Unmet Supportive Care Needs Among Cancer Patients in Sub-Saharan African Countries: A Mixed Method Systematic Review and Meta-Analysis

INTRODUCTION

Supportive cancer care is vital to reducing the current disparities in cancer outcomes in Sub-Saharan Africa (SSA), including poor survival and low quality of life, and ultimately achieving equity in cancer care. This is the first review aimed to evaluate the extent of unmet supportive care needs and identify their contributing factors among patients with cancer in SSA.

METHODS

Six electronic databases (CINAHL, Embase, Medline [Ovid], PsycINFO, PubMed, and Cochrane Library of Databases] were systematically searched. Studies that addressed one or more domains of unmet supportive cancer care needs were included. Findings were analyzed using narrative analysis and meta-analysis, as appropriate.

RESULT

Eleven articles out of 2732 were retained in the review. The pooled prevalence of perceived unmet need for cancer care in SSA was 63% (95% CI: 45, 81) for physical, 59% (95% CI: 45, 72) for health information and system, 58% (95% CI: 42, 74) for psychological, 44% (95% CI: 29, 59) for patient care and support, and 43% (95% CI: 23, 63) for sexual. Older age, female sex, rural residence, advanced cancer stage, and low access to health information were related to high rates of multiple unmet needs within supportive care domains.

CONCLUSION

In SSA, optimal cancer care provision was low, up to two-thirds of patients reported unmet needs for one or more domains. Strengthening efforts to develop comprehensive and integrated systems for supportive care services are keys to improving the clinical outcome, survival, and quality of life of cancer patients in SSA.

Association of Physical Domain Participation with POTFF Domains in Special Forces Operators

BACKGROUND

The purpose of this study was to evaluate the effectiveness of the physical domain (PD) to improve performance in all the POTFF domains (physical, psychological, social/family, and spiritual) among Special Forces (SF) Operators.

METHODS

This was a cross-sectional study of active SF Operators assigned to the United States Army Special Operations Command (USASOC). Recruitment began in October 2016. Testing began on 1 January 2017, and concluded on 28 February 2020. Participants completed physical testing, blood draws, and questionnaires to determine domain metrics. Means, medians, and proportions were compared by level of participation in the PD.

RESULTS

A total of 231 Soldiers participated; n=63 in the control group, n=93 in the <4 days PD/week (PD <4) group, and n=66 in the >4 days PD/week (PD =4) group. The average age was 31 years (range 21-47 y). The average time in the Special Operations Forces (SOF) was 4 years (range 0-19 y). The PD =4 group showed significantly greater overall upper (p=.01) and lower (p=0) body strength, power (p=.01), and positive affect (p=.04). The PD =4 group also had significantly lower anxiety (p=.03), stress (p=.04), and depression (p=.02) than the control group.

CONCLUSION

The PD and psychological domain metrics were most associated with PD participation. This finding is consistent with the goals of the PD, which are to increase physical and mental capabilities and decrease injury recovery time.

Self-care and Wellness Checks in Emergency Field Hospitals During COVID-19 Pandemic: A New Self-check Tool for Military Personnel and Civilians

The authors explore the impact of cumulative stress on United States (US) military service members (SM), including soldiers and medical personnel, deployed to serve in New York City (NYC) communities. Their mission was to assist in establishing emergency field hospitals during the COVID-19 pandemic. Causative biopsychosocial factors are presented, as well as the impact of wellness checks, which were utilized to monitor the mood and morale of frontline healthcare providers, military personnel, and infected patients in a 2,500-bed emergency field hospital and a 1,000-bed Naval hospital ship operating in the metropolitan NYC area. The authors introduce a self-care and wellness tool, which assesses five core domains (physical, mental, emotional, social, and spiritual) for the purpose of assessing and improving individual overall well-being during periods of heightened stress. This instrument could aid attending medical personnel in identifying patients at risk of suicide. Likewise, the utility of this self-care tool is applicable to both military SM and civilians, and includes soldiers and medical personnel.

Comprehensive physical domain care needs of burn patients: a qualitative study

INTRODUCTION

Burn patients have various physical needs. To provide full care for such patients, we need a broad range of services. The current study aims at showing the physical needs of burn patients.

METHODS

The current qualitative study has been done through content analysis. The data were collected from 20 in-depth, unstructured individual interviews with hospitalized patients with burns on more than 25% of their body, nurses, physiotherapists, and psychologists. The participants were selected by purposive sampling. The data were analyzed with a conventional content analysis approach using the Elo and Kyngas method.

RESULTS

By analyzing the data, 7 main categories were obtained from 932 primary codes: the necessity to provide optimal physiotherapy, the necessity of the patient's overall physical assessment, the necessity of monitoring and coordination in care, healthy nutrition for burn patients, the need for pharmacotherapy, the need for pain reliefs, and finally the theme for comprehensive physical care needs in burn patients.

CONCLUSION

According to the findings, by applying the extracted categories, it is possible to provide quality care based on the patient's individual needs. This can help speed up the treatment and shorten the length of hospitalization significantly.

[Psychophysiological determinants of perception of quality of life of gerontological patients with urolithiasis]

The analysis of psychophysiological determinancy perception of life quality of gerontological patients with urolithiasis. The study was performed on 108 patients aged 60 to 76 years (51men, 57women). In order to determine the psychophysiological phenomenology of life survey was selected - before surgery, during the severe clinical manifestations of the disease. Research Methods «integrative anxiety test» (ICT 1997), «type attitude to the disease» (Tobol, 1987), total questionnaire WHOQOL-100. Types relationship to disease, in which anxiety is not significantly improved due to illness, causes higher levels of QOL (86,4±2,69) compared to the level of 70,1±4,28 points (p<0,001, r=-0,35) corresponding types of response in the presence of high anxiety. The presence of trait anxiety levels decreased quality of life in both sexes. In men, there was the highest level of determinism of the quality of life of their independence and physical ability; women - social relations and spiritual sphere. The lowest indicators of quality of life were observed in women and in patients with acute onset and complicated urolithiasis.

How contrast situations affect the assignment of causality in symmetric physical settings

In determining the prime cause of a physical event, people often weight one of two entities in a symmetric physical relation as more important for bringing about the causal effect than the other. In a broad survey (Bender and Beller, 2011), we documented such weighting effects for different kinds of physical events and found that their direction and strength depended on a variety of factors. Here, we focus on one of those: adding a contrast situation that-while being formally irrelevant-foregrounds one of the factors and thus frames the task in a specific way. In two experiments, we generalize and validate our previous findings by using different stimulus material (in Experiment 1), by applying a different response format to elicit causal assignments, an analog rating scale instead of a forced-choice decision (in Experiment 2), and by eliciting explanations for the physical events in question (in both Experiments). The results generally confirm the contrast effects for both response formats; however, the effects were more pronounced with the force-choice format than with the rating format. People tended to refer to the given contrast in their explanations, which validates our manipulation. Finally, people's causal assignments are reflected in the type of explanation given in that contrast and property explanations were associated with biased causal assignments, whereas relational explanations were associated with unbiased assignments. In the discussion, we pick up the normative questions of whether or not these contrast effects constitute a bias in causal reasoning.

Causal asymmetry across cultures: assigning causal roles in symmetric physical settings

Causal cognition in the physical domain has been treated for a long time as if it were (1) objective and (2) independent of culture. Despite some evidence to the contrary, however, these implicit assumptions have been rarely ever explored systematically. While the pervasive tendency of people to consider one of two equally important entities as more important for bringing about an effect (as reported by White, 2006) meanwhile provides one type of counter-evidence for the first assumption, respective findings remained mute to the second. In order to scrutinize how robust such tendencies are across cultures - and, if not, on which aspects of culture they may depend - we asked German and Tongan participants to assign prime causality in nine symmetric settings. For most settings, strong asymmetries in both cultures were found, but not always in the same direction, depending on the task content and by virtue of the multifaceted character of "culture." This indicates that causal asymmetries, while indeed being a robust phenomenon across cultures, are also modulated by task-specific properties (such as figure-ground relations), and are subject to cultural influences.