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Khajoei R, Azadeh P, ZohariAnboohi S, Ilkhani M, Nabavi FH. Breast cancer survivorship needs: a qualitative study. BMC Cancer 2024; 24:96. [PMID: 38233789 PMCID: PMC10795302 DOI: 10.1186/s12885-024-11834-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 01/03/2024] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Breast cancer rates and the number of breast cancer survivors have been increasing among women in Iran. Effective responses from healthcare depend on appropriately identifying survivors' needs. This study investigated the experience and needs of breast cancer survivors in different dimensions. METHODS In this qualitative content analysis, semi-structured in-depth interviews were conducted from April 2023 to July 2023. Data saturation was achieved after interviewing 16 breast cancer survivors (BCSs) and four oncologists using purposive sampling. Survivors were asked to narrate their experiences about their needs during the survivorship. Data were analyzed with an inductive approach in order to extract the themes. RESULTS Twenty interviews were conducted. The analysis focused on four central themes: (1) financial toxicity (healthcare costs, unplanned retirement, and insurance coverage of services); (2) family support (emotional support, Physical support); (3) informational needs (management of side effects, management of uncertainty, and balanced diet); and (4) psychological and physical issues (pain, fatigue, hot flashes, and fear of cancer recurrence). CONCLUSIONS This study provides valuable information for designing survivorship care plans. Identifying the survivorship needs of breast cancer survivors is the first and most important step, leading to optimal healthcare delivery and improving quality of life. It is recommended to check the financial capability of patients and take necessary measures for patients with financial problems. Additionally, support sources should be assessed and appropriate. Psychological interventions should be considered for patients without a support source. Consultation groups can be used to meet the information needs of patients. For patients with physical problems, self-care recommendations may also be useful in addition to doctors' orders.
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Affiliation(s)
- Rahimeh Khajoei
- Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, IR, Iran
| | - Payam Azadeh
- Radiation Oncology Department, School of Medicine, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sima ZohariAnboohi
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, IR, Iran
| | - Mahnaz Ilkhani
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, IR, Iran.
| | - Fatemah Heshmati Nabavi
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Tilahun SW, Kitaw LD, Yusuf NT. Predictors of information needs among women with breast cancer receiving adjuvant therapy at Tikur Anbessa specialized hospital, Addis Ababa Ethiopia: a cross-sectional study. BMC Womens Health 2023; 23:659. [PMID: 38066595 PMCID: PMC10704721 DOI: 10.1186/s12905-023-02805-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 11/25/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Women undergoing adjuvant therapy for breast cancer have diverse information needs that remain unfulfilled. Extensive research has shown that access to relevant information about their condition can significantly enhance the quality of life for these women, making it an essential part of cancer care. However, various clinical and socioeconomic factors influence the information needs of these women. Hence, the primary aim of this study is to identify predictors of the information needs of women undergoing adjuvant therapy for breast cancer. In addition, this study will also describe the preferred sources of information and the optimal timing for its acquisition. METHODS A facility-based cross-sectional study was undertaken at Tikur Anbessa Specialty Hospital, enlisting a cohort comprising 121 women undergoing adjuvant therapy for breast cancer. Trained interviewers administered an Amharic-translated Toronto information needs questionnaire specifically designed for breast cancer to assess the information needs of the study participants Statistical analysis was executed using the sophisticated software SPSS (version 25). Descriptive statistics were employed to summarize the variables of the study. A linear regression analyses was then carried out to identify notable predictors that significantly influenced the information needs of the women. RESULTS The total mean score for overall information needs in the current study was 194.30 (± 28.01), with a range scale of 142-260 and a standardized mean score of 3.74 (± 0.54). The disease and treatment domains had the highest information needs, with standardized mean scores (standard deviation) of 4.00 (± 0.54) and 3.77 (± 0.59), respectively. 95% of the participants sought information from healthcare professionals, and 67.7% of the women needed the information before beginning the treatments. Predictors of information needs were following a single treatment option (β = 12.68; 95% CI (0.68, 24.68); P = 0.039) and joining higher education and above (β = 17.1; 95% CI (1.47, 34.14); P = 0.033). CONCLUSION The women exhibited a substantial demand for information. Healthcare professionals need to consider the women's educational background and treatment status while delivering the needed information.
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Affiliation(s)
- Sosina W Tilahun
- Department of Nursing, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Leul D Kitaw
- Department of Nursing, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Nete T Yusuf
- Department of Nursing, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Anbari AB, Sandheinrich T, Hulett J, Salerno E. Understanding advanced practice registered nurse perspectives on providing care to people with a history of breast cancer. J Am Assoc Nurse Pract 2023; 35:804-812. [PMID: 37560998 DOI: 10.1097/jxx.0000000000000929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 06/23/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND People with a history of breast cancer (PHBC) face a lifelong risk of treatment-related sequelae affecting their quality of life. Stakeholders advocate for improving breast cancer survivorship outcomes by increasing clinicians' knowledge of cancer survivorship issues. In Missouri, advanced practice registered nurses (APRNs) in nononcology settings provide routine survivorship care to PHBC; however, little is known about how they approach survivorship care planning for PHBC. PURPOSE Examine perspectives of Missouri APRNs practicing in nononcology settings about providing survivorship care to PHBC. METHODS A combination of grounded theory and thematic analysis techniques was used for focus groups and semistructured interviews. The interviews were audio-recorded, transcribed, and analyzed using grounded theory coding methods. RESULTS Nineteen nononcology Missouri-based APRNs (18 NPs, 1 CNS/DNP) shared their perspectives about managing care for PHBC. We identified four major themes. Our participants (1) attuned their baseline assessment techniques to a history of breast cancer; (2) were prepared to order additional evaluations; (3) were willing to proactively figure out next best steps for PHBC beyond theneed for breast cancer recurrence surveillance; and (4) suggest that streamlining cancer survivorship care resources would benefit both clinicians and PHBC. CONCLUSIONS Our findings shed light on how APRNs approach care planning for PHBC and the needs of nononcology APRNs for managing PHBC. IMPLICATIONS FOR PRACTICE Advanced practice registered nurses are well-positioned to improve cancer survivorship care. Increasing knowledge of cancer survivorship care guidelines could improve long-term health outcomes of PHBC. Access to cancer survivorship resources or experts via telehealth/technology for both APRNs and patients could improve survivorship care and overall health of PHBC.
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Affiliation(s)
- Allison B Anbari
- Sinclair School of Nursing, University of Missouri, Columbia, Missouri
| | | | - Jennifer Hulett
- Sinclair School of Nursing, University of Missouri, Columbia, Missouri
| | - Elizabeth Salerno
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
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Mendes-Santos C, Nóbrega C, Quinta-Gomes AL, Weiderpass E, Santana R, Andersson G. Validation of the Portuguese version of the supportive care needs survey short-form questionnaire (SCNS-SF34-Pt) and the breast cancer supplementary module (SCNS-BR8-Pt). J Psychosoc Oncol 2023:1-20. [PMID: 37975563 DOI: 10.1080/07347332.2023.2282015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
OBJECTIVE This study aimed to test the psychometric properties of the Portuguese Supportive Care Needs Survey-Short Form-34 (SCNS-SF34-Pt) and its breast cancer-specific complementary module (SCNS-BR8-Pt). A further aim was to characterize Portuguese Breast Cancer Survivors' (BCS) unmet supportive care needs, using these measures. METHODS A convenient sample of BCS was recruited from five hospitals in Portugal and invited to complete SCNS-SF34-Pt and SCNS-BR8-Pt, EORTCQLQC30 and QLQBR23, the Generalized Anxiety Disorder, and the Patient Health-Questionnaire. The validity (i.e. convergent, discriminant and convergent validity) and reliability of SCNS-SF34-Pt and SCNS-BR8-Pt were statistically evaluated. BCS' unmet supportive care needs were descriptively assessed. FINDINGS 336 BCS participated in the study. A four-factor solution was produced for SCNS-SF34-Pt. This solution included the Physical and daily living needs, Psychological needs, Sexuality needs, and Health system, information, and patient support needs dimensions (73% of the total variance; Cronbach's alpha=.82 to .97). SCNS-SF34-Pt demonstrated good convergent validity. It could also discriminate between known-groups regarding age, disease staging, treatment performed, and ECOG performance status. SCNS-BR8-Pt revealed a single-factor structure (62% of the total variance; Cronbach's alpha=.91).Portuguese BCS' most prevalent unmet supportive care needs were associated with the Psychological, and Physical and daily living domains. Fear of cancer spreading, the inability to do things as usual, and lack of energy/tiredness were perceived as issues requiring further supportive care. CONCLUSIONS SCNS-SF34-Pt and the SCNS-BR8-Pt are valid and reliable tools to assess Portuguese BCS' unmet supportive care needs. Fear of cancer spreading and lack of energy/tiredness concerns should be a target of supportive care services.
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Affiliation(s)
| | - Catarina Nóbrega
- Center for Psychology at the University of Porto, Porto, Portugal
| | | | | | - Rui Santana
- NOVA National School of Public Health, Public Health Research Centre, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Stockholm, Sweden
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Şengün İnan F, Yedigün T, Er İ. Exploring the Unmet Supportive Care Needs of Breast Cancer Survivors Experiencing Psychological Distress: Qualitative Study. Semin Oncol Nurs 2023; 39:151449. [PMID: 37246015 DOI: 10.1016/j.soncn.2023.151449] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 02/03/2023] [Accepted: 04/19/2023] [Indexed: 05/30/2023]
Abstract
OBJECTIVES This study aimed to explore the unmet supportive care needs of breast cancer survivors who experience psychological distress. DATA SOURCES A qualitative study design with inductive content analysis was used. Semistructured interviews were conducted with 18 Turkish breast cancer survivors who experienced psychological distress. The Consolidated Criteria for Reporting Qualitative Research checklist was used to report the study. CONCLUSION Three key themes emerged from data analysis: sources of psychological distress, unmet supportive care needs, and barriers to support. The survivors who experienced psychological distress defined a variety of unmet supportive care needs, in the areas of information support, psychological/emotional support, social support, and individualized health care support. They also described personal and health professional-related factors as barriers. IMPLICATIONS FOR NURSING PRACTICE Nurses should assess psychosocial well-being and supportive care needs of breast cancer survivors. Survivors should be supported to discuss their experiences of symptoms in the early survival phase, and they should be referred to an appropriate supportive care resource. A multidisciplinary survivorship services model is needed to offer posttreatment psychological support routinely in Turkey. Early, effective psychological care integrated into follow-up services for survivors can be protective against psychological morbidity.
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Affiliation(s)
- Figen Şengün İnan
- Assistant Professor, Faculty of Nursing, Psychiatric Nursing Department, Gazi University, Çankaya, Ankara, Turkey
| | | | - İlhami Er
- Radiation Oncologist, İzmir Katip Celebi University Atatürk Education and Research Hospital, İzmir, Turkey
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Fan R, Wang L, Bu X, Wang W, Zhu J. Unmet supportive care needs of breast cancer survivors: a systematic scoping review. BMC Cancer 2023; 23:587. [PMID: 37365504 DOI: 10.1186/s12885-023-11087-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 06/19/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Breast cancer is the most common type of cancer in women worldwide. Though improved treatments and prolonged overall survival, breast cancer survivors (BCSs) persistently suffer from various unmet supportive care needs (USCNs) throughout the disease. This scoping review aims to synthesize current literature regarding USCNs among BCSs. METHODS This study followed a scoping review framework. Articles were retrieved from Cochrane Library, PubMed, Embase, Web of Science, and Medline from inception through June 2023, as well as reference lists of relevant literature. Peer-reviewed journal articles were included if USCNs among BCSs were reported. Inclusion/exclusion criteria were adopted to screen articles' titles and abstracts as well as to entirely assess any potentially pertinent records by two independent researchers. Methodological quality was independently appraised following Joanna Briggs Institute (JBI) critical appraisal tools. Content analytic approach and meta-analysis were performed for qualitative and quantitative studies respectively. Results were reported according to the PRISMA extension for scoping reviews. RESULTS A total of 10,574 records were retrieved and 77 studies were included finally. The overall risk of bias was low to moderate. The self-made questionnaire was the most used instrument, followed by The Short-form Supportive Care Needs Survey questionnaire (SCNS-SF34). A total of 16 domains of USCNs were finally identified. Social support (74%), daily activity (54%), sexual/intimacy (52%), fear of cancer recurrence/ spreading (50%), and information support (45%) were the top unmet supportive care needs. Information needs and psychological/emotional needs appeared most frequently. The USCNs was found to be significantly associated with demographic factors, disease factors, and psychological factors. CONCLUSION BCSs are experiencing a large number of USCNs in fearing of cancer recurrence, daily activity, sexual/intimacy, psychology and information, with proportions ranging from 45% to 74%. Substantial heterogeneity in study populations and assessment tools was observed. There is a need for further research to identify a standard evaluation tool targeted to USCNs on BCSs. Effective interventions based on guidelines should be formulated and conducted to decrease USCNs among BCSs in the future.
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Affiliation(s)
- Rongrong Fan
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, No.37, Guoxue Lane, Wuhou District, Chengdu, Sichuan, China
| | - Lili Wang
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, No.37, Guoxue Lane, Wuhou District, Chengdu, Sichuan, China
| | - Xiaofan Bu
- The School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Wenxiu Wang
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, No.37, Guoxue Lane, Wuhou District, Chengdu, Sichuan, China
| | - Jing Zhu
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, No.37, Guoxue Lane, Wuhou District, Chengdu, Sichuan, China.
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Khajoei R, Ilkhani M, Azadeh P, Zohari Anboohi S, Heshmati Nabavi F. Breast cancer survivors-supportive care needs: systematic review. BMJ Support Palliat Care 2023; 13:143-153. [PMID: 36972985 DOI: 10.1136/spcare-2022-003931] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 03/08/2023] [Indexed: 03/29/2023]
Abstract
OBJECTIVES To achieve optimal survival care outcomes, all healthcare services must be tailored to patients' specific needs, preferences and concerns throughout the survival period. This study aimed to identify supportive care needs from the point of view of breast cancer survivors. METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for reporting systematic reviews, a comprehensive search of PubMed, Web of Science and Scopus was performed. The inclusion criteria were studies published from inception to the end of January 2022, covering all stages of breast cancer. The exclusion criteria were mixed-type studies relating to cancer, such as case reports, commentaries, editorials and systematic reviews, as well as studies that assessed patients' needs during cancer treatment. Two quality assessment tools were used for the qualitative and quantitative studies. RESULTS Of the 13 095 records retrieved, 40 studies, including 20 qualitative and 20 quantitative studies, were retained for this review. Survivors' supportive care needs were classified into 10 dimensions and 40 subdimensions. The most frequently mentioned supportive care needs of survivors were psychological/emotional needs (N=32), health system/informational needs (N=30), physical and daily activities (N=19), and interpersonal/intimacy needs (N=19). CONCLUSIONS This systematic review highlights several essential needs for breast cancer survivors. Supportive programmes should be designed in order to take into consideration all aspects of these needs, particularly psychological, emotional and informational needs.
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Affiliation(s)
- Rahimeh Khajoei
- Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Mahnaz Ilkhani
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Payam Azadeh
- Radiation Oncology Department, Imam Hossein Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Sima Zohari Anboohi
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Fatemah Heshmati Nabavi
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran (the Islamic Republic of)
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Kong YC, Danaee M, Kaur R, Thiagarajan M, Zaharah H, Sener M, Rajah HDA, Taib NA, Chinna K, Yip CH, Bhoo-Pathy N. Development and Validation of a Dual-Language (English and Malay) Needs Assessment Tool for Breast Cancer (NeAT-BC). Diagnostics (Basel) 2023; 13:diagnostics13020241. [PMID: 36673050 PMCID: PMC9858119 DOI: 10.3390/diagnostics13020241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/16/2022] [Accepted: 01/05/2023] [Indexed: 01/11/2023] Open
Abstract
Background: Needs assessment tools may be used to guide the optimisation of cancer survivorship services. We sought to develop and validate a dual-language needs assessment tool for women with breast cancer. Methods: The study comprised two phases; (I) co-design, and (II) psychometric testing. In Phase I, items were generated based on focus group discussions with patients and a literature review. These items were then translated into the Malay language. Content and face validation were undertaken with an expert panel. In phase II, 315 Malaysian women living with breast cancer were recruited. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted to determine construct validity and reliability. Criterion validity was assessed using the EORTC QLQ-C30 questionnaire. Results: We co-designed and validated a 48-item dual-language needs assessment tool for breast cancer (NeAT-BC). Five underlying constructs were revealed in the EFA: (1) emotional support, (2) social and intimate relationships, (3) hospital appointments, (4) personal care and health, and (5) information and services. The NeAT-BC demonstrated good reliability across all constructs (Cronbach’s alpha: 0.90 to 0.96). CFA also demonstrated acceptable convergent and divergent validity, composite reliability ≥ 0.87, and Heterotrait−Monotrait index < 0.85 for all constructs. Criterion validity was established given the significant negative correlation between overall needs and quality of life (r = −0.14; p = 0.02). The NeAT-BC took approximately 25 min to be completed and could be interviewer-administered or self-administered. Conclusion: The utilization of the NeAT-BC is expected to guide establishment of evidence-based cancer survivorship services in Malaysia, with wider potentials for adoption in other multi-ethnic and/or low-and-middle income settings.
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Affiliation(s)
- Yek-Ching Kong
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Mahmoud Danaee
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Ranjit Kaur
- Breast Cancer Welfare Association Malaysia, Petaling Jaya 46200, Malaysia
| | | | - Hafizah Zaharah
- Department of Radiotherapy and Oncology, National Cancer Institute, Putrajaya 62250, Malaysia
| | - Mustafa Sener
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia
- Erasmus University Medical Centre, 3015 GD Rotterdam, The Netherlands
| | - Harenthri Devy Alagir Rajah
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Nur Aishah Taib
- Department of Surgery, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Karuthan Chinna
- Faculty of Business and Management, UCSI University, Kuala Lumpur 56100, Malaysia
| | - Cheng-Har Yip
- Subang Jaya Medical Centre, Subang Jaya 47500, Malaysia
| | - Nirmala Bhoo-Pathy
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia
- Correspondence: or ; Tel.: +6-03-7967-7526
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Koçak AT, Arslan S, İlik Y. Posttreatment Experiences of Breast Cancer Survivors in Turkey: A Qualitative Study. Semin Oncol Nurs 2022; 38:151351. [PMID: 36244885 DOI: 10.1016/j.soncn.2022.151351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 09/12/2022] [Accepted: 09/16/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES This study aimed to explore the posttreatment experiences of breast cancer survivors in Turkey. DATA SOURCES The study was conducted in Turkey between February 2020 and April 2020 with 18 breast cancer survivors who completed the treatment process. The data were collected using the individual in-depth interview method with the semi-structured interview form. The interviews were transcribed verbatim, and the data were analyzed using the seven-step Colaizzi method. The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was used to report the study. CONCLUSION Four main themes emerged in the study which are symptom management, emotional responses, change in life, and challenges in health care. The cancer survivors in Turkey reported that moral values had more meaning for them after treatment, they started to feel extremely worried about their children, they tried to manage their own processes with the information they themselves gained and with some support systems, and they experienced radical changes in their family and social relations. In addition, cancer survivors criticized the inadequacy of health care services, including relapse follow-up after the treatment process. IMPLICATIONS FOR NURSING PRACTICE This study provides an overview of the lived experiences of posttreatment breast cancer survivors in Turkey. The findings of this study can be used to better understand breast cancer survivors, identify their needs based on their experience, and develop interventions to improve patient outcomes.
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Affiliation(s)
- Ayyüce Tuba Koçak
- Research Assistant, PhD Student, Nursing Faculty, Department of Internal Medicine Nursing, Selcuk University, Konya, Turkey.
| | - Selda Arslan
- Associate Professor, Nursing Faculty, Department of Internal Medicine Nursing, Necmettin Erbakan University, Konya, Turkey
| | - Yeter İlik
- Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
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Miroševič Š, Prins J, Borštnar S, Besić N, Homar V, Selič-Zupančič P, Smrdel ACŠ, Klemenc-Ketiš Z. Factors associated with a high level of unmet needs and their prevalence in the breast cancer survivors 1–5 years after post local treatment and (neo)adjuvant chemotherapy during the COVID-19: A cross-sectional study. Front Psychol 2022; 13:969918. [PMID: 36262447 PMCID: PMC9574393 DOI: 10.3389/fpsyg.2022.969918] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 09/06/2022] [Indexed: 11/29/2022] Open
Abstract
Objective To assess the prevalence of unmet needs in post-treatment breast cancer survivors and identify sociodemographic, clinical, and psychosocial variables associated with reported unmet needs during the COVID-19 pandemic. Materials and methods In this cross-sectional study, 430 post-treatment breast cancer survivors, ranging between 1 and 5 years after the procedure, completed the Cancer Survivors’ Unmet Needs (CaSUN) questionnaire from September 2021 and January 2022. The multivariate logistic analysis identified factors associated with at least one reported unmet need in the total CaSUN scale and specific domains. Results A total of 67% of survivors reported at least one unmet need. The most frequently reported unmet needs were the lack of accessible hospital parking (43%) and recurrence concerns (39.5%). The majority of reported unmet needs relate to comprehensive care (44%), followed by the psychological and emotional support domain (35.3%). Younger age (OR = 0.95, 95% CI = 0.92–0.99; p < 0.001), three or more comorbidities (OR = 0.27, 95% CI = 0.11–0.71, p < 0.01), a lower quality of life (OR = 0.06, 95% CI = 0.01–0.47, p < 0.01) and low resilience (OR = 0.95, 95% CI = 0.93–0.99) were associated with a high level of unmet needs in the multivariate regression model. Results are presented for factors associated with a high level of unmet needs for comprehensive cancer care and psychological and emotional support domain. Conclusion A high prevalence found in our study could be attributed to the COVID-19 pandemic, where patients may have missed adequate follow-up care, although comparing to studies done in non-pandemic time is difficult. Family physicians should be more attentive toward younger cancer survivors and those with more comorbidities as both characteristics can be easily recognized in the family practice.
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Affiliation(s)
- Špela Miroševič
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- *Correspondence: Špela Miroševič,
| | - Judith Prins
- Department of Medical Psychology, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Simona Borštnar
- Department of Medical Oncology, Institute of Oncology, Ljubljana, Slovenia
| | - Nikola Besić
- Department of Surgical Oncology, Institute of Oncology, Ljubljana, Slovenia
| | - Vesna Homar
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Polona Selič-Zupančič
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- Department of Psychology, Faculty of Medicine, University of Maribor, Maribor, Slovenia
- Community Health Centre Ljubljana, Primary Healthcare Research and Development Institute, Ljubljana, Slovenia
| | | | - Zalika Klemenc-Ketiš
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- Community Health Centre Ljubljana, Primary Healthcare Research and Development Institute, Ljubljana, Slovenia
- Department of Family Medicine, Medical Faculty, University of Maribor, Maribor, Slovenia
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Botto R, De Leonardis B, Salussolia A, Di Nardo C, Ala A, Torta R, Stanizzo MR. Assessment of anxiety, depression, and distress in breast cancer patients: A comparison among different phases of illness. Health Care Women Int 2022; 45:390-402. [PMID: 35695501 DOI: 10.1080/07399332.2022.2078325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 05/12/2022] [Indexed: 10/18/2022]
Abstract
We aimed to assess the levels of anxious and depressive symptoms and distress in a sample of breast cancer patients in the different phases of the illness. We performed a cross-sectional study. We divided 301 female breast cancer patients into three groups, based on the phase of illness they were in being in post-surgery (N = 100), receiving adjuvant therapies (N = 86), and receiving follow-up care (N = 115). We included the follow-up within the phases of illness. We further divided each group into first diagnosed or with recurrence and we administered Hospital Anxiety and Depression Scale and Distress Thermometer. First-diagnosed patients with clinically relevant anxiety increased from being post-surgery (35.8%), to receiving adjuvant therapies (53.7%), and to being in follow-up (61.5%). In patients with recurrence, distress was stable among the illness phases, but many patients had clinically relevant anxiety (55.65%) and depression (43.48%). First-diagnosed patients' emotional distress could be more linked to follow-up-related difficulties. During recurrence, high distress could be due to the failure of previous treatments. Distress screening can better orient psycho-social interventions and healthcare resources.
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Affiliation(s)
- Rossana Botto
- Department of Neuroscience "Rita Levi Montalcini," University of Turin, Turin, Italy
- Clinical Psychology Unit, Department of Neuroscience, "Città della Salute e della Scienza" Hospital of Turin, Turin, Italy
| | - Brigitta De Leonardis
- Clinical Psychology Unit, Department of Neuroscience, "Città della Salute e della Scienza" Hospital of Turin, Turin, Italy
| | - Annarita Salussolia
- Clinical Psychology Unit, Department of Neuroscience, "Città della Salute e della Scienza" Hospital of Turin, Turin, Italy
| | - Cristina Di Nardo
- Clinical Psychology Unit, Department of Neuroscience, "Città della Salute e della Scienza" Hospital of Turin, Turin, Italy
| | - Ada Ala
- Department of Surgery, "Città della Salute e della Scienza" Hospital of Turin, Turin, Italy
| | - Riccardo Torta
- Department of Neuroscience "Rita Levi Montalcini," University of Turin, Turin, Italy
| | - Maria Rosa Stanizzo
- Clinical Psychology Unit, Department of Neuroscience, "Città della Salute e della Scienza" Hospital of Turin, Turin, Italy
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12
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Olsson IM, Malmström M, Rydén L, Olsson Möller U. Feasibility and Relevance of an Intervention with Systematic Screening as a Base for Individualized Rehabilitation in Breast Cancer Patients: A Pilot Trial of the ReScreen Randomized Controlled Trial. J Multidiscip Healthc 2022; 15:1057-1068. [PMID: 35586080 PMCID: PMC9109980 DOI: 10.2147/jmdh.s355055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 03/14/2022] [Indexed: 11/23/2022] Open
Abstract
Background Purpose Patients and methods Results Conclusion
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Affiliation(s)
- Ing-Marie Olsson
- Department of Health Sciences, Lund University, Lund, Sweden
- Skåne University Hospital, Malmö, Sweden
- Correspondence: Ing-Marie Olsson, Department of Health Sciences, Lund University, Box 157, Lund, 221 00, Sweden, Tel +46 701453530, Fax +46 40333674, Email
| | - Marlene Malmström
- Department of Health Sciences, Lund University, Lund, Sweden
- Skåne University Hospital, Malmö, Sweden
| | - Lisa Rydén
- Skåne University Hospital, Malmö, Sweden
- Department of Clinical Sciences Lund, Surgery, Lund University, Lund, Sweden
| | - Ulrika Olsson Möller
- Department of Health Sciences, Lund University, Lund, Sweden
- Department of Nursing and Integrated Health Sciences, Kristianstad University, Kristianstad, Sweden
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13
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Umashankar S, Mamounas ME, Matthys M, Hadeler EK, Wong EC, Hicks G, Hwang J, Chien AJ, Rugo HS, Hamolsky D, Esserman L, Melisko M. Evaluation of the Pathways for Survivors Program to Address Breast Cancer Survivorship-Associated Distress: Survey Study. JMIR Cancer 2022; 8:e31756. [PMID: 35212641 PMCID: PMC8917438 DOI: 10.2196/31756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 11/04/2021] [Accepted: 12/09/2021] [Indexed: 11/17/2022] Open
Abstract
Background Patients with breast cancer frequently experience escalation of anxiety after completing curative treatment. Objective This study evaluated the acceptability and psychological impact of a 1-day workshop to emphasize behavioral strategies involving intention and self-efficacy. Methods Breast cancer survivors who attended a 1-day Pathways for Survivors workshop provided feedback and completed electronic quality of life (QOL) questionnaires at baseline, 1 and 6 weeks, and 6 months after the workshop. Attendees’ baseline QOL scores were compared to follow-up (FUP) scores. Scores from patients receiving routine FUP care were also compiled as a reference population. Results In total, 77 patients attended 1 of 9 workshops. The mean satisfaction score was 9.7 out of 10 for the workshop and 9.96 out of 10 for the moderator. Participants’ baseline mean Patient-Reported Outcomes Measurement Information System (PROMIS) anxiety and depression scores were 57.8 (SD 6.9) and 55.3 (SD 7.5), respectively, which were significantly higher than those of patients receiving routine FUP care (49.1, SD 8.3 and 47.3 SD 8.0, respectively). PROMIS anxiety and depression scores decreased, and the Happiness Index Profile (HIP-10) score—measuring intention and resiliency—increased significantly at 1- and 6-week FUPs. Conclusions The Pathways for Survivors program was favorably received. Anxiety and depression decreased significantly at 1- and 6-weeks after the workshop and remained below baseline at 6 months. Increased HIP-10 scores suggest that patients acquired and implemented skills from the workshop. A 1-day workshop led by a lay moderator significantly improved several psychological measures, suggesting that it may be a useful and time-efficient strategy to improve QOL in breast cancer survivors. We are investigating whether an abbreviated “booster” of the intervention at a later date could further improve and maintain QOL gains.
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Affiliation(s)
- Saumya Umashankar
- Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Matina Elise Mamounas
- Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Madeline Matthys
- Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Edward Kenji Hadeler
- Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Emily Claire Wong
- Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Greg Hicks
- Foster, Hicks & Associates, San Francisco, CA, United States
| | - Jimmy Hwang
- Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Amy Jo Chien
- Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Hope S Rugo
- Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Deborah Hamolsky
- Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Laura Esserman
- Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Michelle Melisko
- Department of Medicine, University of California San Francisco, San Francisco, CA, United States
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14
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Bu X, Jin C, Fan R, Cheng ASK, Ng PHF, Xia Y, Liu X. Unmet needs of 1210 Chinese breast cancer survivors and associated factors: a multicentre cross-sectional study. BMC Cancer 2022; 22:135. [PMID: 35109799 PMCID: PMC8811964 DOI: 10.1186/s12885-022-09224-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 01/14/2022] [Indexed: 11/23/2022] Open
Abstract
Background Breast cancer survivors (BCSs) often have potential unmet needs. Identification of the specific needs of BCSs is very significant for medical service provision. This study aimed to (1) investigate the unmet needs and quality of life (QoL) of BCSs in China, (2) explore the diverse factors associated with their unmet needs, and (3) assess the association between their unmet needs and QoL. Methods A multicentre, cross-sectional survey was administered to 1210 Chinese BCSs. The Cancer Survivor Profile-Breast Cancer and the Functional Assessment of Cancer Therapy-Breast scale were administered to survivors who gave informed consent to participate. Data were analysed using t-test, ANOVA, multiple regression analysis, and Pearson correlations. Results The 1192 participants completed questionnaires (response rate 98.51%). Our study reveals that the most prevalent unmet needs were in the ‘symptom burden domain’. The unmet needs of BCSs depend on eleven factors; age, time since diagnosis, education level, occupation, payment, family income status, stage of cancer, treatment, family history of cancer, pain, and physical activities. To ensure the provision of high-quality survivorship care and a high satisfaction level, more attention should be paid to actively identifying and addressing the unmet needs of BCSs. The problem areas identified in the Cancer Survivor Profile for breast cancer were negatively associated with all subscales of QoL except the health behaviour domain, with the correlation coefficient ranging from − 0.815 to − 0.011. Conclusion Chinese BCSs exhibit a high demand for unmet needs in this study, and the most prevalent unmet needs were in the ‘symptom burden domain’. There was a significant association between patients’ unmet needs (as defined in the Cancer Survivor Profile for breast cancer) and QoL. Future research should focus on enhancements to survivorship or follow-up care to address unmet needs and further improve QoL.
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Affiliation(s)
- Xiaofan Bu
- Nursing Teaching and Research Section, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.,Xiangya School of Nursing, Central South University, Changsha, China
| | - Cai Jin
- Nursing Teaching and Research Section, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.,Department of Nursing, Hunan Xiangya Stomatological Hospital, Central South University, Changsha, China
| | - Rongrong Fan
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Andy S K Cheng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Peter H F Ng
- Department of Computing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Yimin Xia
- Department of Health Service Center, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Xiangyu Liu
- Department of Health Service Center, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.
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15
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Rades D, Narvaez CA, Dziggel L, Tvilsted S, Kjaer TW, Schild SE, Bartscht T. Emotional Problems Prior to Adjuvant Radiation Therapy for Breast Cancer. In Vivo 2021; 35:2763-2770. [PMID: 34410966 DOI: 10.21873/invivo.12561] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/11/2021] [Accepted: 06/17/2021] [Indexed: 01/15/2023]
Abstract
BACKGROUND/AIM Being scheduled for radiotherapy can cause emotional distress. This study aimed to identify risk factors in 338 patients assigned to radiotherapy for breast cancer. PATIENTS AND METHODS Nineteen potential risk factors including the COVID-19 pandemic were investigated for associations with the six emotional problems included in the National Comprehensive Cancer Network Distress Thermometer. RESULTS Worry and fears were significantly associated with age ≤60 years; sadness with age and Karnofsky performance score (KPS) <90; depression with KPS and Charlson Comorbidity Index ≥3; loss of interest with KPS. Trends were found for associations between sadness and additional breast cancer/DCIS, Charlson Index and chemotherapy; between depression and additional breast cancer/DCIS, treatment volume and nodal stage N1-3; between nervousness and additional breast cancer/DCIS, mastectomy and triple-negativity; between loss of interest and Charlson Index, family history of breast cancer/DCIS, invasive cancer, chemotherapy, and treatment volume. The COVID-19 pandemic did not increase emotional problems. CONCLUSION Several risk factors for emotional problems were identified. Patients with such factors should receive psychological support well before radiotherapy.
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Affiliation(s)
- Dirk Rades
- Department of Radiation Oncology, University of Lübeck, Lübeck, Germany;
| | - Carlos A Narvaez
- Department of Radiation Oncology, University of Lübeck, Lübeck, Germany
| | - Liesa Dziggel
- Department of Radiation Oncology, University of Lübeck, Lübeck, Germany
| | - Soeren Tvilsted
- Research Projects and Clinical Optimization, Zealand University Hospital, Koege, Denmark
| | - Troels W Kjaer
- Neurological Department, Zealand University Hospital, Roskilde, Denmark
| | - Steven E Schild
- Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ, U.S.A
| | - Tobias Bartscht
- Department of Hematology and Oncology, University of Lübeck, Lübeck, Germany
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16
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Di Leone A, Terribile D, Magno S, Sanchez AM, Scardina L, Mason EJ, D’Archi S, Maggiore C, Rossi C, Di Micco A, Carnevale S, Paris I, Marazzi F, Masiello V, Orlandi A, Palazzo A, Fabi A, Masetti R, Franceschini G. Neoadjuvant Chemotherapy in Breast Cancer: An Advanced Personalized Multidisciplinary Prehabilitation Model (APMP-M) to Optimize Outcomes. J Pers Med 2021; 11:324. [PMID: 33919061 PMCID: PMC8143137 DOI: 10.3390/jpm11050324] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/09/2021] [Accepted: 04/12/2021] [Indexed: 01/01/2023] Open
Abstract
Neoadjuvant chemotherapy is increasingly being employed in the management of breast cancer patients. Efforts and resources have been devoted over the years to the search for an optimal strategy that can improve outcomes in the neoadjuvant setting. Today, a multidisciplinary approach with the application of evidence-based medicine is considered the gold standard for the improvement of oncological results and patient satisfaction. However, several clinical complications and psychological issues due to various factors can arise during neoadjuvant therapy and undermine outcomes. To ensure that health care needs are adequately addressed, clinicians must consider that women with breast cancer have a high risk of developing "unmet needs" during treatment, and often require a clinical intervention or additional care resources to limit possible complications and psychological issues that can occur during neoadjuvant treatment. This work describes a multidisciplinary model developed at "Fondazione Policlinico Universitario Agostino Gemelli" (FPG) in Rome in an effort to optimize treatment, ease the application of evidence-based medicine, and improve patient quality of life in the neoadjuvant setting. In developing our model, our main goal was to adequately meet patient needs while preventing high levels of distress.
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Affiliation(s)
- Alba Di Leone
- Multidisciplinary Breast Centre, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (D.T.); (S.M.); (A.M.S.); (L.S.); (E.J.M.); (S.D.); (R.M.); (G.F.)
| | - Daniela Terribile
- Multidisciplinary Breast Centre, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (D.T.); (S.M.); (A.M.S.); (L.S.); (E.J.M.); (S.D.); (R.M.); (G.F.)
| | - Stefano Magno
- Multidisciplinary Breast Centre, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (D.T.); (S.M.); (A.M.S.); (L.S.); (E.J.M.); (S.D.); (R.M.); (G.F.)
| | - Alejandro Martin Sanchez
- Multidisciplinary Breast Centre, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (D.T.); (S.M.); (A.M.S.); (L.S.); (E.J.M.); (S.D.); (R.M.); (G.F.)
| | - Lorenzo Scardina
- Multidisciplinary Breast Centre, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (D.T.); (S.M.); (A.M.S.); (L.S.); (E.J.M.); (S.D.); (R.M.); (G.F.)
| | - Elena Jane Mason
- Multidisciplinary Breast Centre, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (D.T.); (S.M.); (A.M.S.); (L.S.); (E.J.M.); (S.D.); (R.M.); (G.F.)
| | - Sabatino D’Archi
- Multidisciplinary Breast Centre, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (D.T.); (S.M.); (A.M.S.); (L.S.); (E.J.M.); (S.D.); (R.M.); (G.F.)
| | - Claudia Maggiore
- Centre of Integrative Oncology—Multidisciplinary Breast Centre—Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli I RCCS, 00168 Rome, Italy; (C.M.); (C.R.); (A.D.M.)
| | - Cristina Rossi
- Centre of Integrative Oncology—Multidisciplinary Breast Centre—Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli I RCCS, 00168 Rome, Italy; (C.M.); (C.R.); (A.D.M.)
| | - Annalisa Di Micco
- Centre of Integrative Oncology—Multidisciplinary Breast Centre—Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli I RCCS, 00168 Rome, Italy; (C.M.); (C.R.); (A.D.M.)
| | - Stefania Carnevale
- UOS Psicologia Clinica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy;
| | - Ida Paris
- Department of Woman and Child Health and Public Health, Woman Health Area, Fondazione Policlinico Universitario A. Gemelli I RCCS, 00168 Rome, Italy;
| | - Fabio Marazzi
- UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli I RCCS, 00168 Rome, Italy; (F.M.); (V.M.)
| | - Valeria Masiello
- UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli I RCCS, 00168 Rome, Italy; (F.M.); (V.M.)
| | - Armando Orlandi
- Comprehensive Cancer Center, Multidisciplinary Breast Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli, 8, 00168 Rome, Italy; (A.O.); (A.P.)
| | - Antonella Palazzo
- Comprehensive Cancer Center, Multidisciplinary Breast Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli, 8, 00168 Rome, Italy; (A.O.); (A.P.)
| | - Alessandra Fabi
- Medicina di Precisione in Senologia, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy;
| | - Riccardo Masetti
- Multidisciplinary Breast Centre, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (D.T.); (S.M.); (A.M.S.); (L.S.); (E.J.M.); (S.D.); (R.M.); (G.F.)
| | - Gianluca Franceschini
- Multidisciplinary Breast Centre, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (D.T.); (S.M.); (A.M.S.); (L.S.); (E.J.M.); (S.D.); (R.M.); (G.F.)
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17
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Kim SH, Choe YH, Han AR, Yeon GJ, Lee GH, Lee BG, Cho YU, Park S, Lee MH. Design of a randomized controlled trial of a partnership-based, needs-tailored self-management support intervention for post-treatment breast cancer survivors. BMC Cancer 2020; 20:367. [PMID: 32357926 PMCID: PMC7193410 DOI: 10.1186/s12885-020-06861-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 04/13/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Self-management is becoming essential for breast cancer survivors, but evidence about the effectiveness of self-management support (SMS) intervention is lacking. To address this issue, we developed a theory-based SMS intervention, the 'EMPOWER', aimed at empowering breast cancer survivors. Here we describe the rationale of the intervention and its development. METHODS The conceptual framework of this study is the Chronic Care Model, which posits that SMS can influence patient-provider relationships and ultimately improve health outcomes. We will conduct a multi-center, 2-armed randomized controlled trial to assess the effectiveness of EMPOWER among post-treatment breast cancer survivors in South Korea. The trial will include 94 women who completed primary breast cancer treatment within the last 6 months. Participants will be randomly assigned to the intervention group or the wait-list control group (1:1). The intervention group will receive a 7-week partnership-based and needs-tailored SMS intervention via telephone counseling. The primary outcome is empowerment. The secondary outcomes include self-efficacy for post-treatment self-management behaviors, mental adjustment, psychological distress, and health-related quality of life (HRQOL). Data will be collected by self-reported questionnaire at baseline, post-intervention, and 3-month follow-up. DISCUSSION We believe that the EMPOWER intervention could improve HRQOL of post-treatment breast cancer survivors by enhancing their empowerment. If found successful, it could aid clinicians engaged in the long-term care of breast cancer survivors. TRIAL REGISTRATION Clinical Research Information Service, KCT0004794. Registered 5 March 2020.
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Affiliation(s)
- Soo Hyun Kim
- Department of Nursing, Inha University, 100 Inha-ro, Michuhol-gu, Incheon, 22212, South Korea.
| | - Yu Hyeon Choe
- Department of Nursing, Inha University, 100 Inha-ro, Michuhol-gu, Incheon, 22212, South Korea
| | - Ah Reum Han
- Department of Nursing, Inha University, 100 Inha-ro, Michuhol-gu, Incheon, 22212, South Korea
| | - Gwui Jeong Yeon
- Department of Nursing, Inha University, 100 Inha-ro, Michuhol-gu, Incheon, 22212, South Korea
| | - Gyeong Hee Lee
- Department of Nursing, Inha University, 100 Inha-ro, Michuhol-gu, Incheon, 22212, South Korea
| | - Bo Gyeong Lee
- College of Nursing, The Research Institute of Nursing Science, Daegu Catholic University, Daegu, South Korea
| | - Young Up Cho
- Department of Surgery, Ilsan Women's & Children's Hospital, Cha University, Goyang, South Korea
| | - Seho Park
- Division of Breast Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea
| | - Moon Hee Lee
- Division of Hematology-Oncology, College of Medicine, Inha University, Incheon, South Korea
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18
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Lo-Fo-Wong DNN, de Haes HCJM, Aaronson NK, van Abbema DL, den Boer MD, van Hezewijk M, Immink M, Kaptein AA, Menke-Pluijmers MBE, Reyners AKL, Russell NS, Schriek M, Sijtsema S, van Tienhoven G, Verdam MGE, Sprangers MAG. Risk factors of unmet needs among women with breast cancer in the post-treatment phase. Psychooncology 2019; 29:539-549. [PMID: 31785043 PMCID: PMC7065096 DOI: 10.1002/pon.5299] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 10/30/2019] [Accepted: 11/18/2019] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Unmet health care needs require additional care resources to achieve optimal patient well-being. In this nationwide study we examined associations between a number of risk factors and unmet needs after treatment among women with breast cancer, while taking into account their health care practices. We expected that more care use would be associated with lower levels of unmet needs. METHODS A multicenter, prospective, observational design was employed. Women with primary breast cancer completed questionnaires 6 and 15 months post-diagnosis. Medical data were retrieved from medical records. Direct and indirect associations between sociodemographic and clinical risk factors, distress, care use, and unmet needs were investigated with structural equation modeling. RESULTS Seven hundred forty-six participants completed both questionnaires (response rate 73.7%). The care services received were not negatively associated with the reported levels of unmet needs after treatment. Comorbidity was associated with higher physical and daily living needs. Higher age was associated with higher health system-related and informational needs. Having had chemotherapy and a mastectomy were associated with higher sexuality needs and breast cancer-specific issues, respectively. A higher level of distress was associated with higher levels of unmet need in all domains. CONCLUSIONS Clinicians may use these results to timely identify which women are at risk of developing specific unmet needs after treatment. Evidence-based, cost-effective (online) interventions that target distress, the most influential risk factor, should be further implemented and disseminated among patients and clinicians.
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Affiliation(s)
- Deborah N N Lo-Fo-Wong
- Academic Medical Center, Cancer Center Amsterdam, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Hanneke C J M de Haes
- Academic Medical Center, Cancer Center Amsterdam, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Neil K Aaronson
- Antoni van Leeuwenhoek Hospital, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Doris L van Abbema
- GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | | | | | | | - Ad A Kaptein
- Leiden University Medical Center, Leiden, The Netherlands
| | | | - Anna K L Reyners
- University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Nicola S Russell
- Antoni van Leeuwenhoek Hospital, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | - Sieta Sijtsema
- University Medical Center Utrecht, Utrecht, The Netherlands
| | - Geertjan van Tienhoven
- Academic Medical Center, Cancer Center Amsterdam, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Mathilde G E Verdam
- Academic Medical Center, Cancer Center Amsterdam, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Mirjam A G Sprangers
- Academic Medical Center, Cancer Center Amsterdam, Amsterdam University Medical Centers, Amsterdam, The Netherlands
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