samani NJ. Determinants of day-night difference in blood pressure, a comparison with determinants of daytime and night-time blood pressure. J Hum Hypertens 2016; 31:43-48. [PMID: 26984683 PMCID: PMC5144126 DOI: 10.1038/jhh.2016.14] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [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: 08/29/2015] [Revised: 01/05/2016] [Accepted: 02/10/2016] [Indexed: 12/26/2022]
Abstract
Blunted day–night difference in blood pressure (BP) is an independent cardiovascular risk factor, although there is limited information on determinants of diurnal variation in BP. We investigated determinants of day–night difference in systolic (SBP) and diastolic (DBP) BP and how these compared with determinants of daytime and night-time SBP and DBP. We analysed the association of mean daytime, mean night-time and mean day–night difference (defined as (mean daytime−mean night-time)/mean daytime) in SBP and DBP with clinical, lifestyle and biochemical parameters from 1562 adult individuals (mean age 38.6) from 509 nuclear families recruited in the GRAPHIC Study. We estimated the heritability of the various BP phenotypes. In multivariate analysis, there were significant associations of age, sex, markers of adiposity (body mass index and waist–hip ratio), plasma lipids (total and low-density lipoprotein cholesterol and triglycerides), serum uric acid, alcohol intake and current smoking status on daytime or night-time SBP and/or DBP. Of these, only age (P=4.7 × 10−5), total cholesterol (P=0.002), plasma triglycerides (P=0.006) and current smoking (P=3.8 × 10−9) associated with day–night difference in SBP, and age (P=0.001), plasma triglyceride (P=2.2 × 10−5) and current smoking (3.8 × 10−4) associated with day–night difference in DBP. 24-h, daytime and night-time SBP and DBP showed substantial heritability (ranging from 18–43%). In contrast day–night difference in SBP showed a lower heritability (13%) while heritability of day–night difference in DBP was not significant. These data suggest that specific clinical, lifestyle and biochemical factors contribute to inter-individual variation in daytime, night-time and day–night differences in SBP and DBP. Variation in day–night differences in BP is largely non-genetic.
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Affiliation(s)
- M D Musameh
- Department of Cardiovascular Sciences, University of Leicester, British Heart Foundation Cardiovascular Research Centre, Glenfield Hospital, Leicester, UK.,National Institute for Health Research Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK
| | - C P Nelson
- Department of Cardiovascular Sciences, University of Leicester, British Heart Foundation Cardiovascular Research Centre, Glenfield Hospital, Leicester, UK.,National Institute for Health Research Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK
| | - J Gracey
- Department of Cardiovascular Sciences, University of Leicester, British Heart Foundation Cardiovascular Research Centre, Glenfield Hospital, Leicester, UK.,National Institute for Health Research Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK
| | - M Tobin
- Department of Health Sciences, University of Leicester, University Road, Leicester, UK
| | - M Tomaszewski
- Department of Cardiovascular Sciences, University of Leicester, British Heart Foundation Cardiovascular Research Centre, Glenfield Hospital, Leicester, UK.,National Institute for Health Research Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK
| | - N J Samani
- Department of Cardiovascular Sciences, University of Leicester, British Heart Foundation Cardiovascular Research Centre, Glenfield Hospital, Leicester, UK.,National Institute for Health Research Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK
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Gracey J, Harte A, Allen S, Dunwoody L. Establishing current practice in pilates. Large scale questionnaire surveys of instructors and clients. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.3267] [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: 11/26/2022]
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Braund P, Kharodia S, Moore J, Gracey J, Codd V, Webb T, Samani N. The coronary artery disease associated variant at 10q23.31 is associated with increased lysosomal acid lipase A activity. Atherosclerosis 2014. [DOI: 10.1016/j.atherosclerosis.2014.10.046] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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McFeely JA, Gracey J. Postoperative exercise programmes for lumbar spine decompression surgery: a systematic review of the evidence. Physical Therapy Reviews 2013. [DOI: 10.1179/108331906x144127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Abstract
This aim of this systematic review was to determine the prevalence and pattern of cancer-related fatigue (CRF), and identify factors associated with its development. Relevant literature was identified through an electronic database search using specified keywords. Included studies investigated CRF in adult cancer patients using a multidimensional fatigue measure. The methodological quality was assessed using six published standards. CRF is apparent both during and after anti-cancer therapy, however, the prevalence of CRF varied between studies. The variables associated with the development and persistence of CRF remain to be identified. Inconsistencies were evident in the pattern of CRF and its associated factors. This is likely to have arisen from the inherent difficulties in the measurement of a subjective sensation, further complicated by the myriad of outcome measures used. More methodologically sound research; assessing CRF from the commencement of therapy, considering all pertinent variables is needed.
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Affiliation(s)
- G Prue
- Health and Rehabilitation Sciences Research Institute, University of Ulster, Room 14J17, Shore Road, Newtownabbey, Co. Antrim, Northern Ireland BT37 0QB, United Kingdom
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Prue G, Rankin J, Cramp F, Allen J, Gracey J. Fatigue in gynaecological cancer patients: a pilot study. Support Care Cancer 2005; 14:78-83. [PMID: 15883794 DOI: 10.1007/s00520-005-0830-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2004] [Accepted: 04/20/2005] [Indexed: 10/25/2022]
Abstract
RATIONALE Fatigue is a frequent complaint of women with cancer. However, the incidence of fatigue has not been well studied, in particular gynaecological cancer, which despite its prevalence has received minimal investigation. GOALS OF WORK The study aims were (1) to explore the symptoms experienced in a gynaecological cancer population, primarily fatigue and (2) to determine the acceptability of a fatigue questionnaire for use in a longitudinal survey. PATIENTS AND METHODS Over the course of 1 month, women with gynaecological cancer attending a Regional Cancer Centre completed a demographic and symptom questionnaire and the Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF). MAIN RESULTS Of the 32 individuals approached, 30 agreed to participate (mean age, 61 years; the most common treatment received was surgery followed by chemotherapy n=11; mean time from commencement of treatment, including surgery = 3 months). All participants completed the MFSI-SF. Tiredness was the most commonly reported symptom, experienced by 90% of subjects and the most frequently stated worst symptom, reported by 23.3%. Furthermore, 23 of 27 subjects reported that tiredness interfered completely with their daily living. The MFSI-SF mean total fatigue score was 14.4 (SD 15.9), ranging from -15 to 50. The possible total fatigue score ranges from -24 to 96. CONCLUSION Despite the heterogeneous nature of the group, all participants completed the MFSI-SF. The study suggests that fatigue could be a problem for this population group. Thus, a longitudinal survey using the MFSI-SF to investigate the phenomenon further would appear feasible and justified.
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Affiliation(s)
- G Prue
- Health and Rehabilitation Sciences Research Institute, University of Ulster, Shore Road, Newtownabbey, Co. Antrim, Northern Ireland, BT37 0QB, UK
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