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Pearson EJ, Drosdowsky A, Edbrooke L, Denehy L. Exploring the Use of Two Brief Fatigue Screening Tools in Cancer Outpatient Clinics. Integr Cancer Ther 2021; 20:1534735420983443. [PMID: 33522317 PMCID: PMC7871054 DOI: 10.1177/1534735420983443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE Cancer fatigue guidelines recommend routine fatigue screening, with further assessment for people reporting moderate to severe fatigue. There is neither a gold-standard, nor a broadly accepted screening method, and knowledge about the impact of screening on care processes is limited. This study aimed to explore the feasibility of 2 fatigue screening methods and current clinical practice in cancer outpatient clinics. METHODS Hospital outpatients attending cancer clinics during 1 week completed a five-item survey: a numeric scale for current tiredness, 2 categorical pictorial scales rating tiredness last week and the impact of fatigue (Fatigue Pictogram), screening tool preference and help needed for survey completion. Participant demographics and fatigue documentation by clinical staff for that appointment were extracted from medical records. Analyses used descriptive statistics. Groups were compared using appropriate statistical tests. RESULTS Over 75% of participants rated their fatigue consistently as mild or significant on both screening tools. Of 1709 eligible outpatients, 533 (31%) completed the survey. Records were audited for 430 (81%) identifiable participants. Over half of the participants reported moderate or severe tiredness either "now" (237, 57%) and/or "last week" (226, 53%). Clinician documentation of fatigue seldom matched self-reports. Fatigue was rated as severe by 103 participants (24%), yet was noted in only 21 (20%) of these individuals' clinical notes. Both screening tools were equally preferred. CONCLUSION The numeric rating scale and Fatigue Pictogram are equally applicable for screening fatigue in cancer outpatient care. There is a high prevalence of clinically significant fatigue in a hospital outpatient setting that is not documented. Adequate care pathways for further management should be established alongside fatigue screening.
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Affiliation(s)
- Elizabeth J Pearson
- The University of Melbourne, Melbourne, Victoria, Australia.,Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Allison Drosdowsky
- The University of Melbourne, Melbourne, Victoria, Australia.,Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Lara Edbrooke
- The University of Melbourne, Melbourne, Victoria, Australia.,Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Linda Denehy
- The University of Melbourne, Melbourne, Victoria, Australia.,Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
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2
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Hertler C, Seiler A, Gramatzki D, Schettle M, Blum D. Sex-specific and gender-specific aspects in patient-reported outcomes. ESMO Open 2020; 5:e000837. [PMID: 33184099 PMCID: PMC7662538 DOI: 10.1136/esmoopen-2020-000837] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 09/22/2020] [Accepted: 10/07/2020] [Indexed: 01/10/2023] Open
Abstract
Patient-reported outcomes (PROs) are important tools in patient-centred medicine and allow for individual assessment of symptom burden and aspects of patients’ quality of life. While sex and gender differences have emerged in preclinical and clinical medicine, these differences are not adequately represented in the development and use of patient-reported outcome measures. However, even in personalised approaches, undesirable biases may occur when samples are unbalanced for certain characteristics, such as sex or gender. This review summarises the current status of the literature and trends in PROs with a focus on sex and gender aspects.
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Affiliation(s)
- Caroline Hertler
- Department of Radiation Oncology and Competence Center for Palliative Care, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
| | - Annina Seiler
- Department of Radiation Oncology and Competence Center for Palliative Care, University Hospital Zurich and University of Zurich, Zurich, Switzerland; Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Dorothee Gramatzki
- Department of Neurology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Markus Schettle
- Department of Radiation Oncology and Competence Center for Palliative Care, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - David Blum
- Department of Radiation Oncology and Competence Center for Palliative Care, University Hospital Zurich and University of Zurich, Zurich, Switzerland
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3
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Solvik E, Ytrehus S, Utne I, Grov EK. Pain, fatigue, anxiety and depression in older home-dwelling people with cancer. Nurs Open 2020; 7:430-438. [PMID: 31871728 PMCID: PMC6918018 DOI: 10.1002/nop2.406] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 10/07/2019] [Indexed: 11/22/2022] Open
Abstract
Aim Globally, cancer incidence counts for more than 14 million cases and the number increases with age. The aim of this study was to investigate the occurrence of pain, fatigue, anxiety and depression in association with demographic and clinical factors. Design A cross-sectional descriptive design was used. Methods We performed descriptive statistics to analyse the questionnaires completed from 174 older home-dwelling people with cancer. Results The people with cancer reported low occurrence of pain, fatigue, anxiety and depression. We found strong correlation between anxiety and depression. Women reported significantly higher scores of anxiety and depression than men. A higher pain score was associated with higher scores of fatigue and anxiety. Conclusions Home care personnel meeting older home-dwelling people with cancer should emphasize these people' mental health problems and be aware that pain, fatigue and anxiety may occur at the same time.
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Affiliation(s)
- Elena Solvik
- Department of Emergency ReceptionOstfold Hospital Trust, KalnesGrålumNorway
| | - Siri Ytrehus
- Faculty of HealthWestern Norway University of Applied SciencesBergenNorway
| | - Inger Utne
- Faculty of Health SciencesInstitute of Nursing and Health PromotionOslo Metropolitan UniversityOsloNorway
| | - Ellen Karine Grov
- Faculty of Health SciencesInstitute of Nursing and Health PromotionOslo Metropolitan UniversityOsloNorway
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Ahlam A, Hind M, Haddou Rahou B, Rachid R, Hassan E. Quality of life of Moroccan patients on the palliative phase of advanced cancer. BMC Res Notes 2019; 12:351. [PMID: 31227021 PMCID: PMC6588852 DOI: 10.1186/s13104-019-4390-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Accepted: 06/14/2019] [Indexed: 11/10/2022] Open
Abstract
Objective The aim of this study is to assess the quality of life of caregiver’s. The study was conducted at the RABAT National Institute of Oncology in MOROCCO. Results 120 patients on the palliative phase of advanced cancer were included. Severe fatigue was observed in 64.2% of patients with an average of 90.55 ± 14.7. There was a positive association between functional dimensions and overall quality of life and a negative association between symptoms and overall quality of life. Patients under 30 years had a lower quality of life. According to the multi-varied analysis, physical function, emotional functioning and fatigue were significant predictors of Health related quality of life/overall quality of life (p < 0.05). Electronic supplementary material The online version of this article (10.1186/s13104-019-4390-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Aitouma Ahlam
- Department of Medical Oncology, National Institute of Oncology, Rabat, Morocco. .,Translational Oncology Research Team, Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, Morocco.
| | - Mrabti Hind
- Department of Medical Oncology, National Institute of Oncology, Rabat, Morocco.,Translational Oncology Research Team, Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, Morocco
| | - Bouchra Haddou Rahou
- Research Department, Higher Institute of Nursing Professions and Technical Health, Rabat, Morocco
| | - Razine Rachid
- Laboratory of Social Medicine and Public Health, Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, Morocco
| | - Errihani Hassan
- Department of Medical Oncology, National Institute of Oncology, Rabat, Morocco.,Translational Oncology Research Team, Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, Morocco
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Walker J, O'Brien B, Vera E, Armstrong T. Describing Symptom Burden and Functional Status at the Diagnosis of Leptomeningeal Metastasis. Oncol Nurs Forum 2018; 45:372-379. [PMID: 29683126 DOI: 10.1188/18.onf.372-379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To investigate the associations of primary cancer, tumor characteristics, and cancer treatment with symptom burden and functional status. SAMPLE & SETTING 52 patients with leptomeningeal metastasis (LM) at the University of Texas MD Anderson Cancer Center in Houston. METHODS & VARIABLES Records of 52 patients were reviewed, and presenting symptoms were recorded. Mean differences in number and specific symptoms and functional status were explored. Correlations between age and overall number of symptoms with specific symptoms were assessed with Pearson correlations. RESULTS Pain was the most frequently reported symptom. Hormonal ablation therapy within six months of LM diagnosis was associated with a higher number of symptoms. Receiving biotherapy more than six months prior to an LM diagnosis was associated with pain, and cerebrospinal fluid leukocytosis was associated with a poor Karnofsky Performance Status score. IMPLICATIONS FOR NURSING Nurses caring for patients with advanced cancer can help ensure the highest possible quality of life by obtaining a careful history, assessing symptoms, and noting any changes since the last encounter.
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Yogananda MN, Muthu V, Prasad KT, Kohli A, Behera D, Singh N. Utility of the revised Edmonton Symptom Assessment System (ESAS-r) and the Patient-Reported Functional Status (PRFS) in lung cancer patients. Support Care Cancer 2018; 26:767-775. [PMID: 29027005 DOI: 10.1007/s00520-017-3887-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 09/11/2017] [Indexed: 01/09/2023]
Abstract
BACKGROUND Symptom palliation is an important objective of treatment in advanced/metastatic lung cancer (LC). Significant psychological, minor physical symptoms and several social/emotional issues often go unnoticed. This prospective study aimed to evaluate utility of patients' perspectives [self-reported symptom assessment by revised Edmonton Symptom Assessment System (ESAS-r) and self-reported functional status by Patient-Reported Functional Status (PRFS)] amongst LC patients undergoing chemotherapy. METHODS Consecutive newly diagnosed treatment-naïve LC patients attending a tertiary referral center in North India from January 2014 to March 2015 were included. All patients received standard histology-guided platinum-doublet chemotherapy. ESAS-r and PRFS questionnaires were administered under guidance, once at the time of initial assessment/diagnosis, repeated at start of chemotherapy, before C4, and after completion of chemotherapy (end of chemotherapy (EOCTx)). Functional Assessment of Cancer Therapy-Lung (FACT-L) questionnaire was also administered. Baseline and post-treatment scores were compared. RESULTS Majority of 133 patients enrolled were males (86.5%,n = 115), were current/ex-smokers (81.2%, n = 108), had advanced stage [IIIB = 30.1% (n = 40), IV = 52.6% (n = 70)], and were of non-small-cell type (NSCLC;84.2%,n = 112). On baseline ESAS-r, the highest mean symptom scores were observed for tiredness followed by anorexia. Mean ESAS-r scores before C4 as well as at EOCTX were significantly better than baseline ESAS-r scores in all its components except nausea. Similarly, PRFS before C4 and EOCTx was significantly improved compared to baseline. However, Karnofsky Performance Scale (KPS) and Eastern Cooperative Oncology Group Performance Status assessed at baseline did not show significant improvement at treatment completion. FACT-L score at EOCTx showed significant improvement from baseline in physical and functional well-being domains but not for social/family and emotional well-being domains. CONCLUSION This study validated utility of ESAS-r and PRFS in Indian LC patients. These instruments should be used in routine clinical practice besides physicians' assessment of PS (KPS/ECOG).
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Affiliation(s)
- M N Yogananda
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Sector-12, Chandigarh, 160012, India
| | - Valliappan Muthu
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Sector-12, Chandigarh, 160012, India
| | - Kuruswamy Thurai Prasad
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Sector-12, Chandigarh, 160012, India
| | - Adarsh Kohli
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research (PGIMER), Sector-12, Chandigarh, 160012, India
| | - Digambar Behera
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Sector-12, Chandigarh, 160012, India
| | - Navneet Singh
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Sector-12, Chandigarh, 160012, India.
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Nieder C, Kämpe TA, Pawinski A, Dalhaug A. Patient-reported symptoms before palliative radiotherapy predict survival differences. Strahlenther Onkol 2018; 194:533-538. [PMID: 29344766 DOI: 10.1007/s00066-018-1259-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 01/05/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Widely used prognostic scores, e. g., for brain or bone metastases, are based on disease- and patient-related factors such as extent of metastases, age and performance status, which were available in the databases used to develop the scores. Few groups were able to include patient-reported symptoms. In our department, all patients were assessed with the Edmonton Symptom Assessment System (ESAS, a one-sheet questionnaire addressing 11 major symptoms and wellbeing on a numeric scale of 0-10) at the time of treatment planning since 2012. Therefore, we analyzed the prognostic impact of baseline ESAS symptom severity. METHODS Retrospective review of 102 patients treated with palliative radiotherapy (PRT) between 2012 and 2015. All ESAS items were dichotomized (below/above median). Uni- and multivariate analyses were performed to identify prognostic factors for survival. RESULTS The most common tumor types were prostate, breast and non-small cell lung cancer, predominantly with distant metastases. Median survival was 6 months. Multivariate analysis resulted in six significant prognostic factors. These were ESAS pain while not moving (median 3), ESAS appetite (median 5), Eastern Cooperative Oncology Group (ECOG) performance status, pleural effusion/metastases, intravenous antibiotics at start or within 2 weeks before PRT and no systemic cancer treatment. CONCLUSIONS Stronger pain while not moving and reduced appetite (below/above median) predicted significantly shorter survival. Development of new prognostic scores should include patient-reported symptoms and other innovative parameters because they were more important than primary tumor type, age and other traditional baseline parameters.
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Affiliation(s)
- Carsten Nieder
- Department of Oncology and Palliative Medicine, Nordland Hospital Trust, 8092, Bodø, Norway. .,Department of Clinical Medicine, Faculty of Health Sciences, UiT-The Artic University of Norway, 9038, Tromsø, Norway.
| | - Thomas A Kämpe
- Department of Oncology and Palliative Medicine, Nordland Hospital Trust, 8092, Bodø, Norway
| | - Adam Pawinski
- Department of Oncology and Palliative Medicine, Nordland Hospital Trust, 8092, Bodø, Norway
| | - Astrid Dalhaug
- Department of Oncology and Palliative Medicine, Nordland Hospital Trust, 8092, Bodø, Norway.,Department of Clinical Medicine, Faculty of Health Sciences, UiT-The Artic University of Norway, 9038, Tromsø, Norway
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8
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Nieder C, Kämpe TA. Frequency and Prognostic Impact of Consistently Low Edmonton Symptom Assessment System Score in the Patients Treated with Palliative Radiotherapy. Cureus 2018. [PMID: 29535905 PMCID: PMC5839746 DOI: 10.7759/cureus.2032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Introduction Our department's standard work-flow includes assessment of all the patients with the Edmonton Symptom Assessment System (ESAS), a one-sheet questionnaire addressing 11 major symptoms and wellbeing on a numeric scale of zero-10, before the palliative radiotherapy (PRT). Based on previous research, we hypothesized that the patients with minimal or moderate total symptom burden might have better overall survival after the PRT than those with at least one higher symptom score. Methods We performed a retrospective analysis of 94 patients and calculated actuarial survival from the first day of the PRT (Kaplan-Meier method). We identified the patients with the score zero for all ESAS items (no symptoms), at least one item with score one-two (minimal symptoms), and at least one item with the score three (moderate symptoms). Results High proportions of the patients had ESAS scores zero- two for nausea (80%), sadness/depression (65%) and constipation (64%). The mean values were often in the range of two-four. Only one patient reported scores of zero throughout the questionnaire. He was treated for hematuria, a symptom that is not part of the ESAS. Three patients reported scores of zero-two throughout the questionnaire. Except for the performance status zero-one, their baseline characteristics were heterogeneous. Two patients reported scores not exceeding three for all items. These patients had excellent performance status, too. None of the six patients (6%) with relatively low ESAS scores of zero-three received care by the hospital's multidisciplinary palliative team. Only one was using opioid analgesics. The median survival for this small subset of six patients was six months, identical to the result for all the patients with higher symptom burden (p = 0.62). Conclusion The proportion of the patients with ESAS scores zero-three throughout the questionnaire was 6%, which resulted in the limited statistical power for the survival comparisons. The survival outcomes were similar. Before PRT, 94% of the patients reported at least one ESAS item of severity four-10. The symptoms not included in the questionnaire, e.g., hematuria might result in erroneous assignment to the low-symptom-burden group and obscure the prognostic impact of low ESAS symptom burden.
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Affiliation(s)
- Carsten Nieder
- Dept. of Oncology and Palliative Medicine, Nordland Hospital Trust
| | - Thomas A Kämpe
- Dept. of Oncology and Palliative Medicine, Nordland Hospital Trust
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9
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Salem S, Komisarenko M, Timilshina N, Martin L, Grewal R, Alibhai S, Finelli A. Impact of Abiraterone Acetate and Enzalutamide on Symptom Burden of Patients with Chemotherapy-naive Metastatic Castration-resistant Prostate Cancer. Clin Oncol (R Coll Radiol) 2017; 29:601-608. [DOI: 10.1016/j.clon.2017.03.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 03/06/2017] [Accepted: 03/15/2017] [Indexed: 11/25/2022]
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10
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Nieder C, Kämpe TA. Patient-reported symptoms and performance status before palliative radiotherapy in geriatric cancer patients (octogenarians). Tech Innov Patient Support Radiat Oncol 2017; 1:8-12. [PMID: 32095537 PMCID: PMC7033783 DOI: 10.1016/j.tipsro.2016.12.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 12/16/2016] [Accepted: 12/22/2016] [Indexed: 11/28/2022] Open
Abstract
Purpose To evaluate differences in baseline parameters including performance status and self-reported symptom burden between geriatric and non-geriatric cancer patients, and to assess the hypothesis that these factors might predispose older patients to incomplete radiotherapy and short survival. Patients and methods Retrospective comparison of geriatric and non-geriatric patients treated with palliative radiotherapy (age ⩾80 years and <80 years, respectively). Between 2013 and 2015, 26 geriatric and 76 non-geriatric patients were treated. The Edmonton symptom assessment system (ESAS) was employed to document baseline symptoms. Results Most patients received radiotherapy for bone metastases, commonly 5-10 fractions. Geriatric patients had significantly less pain at rest and depression. No strong trends towards higher symptom burden in older patients emerged for any of the items. Overall survival was similar in the two subgroups with different age and also in a separate age-stratified analysis of patients with performance status >2. Relatively few patients were irradiated in the terminal stage of disease, defined as final 30 days of life (8% in geriatric and 12% in other patients, p = 0.73). A higher number of geriatric patients failed to complete their prescribed course of radiotherapy (14 vs. 3%, p = 0.08), despite lower rates of prescription of more than 10 fractions in this group (15 vs. 23%, p > 0.2). Conclusions These data support utilization of palliative radiotherapy irrespective of age. However, care should be taken in assigning the right fractionation regimen in order to avoid lengthy treatment courses when survival is limited, such as in patients with performance status >2.
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Affiliation(s)
- Carsten Nieder
- Department of Oncology and Palliative Medicine, Nordland Hospital Trust, 8092 Bodø, Norway.,Department of Clinical Medicine, Faculty of Health Sciences, UiT - The Arctic University of Norway, 9038 Tromsø, Norway
| | - Thomas A Kämpe
- Department of Oncology and Palliative Medicine, Nordland Hospital Trust, 8092 Bodø, Norway
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Ghoshal A, Salins N, Deodhar J, Damani A, Muckaden M. Impact of symptom control on fatigue improvement in patients with advanced cancer: A prospective observational study. PROGRESS IN PALLIATIVE CARE 2016. [DOI: 10.1080/09699260.2016.1200818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Koom WS, Choi MY, Lee J, Park EJ, Kim JH, Kim SH, Kim YB. Art therapy using famous painting appreciation maintains fatigue levels during radiotherapy in cancer patients. Radiat Oncol J 2016; 34:135-44. [PMID: 27306778 PMCID: PMC4938348 DOI: 10.3857/roj.2016.01760] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 04/22/2016] [Accepted: 05/09/2016] [Indexed: 11/03/2022] Open
Abstract
PURPOSE The purpose of this study was to evaluate the efficacy of art therapy to control fatigue in cancer patients during course of radiotherapy and its impact on quality of life (QoL). MATERIALS AND METHODS Fifty cancer patients receiving radiotherapy received weekly art therapy sessions using famous painting appreciation. Fatigue and QoL were assessed using the Brief Fatigue Inventory (BFI) Scale and the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) at baseline before starting radiotherapy, every week for 4 weeks during radiotherapy, and at the end of radiotherapy. Mean changes of scores over time were analyzed using a generalized linear mixed model. RESULTS Of the 50 patients, 34 (68%) participated in 4 sessions of art therapy. Generalized linear mixed models testing for the effect of time on mean score changes showed no significant changes in scores from baseline for the BFI and FACIT-F. The mean BFI score and FACIT-F total score changed from 3.1 to 2.7 and from 110.7 to 109.2, respectively. Art therapy based on the appreciation of famous paintings led to increases in self-esteem by increasing self-realization and forming social relationships. CONCLUSION Fatigue and QoL in cancer patients with art therapy do not deteriorate during a period of radiotherapy. Despite the single-arm small number of participants and pilot design, this study provides a strong initial demonstration that art therapy of appreciation for famous painting is worthy of further study for fatigue and QoL improvement. Further, it can play an important role in routine practice in cancer patients during radiotherapy.
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Affiliation(s)
- Woong Sub Koom
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea.,Cancer Information Center, Yonsei Cancer Center, Yonsei University Health System, Seoul, Korea
| | - Mi Yeon Choi
- Graduate School of Clinical Art Therapy, CHA University, Pocheon, Korea
| | - Jeongshim Lee
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea
| | - Eun Jung Park
- Graduate School of Clinical Art Therapy, CHA University, Pocheon, Korea
| | - Ju Hye Kim
- Graduate School of Clinical Art Therapy, CHA University, Pocheon, Korea
| | - Sun-Hyun Kim
- Graduate School of Clinical Art Therapy, CHA University, Pocheon, Korea
| | - Yong Bae Kim
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea
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Antoniu SA, Ungureanu D. Measuring fatigue as a symptom in COPD: From descriptors and questionnaires to the importance of the problem. Chron Respir Dis 2015; 12:179-88. [PMID: 25749347 DOI: 10.1177/1479972315575716] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Fatigue is a symptom commonly diagnosed in cancers and in many other chronic debilitating diseases and is one of the main therapeutic targets for various pharmacologic and non-pharmacologic interventions. However, in chronic obstructive pulmonary disease (COPD), this symptom, which can be considered as the main extrapulmonary clinical feature of the disease, can impact significantly on the health-related quality of life of the patients. The aims of this review are to discuss the issues related to fatigue assessment in COPD and to highlight the importance of this symptom in this setting based on the data retrieved from articles published between 1987 through August 2014 available on MEDLINE database. Fatigue can be measured by various scales or questionnaires that are designed for generic purposes or for COPD-related purposes but is still underdiagnosed and undertreated. This is due to the fact that its clinical and prognostic relevance are not appropriately acknowledged. The early identification of fatigue clinical descriptors from patients' reports could help with better management of this symptom.
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Affiliation(s)
- Sabina Antonela Antoniu
- Palliative Care Nursing Preventive Medicine and Interdisciplinarity Department, Faculty of Medicine, "Grigore T Popa" University of Medicine and Pharmacy, Iaşi, Romania
| | - Didona Ungureanu
- Faculty of Medicine, "Grigore T Popa" University of Medicine and Pharmacy, Iaşi, Romania
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Cheon PM, Pulenzas N, Zhang L, Mauti E, Wong E, Thavarajah N, Tsao M, Danjoux C, Holden L, DeAngelis C, Chow E. Fatigue scores in patients receiving palliative radiotherapy for painful bone metastases. Support Care Cancer 2014; 23:2097-103. [DOI: 10.1007/s00520-014-2561-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 12/07/2014] [Indexed: 11/28/2022]
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Rief H, Akbar M, Keller M, Omlor G, Welzel T, Bruckner T, Rieken S, Häfner MF, Schlampp I, Gioules A, Debus J. Quality of life and fatigue of patients with spinal bone metastases under combined treatment with resistance training and radiation therapy- a randomized pilot trial. Radiat Oncol 2014; 9:151. [PMID: 24998293 PMCID: PMC4105868 DOI: 10.1186/1748-717x-9-151] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 06/30/2014] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The aim of this trial was to compare the effects of resistance training versus passive physical therapy on quality of life (QoL), fatigue, and emotional distress outcomes during radiation therapy in patients with spinal bone metastases under radiotherapy (RT). METHODS In this randomized trial, 60 patients were treated from September 2011 until March 2013 into one of the two groups: isometric resistance training or physical therapy with thirty patients in each group during RT. EORTC QLQ-BM22, EORTC QLQ-FA13, and FBK-R10 were assessed at baseline, three months, and six months after RT. RESULTS Psychosocial aspects in resistance training group (Arm A) were significantly improved after three (p = 0.001) and six months (p = 0.010). Other rated items of the QLQ-BM22 painful site, and pain characteristics were without significant differences. Functional interference showed a positive trend after six months (p = 0.081). After six months, physical fatigue (p = 0.013), and interference with daily life (p = 0.006) according to the QLQ-FA13 assessment improved in Arm A significantly. Emotional distress was in Arm A lower after six months (p = 0.016). The Cohen's effect size confirmed the clinically significant improvement of these findings. CONCLUSIONS In this group of patients we were able to show that guided isometric resistance training of the paravertebral muscles can improve functional capacity, reduce fatigue and thereby enhance QoL over a 6-months period in patients with stable spinal metastases. The results offer a rationale for future large controlled investigations to confirm these findings. TRIAL REGISTRATION Clinical trial identifier NCT01409720.
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Affiliation(s)
- Harald Rief
- Department of Radiation Oncology, University Hospital of Heidelberg, Im Neuenheimer Feld 400, Heidelberg 69120, Germany.
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Cramarossa G, Zeng L, Zhang L, Tseng LM, Hou MF, Fairchild A, Vassiliou V, Jesus-Garcia R, Alm El-Din MA, Kumar A, Forges F, Chie WC, Sahgal A, Lam H, Pulenzas N, Chow E. Predictive factors of overall quality of life in advanced cancer patients using EORTC QLQ-C30. Expert Rev Pharmacoecon Outcomes Res 2013; 14:139-46. [PMID: 24325545 DOI: 10.1586/14737167.2014.864560] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To identify which domains/symptoms from the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) were predictive of overall quality of life (QoL) in advanced cancer patients. METHODS Four hundred and forty seven patients with brain metastases or bone metastases from seven countries were enrolled with regression analysis to determine the predictive value of the QLQ-C30 functional/symptom scores for patient reported overall QoL (question 30), overall health (question 29) and the global health status domain (questions 29 and 30). RESULTS Worse role functioning, social functioning, fatigue and financial problems were the most significant predictive factors for worse QoL. In the bone metastases subgroup (n = 400), role functioning, fatigue and financial problems were the most significant predictors. In patients with brain metastases (n = 47), none of the EORTC domains significantly predicted worse QOL. CONCLUSION Deterioration of certain QLQ-C30 functional/symptom scores significantly contributes to worse QoL, overall health and global health status.
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Affiliation(s)
- Gemma Cramarossa
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario M4N 3M5, Canada
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Lam K, Zeng L, Zhang L, Tseng LM, Hou MF, Fairchild A, Vassiliou V, Jesus-Garcia R, El-Din MAA, Kumar A, PharmD FF, Chie WC, Sahgal A, Poon M, Chow E. Predictive Factors of Overall Well-Being Using the EORTC QLQ-C15-PAL Extracted from the EORTC QLQ-C30. J Palliat Med 2013; 16:402-8. [DOI: 10.1089/jpm.2012.0398] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Kinsey Lam
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Liang Zeng
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Liying Zhang
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Ling-Ming Tseng
- Department of Surgery, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan
| | - Ming-Feng Hou
- Department of Gastroenterologic Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Alysa Fairchild
- Department of Radiation Oncology, Cross Cancer Institute, Edmonton, Alberta, Canada
| | - Vassilios Vassiliou
- Department of Radiation Oncology, Bank of Cyprus Oncology Centre, Nicosia, Cyprus
| | - Reynaldo Jesus-Garcia
- Department of Orthopedic Oncology, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Mohamed A. Alm El-Din
- Department of Clinical Oncology, Tanta University Hospital, Tanta Faculty of Medicine, Tanta, Egypt
| | - Aswin Kumar
- Division of Gynaecology and Genitourinary Oncology, Department of Radiation Oncology, Regional Cancer Center, Trivandrum, Kerala, India
| | - Fabien Forges PharmD
- Inserm CIE3, Saint Etienne University Hospital, France
- Unit of Clinical Research, Innovation, and Pharmacology, Saint Etienne University Hospital, France
| | - Wei-Chu Chie
- Department of Public Health and Institute of Epidemiology and Preventative Medicine, National Taiwan University, Taipei, Taiwan
| | - Arjun Sahgal
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Michael Poon
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Edward Chow
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
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Predictive factors for overall quality of life in patients with advanced cancer. Support Care Cancer 2013; 21:1709-16. [DOI: 10.1007/s00520-013-1717-7] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Accepted: 01/09/2013] [Indexed: 11/12/2022]
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Yennu S, Urbauer DL, Bruera E. Factors associated with the severity and improvement of fatigue in patients with advanced cancer presenting to an outpatient palliative care clinic. BMC Palliat Care 2012; 11:16. [PMID: 22985058 PMCID: PMC3515470 DOI: 10.1186/1472-684x-11-16] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Accepted: 09/13/2012] [Indexed: 12/22/2022] Open
Abstract
Background The aim of this study was to determine factors associated with the severity of cancer related fatigue (CRF) and predictors of improvement of CRF at the first follow-up visit in patients with advanced cancer referred to outpatient palliative care clinic (OPC). Methods We reviewed the records of consecutive patients with advanced cancer presenting to OPC. Edmonton Symptom Assessment System (ESAS) scores were obtained at the initial and subsequent visits between January 2003 and December 2008. All patients received interdisciplinary care led by palliative medicine specialists following an institutional protocol. Fatigue improvement was defined as a reduction of ≥2 points in ESAS score relative to the baseline. Descriptive statistics were used to summarize patient characterstics. Univariate analyses were performed and only significant variables were included in multivariate regression analysis to determine factors associated with severity and improvement in CRF. Results A total of 1778 evaluable patients were analyzed (median age, 59 years; 52% male). The median time between visits was 15 days. Median fatigue scores on the ESAS were 6 at baseline and 5 at follow-up. Severity of all ESAS items and low serum albumin were associated with fatigue at baseline (p < 0.0001). The improvement of fatigue was observed in 586 patients (33%). The hierarchical model showed that fatigue improved over time (b = −0.009; p = 0.0009). low appetite (odds ratio [OR] = 1.09 per point; p = 0.0113) and genitourinary cancer (OR = 1.74 per point; p = 0.0458) were significantly associated with improvement of fatigue. Conclusions CRF is strongly associated with physical and emotional symptoms. Genitourinary cancer and low appetite at baseline were associated with successful improvement of fatigue.
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Affiliation(s)
- Sriram Yennu
- Department of Palliative Care and Rehabilitation Medicine, Unit 1414, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, USA.
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Abstract
OBJECTIVES To present a clinical update regarding common distressing lung cancer symptoms and provide an update on management interventions. DATA SOURCES Journal articles, systematic reviews. CONCLUSION Goals of treatment of the patient with lung cancer must include management of the high symptom burden that often accompanies the disease. IMPLICATIONS FOR NURSING PRACTICE Early assessment and management of symptoms improves quality of life. Nurses play a key role in implementing and monitoring these interventions.
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Affiliation(s)
- Maureen Huhmann
- Department of Nutritional Sciences, University of Medicine and Dentistry of New Jersey, Newark, NJ, USA.
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Rhondali W, Perceau E, Berthiller J, Saltel P, Trillet-Lenoir V, Tredan O, Coulon JP, Bruera E, Filbet M. Frequency of depression among oncology outpatients and association with other symptoms. Support Care Cancer 2012; 20:2795-802. [DOI: 10.1007/s00520-012-1401-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2011] [Accepted: 02/03/2012] [Indexed: 01/06/2023]
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