1
|
Alamoudi W, Alsoghair A, Riordain RN, Fedele S, Porter S. Patient Education and Levels of Disease-Specific Information Needs Among Individuals With Oral Epithelial Dysplasia. J Oral Pathol Med 2025. [PMID: 40360396 DOI: 10.1111/jop.13642] [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] [Received: 01/16/2025] [Revised: 03/14/2025] [Accepted: 04/27/2025] [Indexed: 05/15/2025]
Abstract
BACKGROUND Oral epithelial dysplasia (OED) is a histological diagnosis that carries an increased risk of the individual developing oral squamous cell carcinoma. We assessed the information needs (IN) and explored the sources of education used by individuals with OED using a validated OED-specific measurement. METHODS A total of 102 adults with OED from the oral medicine clinic of a dental hospital in Central London were selected using convenience sampling. A cross-sectional survey was conducted in which participants completed the 33-item Oral Epithelial Dysplasia Informational Needs Questionnaire (ODIN-Q), which assessed IN and gathered perspectives on patient education. RESULTS Approximately two-thirds of the participants (n = 66, 64%) reported meeting the IN, whereas the remaining participants (n = 36, 35%) did not. The mean and median total scores from the questionnaire were 2.43 (± 0.38) and 2.6, respectively, indicating a low sufficient level of IN. Most participants (n = 80, 78%) preferred one-on-one meetings as the primary mode of obtaining information, followed by written materials (n = 64, 62%), audiovisual resources (n = 24, 23%), and group discussions (n = 8, 0.7%). CONCLUSIONS Some topics were insufficiently met, necessitating additional educational efforts, such as risk factors and lifestyle modifications, physical and psychological impacts, awareness of potential complications, and seeking medical and psychological support. Sex and degree of dysplasia were associated with the levels of IN. These findings may guide future longitudinal research on OED IN assessment, support the creation of tailored educational tools, and facilitate further evaluation of the psychometric properties of the ODIN-Q.
Collapse
Affiliation(s)
- Waleed Alamoudi
- Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
- UCL Eastman Dental Institute, University College London, London, UK
| | | | - Richeal Ni Riordain
- Cork University Dental School and Hospital, University College Cork, Cork, Ireland
| | - Stefano Fedele
- UCL Eastman Dental Institute, University College London, London, UK
- Biomedical Research Centre, NIHR, University College London Hospitals, London, UK
| | - Stephen Porter
- UCL Eastman Dental Institute, University College London, London, UK
| |
Collapse
|
2
|
Saldivia-Siracusa C, Dos Santos ES, González-Arriagada WA, Prado-Ribeiro AC, Brandão TB, Owosho A, Lopes MA, Epstein JB, Santos-Silva AR. Conspiracy of Silence in Head and Neck Cancer Diagnosis: A Scoping Review. Dent J (Basel) 2024; 12:214. [PMID: 39057001 PMCID: PMC11276277 DOI: 10.3390/dj12070214] [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] [Received: 05/24/2024] [Revised: 06/30/2024] [Accepted: 07/09/2024] [Indexed: 07/28/2024] Open
Abstract
Cancer disclosure represents a complex healthcare dynamic. Physicians or caregivers may be prompted to withhold diagnosis information from patients. This study aims to comprehensively map and synthesize available evidence about diagnosis nondisclosure regarding head and neck cancer (HNC) patients. Following the Joanna Briggs Institute guidelines, a scoping review was conducted across major databases without period restriction, yielding 9238 publications. After screening and selection, a descriptive synthesis was conducted. Sixteen studies were included, primarily conducted in academic settings (75%) from Europe and Asia, with a total population of 662 patients predominantly diagnosed with brain, oral, pharyngeal, or laryngeal tumors. Remarkably, 22.51% of patients were unaware of their diagnosis. Although physicians were the main source of diagnostic information (35%), they reported to often use vague terms to convey malignancy. Additionally, 13.29% of patients were aware of their diagnosis from sources other than doctors or caregivers. Caregivers (55%) supported diagnosis concealment, and physicians tended to respect family wishes. A high diagnosis-to-death interval, education, and age significantly influenced diagnosis disclosure. HNC patients expressed a desire for personalized open communication. Multiple factors influenced the decision on diagnosis disclosure. Current evidence on this topic varies significantly, and there is limited research on the consequences of nondisclosure. These findings reflect the underestimation of the patients' outlook in the diagnosis process and highlight the need for further research, aiming to establish open communication and patient autonomy during the oncological journey.
Collapse
Affiliation(s)
- Cristina Saldivia-Siracusa
- Departamento de Diagnóstico Oral, Faculdade de Odontologia de Piracicaba (FOP), Universidade Estadual de Campinas (UNICAMP), São Paulo 13414-903, Brazil; (C.S.-S.); (E.S.D.S.); (A.C.P.-R.); (M.A.L.)
| | - Erison Santana Dos Santos
- Departamento de Diagnóstico Oral, Faculdade de Odontologia de Piracicaba (FOP), Universidade Estadual de Campinas (UNICAMP), São Paulo 13414-903, Brazil; (C.S.-S.); (E.S.D.S.); (A.C.P.-R.); (M.A.L.)
| | | | - Ana Carolina Prado-Ribeiro
- Departamento de Diagnóstico Oral, Faculdade de Odontologia de Piracicaba (FOP), Universidade Estadual de Campinas (UNICAMP), São Paulo 13414-903, Brazil; (C.S.-S.); (E.S.D.S.); (A.C.P.-R.); (M.A.L.)
- Oral Medicine Service, Sírio Libanês Hospital, São Paulo 01308-050, Brazil
| | - Thaís Bianca Brandão
- Dental Oncology Service, São Paulo State Cancer Institute (ICESP-FMUSP), São Paulo 01246-903, Brazil;
| | - Adepitan Owosho
- Departments of Diagnostic Sciences, Department of Otolaryngology—Head & Neck Surgery and Bioscience Research, College of Dentistry, The University of Tennessee Health Science Center, Memphis, TN 38163, USA;
| | - Marcio Ajudarte Lopes
- Departamento de Diagnóstico Oral, Faculdade de Odontologia de Piracicaba (FOP), Universidade Estadual de Campinas (UNICAMP), São Paulo 13414-903, Brazil; (C.S.-S.); (E.S.D.S.); (A.C.P.-R.); (M.A.L.)
| | - Joel B. Epstein
- City of Hope Comprehensive Cancer Center, Duarte, CA 91010, USA;
- Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Alan Roger Santos-Silva
- Departamento de Diagnóstico Oral, Faculdade de Odontologia de Piracicaba (FOP), Universidade Estadual de Campinas (UNICAMP), São Paulo 13414-903, Brazil; (C.S.-S.); (E.S.D.S.); (A.C.P.-R.); (M.A.L.)
| |
Collapse
|
3
|
Maeda CY, Serrano RV, Campos L, Palma LF, Marcucci M. Is there an association between head and neck cancer diagnosis and self-reported dental fear? A dual-center cross-sectional study. Natl J Maxillofac Surg 2024; 15:36-39. [PMID: 38690231 PMCID: PMC11057582 DOI: 10.4103/njms.njms_119_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 03/17/2023] [Accepted: 05/19/2023] [Indexed: 05/02/2024] Open
Abstract
Introduction Mental distress is highly reported in cancer patients, resulting in anxiety and depression most of the time. Both conditions, in turn, are recognized to be related to dental fear in adults; however, there are no studies on patients suffering from head and neck cancer. Thus, the present study aimed to investigate whether newly diagnosed patients with head and neck cancer are more prone to self-reported dental fear. Material and Methods This dual-center cross-sectional study was conducted with 25 healthy outpatients and 25 patients with a recent diagnosis of head and neck cancer, all requiring dental care. The patients were informed at the first appointment about their dental therapy planning and the Brazilian Portuguese Version of the Dental Fear Survey (DFS) questionnaire was then applied after appropriate instructions. Results The DFS total scores did not differ statistically between the groups (Mann-Whitney U test, P = 0,120) but the Cancer Group presented a slightly higher mean score (32.2 ± 10.0) than the Control Group (30.0 ± 14.2). Conclusion Within the limitations of this study, newly diagnosed patients with head and neck cancer and healthy individuals seem to experience similar self-reported dental fear.
Collapse
Affiliation(s)
- Claudia Y. Maeda
- Stomatology and Oral and Maxillofacial Surgery Center, Hospital Heliópolis, São Paulo - SP, Brazil
| | - Rafael V. Serrano
- Graduate Dentistry Program, Ibirapuera University, São Paulo - SP, Brazil
| | - Luana Campos
- Graduate Program in Implantology, University of Santo Amaro, São Paulo - SP, Brazil
| | - Luiz F. Palma
- Department of Pathology, Federal University of São Paulo, São Paulo - SP, Brazil
| | - Marcelo Marcucci
- Stomatology and Oral and Maxillofacial Surgery Center, Hospital Heliópolis, São Paulo - SP, Brazil
| |
Collapse
|
4
|
Bandeira CM, Almeida AÁ, Alves MGO, Pascoal MBN, Chagas JFS, Neto MB, de Barros PP, Nunes FD, Carta CFL, Almeida JD. The Fagerström and AUDIT Tests as Probable Screening Tools in Oral Cancer and Their Correlation with CYP1A1, GSTM1, GSTP1, and GSTT1 Gene Expression. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3991. [PMID: 35409669 PMCID: PMC8997590 DOI: 10.3390/ijerph19073991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/26/2022] [Accepted: 03/01/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Cancer is currently a major public health problem worldwide, with a marked increase of about 70% in the number of expected diagnosed cases over the next two decades. The amount of tobacco and alcohol consumed is calculated based on the subjective information provided by the user. Tobacco exposure can be assessed using the Fagerström Test for Cigarette Dependence (FTCD) and alcohol consumption by the Alcohol Use Disorder Identification Test (AUDIT). MATERIALS AND METHODS Forty-eight subjects answered the Fagerström, and AUDIT tests and we studied them as likely screening tools for oral cancer and their correlation with the expression of CYP1A1, GSTM1, GSTP1, and GSTT1 genes by the RT-qPCR method. RESULTS There were significant differences in the AUDIT score and CYP1A1 expression between cancer and control groups. Participants in advanced stages, whether due to tumor size or regional metastasis, showed significant differences in the duration of tobacco use, FTCD, AUDIT score, and CYP1A1 expression when compared to patients in early stages. Among subjects without cancer, we found a significant correlation between participant age and GSTP1 expression. Furthermore, the expression of GSTP1 was significantly correlated with the number of cigarettes smoked per day, duration of tobacco use, and FTCD. CONCLUSIONS Questionnaires designed to evaluate the degree of tobacco and alcohol exposure and dependence combined with gene expression tests can be useful to assess the risk of developing oral cancer. Furthermore, raising the awareness of individuals regarding their degree of dependence and encouraging them to participate in cessation programs are important educational measures for the prevention of tobacco-related malignancies.
Collapse
Affiliation(s)
- Celso Muller Bandeira
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology of São José dos Campos, São Paulo State University (Unesp), São José dos Campos 12245-000, Brazil; (C.M.B.); (A.Á.A.); (P.P.d.B.); (C.F.L.C.)
- Faculdade de Ciências Médicas de São José dos Campos—Humanitas, São José dos Campos 12220-061, Brazil
| | - Adriana Ávila Almeida
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology of São José dos Campos, São Paulo State University (Unesp), São José dos Campos 12245-000, Brazil; (C.M.B.); (A.Á.A.); (P.P.d.B.); (C.F.L.C.)
| | - Mônica Ghislaine Oliveira Alves
- School of Medicine, Anhembi Morumbi University, São José dos Campos 12230-002, Brazil;
- Technology Research Center (NPT), Universidade Mogi das Cruzes, Mogi das Cruzes 08780-911, Brazil
| | - Maria Beatriz Nogueira Pascoal
- Department of Head and Neck Surgery, São Leopoldo Mandic College, Campinas 13045-755, Brazil; (M.B.N.P.); (J.F.S.C.)
- Department of Head and Neck Surgery, Hospital Municipal Doutor Mário Gatti, Campinas 13036-902, Brazil
| | - José Francisco Sales Chagas
- Department of Head and Neck Surgery, São Leopoldo Mandic College, Campinas 13045-755, Brazil; (M.B.N.P.); (J.F.S.C.)
| | - Morun Bernardino Neto
- Department of Basic Sciences and Environment, São Paulo University, São Paulo 12602-810, Brazil;
| | - Patrícia Pimentel de Barros
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology of São José dos Campos, São Paulo State University (Unesp), São José dos Campos 12245-000, Brazil; (C.M.B.); (A.Á.A.); (P.P.d.B.); (C.F.L.C.)
| | - Fábio Daumas Nunes
- Department of Oral Pathology, School of Dentistry, São Paulo University, São Paulo 05508-000, Brazil;
| | - Celina Faig Lima Carta
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology of São José dos Campos, São Paulo State University (Unesp), São José dos Campos 12245-000, Brazil; (C.M.B.); (A.Á.A.); (P.P.d.B.); (C.F.L.C.)
| | - Janete Dias Almeida
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology of São José dos Campos, São Paulo State University (Unesp), São José dos Campos 12245-000, Brazil; (C.M.B.); (A.Á.A.); (P.P.d.B.); (C.F.L.C.)
| |
Collapse
|
5
|
Toralla O, Lopez Jornet P, Pons-Fuster E. The Effect of an Informative Video upon Anxiety and Stress in Patients Requiring an Oral Biopsy: A Randomized Controlled Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020783. [PMID: 35055603 PMCID: PMC8775441 DOI: 10.3390/ijerph19020783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 01/04/2022] [Accepted: 01/06/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The use of multimedia tools improves patient understanding of surgical procedures, reduces anxiety and increases satisfaction. The present study evaluates the impact of an audiovisual intervention (video) upon anxiety and stress in patients requiring an oral biopsy. MATERIAL AND METHODS A prospective randomized clinical trial was carried out in patients requiring an oral biopsy. The control group (n = 60) received verbal standard information while the experimental group (n = 60) received information in the form of a video. The following data were recorded: gender, age, educational level and hemodynamic parameters (blood pressure, heart rate and blood oxygen saturation). The following questionnaires were used to assess anxiety and stress before and after the biopsy procedure: Corah's Modified Dental Anxiety Scale (MDAS), the State-Trait Anxiety Inventory (STAI) and the Hospital Anxiety and Depression Scale (HADS). RESULTS The final study sample consisted of 120 patients, of which 65.8% were women and 34.2% men, with a mean age of 40.5 ± 15.3 years. At the end of the study, the experimental group presented a significantly lower MDAS score than the control group (p = 0.041). The STAI score also showed a significant decrease with respect to the control group at the end of the study (p = 0.012). There were no statistically significant changes in the hemodynamic parameters in either group. CONCLUSIONS The video constituted a useful and easy tool for reducing anxiety among patients requiring an oral biopsy.
Collapse
Affiliation(s)
- Oscar Toralla
- Departamento Odontologia, Universidad San Carlos de Guatemala, Guatemala 01018, Guatemala;
| | - Pia Lopez Jornet
- Faculty of Medicine and Odontology, University of Murcia, 30008 Murcia, Spain;
- Correspondence:
| | - Eduardo Pons-Fuster
- Faculty of Medicine and Odontology, University of Murcia, 30008 Murcia, Spain;
| |
Collapse
|
6
|
A qualitative examination of patient priorities and preferences during treatment decision-making for recurrent head and neck cancer. Support Care Cancer 2020; 29:377-385. [PMID: 32377842 DOI: 10.1007/s00520-020-05488-9] [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: 12/02/2019] [Accepted: 04/20/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Patients with recurrent head and neck cancer (HNC) may feel overwhelmed at the prospect of having to consider treatment options particularly if they recently completed treatment for their primary disease or when they have no options that may lead to long-term survival. The purpose of this study was to examine patient priorities and preferences during treatment decision-making for recurrent HNC. METHODS Individuals with newly diagnosed recurrent HNC were recruited at a National Cancer Institute-Designated Cancer Center. Participants were interviewed using a structured interview guide. Descriptive statistics were used to describe participants, and qualitative template analysis was used to analyze interview data. RESULTS Participants (n = 38) considered information from healthcare providers, likelihood of treatment success, and other patient-specific factors in making their treatment decisions. CONCLUSIONS Although patients with recurrent HNC endorse a myriad of decision-making factors, the recommendation of their healthcare provider and the likelihood of treatment success are of paramount importance. Future research should focus on methods to rapidly identify patient priorities at the time of diagnosed recurrence while respecting patient coping and communication styles.
Collapse
|
7
|
Strategies for communicating oral and oropharyngeal cancer diagnosis: why talk about it? Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 129:347-356. [PMID: 31928903 DOI: 10.1016/j.oooo.2019.11.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 11/13/2019] [Accepted: 11/19/2019] [Indexed: 12/09/2022]
Abstract
OBJECTIVE This review aimed to explore the paradigms of disclosing a cancer diagnosis with a focus on oral and oropharyngeal cancer and patient-related considerations. STUDY DESIGN A search of MEDLINE, Embase, and Scopus was conducted using the following keywords: oral cancer; mouth lesions; oncology; breaking bad news; truth disclosure; and communication skills training. English and Spanish language studies published through October 2019 were included. RESULTS The way bad news is conveyed to patients with cancer may affect their comprehension of information, emotional distress, treatment adherence, and health outcomes. Models of communication that are focused on patients' preferences may result in better treatment outcomes. Available protocols, such as SPIKES and ABCDE, have useful recommendations for health care professionals communicating an oral cancer diagnosis. However, it is important to be attentive to the particular information needs of patients. CONCLUSIONS When communicating a cancer diagnosis, providers should employ validated methods of information delivery and support for oncology patients. Further studies are needed to evaluate the experiences and preferences of patients with oral cancer during these communications.
Collapse
|
8
|
Pinto E, Cavallin F, Scarpa M. Psychological support of esophageal cancer patient? J Thorac Dis 2019; 11:S654-S662. [PMID: 31080642 PMCID: PMC6503274 DOI: 10.21037/jtd.2019.02.34] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 02/04/2019] [Indexed: 12/22/2022]
Abstract
Important questions are still open about psychological aspects in esophageal cancer (EC) and about the related psychological support. How to cope with the cancer diagnosis and poor prognosis: a psychological counselling may be a valid option to personalize the communication to patients with a poor prognosis. How to cope with long chemoradiotherapy: after neoadjuvant therapy, patients know that curative process is not completed, and they perceive the severity of the neoadjuvant side effects, considering themselves "fragile" and far from a healthy condition before the major surgery they are going to undergo. Therefore, this is a particularly crucial point when psychological support may be useful. How to cope with change of nutritional habits: esophagectomy for cancer strongly impairs nutritional function in the early postoperative period and feeding Jejunostomy impairs emotional function. How to cope with sleep disturbances: most cancer patients report disturbed sleep after cancer diagnosis and/or following cancer treatment. Psychological intervention aims to identify underlying concerns worsening sleep quality. How to cope with postoperative complications: the occurrence of such complications reduces patient's satisfaction and has a negative effect on doctor-patient relationship. How to cope with long-term functions impairment: EC patients need a plan for the future.
Collapse
Affiliation(s)
- Eleonora Pinto
- Esophageal and Digestive Tract Surgical Unit, Regional Centre for Esophageal Disease, Veneto Institute of Oncology (IOV-IRCCS), Padova, Italy
| | | | - Marco Scarpa
- General Surgery Unit, Azienda Ospedaliera di Padova, Padova, Italy
| |
Collapse
|
9
|
Wang TJ, Lu MH, Kuo PL, Chen YW, Lee SC, Liang SY. Influences of facial disfigurement and social support for psychosocial adjustment among patients with oral cancer in Taiwan: a cross-sectional study. BMJ Open 2018; 8:e023670. [PMID: 30478118 PMCID: PMC6254494 DOI: 10.1136/bmjopen-2018-023670] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To explore the influences of facial disfigurement and social support for psychosocial adjustment in patients with oral cancer. DESIGN A cross-sectional design was used for the study. PARTICIPANTS AND SETTING A convenience sample of 77 patients with oral cancer was recruited from the otolaryngology and oral and maxillofacial surgery outpatient clinics of three general hospitals in Taiwan. MEASURES Data were collected using the study questionnaires, including the Facial Disfigurement Scale, the Social Support Scale and the Psychosocial Adjustment to Illness Scale. RESULTS The mean score on the Psychosocial Adjustment to Illness Scale was 413.01 (SD=32.32); 71.4% of the participants were maladjusted. Results of multiple regression analysis showed statistically significant main effects of tumour site (beta=0.37), facial disfigurement (beta=0.35) and social support (beta=-1.01), and the interaction effect of facial disfigurement and social support (beta=0.79) (all p<0.05) on psychosocial adjustment after controlling for other sociodemographic and clinical variables. All variables together explained 62% of the variance in psychosocial adjustment (F(16, 55)=14.98, p<0.001). CONCLUSIONS The level of psychosocial adjustment in patients with oral cancer was suboptimal. Poorer psychosocial adjustment was reported by patients with more severe facial disfigurement and less social support. Patients with cancers in other areas of the oral cavity also reported poorer psychosocial adjustment than patients with cancers in the buccal mucosa. Medical professionals may use these variables to identify higher risk groups for early intensive intervention.
Collapse
Affiliation(s)
- Tsae-Jyy Wang
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Ming-Hsiu Lu
- Department of Nursing, Tri-Service General Hospital, Taipei, Taiwan
| | - Pei-Ling Kuo
- School of Nursing, University of Kang Ning, Taipei, Taiwan
| | - Yi-Wei Chen
- Department of Cardiothoracic Surgery, Tzu Chi Hospital, Hualien, Taiwan
| | - Shu-Chiung Lee
- Department of Nursing, Veteran General Hospital, Taipei, Taiwan
| | - Shu-Yuan Liang
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| |
Collapse
|
10
|
Mills IJ. Through the patient's eyes – the importance of person-centred care in oral cancer. Br Dent J 2018; 225:889-891. [DOI: 10.1038/sj.bdj.2018.923] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2018] [Indexed: 11/10/2022]
|
11
|
Ahmed AE, Albalawi AN, Qureshey ET, Qureshey AT, Yenugadhati N, Al-Jahdali H, Jazieh AR. Psychological symptoms in adult Saudi Arabian cancer patients: prevalence and association with self-rated oral health. BREAST CANCER-TARGETS AND THERAPY 2018; 10:153-159. [PMID: 30323659 PMCID: PMC6174894 DOI: 10.2147/bctt.s168139] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background Although psychological symptoms and oral health status are associated with health management and outcomes among cancer patients, their association has not been assessed in Saudi Arabia. We aimed to assess the symptoms of depression, anxiety, and stress and their association with their oral health status, adjusting for sociodemographic and clinical factors. Methods A self-reported study included 375 adult cancer patients who received outpatient healthcare services in the Oncology Department, King Abdulaziz Medical City-Riyadh, Saudi Arabia, between April 1 and August 31, 2017. We used the Arabic version of the Depression Anxiety Stress Scale to dichotomize a binary outcome for each. Oral health was evaluated by self-rating from "very good" to "bad". Results A high prevalence of subjective depression, anxiety, and stress was found (44.8%, 52.5%, and 42.7%, respectively). Of the sample, 17.9% self-reported "bad" oral health, which is associated with a high risk of anxiety and stress, and its association remains significant after controlling for other factors (adjusted odds ratio=6.48 and 4.73, respectively). Being <60 years old, high level of formal education, low income, breast cancer, and lung cancer were associated with increased psychological symptoms. Conclusion Every 6 in 10 cancer patients in this study reported at least one psychosocial symptom. The findings suggest that there exists an association between self-reported "bad" oral health and psychosocial symptoms. Being <60 years old, low income, high level of formal education, breast cancer, and lung cancer were associated with psychological symptoms. Routine psychological counseling and oral health screening in outpatient oncology clinics may improve psychological outcomes and cancer management.
Collapse
Affiliation(s)
- Anwar E Ahmed
- King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia, .,College of Public Health and Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia,
| | | | | | | | - Nagarajkumar Yenugadhati
- College of Public Health and Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia,
| | - Hamdan Al-Jahdali
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Abdul Rahman Jazieh
- Department of Oncology, King Abdulaziz Medical City for National Guard, Ministry of National Guard, Riyadh, Saudi Arabia
| |
Collapse
|
12
|
Communication of prognosis in head and neck cancer patients; a descriptive qualitative analysis. Oral Oncol 2018; 84:76-81. [PMID: 30115480 DOI: 10.1016/j.oraloncology.2018.07.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 07/17/2018] [Accepted: 07/18/2018] [Indexed: 12/13/2022]
Abstract
OBJECTIVES In shared decision making it is important to adequately, timely and actively involve patients in treatment decisions. Sharing prognostic information can be of key importance. This study describes whether and how prognostic information on life expectancy is included during communication on diagnosis and treatment plans between physicians and head and neck (H&N) oncologic patients in different phases of disease. METHODS A descriptive, qualitative study was performed of n = 23 audiotaped physician-patient conversations in which both palliative and curative treatment options were discussed and questions on prognosis were expected. Verbatim transcribed consultations were systematically analyzed. A distinction was made between prognostic information that was provided (a) quantitatively: by giving numerical probability estimates, such as percentages or years or (b) qualitatively: through the use of words such as 'most likely' or 'highly improbable'. RESULTS In all consultations, H&N surgeons provided some prognostic information. In 5.9% of the provided prognostic information, a quantitative method was used. In 94.1% prognostic information was provided qualitatively, using six identified approaches. H&N surgeons possibly affect patients' perception of prognostic content with two identified communication styles: directive (more physician-centered) and affective (more patient-centered). CONCLUSION This study is first in providing examples of how H&N surgeons communicate with their patients regarding prognosis in all stages of disease. They often exclude specific prognostic information. The study outcomes can be used as a first step in developing a guideline for sharing prognostic information in H&N oncologic patients, in order enable the process of shared decision making.
Collapse
|
13
|
Nicholson AB, Watson GR, Derry S, Wiffen PJ, Cochrane Pain, Palliative and Supportive Care Group. Methadone for cancer pain. Cochrane Database Syst Rev 2017; 2:CD003971. [PMID: 28177515 PMCID: PMC6464101 DOI: 10.1002/14651858.cd003971.pub4] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND This is an updated review originally published in 2004 and first updated in 2007. This version includes substantial changes to bring it in line with current methodological requirements. Methadone is a synthetic opioid that presents some challenges in dose titration and is recognised to cause potentially fatal arrhythmias in some patients. It does have a place in therapy for people who cannot tolerate other opioids but should be initiated only by experienced practitioners. This review is one of a suite of reviews on opioids for cancer pain. OBJECTIVES To determine the effectiveness and tolerability of methadone as an analgesic in adults and children with cancer pain. SEARCH METHODS For this update we searched CENTRAL, MEDLINE, Embase, CINAHL, and clinicaltrials.gov, to May 2016, without language restriction. We also checked reference lists in relevant articles. SELECTION CRITERIA We sought randomised controlled trials comparing methadone (any formulation and by any route) with active or placebo comparators in people with cancer pain. DATA COLLECTION AND ANALYSIS All authors agreed on studies for inclusion. We retrieved full texts whenever there was any uncertainty about eligibility. One review author extracted data, which were checked by another review author. There were insufficient comparable data for meta-analysis. We extracted information on the effect of methadone on pain intensity or pain relief, the number or proportion of participants with 'no worse than mild pain'. We looked for data on withdrawal and adverse events. We looked specifically for information about adverse events relating to appetite, thirst, and somnolence. We assessed the evidence using GRADE and created a 'Summary of findings' table. MAIN RESULTS We revisited decisions made in the earlier version of this review and excluded five studies that were previously included. We identified one new study for this update. This review includes six studies with 388 participants. We did not identify any studies in children.The included studies differed so much in their methods and comparisons that no synthesis of results was feasible. Only one study (103 participants) specifically reported the number of participants with a given level of pain relief, in this case a reduction of at least 20% - similar in both the methadone and morphine groups. Using an outcome of 'no worse than mild pain', methadone was similar to morphine in effectiveness, and most participants who could tolerate methadone achieved 'no worse than mild pain'. Adverse event withdrawals with methadone were uncommon (12/202) and similar in other groups. Deaths were uncommon except in one study where the majority of participants died, irrespective of treatment group. For specific adverse events, somnolence was more common with methadone than with morphine, while dry mouth was more common with morphine than with methadone. None of the studies reported effects on appetite.We judged the quality of evidence to be low, downgraded due to risk of bias and sparse data. For specific adverse events, we considered the quality of evidence to be very low, downgraded due to risk of bias, sparse data, and indirectness, as surrogates for appetite, thirst and somnolence were used.There were no data on the use of methadone in children. AUTHORS' CONCLUSIONS Based on low-quality evidence, methadone is a drug that has similar analgesic benefits to morphine and has a role in the management of cancer pain in adults. Other opioids such as morphine and fentanyl are easier to manage but may be more expensive than methadone in many economies.
Collapse
Affiliation(s)
| | - Graeme R Watson
- South Tees Hospitals NHS Foundation TrustMiddlesbroughUKTS4 3BW
| | - Sheena Derry
- University of OxfordPain Research and Nuffield Department of Clinical Neurosciences (Nuffield Division of Anaesthetics)Pain Research UnitChurchill HospitalOxfordOxfordshireUKOX3 7LE
| | - Philip J Wiffen
- University of OxfordPain Research and Nuffield Department of Clinical Neurosciences (Nuffield Division of Anaesthetics)Pain Research UnitChurchill HospitalOxfordOxfordshireUKOX3 7LE
| | | |
Collapse
|