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Faust C, Auquier P, Gandemer V, Bertrand Y, Tabone M, Ansoborlo S, Baruchel A, Bonneau J, Dalle J, Chastagner P, Kanold J, Poirée M, Theron A, Olivier L, Pellier I, Michel G, Berbis J. Educational outcomes in siblings of childhood leukemia survivors: Factors associated with school difficulties and comparison with general population. Cancer Med 2024; 13:e6821. [PMID: 38204153 PMCID: PMC10904966 DOI: 10.1002/cam4.6821] [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: 09/26/2023] [Revised: 11/15/2023] [Accepted: 12/03/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND To investigate the educational outcomes of siblings of childhood leukemia survivors, explore determinants of school difficulties, and compare the rates of repeating grades between siblings and the general population. METHODS A cross-sectional study of childhood leukemia survivors' siblings recruited through the Leucémies de l'Enfant et de l'Adolescent cohort, a French long-term follow-up program, was conducted, and education-related data were obtained via self-report questionnaires. Adjusted logistic regression models were used to identify variables associated with school difficulties and time since diagnosis. Rates of repeating a grade in middle school were compared between siblings and the general population of the same generation. RESULTS A total of 564 siblings with a mean time from diagnosis of 14.1 ± 6.4 years were included, among whom 139 (24.6%) repeated a grade, at an average of 6.4 ± 4.5 years after diagnosis. In multivariate analysis, the risk factors for repeating a grade were older siblings (odds ratio [OR] 2.3, p = 0.006), family financial difficulties (OR 2.8, p = 0.008), and history of repetition in survivors (OR, 2.5, p = 0.001). Sibling hematopoietic stem cell donors were at greater risk of repeating a grade long-term after diagnosis (p = 0.018). Overall, siblings did not have a higher risk of educational delays at the end of middle school than the general population. CONCLUSION Although the results are reassuring, socioeconomic and cancer-related factors may have an impact on siblings' schooling long after diagnosis. Paying attention to siblings contributes to identifying the most vulnerable families, allowing more attention and appropriate resources to avoid long-term repercussions. Additionally, supportive and targeted interventions can be developed to improve the organization of education and the health care system.
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Affiliation(s)
- Cindy Faust
- UR 3279, CERESS – Health Service Research and Quality of Life CenterAix‐Marseille UniversityMarseilleFrance
| | - Pascal Auquier
- UR 3279, CERESS – Health Service Research and Quality of Life CenterAix‐Marseille UniversityMarseilleFrance
| | - Virginie Gandemer
- Department of Pediatric Hematology‐OncologyUniversity Hospital of RennesRennesFrance
| | - Yves Bertrand
- Department of Pediatric Hematology‐OncologyUniversity Hospital of LyonLyonFrance
| | | | - Sophie Ansoborlo
- Department of Pediatric Hematology‐OncologyUniversity Hospital of BordeauxBordeauxFrance
| | - André Baruchel
- Department of Pediatric Hematology‐Oncology, Robert Debré HospitalGHU AP‐HP Nord Université Paris CitéParisFrance
| | - Jacinthe Bonneau
- Department of Pediatric Hematology‐OncologyUniversity Hospital of RennesRennesFrance
| | - Jean‐Hugues Dalle
- Department of Pediatric Hematology‐Oncology, Robert Debré HospitalGHU AP‐HP Nord Université Paris CitéParisFrance
| | - Pascal Chastagner
- Department of Pediatric Hematology‐OncologyChildren's Hospital of BraboisVandoeuvre Les NancyFrance
| | - Justyna Kanold
- Department of Pediatric Hematology‐OncologyCIC Inserm 501, University Hospital of Clermont‐FerrandClermont‐FerrandFrance
| | - Maryline Poirée
- Department of Pediatric Hematology‐OncologyUniversity Hospital L'ArchetNiceFrance
| | - Alexandre Theron
- Department of Pediatric Hematology‐OncologyUniversity Hospital of MontpellierMontpellierFrance
| | - Laura Olivier
- Department of Pediatric Hematology‐OncologyUniversity Hospital of ToulouseToulouseFrance
| | - Isabelle Pellier
- Department of Pediatric Hematology‐OncologyUniversity Hospital of AngersAngersFrance
| | - Gérard Michel
- UR 3279, CERESS – Health Service Research and Quality of Life CenterAix‐Marseille UniversityMarseilleFrance
- Department of Pediatric Hematology‐OncologyTimone Children's Hospital and Aix‐Marseille UniversityMarseilleFrance
| | - Julie Berbis
- UR 3279, CERESS – Health Service Research and Quality of Life CenterAix‐Marseille UniversityMarseilleFrance
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Mullins MA, Reber L, Washington A, Stasenko M, Rankin A, Friese CR, Cooley ME, Hudson MF, Wallner LP. Barriers, facilitators, and recommendations for sexual orientation and gender identity data collection in community oncology practices. Cancer Med 2023; 12:19203-19214. [PMID: 37732470 PMCID: PMC10557876 DOI: 10.1002/cam4.6517] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 08/22/2023] [Accepted: 08/30/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Sexual orientation and gender identity (SOGI) data collection in community oncology practices is critical to identify and address cancer inequities, but less than 20% of NCI Community Oncology Research Program (NCORP)-affiliated practices regularly collect SOGI data despite widespread recommendations. We evaluated multilevel barriers and facilitators for SOGI data collection at NCORP practices. METHODS We conducted 14 semi-structured interviews at seven purposefully sampled NCORP oncology practices. We interviewed one clinician (oncologist, advanced practice provider) and one clinic staff member per practice. Thematic analysis informed by the Consolidated Framework for Implementation Research (CFIR) was conducted to identify barriers and facilitators. RESULTS Thematic saturation occurred after interviews at six practices and was confirmed with interviews at an additional practice. Participants highlighted multilevel barriers including low levels of understanding, information technology infrastructure, and perceived low relative priority. Not understanding the role of SOGI data in oncology care contributed to cis-heteronormative culture. At the clinic level, this culture coincided with a lack of processes and policies for collecting SOGI from all patients. At the care team level, perceived irrelevance to oncology care was related to discomfort asking SOGI, fear of patient discomfort, and limited awareness of SOGI in electronic health records. Suggested solutions included: normalizing asking SOGI questions, giving patients privacy to complete SOGI, and clarifying clinical relevance. CONCLUSIONS SOGI data collection barriers stemmed from perceptions that SOGI disclosure does not influence care quality. Oncology teams may benefit from training on culturally sensitive SOGI collection, education on SOGI data relevance to oncology practices, and support for implementing SOGI data collection policies.
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Affiliation(s)
- Megan A. Mullins
- Peter O'Donnell Jr. School of Public HealthUT Southwestern Medical CenterDallasTexasUSA
- Harold C. Simmons Comprehensive Cancer CenterUT Southwestern Medical CenterDallasTexasUSA
| | - Lisa Reber
- Peter O'Donnell Jr. School of Public HealthUT Southwestern Medical CenterDallasTexasUSA
| | - Ariel Washington
- Karmanos Cancer Institute, Department of OncologyWayne State University School of MedicineDetroitMichiganUSA
| | - Marina Stasenko
- Division of Gynecologic Oncology, Department of Obstetrics and GynecologyNYU Langone HealthNew YorkNew YorkUSA
| | - Aaron Rankin
- Department of Internal MedicineUniversity of MichiganAnn ArborMichiganUSA
| | - Christopher R. Friese
- Center for Improving Patient and Population HealthUniversity of MichiganAnn ArborMichiganUSA
- Rogel Cancer CenterUniversity of MichiganAnn ArborMichiganUSA
| | - Mary E. Cooley
- Phyllis F. Cantor Center, Research in Nursing and Patient Care ServicesDana‐Farber Cancer InstituteBostonMassachusettsUSA
| | - Matthew F. Hudson
- Prisma Health Cancer Institute Greenville South CarolinaGreenvilleSouth CarolinaUSA
| | - Lauren P. Wallner
- Department of Internal MedicineUniversity of MichiganAnn ArborMichiganUSA
- Rogel Cancer CenterUniversity of MichiganAnn ArborMichiganUSA
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Skog R, Lampic C, Olsson E, Wettergren L. The role of a discussion forum within a web-based psychoeducational intervention focusing on sex and fertility-What do young adults communicate? Cancer Med 2023; 12:17273-17283. [PMID: 37401398 PMCID: PMC10501254 DOI: 10.1002/cam4.6317] [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: 02/17/2023] [Revised: 06/16/2023] [Accepted: 06/24/2023] [Indexed: 07/05/2023] Open
Abstract
OBJECTIVE This study sought to investigate interactive participation and content of a moderated discussion forum within a web-based psychoeducational intervention aimed at alleviating sexual dysfunction and fertility distress in young adults diagnosed with cancer. METHODS The study is part of the Fex-Can Young Adult randomized controlled trial (RCT), in which young adults with self-reported sexual dysfunction or fertility distress were invited to participate. This study focuses on RCT participants that were randomized into the intervention condition. Sociodemographics and clinical characteristics of intervention participants and level of activity in the intervention were analyzed with descriptive statistics and compared between subgroups ("high" and "low" activity participants). Inductive qualitative thematic analysis was used to analyze the posts in the discussion forum. RESULTS Of 135 intervention participants, 24% met the criteria for high activity participation. There were no statistically significant differences found in terms of clinical and sociodemographic characteristics between high and low activity participants. Ninety-one participants (67%) accessed the discussion forum, and 19 (14%) posted at least once. Posters shared intimate details of their experiences of sexuality and fertility following cancer. The thematic analysis of posts resulted in four themes: fertility fears, perceptions of the changed body, missing out on life, and importance of support and information. CONCLUSIONS While a smaller proportion of participants posted in the discussion forum, a majority spent time reading posts (lurkers). Participants posting in the forum shared experiences of intimate relationships, body image, parenthood concerns, and support needs. The discussion forum was used by a majority of intervention participants, and provided appreciated support for those who posted in the forum. We therefore recommend similar interventions to include this opportunity for interaction and communication.
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Affiliation(s)
- Rebecca Skog
- Department of Public Health and Caring SciencesUppsala UniversityUppsalaSweden
| | - Claudia Lampic
- Department of Public Health and Caring SciencesUppsala UniversityUppsalaSweden
- Department of Women's and Children's HealthKarolinska InstituteStockholmSweden
- Department of PsychologyUmeå UniversityUmeåSweden
| | - Erik Olsson
- Department of Women's and Children's HealthUppsala UniversityUppsalaSweden
| | - Lena Wettergren
- Department of Public Health and Caring SciencesUppsala UniversityUppsalaSweden
- Department of Women's and Children's HealthKarolinska InstituteStockholmSweden
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4
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Thomson MD, Van Houtven CH, Xu R, Siminoff LA. The many "costs" of transportation: Examining what cancer caregivers experience as transportation obstacles. Cancer Med 2023; 12:17356-17364. [PMID: 37485648 PMCID: PMC10501274 DOI: 10.1002/cam4.6351] [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: 04/12/2023] [Revised: 07/06/2023] [Accepted: 07/07/2023] [Indexed: 07/25/2023] Open
Abstract
BACKGROUND Transportation has been identified as a specific source of burden for cancer caregivers. This study examined cancer caregivers' subjective experiences and objectives costs associated with transportation over a 6-month period of providing end-of-life care to a family member or friend. METHODS This was a multi-site longitudinal, prospective cohort study that followed 223 caregiver-patient dyads. Data were collected using biweekly, semi-structured interviews for up to 6 months and collection of all caregiving related receipts. Interviews were coded and analyzed using a comparative, iterative analysis and actual out of pockets costs were described using descriptive statistics. RESULTS Over the 6-month study period most caregivers (n = 143; 74%) discussed transportation at one or more timepoints. Average biweekly transportations costs to caregivers were $43.6. Caregivers described (n = 56; 39%) multiple direct and indirect costs of transportation, and 58% (n = 84) discussed the need for transportations services or assistance at the institutional level. CONCLUSIONS Caregivers described the multifaceted costs of transportation they experienced which are in line with previous work. Alongside descriptions of direct costs, caregivers described key opportunity costs, such as personal and work time forgone to transporting patients. Caregivers also made suggestions for institutional and/or civic based solutions to facilitate reliable modes of transportation, rather than individual-level intervention.
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Affiliation(s)
- Maria D. Thomson
- Department of Health Behavior and PolicyVirginia Commonwealth UniversityRichmondVirginiaUSA
| | - Courtney Harold Van Houtven
- Department of Population Health SciencesDuke UniversityDurhamNorth CarolinaUSA
- Durham ADAPT, Durham Veterans Affairs Medical CenterDurhamNorth CarolinaUSA
| | - Rebecca Xu
- Virginia Commonwealth University School of MedicineRichmondVirginiaUSA
| | - Laura A. Siminoff
- Department of Social and Behavioral SciencesTemple UniversityPhiladelphiaPennsylvaniaUSA
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5
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Ferrara G, Aguina M, Mirochnick E, Wiphatphumiprates P, Moreira DC, Sniderman E, Villegas CA, Kaye EC, Ragab I, Maliti B, Naidu G, Gassant PY, Arce D, Arora RS, Alcasabas AP, Raza MR, Velasco P, Kambugu J, Vinitsky A, Rodriguez Galindo C, Agulnik A, Graetz DE. Communication transforms the impact of the COVID-19 pandemic on children with cancer and their families. Cancer Med 2023. [PMID: 37081718 DOI: 10.1002/cam4.5950] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 03/15/2023] [Accepted: 04/02/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic altered healthcare systems globally, causing delays in care delivery and increased anxiety among patients and families. This study examined how hospital stakeholders and clinicians perceived the global impact of the COVID-19 pandemic on children with cancer and their families. METHODS This secondary analysis examined data from a qualitative study consisting of 19 focus groups conducted in 8 languages throughout 16 countries. A codebook was developed with novel codes derived inductively from transcript review. In-depth analysis focused on the impact of the COVID-19 pandemic on children with cancer and their families. RESULTS Eight themes describing the impact of the pandemic on patients and their families were identified and classified into three domains: contributing factors (COVID-19 Policies, Cancer Treatment Modifications, COVID-19 Symptoms, Beliefs), patient-related impacts (Quality of Care, Psychosocial impacts, Treatment Reluctance), and the central transformer (Communication). Participants described the ability of communication to transform the effect of contributing factors on patient-related impacts. The valence of impacts depended on the quality and quantity of communication among clinicians and between clinicians and patients and families. CONCLUSIONS Communication served as the central factor impacting whether the COVID-19 pandemic positively or negatively affected children with cancer and families. These findings emphasize the key role communication plays in delivering patient-centered care and can guide future development of communication-centered interventions globally.
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Affiliation(s)
- Gia Ferrara
- St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Molly Aguina
- Princeton University, Princeton, New Jersey, USA
| | - Emily Mirochnick
- The Chicago Medical School at Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA
| | | | | | - Elizabeth Sniderman
- Northern Alberta Children's Cancer Program, Stollery Children's Hospital, Edmonton, Alberta, Canada
| | | | - Erica C Kaye
- St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Iman Ragab
- Ain Shams University, Children's Hospital, Hematology-Oncology Unit, Cairo, Egypt
| | | | - Gita Naidu
- Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Daniela Arce
- Hospital Pediátrico de Sinaloa, Culiacan, Mexico
| | | | | | | | - Pablo Velasco
- Pediatric Oncology and Hematology Department, Vall d'Hebron Hospital, Barcelona, Spain
| | | | - Anna Vinitsky
- St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | | | - Asya Agulnik
- St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Dylan E Graetz
- St. Jude Children's Research Hospital, Memphis, Tennessee, USA
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6
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Williams AH, Rivas S, Fuentes L, Cáceres‐Serrano A, Ferrara G, Reeves T, Antillon‐Klussmann F, Rodriguez‐Galindo C, Mack JW, Graetz DE. Understanding hope at diagnosis: A study among Guatemalan parents of children with cancer. Cancer Med 2023; 12:9966-9975. [PMID: 36846975 PMCID: PMC10166945 DOI: 10.1002/cam4.5725] [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: 09/27/2022] [Revised: 01/05/2023] [Accepted: 02/10/2023] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND In high-income countries, hope facilitates parental coping and builds the clinical relationship between families of children with cancer and their clinicians. However, the manifestation of hope in low- and middle-income countries (LMICs) remains poorly understood. Our study explores Guatemalan parents' experiences with hope during the pediatric oncology diagnostic process and aims to identify discrete actions clinicians take to support hope. METHODS This qualitative study utilized audio-recordings of the diagnostic process and an additional semi-structured interview for 20 families of children with cancer at Unidad Nacional de Oncología Pediátrica in Guatemala. Spanish audio-recordings were translated into English, transcribed, and coded using a priori and novel codes. Thematic content analysis using constant comparative methods explored parents' hopes and concerns. RESULTS At diagnosis, Guatemalan parents expressed both hopes and concerns related to the entire cancer continuum. Throughout the diagnostic process, hope grew as concerns were alleviated. Clinicians supported hope by creating a supportive environment, providing information, affirming religious beliefs, and empowering parents. These strategies helped parents shift their focus from fear and uncertainty toward hope for their child's future. Parents expressed that establishing hope improved mood, promoted acceptance, and enabled them to care for themselves and their children. CONCLUSION These results confirm the relevance of supporting hope in pediatric oncology settings in LMICs and suggest that culture informs hope-related needs. Supporting hope is critical across cultures and can be integrated into clinical conversation using the four processes identified by our results.
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Affiliation(s)
| | - Silvia Rivas
- Unidad Nacional de Oncología PediátricaGuatemala CityGuatemala
| | - Lucia Fuentes
- Unidad Nacional de Oncología PediátricaGuatemala CityGuatemala
| | | | - Gia Ferrara
- St. Jude Children's Research HospitalMemphisTennesseeUSA
| | - Tegan Reeves
- St. Jude Children's Research HospitalMemphisTennesseeUSA
| | - Federico Antillon‐Klussmann
- Unidad Nacional de Oncología PediátricaGuatemala CityGuatemala
- Francisco Marroquin University School of MedicineGuatemala CityGuatemala
| | | | - Jennifer W. Mack
- Dana Farber Cancer Institute/Boston Children's HospitalBostonMassachusettsUSA
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Teo I, Ng S, Bundoc FG, Malhotra C, Ozdemir S, Steel JL, Finkelstein EA. A prospective study of psychological distress among patients with advanced cancer and their caregivers. Cancer Med 2023; 12:9956-9965. [PMID: 36934452 PMCID: PMC10166955 DOI: 10.1002/cam4.5713] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 03/20/2023] Open
Abstract
BACKGROUND Cancer can impact the psychological well-being of both patients and their informal caregivers. We investigated the joint trajectories of psychological distress among Singaporean advanced cancer patients-caregiver dyads. We also examined predictors of trajectory group membership. METHODS This study utilised data from 299 patients with advanced solid cancer and their caregivers over 33 months (12 times points). Group-based trajectory modelling was used to examine the joint trajectories of patient anxiety, patient depression, caregiver anxiety and caregiver depression scores using the Hospital Anxiety and Depression Scale. RESULTS Four joint trajectory groups were found: (1) Patient-caregiver low distress (27%), (2) patient-caregiver increasing distress (28.5%), (3) patient low- caregiver borderline distress (25%), (4) patient-caregiver high distress (19.5%). Dyads where the patient is below 50 years of age were more likely to be in Group 4. Dyads where caregiver-patient emotional closeness was low were more likely to be in Groups 2 or 4 where dyads reported increasing/high distress. Dyads that reported financial inadequacy were more likely to be in Groups 2, 3 and 4, while dyads with caregivers who were employed were more likely to be in group 3. CONCLUSIONS A substantial proportion of patients and caregivers reported anxiety and/or depression that lasted or increased throughout the study duration. We found significant heterogeneity in how dyads experienced psychological distress, suggesting that efforts should consider dyadic differences when providing psychological support. Particular focus should be placed on identifying dyads that are at risk and who require additional support.
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Affiliation(s)
- Irene Teo
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore.,Signature Programme in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.,National Cancer Centre Singapore, Singapore, Singapore
| | - Sean Ng
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore
| | | | - Chetna Malhotra
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore.,Signature Programme in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Semra Ozdemir
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore.,Signature Programme in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Jennifer L Steel
- Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Eric A Finkelstein
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore.,Signature Programme in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.,Duke Global Health Institute, Duke University, Durham, North Carolina, USA
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8
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Guan A, Shim JK, Allen L, Kuo MC, Lau K, Loya Z, Brooks JD, Carroll PR, Cheng I, Chung BI, DeRouen MC, Frosch DL, Golden T, Leppert JT, Lichtensztajn DY, Lu Q, Oh DL, Sieh W, Wadhwa M, Gomez SL, Shariff-Marco S. Factors that influence treatment decisions: A qualitative study of racially and ethnically diverse patients with low- and very-low risk prostate cancer. Cancer Med 2023; 12:6307-6317. [PMID: 36404625 PMCID: PMC10028041 DOI: 10.1002/cam4.5405] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 10/10/2022] [Accepted: 10/22/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Factors that influence prostate cancer treatment decisions are complex, multifaceted, and personal, and may vary by race/ethnicity. Although research has been published to quantify factors involved in decision-making, these studies have been limited to primarily white, and to a lesser extent, Black patients, and quantitative studies are limited for discerning the cultural and contextual processes that shape decision-making. METHODS We conducted 43 semi-structured interviews with a racially and ethnically diverse sample of patients diagnosed with low- and very-low risk prostate cancer who had undergone treatment for their prostate cancer. Interviews were transcribed, independently coded, and analyzed to identify themes salient for decision-making, with attention to sociocultural differences. RESULTS We found racial and ethnic differences in three areas. First, we found differences in how socialized masculinity influenced patient's feelings about different treatment options. Second, we found that for some men, religion and spirituality alleviated anxiety associated with the active surveillance protocol. Finally, for racially and ethnically minoritized patients, we found descriptions of how historic and social experiences within the healthcare system influenced decision-making. CONCLUSIONS Our study adds to the current literature by expounding on racial and ethnic differences in the multidimensional, nuanced factors related to decision-making. Our findings suggest that factors associated with prostate cancer decision-making can manifest differently across racial and ethnic groups, and provide some guidance for future research.
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Affiliation(s)
- Alice Guan
- Department of Epidemiology & Biostatistics, University of California, San Francisco, California, USA
| | - Janet K Shim
- Department of Social & Behavioral Sciences, University of California, San Francisco, California, USA
| | - Laura Allen
- Department of Epidemiology & Biostatistics, University of California, San Francisco, California, USA
| | - Mei-Chin Kuo
- Department of Epidemiology & Biostatistics, University of California, San Francisco, California, USA
| | - Kathie Lau
- Department of Epidemiology & Biostatistics, University of California, San Francisco, California, USA
| | - Zinnia Loya
- Department of Epidemiology & Biostatistics, University of California, San Francisco, California, USA
| | - James D Brooks
- Department of Urology, Stanford University, Stanford, California, USA
| | - Peter R Carroll
- Department of Urology, University of California, San Francisco, California, USA
| | - Iona Cheng
- Department of Epidemiology & Biostatistics, University of California, San Francisco, California, USA
| | - Benjamin I Chung
- Department of Urology, Stanford University, Stanford, California, USA
| | - Mindy C DeRouen
- Department of Epidemiology & Biostatistics, University of California, San Francisco, California, USA
| | - Dominic L Frosch
- Center for Health Systems Research, Sutter Health/Palo Alto Medical Foundation Research Institute, Palo Alto, California, USA
| | - Todd Golden
- Department of Epidemiology & Biostatistics, University of California, San Francisco, California, USA
| | - John T Leppert
- Department of Urology, Stanford University, Stanford, California, USA
| | - Daphne Y Lichtensztajn
- Department of Epidemiology & Biostatistics, University of California, San Francisco, California, USA
| | - Qian Lu
- Department of Health Disparities Research, University of Texas MD-Anderson Cancer Center, Houston, Texas, USA
| | - Debora L Oh
- Department of Epidemiology & Biostatistics, University of California, San Francisco, California, USA
| | - Weiva Sieh
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Michelle Wadhwa
- Department of Epidemiology & Biostatistics, University of California, San Francisco, California, USA
| | - Scarlett L Gomez
- Department of Epidemiology & Biostatistics, University of California, San Francisco, California, USA
| | - Salma Shariff-Marco
- Department of Epidemiology & Biostatistics, University of California, San Francisco, California, USA
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9
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Bethea TN, Zhai W, Zhou X, Ahles TA, Ahn J, Cohen HJ, Dilawari AA, Graham DMA, Jim HSL, McDonald BC, Nakamura ZM, Patel SK, Rentscher KE, Root J, Saykin AJ, Small BJ, Van Dyk KM, Mandelblatt JS, Carroll JE. Associations between longitudinal changes in sleep disturbance and depressive and anxiety symptoms during the COVID-19 virus pandemic among older women with and without breast cancer in the thinking and living with breast cancer study. Cancer Med 2022; 11:3352-3363. [PMID: 35315588 PMCID: PMC9110906 DOI: 10.1002/cam4.4682] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 02/25/2022] [Accepted: 02/28/2022] [Indexed: 12/16/2022] Open
Abstract
PURPOSE Several studies have reported sleep disturbances during the COVID-19 virus pandemic. Little data exist about the impact of the pandemic on sleep and mental health among older women with breast cancer. We sought to examine whether women with and without breast cancer who experienced new sleep problems during the pandemic had worsening depression and anxiety. METHODS Breast cancer survivors aged ≥60 years with a history of nonmetastatic breast cancer (n = 242) and frequency-matched noncancer controls (n = 158) active in a longitudinal cohort study completed a COVID-19 virus pandemic survey from May to September 2020 (response rate 83%). Incident sleep disturbance was measured using the restless sleep item from the Center for Epidemiological Studies-Depression Scale (CES-D). CES-D score (minus the sleep item) captured depressive symptoms; the State-Anxiety subscale of the State Trait Anxiety Inventory measured anxiety symptoms. Multivariable linear regression models examined how the development of sleep disturbance affected changes in depressive or anxiety symptoms from the most recent prepandemic survey to the pandemic survey, controlling for covariates. RESULTS The prevalence of sleep disturbance during the pandemic was 22.3%, with incident sleep disturbance in 10% and 13.5% of survivors and controls, respectively. Depressive and anxiety symptoms significantly increased during the pandemic among women with incident sleep disturbance (vs. no disturbance) (β = 8.16, p < 0.01 and β = 6.14, p < 0.01, respectively), but there were no survivor-control differences in the effect. CONCLUSION Development of sleep disturbances during the COVID-19 virus pandemic may negatively affect older women's mental health, but breast cancer survivors diagnosed with the nonmetastatic disease had similar experiences as women without cancer.
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Affiliation(s)
- Traci N. Bethea
- Office of Minority Health and Health Disparities ResearchGeorgetown Lombardi Comprehensive Cancer CenterWashingtonDistrict of ColumbiaUSA
- Cancer Prevention and Control ProgramGeorgetown Lombardi Comprehensive Cancer CenterWashingtonDistrict of ColumbiaUSA
| | - Wanting Zhai
- Cancer Prevention and Control ProgramGeorgetown Lombardi Comprehensive Cancer CenterWashingtonDistrict of ColumbiaUSA
| | - Xingtao Zhou
- Cancer Prevention and Control ProgramGeorgetown Lombardi Comprehensive Cancer CenterWashingtonDistrict of ColumbiaUSA
| | - Tim A. Ahles
- Department of Psychiatry and Behavioral SciencesMemorial Sloan Kettering Cancer CenterNew YorkNew York CityUSA
| | - Jaeil Ahn
- Department of Biostatistics, Bioinformatics, and BiomathematicsGeorgetown UniversityWashingtonDistrict of ColumbiaUSA
| | - Harvey J. Cohen
- Center for the Study of Aging and Human DevelopmentDuke University Medical CenterDurhamNorth CarolinaUSA
| | - Asma A. Dilawari
- Cancer Prevention and Control ProgramGeorgetown Lombardi Comprehensive Cancer CenterWashingtonDistrict of ColumbiaUSA
- Medstar Washington Hospital CenterWashingtonDistrict of ColumbiaUSA
| | - Deena M. A. Graham
- John Theurer Cancer CenterHackensack University Medical CenterHackensackNew JerseyUSA
| | | | - Brenna C. McDonald
- Department of Radiology and Imaging SciencesIndiana University School of Medicine and Indiana University Melvin and Bren Simon Comprehensive Cancer CenterIndianapolisIndianaUSA
| | - Zev M. Nakamura
- Department of PsychiatryUniversity of North Carolina‐Chapel HillChapel HillNorth CarolinaUSA
| | - Sunita K. Patel
- City of Hope National Medical CenterLos AngelesCaliforniaUSA
| | - Kelly E. Rentscher
- Cousins Center for PsychoneuroimmunologyUniversity of California, Los AngelesLos AngelesCaliforniaUSA
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry & Biobehavioral SciencesUniversity of California, Los AngelesLos AngelesCaliforniaUSA
| | - James Root
- Department of Psychiatry and Behavioral SciencesMemorial Sloan Kettering Cancer CenterNew YorkNew York CityUSA
| | - Andrew J. Saykin
- Department of Radiology and Imaging SciencesIndiana University School of Medicine and Indiana University Melvin and Bren Simon Comprehensive Cancer CenterIndianapolisIndianaUSA
| | - Brent J. Small
- College of Behavioral and Community Sciences, School of Aging StudiesUniversity of South FloridaTampaFloridaUSA
| | - Kathleen M. Van Dyk
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry & Biobehavioral SciencesUniversity of California, Los AngelesLos AngelesCaliforniaUSA
| | - Jeanne S. Mandelblatt
- Cancer Prevention and Control ProgramGeorgetown Lombardi Comprehensive Cancer CenterWashingtonDistrict of ColumbiaUSA
| | - Judith E. Carroll
- Cousins Center for PsychoneuroimmunologyUniversity of California, Los AngelesLos AngelesCaliforniaUSA
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry & Biobehavioral SciencesUniversity of California, Los AngelesLos AngelesCaliforniaUSA
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10
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Agostinelli V, De Filippis C, Torniai M, Rocchi MBL, Pagliacci A, Ricci G, Corsi R, Luzi P, Caporossi M, Berardi R. Primum non Nocere: How to ensure continuity of care and prevent cancer patients from being overlooked during the COVID- 19 pandemic. Cancer Med 2022; 12:1821-1828. [PMID: 35754357 PMCID: PMC9350138 DOI: 10.1002/cam4.4986] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 12/27/2021] [Revised: 05/30/2022] [Accepted: 06/06/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) has spread to all countries since December 2019, triggering a pandemic within weeks of the initial outbreak. Doctors were presented with the challenge of having to reimagine the traditional hospital organisation in order to effectively manage patients. PATIENTS AND METHODS During the months of the COVID-19 pandemic our Institution was assisted by a call-center (CC) that triaged cancer patients planned for follow-up in our outpatient clinics: C1 (for female cancers), C2 (for gastrointestinal, urogenital, and thoracic tumours), and D1 (for melanoma and for patients with tumours in over 5 years follow up). Data refers to the period between 15 April and 3 July 2020. RESULTS A total of 1054 patients have been included in our study and 1005 (95%) of the contacts were successful. The analysis showed a majority of female patients (74%) and patients affected by breast cancer (56%). Among the options provided 646 patients (92.4%) opted for online consultancy. CONCLUSION This study has shown that cancer patients valued technology-mediated follow-up visits mainly during the beginning of the pandemic because patients themselves were afraid to come to the hospital. Although telemedicine has intrinsic limitations, it is important for providing assistance and preventing cancer patients from feeling isolated during an emergency.
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Affiliation(s)
- Veronica Agostinelli
- Department of Medical OncologyUniversità Politecnica delle Marche, AOU Ospedali Riuniti AnconaAnconaItaly
| | - Chiara De Filippis
- Department of Medical OncologyUniversità Politecnica delle Marche, AOU Ospedali Riuniti AnconaAnconaItaly
| | - Mariangela Torniai
- Department of Medical OncologyUniversità Politecnica delle Marche, AOU Ospedali Riuniti AnconaAnconaItaly,Department of Medical OncologyFermoItaly
| | - Marco Bruno Luigi Rocchi
- Department of Biomolecular Sciences‐Service of BiostatisticsUniversity of Urbino Carlo BoUrbinoItaly
| | - Alessandra Pagliacci
- Department of Medical OncologyUniversità Politecnica delle Marche, AOU Ospedali Riuniti AnconaAnconaItaly
| | - Giulia Ricci
- Department of Medical OncologyUniversità Politecnica delle Marche, AOU Ospedali Riuniti AnconaAnconaItaly
| | | | - Paolo Luzi
- TOPS Healthcare Communication srlRomeItaly
| | | | - Rossana Berardi
- Department of Medical OncologyUniversità Politecnica delle Marche, AOU Ospedali Riuniti AnconaAnconaItaly
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11
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Turgeman I, Goshen‐Lago T, Waldhorn I, Karov K, Groisman L, Reiner Benaim A, Almog R, Halberthal M, Ben‐Aharon I. Psychosocial perspectives among cancer patients during the coronavirus disease 2019 (COVID-19) crisis: An observational longitudinal study. Cancer Rep (Hoboken) 2022; 5:e1506. [PMID: 34405968 PMCID: PMC8420321 DOI: 10.1002/cnr2.1506] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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] [Received: 01/11/2021] [Revised: 05/20/2021] [Accepted: 05/26/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) crisis and consequent changes in medical practice have engendered feelings of distress in diverse populations, potentially adversely affecting the psychological well-being of cancer patients. AIM The purpose of this observational longitudinal study was to evaluate psychosocial perspectives among patients with cancer on intravenous treatment during the COVID-19 pandemic. METHODS AND RESULTS The study recruited 164 cancer patients undergoing intravenous anti-neoplastic therapy in a tertiary cancer center. Psychosocial indices were assessed at two points in time, corresponding with the beginning of the first wave of COVID-19 pandemic in Israel (March 2020) and the time of easing of restrictions implemented to curtail spread of infection (May 2020). At Time 1 (T1), elevated COVID-19 distress levels (score 1 and 2 on 5-point scale) were observed in 44% of patients, and associated with pre-existing hypertension and lung disease in multivariate analyses but no demographic or cancer related factors. At Time 2 (T2), 10% had elevated anxiety and 24% depression as indicated by Hospital Anxiety and Depression Scale (HADS-A/D). COVID-19 distress at T1 was related to higher levels of HADS-A at T2 (Spearman 0.33 p < .01), but not HADS-D. Patients with breast cancer expressed greater COVID-19 distress compared with other cancer types (p < .01), while both HADS-A and HADS-D were highest for patients with GI cancer. Patient report of loneliness and decreased support from relatives were factors associated with HADS-A (p = .03 and p < .01, respectively), while HADS-D was not similarly related to the factors evaluated. CONCLUSION Patients with cancer undergoing intravenous treatment may be vulnerable to acute adverse psychological ramifications of COVID-19, specifically exhibiting high levels of anxiety. These appear unrelated to patient age or disease stage. Those with underlying comorbidities, breast cancer or reduced social support may be at higher risk.
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Affiliation(s)
- Ilit Turgeman
- Division of OncologyRambam Health Care CenterHaifaIsrael
| | | | - Ithai Waldhorn
- Division of OncologyRambam Health Care CenterHaifaIsrael
| | - Keren Karov
- Division of OncologyRambam Health Care CenterHaifaIsrael
| | - Leora Groisman
- Division of OncologyRambam Health Care CenterHaifaIsrael
| | | | - Ronit Almog
- Technion Integrated Cancer Center (TICC)Faculty of MedicineHaifaIsrael
- Epidemiology Department and BiobankRambam Health Care CampusHaifaIsrael
| | - Michael Halberthal
- Technion Integrated Cancer Center (TICC)Faculty of MedicineHaifaIsrael
- General ManagementRambam Health Care CampusHaifaIsrael
| | - Irit Ben‐Aharon
- Division of OncologyRambam Health Care CenterHaifaIsrael
- Technion Integrated Cancer Center (TICC)Faculty of MedicineHaifaIsrael
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12
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Köther AK, Büdenbender B, Grüne B, Holbach S, Huber J, von Landenberg N, Lenk J, Martini T, Michel MS, Kriegmair MC, Alpers GW. Different patients, different preferences: A multicenter assessment of patients' personality traits and anxiety in shared decision making. Cancer Med 2022; 11:2999-3008. [PMID: 35322925 PMCID: PMC9359866 DOI: 10.1002/cam4.4667] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 01/18/2022] [Accepted: 01/19/2022] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Patient-centered care and shared decision making (SDM) are generally recognized as the gold standard for medical consultations, especially for preference-sensitive decisions. However, little is known about psychological patient characteristics that influence patient-reported preferences. We set out to explore the role of personality and anxiety for a preference-sensitive decision in bladder cancer patients (choice of urinary diversion, UD) and to determine if anxiety predicts patients' participation preferences. METHODS We recruited a sample of bladder cancer patients (N = 180, primarily male, retired) who awaited a medical consultation on radical cystectomy and their choice of UD. We asked patients to fill in a set of self-report questionnaires before this consultation, including measures of treatment preference, personality (BFI-10), anxiety (STAI), and participation preference (API and API-Uro), as well as sociodemographic characteristics. RESULTS Most patients (79%) indicated a clear preference for one of the treatment options (44% continent UD, 34% incontinent UD). Patients who reported more conscientiousness were more likely to prefer more complex methods (continent UD). The majority (62%) preferred to delegate decision making to healthcare professionals. A substantial number of patients reported elevated anxiety (32%), and more anxiety was predictive of higher participation preference, specifically for uro-oncological decisions (β = 0.207, p < 0.01). CONCLUSIONS Our findings provide insight into the role of psychological patient characteristics for SDM. Aspects of personality such as conscientiousness influence treatment preferences. Anxiety contributes to patients' motivation to be involved in pertinent decisions. Thus, personality and negative affect should be considered to improve SDM.
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Affiliation(s)
- Anja K Köther
- Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany
| | - Björn Büdenbender
- Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany
| | - Britta Grüne
- Department of Urology and Urosurgery, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Sonja Holbach
- Department of Urology, Caritas St Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - Johannes Huber
- Department of Urology, Philipps-University Marburg, Marburg, Germany.,Department of Urology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | | | - Julia Lenk
- Urological Hospital Munich-Planegg, Planegg, Germany
| | - Thomas Martini
- Department of Urology, University Hospital Ulm, Ulm, Germany
| | - Maurice S Michel
- Department of Urology and Urosurgery, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Maximilian C Kriegmair
- Department of Urology and Urosurgery, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Georg W Alpers
- Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany
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13
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Gaiger A, Lubowitzki S, Krammer K, Zeilinger EL, Acel A, Cenic O, Schrott A, Unseld M, Rassoulian AP, Skrabs C, Valent P, Gisslinger H, Marosi C, Preusser M, Prager G, Kornek G, Pirker R, Steger GG, Bartsch R, Raderer M, Simonitsch-Klupp I, Thalhammer R, Zielinski C, Jäger U. The cancer survival index-A prognostic score integrating psychosocial and biological factors in patients diagnosed with cancer or haematologic malignancies. Cancer Med 2022; 11:3387-3396. [PMID: 35315594 PMCID: PMC9487871 DOI: 10.1002/cam4.4697] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/03/2022] [Accepted: 03/11/2022] [Indexed: 12/20/2022] Open
Abstract
Objective We aimed to investigate whether (1) psychological and social indicators influence survival in patients diagnosed with cancer or haematologic malignancies when important biological aspects are controlled for, (2) psychological, social and biological indicators can be utilised to design one collated index for survival, usable in clinical practice to identify patients at risk of shorter survival and to improve personalised healthcare provision. Methods In this cross‐sectional study, 2263 patients with cancer or haematologic malignancies participated. We analysed 15 biological, psychological and social indicators as risk factors for survival with a Cox proportional hazards model. Indicators significantly associated with survival were combined to compute models for the identification of patient groups with different risks of death. The training sample contained 1122 patients. Validation samples included the remaining 1141 patients, the total sample, as well as groups with different cancer entities. Results Five indicators were found to significantly impact survival: Cancer site (HR: 3.56), metastatic disease (HR: 1.88), symptoms of depression (HR: 1.34), female sex (HR: 0.73) and anaemia (HR: 0.48). Combining these indicators to a model, we developed the Cancer Survival Index, identifying three distinct groups of patients with estimated survival times of 47.2 months, 141 months and 198.2 months (p < 0.001). Post hoc analysis of the influence of depression on survival showed a mediating effect of the following four factors, related to both depression and survival: previous psychiatric conditions, employment status, metastatic disease and haemoglobin levels. Conclusions Psychosocial and biological factors impact survival in various malignancies and can be utilised jointly to compute an index for estimating the survival of each patient individually—the Cancer Survival Index.
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Affiliation(s)
- Alexander Gaiger
- Department of Medicine I, Division of Haematology and Haemostaseology, Medical University of Vienna, Vienna, Austria
| | - Simone Lubowitzki
- Department of Medicine I, Division of Haematology and Haemostaseology, Medical University of Vienna, Vienna, Austria
| | - Katharina Krammer
- Department of Medicine I, Division of Haematology and Haemostaseology, Medical University of Vienna, Vienna, Austria
| | - Elisabeth L Zeilinger
- Department of Medicine I, Division of Haematology and Haemostaseology, Medical University of Vienna, Vienna, Austria
| | - Andras Acel
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Comprehensive Cancer Centre, Medical University Vienna - General Hospital, Vienna, Austria
| | - Olivera Cenic
- Department of Medicine I, Division of Haematology and Haemostaseology, Medical University of Vienna, Vienna, Austria
| | | | - Matthias Unseld
- Department of Medicine I, Division of Palliative Medicine, Medical University of Vienna, Vienna, Austria
| | - Anahita Paula Rassoulian
- Department of Medicine I, Division of Haematology and Haemostaseology, Medical University of Vienna, Vienna, Austria
| | - Cathrin Skrabs
- Department of Medicine I, Division of Haematology and Haemostaseology, Medical University of Vienna, Vienna, Austria
| | - Peter Valent
- Department of Medicine I, Division of Haematology and Haemostaseology, Medical University of Vienna, Vienna, Austria.,Ludwig Boltzmann Institute for Haematology and Oncology, Medical University of Vienna, Vienna, Austria
| | - Heinz Gisslinger
- Department of Medicine I, Division of Haematology and Haemostaseology, Medical University of Vienna, Vienna, Austria
| | - Christine Marosi
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Comprehensive Cancer Centre, Medical University Vienna - General Hospital, Vienna, Austria
| | - Matthias Preusser
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Comprehensive Cancer Centre, Medical University Vienna - General Hospital, Vienna, Austria
| | - Gerald Prager
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Comprehensive Cancer Centre, Medical University Vienna - General Hospital, Vienna, Austria
| | - Gabriela Kornek
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Comprehensive Cancer Centre, Medical University Vienna - General Hospital, Vienna, Austria
| | - Robert Pirker
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Comprehensive Cancer Centre, Medical University Vienna - General Hospital, Vienna, Austria
| | - Günther G Steger
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Comprehensive Cancer Centre, Medical University Vienna - General Hospital, Vienna, Austria
| | - Rupert Bartsch
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Comprehensive Cancer Centre, Medical University Vienna - General Hospital, Vienna, Austria
| | - Markus Raderer
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Comprehensive Cancer Centre, Medical University Vienna - General Hospital, Vienna, Austria
| | | | - Renate Thalhammer
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Christoph Zielinski
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Comprehensive Cancer Centre, Medical University Vienna - General Hospital, Vienna, Austria
| | - Ulrich Jäger
- Department of Medicine I, Division of Haematology and Haemostaseology, Medical University of Vienna, Vienna, Austria
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14
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Brown CM, Kanu C, Richards KM, Stevens L, Sasane R, McAneny B. Exploring access to care from the perspective of patients with breast cancer: A qualitative study. Cancer Med 2022; 11:2455-2466. [PMID: 35266321 PMCID: PMC9189472 DOI: 10.1002/cam4.4624] [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: 08/31/2021] [Revised: 12/18/2021] [Accepted: 12/30/2021] [Indexed: 11/10/2022] Open
Abstract
Objectives Patients face a myriad of personal and system‐based challenges in accessing breast cancer care, but less is known about access as expressed and experienced by patients themselves. The objective of this qualitative study was to further explore the breadth of issues related to access from the perspective of patients with breast cancer across their care journey. Methods Twelve women participated in 1‐h semi‐structured interviews and 48 women participated in 2‐h focus groups at six oncology practices in 2018. Grounded theory was used to analyze the data. Results Six primary themes emerged concerning access to care: information, psychosocial support, health insurance, financial resources, timeliness, and emotions. Conclusions This study identified six core dimensions of access to care. Access encompassed not only gaining entrée to care services—in the traditional sense of access—but also the continuing support needed to effectively use those services throughout the cancer care journey. Future strategies aimed at improving access to breast cancer care should attend to these ongoing patient‐centric and system‐based issues which are mostly amenable to change.
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Affiliation(s)
- Carolyn M Brown
- TxCORE (Texas Center for Health Outcomes Research and Education), The University of Texas at Austin College of Pharmacy, Austin, Texas, USA
| | - Chisom Kanu
- Research Triangle Institute, Research Triangle Park, North Carolina, USA
| | - Kristin M Richards
- TxCORE (Texas Center for Health Outcomes Research and Education), The University of Texas at Austin College of Pharmacy, Austin, Texas, USA
| | - Laura Stevens
- Innovative Oncology Business Solutions, Albuquerque, New Mexico, USA
| | - Rahul Sasane
- Cerevel Therapeutics, Cambridge, Massachusetts, USA
| | - Barbara McAneny
- Innovative Oncology Business Solutions, Albuquerque, New Mexico, USA.,New Mexico Oncology Hematology Consultants, Albuquerque, New Mexico, USA
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15
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Khoo AMG, Lau J, Loh XS, Ng CWT, Griva K, Tan KK. Understanding the psychosocial impact of colorectal cancer on young-onset patients: A scoping review. Cancer Med 2022; 11:1688-1700. [PMID: 35150052 PMCID: PMC8986148 DOI: 10.1002/cam4.4575] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 10/08/2021] [Revised: 12/09/2021] [Accepted: 01/10/2022] [Indexed: 12/03/2022] Open
Abstract
Objective The incidence of young‐onset (<50 years) colorectal cancer (CRC) has been increasing internationally. The psychosocial experience of younger cancer patients is vastly different from older patients, especially in domains such as financial toxicity, body image, and sexual dysfunction. What is unknown is the cancer type‐specific experience. The aim of the current scoping review was to examine (1) the psychosocial factors and/or outcomes associated with young‐onset CRC and (2) other determinants that influences these outcomes. Methods A systematic search was conducted on four databases (PubMed, CINAHL, Scopus and PsycINFO) from inception to December 2020 using key terms and combinations. Primary literature that examined the psychosocial (e.g., quality‐of‐life, emotional, social, sexual) impact of young‐onset CRC were included. Results A total of 1389 records were assessed by four reviewers, with a total of seven studies meeting inclusion criteria (n = 5 quantitative, n = 1 qualitative and n = 1 case series). All studies indicated there was significant psychosocial impact in younger CRC patients, including emotional impact, social impact, physical burden, sexual impact, work impact, unmet needs, financial impact and global quality of life. Three studies explored other determinants that influenced the psychosocial experience and found that socioeconomic background (e.g., being female, lower education), CRC treatment (e.g., chemotherapy) and health status were associated with worse psychosocial impact. Conclusions Young‐onset CRC patients face severe psychosocial impact unique to this age group, such as self‐image and sexual impact. Social support services and resources needs to be uniquely tailored. More empirical investigations are required to understand its long‐term impact and influence of other psychosocial domains. This scoping review of psychosocial impact in young‐onset colorectal cancer patients uncovered significant psychosocial impact which are in‐line with previous studies on young cancer (e.g., emotional impact, social impact, physical burden) as well as impact unique to colorectal cancer (e.g., self‐image, embarrassment with bowel movements and the impact of stoma). More empirical investigations are required to understand its long‐term impact and influence of other psychosocial domains.
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Affiliation(s)
- Athena Ming-Gui Khoo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jerrald Lau
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Xin-Sheng Loh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Celeste Wen-Ting Ng
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Konstadina Griva
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Ker-Kan Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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16
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Schechter-Finkelstein T, Plenert E, La Rosa J, McLean J, Chiang KY, Krueger J, Hearne E, Sung L. Pediatric hematology/oncology healthcare professional emotional health during COVID-19. Cancer Med 2021; 10:7144-7151. [PMID: 34467652 PMCID: PMC8525130 DOI: 10.1002/cam4.4253] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 08/06/2021] [Accepted: 08/17/2021] [Indexed: 01/26/2023] Open
Abstract
Objectives Little is known about the impact of coronavirus disease 2019 (COVID‐19) on healthcare professional emotional health in pediatric hematology/oncology. Primary objective was to describe anxiety, depression, positive affect, and perceived stress among pediatric hematology/oncology healthcare professionals following a COVID‐19 outbreak. Secondary objectives were to compare these outcomes based on contact with a positive person, and to identify risk factors for worse outcomes. Materials and methods We included 272 healthcare professionals working with pediatric hematology/oncology patients. We determined whether respondents had direct or indirect contact with a COVID‐19‐positive individual and then measured outcomes using the Patient‐Reported Outcomes Measurement Information System (PROMIS) depression, anxiety, and positive affect measures, and the Perceived Stress Scale. Results Among eligible respondents, 205 agreed to participate (response rate 75%). Sixty‐nine (33.7%) had contact with a COVID‐19‐positive person. PROMIS anxiety, depression, and positive affect scores were similar to the general United States population. Those who had contact with a COVID‐19‐positive individual did not have significantly different outcomes. In multiple regression, non‐physicians had significantly increased anxiety (nurses: p = 0.013), depression (nurses: p = 0.002, pharmacists: p = 0.038, and other profession: p = 0.021), and perceived stress (nurses: p = 0.002 and other profession: p = 0.011) when compared to physicians. Conclusions Pediatric hematology/oncology healthcare professionals had similar levels of anxiety, depression, and positive affect as the general population. Contact with a COVID‐19‐positive individual was not significantly associated with outcomes. Non‐physician healthcare professionals had more anxiety, depression, and perceived stress when compared to physicians. These findings may help to develop programs to support healthcare professional resilience.
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Affiliation(s)
| | - Erin Plenert
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada
| | - Jennifer La Rosa
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Jennifer McLean
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | - K Y Chiang
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Joerg Krueger
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Erin Hearne
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Lillian Sung
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada.,Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada
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17
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Oswald LB, Lee JW, Argiris A, Webster KA, Forastiere AA, Cella D. Validation of brief symptom indexes among patients with recurrent or metastatic squamous cell carcinoma of the head and neck: A trial of the ECOG-ACRIN Cancer Research Group (E1302). Cancer Med 2020; 9:8884-8894. [PMID: 33040481 PMCID: PMC7724483 DOI: 10.1002/cam4.3506] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 07/14/2020] [Accepted: 09/13/2020] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Patients with advanced head and neck cancer have identified pain, fatigue, and difficulties swallowing, breathing, and communicating as high-priority disease-related symptoms. The Functional Assessment of Cancer Therapy-Head and Neck Symptom Index-10 (FHNSI-10) assesses these symptoms. We sought to validate the FHNSI-10, another brief symptom index (FHNSI-7), and individual symptom endpoints representing these high-rated priority disease symptoms among patients with recurrent or metastatic squamous cell carcinoma of the head and neck (SCCHN). METHODS Patients (N = 239) were enrolled in a phase III randomized clinical trial (E1302) and completed the FHNSI-10 at multiple time points. We assessed the internal consistencies and test-retest reliabilities of the FHNSI-10 and FHNSI-7 scores, and the known-groups validity, predictive criterion validity, and responsiveness-to-change of the symptom indexes and individual symptom endpoint scores. RESULTS The FHNSI-10 and FHNSI-7 indexes showed satisfactory internal consistencies (Cronbach's alpha coefficient range 0.60-0.75) and acceptable test-retest reliabilities (intraclass correlation coefficients = 0.75 and 0.74, respectively). The FHNSI-10, FHNSI-7, and the pain, fatigue, swallowing, and breathing symptom scores showed evidence of known-groups validity by performance status at baseline. The FHNSI-10, FHNSI-7, and the pain, fatigue, and breathing symptom scores at baseline showed evidence of predictive criterion validity for overall survival, but not time-to-progression (TTP). Changes in the symptom indexes and individual symptom scores were not associated with changes in performance status over 4 weeks, though most patients had stable performance status. CONCLUSIONS There is initial evidence of validity for the FHNSI-10 and FHNSI-7 indexes and selected individual symptom endpoints as brief disease-related symptom assessments for patients with recurrent or metastatic SCCHN.
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Affiliation(s)
- Laura B Oswald
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Ju-Whei Lee
- Department of Data Sciences, Dana-Farber Cancer Institute, ECOG-ACRIN Biostatistics Center, Boston, MA, USA
| | - Athanassios Argiris
- Department of Medical Oncology, Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - Kimberly A Webster
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - David Cella
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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18
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Schroyen S, Letenneur L, Missotten P, Jérusalem G, Adam S. Impact of self-perception of aging on mortality of older patients in oncology. Cancer Med 2020; 9:2283-2289. [PMID: 32020758 PMCID: PMC7131843 DOI: 10.1002/cam4.2819] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 12/02/2019] [Accepted: 12/09/2019] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Several studies show that self-perception of aging (SPA) is a significant predictor of mental and physical health. In this study, we analyze the effect of SPA on mortality in the specific context of geriatric oncology. METHODS The sample constituted of 140 individuals aged 65 years and older suffering from a recent nonmetastatic cancer (breast, lung, gynecological, or hematological), followed up to 6 years. We used Cox proportional hazards model to assess the effect of SPA at baseline on mortality. It was adjusted for age, gender, educational and cognitive level, oncological information (the site and kind of cancer), number of comorbidities, and physical and mental health at baseline. RESULTS Patients were aged 73 years at diagnosis and were more often women (85.7%). Individuals with more negative SPA were 3.62 times more likely to die than those with a more positive SPA, with control of gender, age, education and cognitive level, mental and physical health, the category (breast, lung, gynecological, or hematological), and kind (initial or recurrence) of cancer. CONCLUSIONS These findings suggest that SPA influence the mortality of older people in the particular context of oncology. Therefore, the need to change our attitudes toward aging and older people implied indirectly by these results is discussed.
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Affiliation(s)
| | - Luc Letenneur
- UMR1219 Bordeaux Population HealthINSERMUniversity of BordeauxBordeauxFrance
| | | | - Guy Jérusalem
- Laboratory of Medical OncologyUniversity of LiègeLiègeBelgium
- Department of Medical OncologyCHU Sart‐Tilman LiègeLiègeBelgium
| | - Stéphane Adam
- Psychology of Aging UnitUniversity of LiègeLiègeBelgium
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19
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Harris JN, Liljestrand P, Alexander GL, Goddard KAB, Kauffman T, Kolevska T, McCarty C, O'Neill S, Pawloski P, Rahm A, Williams A, Somkin CP. Oncologists' attitudes toward KRAS testing: a multisite study. Cancer Med 2013; 2:881-8. [PMID: 24403261 PMCID: PMC3892392 DOI: 10.1002/cam4.135] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [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: 06/03/2013] [Revised: 08/12/2013] [Accepted: 08/13/2013] [Indexed: 01/18/2023] Open
Abstract
Recent discoveries promise increasingly to help oncologists individually tailor anticancer therapy to their patients’ molecular tumor characteristics. One such promising molecular diagnostic is Kirsten ras (KRAS) tumor mutation testing for metastatic colorectal cancer (mCRC) patients. In the current study, we examined how and why physicians adopt KRAS testing and how they subsequently utilize the information when discussing treatment strategies with patients. We conducted 34 semi-structured in-person or telephone interviews with oncologists from seven different health plans. Each interview was audiotaped, transcribed, and coded using qualitative research methods. Information and salient themes relating to the research questions were summarized for each interview. All of the oncologists in this study reported using the KRAS test at the time of the interview. Most appeared to have adopted the test rapidly, within 6 months of the publication of National Clinical Guidelines. Oncologists chose to administer the test at various time points, although the majority ordered the test at the time their patient was diagnosed with mCRC. While oncologists expressed a range of opinions about the KRAS test, there was a general consensus that the test was useful and provided benefits to mCRC patients. The rapid adoption and enthusiasm for KRAS suggests that these types of tests may be filling an important informational need for oncologists when making treatment decisions. Future research should focus on the informational needs of patients around this test and whether patients feel informed or confident with their physicians’ use of these tests to determine treatment access.
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Affiliation(s)
- Julie N Harris
- Division of Research, Kaiser Permanente Northern California, Oakland, California
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