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Gartrell BA, Phalguni A, Bajko P, Mundle SD, McCarthy SA, Brookman-May SD, De Solda F, Jain R, Yu Ko W, Ploussard G, Hadaschik B. Influential Factors Impacting Treatment Decision-making and Decision Regret in Patients with Localized or Locally Advanced Prostate Cancer: A Systematic Literature Review. Eur Urol Oncol 2024:S2588-9311(24)00106-8. [PMID: 38744587 DOI: 10.1016/j.euo.2024.04.016] [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: 01/22/2024] [Revised: 04/06/2024] [Accepted: 04/29/2024] [Indexed: 05/16/2024]
Abstract
CONTEXT Treatment decision-making (TDM) for patients with localized (LPC) or locally advanced (LAPC) prostate cancer is complex, and post-treatment decision regret (DR) is common. The factors driving TDM or predicting DR remain understudied. OBJECTIVE Two systematic literature reviews were conducted to explore the factors associated with TDM and DR. EVIDENCE ACQUISITION Three online databases, select congress proceedings, and gray literature were searched (September 2022). Publications on TDM and DR in LPC/LAPC were prioritized based on the following: 2012 onward, ≥100 patients, journal article, and quantitative data. The Preferred Reporting Items Reviews and Meta-analyses guidelines were followed. Influential factors were those with p < 0.05; for TDM, factors described as "a decision driver", "associated", "influential", or "significant" were also included. The key factors were determined by number of studies, consistency of evidence, and study quality. EVIDENCE SYNTHESIS Seventy-five publications (68 studies) reported TDM. Patient participation in TDM was reported in 34 publications; overall, patients preferred an active/shared role. Of 39 influential TDM factors, age, ethnicity, external factors (physician recommendation most common), and treatment characteristics/toxicity were key. Forty-nine publications reported DR. The proportion of patients experiencing DR varied by treatment type: 7-43% (active surveillance), 12-57% (radical prostatectomy), 1-49% (radiotherapy), 28-49% (androgen-deprivation therapy), and 21-47% (combination therapy). Of 42 significant DR factors, treatment toxicity (sexual/urinary/bowel dysfunction), patient role in TDM, and treatment type were key. CONCLUSIONS The key factors impacting TDM were physician recommendation, age, ethnicity, and treatment characteristics. Treatment toxicity and TDM approach were the key factors influencing DR. To help patients navigate factors influencing TDM and to limit DR, a shared, consensual TDM approach between patients, caregivers, and physicians is needed. PATIENT SUMMARY We looked at factors influencing treatment decision-making (TDM) and decision regret (DR) in patients with localized or locally advanced prostate cancer. The key factors influencing TDM were doctor's recommendation, patient age/ethnicity, and treatment side effects. A shared, consensual TDM approach between patients and doctors was found to limit DR.
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Affiliation(s)
- Benjamin A Gartrell
- Departments of Oncology and Urology, Montefiore Einstein Comprehensive Cancer Center, Bronx, NY, USA.
| | - Angaja Phalguni
- Evidence Synthesis, Genesis Research Group, Newcastle upon Tyne, UK
| | - Paulina Bajko
- Evidence Synthesis, Genesis Research Group, Newcastle upon Tyne, UK
| | - Suneel D Mundle
- Global Medical Affairs, Janssen Research & Development, Raritan, NJ, USA
| | - Sharon A McCarthy
- Clinical Research Oncology, Janssen Research & Development, Raritan, NJ, USA
| | - Sabine D Brookman-May
- Clinical Research Oncology, Janssen Research & Development, Spring House, PA, USA; Ludwig-Maximilians-University, München, Germany
| | - Francesco De Solda
- Global Commercial Strategy Organization, Janssen Global Services, Raritan, NJ, USA
| | - Ruhee Jain
- Global Commercial Strategy Organization, Janssen Global Services, Raritan, NJ, USA
| | - Wellam Yu Ko
- University of British Columbia Men's Health Research Program, Vancouver, BC, Canada
| | | | - Boris Hadaschik
- Department of Urology, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany
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Neves NM, Queiroz LA, Cuck G, Dzik C, Pereira FMT. Prostate Cancer and Spirituality: A Systematic Review. JOURNAL OF RELIGION AND HEALTH 2024; 63:1360-1372. [PMID: 37314598 DOI: 10.1007/s10943-023-01845-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/30/2023] [Indexed: 06/15/2023]
Abstract
The diagnosis, treatment, and sequels of cancer are relevant sources of stress, conflicts, and suffering, but spirituality may be a positive coping element. However, studies involving the correlation between prostate cancer patients and spirituality are few and heterogeneous. MEDLINE (PUBMED), SCOPUS, and EMBASE were the databases used for this review with the keywords "spirituality," "religion," and "prostate cancer." The review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. About 250 articles were found, and 30 were eligible. Most studies (N = 26; 86.6%) reported the relationship between spirituality and better health findings such as 80% being positively associated with more screening for prostate cancer and better patients' quality of life. More interventional, randomized, and multicentric trials are needed to clarify this relationship.
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Affiliation(s)
- Nathália M Neves
- Department of Medicine, Faculdade Santa Marcelina, São Paulo, SP, Brazil.
| | - Leticia A Queiroz
- Department of Medicine, Faculdade Santa Marcelina, São Paulo, SP, Brazil
| | - Gustavo Cuck
- Department of Medicine, Faculdade São Camilo, São Paulo, SP, Brazil
| | - Carlos Dzik
- Oncology Department, Hospital Nove de Julho, São Paulo, SP, Brazil
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Shamieh O, Alarjeh G, Qadire MA, Alrjoub W, Abu-Nasser M, Abu Farsakh F, AlHawamdeh A, Al-Omari M, Amin Z, Ayaad O, Al-Tabba A, Hui D, Bruera E, Yennurajalingam S. Decision-Making Preferences among Advanced Cancer Patients in a Palliative Setting in Jordan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085550. [PMID: 37107832 PMCID: PMC10138437 DOI: 10.3390/ijerph20085550] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 04/05/2023] [Accepted: 04/11/2023] [Indexed: 05/11/2023]
Abstract
Understanding patients' decision-making preferences is crucial for enhancing patients' outcomes. The current study aims to identify Jordanian advanced cancer patients' preferred decision-making and to explore the associated variables of the passive decision-making preference. We used a cross-sectional survey design. Patients with advanced cancer referred to the palliative care clinic at a tertiary cancer center were recruited. We measured patients' decision-making preferences using the Control Preference Scale. Patients' satisfaction with decision-making was assessed with the Satisfaction with Decision Scale. Cohen's kappa statistic was used to assess the agreement between decision-control preferences and actual decision-making, and the bivariate analysis with 95% CI and the univariate and multivariate logistic regression were used to examine the association and predictors of the demographical and clinical characteristics of the participants and the participants' decision-control preferences, respectively. A total of 200 patients completed the survey. The patients' median age was 49.8 years, and 115 (57.5%) were female. Of them, 81 (40.5%) preferred passive decision control, and 70 (35%) and 49 (24.5%) preferred shared and active decision control, respectively. Less educated participants, females, and Muslim patients were found to have a statistically significant association with passive decision-control preferences. Univariate logistic regression analysis showed that, being a male (p = 0.003), highly educated (p = 0.018), and a Christian (p = 0.006) were statistically significant correlates of active decision-control preferences. Meanwhile, the multivariate logistic regression analysis showed that being a male or a Christian were the only statistically significant predictors of active participants' decision-control preferences. Around 168 (84%) of participants were satisfied with the way decisions were made, 164 (82%) of patients were satisfied with the actual decisions made, and 143 (71.5%) were satisfied with the shared information. The agreement level between decision-making preferences and actual decision practices was significant (ⱪ coefficient = 0.69; 95% CI = 0.59 to 0.79). The study's results demonstrate that a passive decision-control preference was prominent among patients with advanced cancer in Jordan. Further studies are needed to evaluate decision-control preference for additional variables, such as patients' psychosocial and spiritual factors, communication, and information sharing preferences, throughout the cancer trajectory so as to inform policies and improve practice.
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Affiliation(s)
- Omar Shamieh
- Department of Palliative Care, King Hussein Cancer Center, Amman 11941, Jordan
- Center for Palliative & Cancer Care in Conflict, King Hussein Cancer Center, Amman 11941, Jordan
- Faculty of Medicine, The University of Jordan, Amman 11941, Jordan
- Correspondence: ; Tel.: +962-(6)5-300-460; Fax: +962-(6)5-342-567
| | - Ghadeer Alarjeh
- Center for Palliative & Cancer Care in Conflict, King Hussein Cancer Center, Amman 11941, Jordan
| | - Mohammad Al Qadire
- Faculty of Nursing, Al al-Bayt University, Mafraq 25113, Jordan
- College of Nursing, Sultan Qaboos University, Muscat 123, Oman
| | - Waleed Alrjoub
- Center for Palliative & Cancer Care in Conflict, King Hussein Cancer Center, Amman 11941, Jordan
| | - Mahmoud Abu-Nasser
- Department of Palliative Care, King Hussein Cancer Center, Amman 11941, Jordan
- Department of Medicine, King Hussein Cancer Center, Amman 11941, Jordan
| | - Fadi Abu Farsakh
- Department of Palliative Care, King Hussein Cancer Center, Amman 11941, Jordan
| | | | - Mohammad Al-Omari
- Department of Palliative Care, King Hussein Cancer Center, Amman 11941, Jordan
| | - Zaid Amin
- Department of Palliative Care, King Hussein Cancer Center, Amman 11941, Jordan
| | - Omar Ayaad
- Office of Nursing, King Hussein Cancer Center, Amman 11941, Jordan
| | - Amal Al-Tabba
- Department of Palliative Care, King Hussein Cancer Center, Amman 11941, Jordan
| | - David Hui
- MD Anderson Cancer Center, Houston, TX 77030, USA
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Guan A, Shim JK, Allen L, Kuo MC, Lau K, Loya Z, Brooks JD, Carroll PR, Cheng I, Chung BI, DeRouen MC, Frosch DL, Golden T, Leppert JT, Lichtensztajn DY, Lu Q, Oh DL, Sieh W, Wadhwa M, Gomez SL, Shariff-Marco S. Factors that influence treatment decisions: A qualitative study of racially and ethnically diverse patients with low- and very-low risk prostate cancer. Cancer Med 2023; 12:6307-6317. [PMID: 36404625 PMCID: PMC10028041 DOI: 10.1002/cam4.5405] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 10/10/2022] [Accepted: 10/22/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Factors that influence prostate cancer treatment decisions are complex, multifaceted, and personal, and may vary by race/ethnicity. Although research has been published to quantify factors involved in decision-making, these studies have been limited to primarily white, and to a lesser extent, Black patients, and quantitative studies are limited for discerning the cultural and contextual processes that shape decision-making. METHODS We conducted 43 semi-structured interviews with a racially and ethnically diverse sample of patients diagnosed with low- and very-low risk prostate cancer who had undergone treatment for their prostate cancer. Interviews were transcribed, independently coded, and analyzed to identify themes salient for decision-making, with attention to sociocultural differences. RESULTS We found racial and ethnic differences in three areas. First, we found differences in how socialized masculinity influenced patient's feelings about different treatment options. Second, we found that for some men, religion and spirituality alleviated anxiety associated with the active surveillance protocol. Finally, for racially and ethnically minoritized patients, we found descriptions of how historic and social experiences within the healthcare system influenced decision-making. CONCLUSIONS Our study adds to the current literature by expounding on racial and ethnic differences in the multidimensional, nuanced factors related to decision-making. Our findings suggest that factors associated with prostate cancer decision-making can manifest differently across racial and ethnic groups, and provide some guidance for future research.
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Affiliation(s)
- Alice Guan
- Department of Epidemiology & Biostatistics, University of California, San Francisco, California, USA
| | - Janet K Shim
- Department of Social & Behavioral Sciences, University of California, San Francisco, California, USA
| | - Laura Allen
- Department of Epidemiology & Biostatistics, University of California, San Francisco, California, USA
| | - Mei-Chin Kuo
- Department of Epidemiology & Biostatistics, University of California, San Francisco, California, USA
| | - Kathie Lau
- Department of Epidemiology & Biostatistics, University of California, San Francisco, California, USA
| | - Zinnia Loya
- Department of Epidemiology & Biostatistics, University of California, San Francisco, California, USA
| | - James D Brooks
- Department of Urology, Stanford University, Stanford, California, USA
| | - Peter R Carroll
- Department of Urology, University of California, San Francisco, California, USA
| | - Iona Cheng
- Department of Epidemiology & Biostatistics, University of California, San Francisco, California, USA
| | - Benjamin I Chung
- Department of Urology, Stanford University, Stanford, California, USA
| | - Mindy C DeRouen
- Department of Epidemiology & Biostatistics, University of California, San Francisco, California, USA
| | - Dominic L Frosch
- Center for Health Systems Research, Sutter Health/Palo Alto Medical Foundation Research Institute, Palo Alto, California, USA
| | - Todd Golden
- Department of Epidemiology & Biostatistics, University of California, San Francisco, California, USA
| | - John T Leppert
- Department of Urology, Stanford University, Stanford, California, USA
| | - Daphne Y Lichtensztajn
- Department of Epidemiology & Biostatistics, University of California, San Francisco, California, USA
| | - Qian Lu
- Department of Health Disparities Research, University of Texas MD-Anderson Cancer Center, Houston, Texas, USA
| | - Debora L Oh
- Department of Epidemiology & Biostatistics, University of California, San Francisco, California, USA
| | - Weiva Sieh
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Michelle Wadhwa
- Department of Epidemiology & Biostatistics, University of California, San Francisco, California, USA
| | - Scarlett L Gomez
- Department of Epidemiology & Biostatistics, University of California, San Francisco, California, USA
| | - Salma Shariff-Marco
- Department of Epidemiology & Biostatistics, University of California, San Francisco, California, USA
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5
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Bashir S, Mir A, Altwaijri N, Uzair M, Khalil A, Albesher R, Khallaf R, Alshahrani S, Abualait T. Neuroeconomics of decision-making during COVID-19 pandemic. Heliyon 2023; 9:e13252. [PMID: 36744067 PMCID: PMC9882954 DOI: 10.1016/j.heliyon.2023.e13252] [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: 08/25/2022] [Revised: 12/27/2022] [Accepted: 01/23/2023] [Indexed: 01/29/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic reveals the decision-making challenges faced by communities, governments, and international organizations, globally. Policymakers are much concerned about protecting the population from the deadly virus while lacking reliable information on the virus and its spread mechanisms and the effectiveness of possible measures and their (direct and indirect) health and socioeconomic costs. This review aims to highlight the various balanced policy decision that would combine the best obtainable scientific evidence characteristically provided by expert opinions and modeling studies. This article's main goal is to summarize the main significant progress in the understanding of neuroeconomics of decision-making and discuss the anatomy of decision making in the light of COVID-19 pandemic.
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Affiliation(s)
- Shahid Bashir
- Neuroscience Center, King Fahad Specialist Hospital, Dammam, Saudi Arabia,Corresponding author
| | - Ali Mir
- Neuroscience Center, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Nouf Altwaijri
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mohammad Uzair
- Department of Biological Sciences, International Islamic University, Islamabad, Pakistan
| | - Amani Khalil
- Department of Mental Health, Neuroscience Center, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Rania Albesher
- Department of Mental Health, Neuroscience Center, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Roaa Khallaf
- Department of Neurology, Neuroscience Center, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Saad Alshahrani
- Department of Research Operation and Administration, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Turki Abualait
- College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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6
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Owens OL, Dawson RM, Thomas T. Development of the Prostate Cancer Treatment Decision Framework: A Context-Specific Expansion of the Risk-as-Feelings Hypothesis. Cancer Nurs 2021; 44:E467-E475. [PMID: 33332918 PMCID: PMC8609530 DOI: 10.1097/ncc.0000000000000918] [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] [Indexed: 11/26/2022]
Abstract
BACKGROUND Over the past 2 decades, numerous decision-making interventions have been developed to guide the prostate cancer (PrCA) treatment choices of patients and families. These interventions are often supported by economic decision frameworks, which do not account for the role of emotions in treatment decisions. In some instances, emotion-driven decisions can override an individual's cognitive evaluation of a decision, leading to unfavorable outcomes such as decision regret. OBJECTIVES To produce a Prostate Cancer Treatment Decision Framework based on the Risk-as-Feelings Hypothesis. METHODS The authors reviewed seminal research in emotion and decision-making in an effort to create a context-specific decision framework. RESULTS Five variables, not germane to the Risk-as-Feelings Hypothesis, play prominent roles in PrCA decision-making including age, spirituality, family support, healthcare provider communication, and perception of treatment outcomes. While family support only affects decision outcomes by influencing emotion and cognitive evaluation of a PrCA decision, age, spirituality, and healthcare provider communication can have direct effects on an individual's perception of treatment outcomes. CONCLUSIONS The Prostate Cancer Treatment Decision Framework combines new variables with older models to explain the PrCA treatment decision-making process and elucidate relationships affecting treatment outcomes and survivors' perceptions of these outcomes. The core premise of this model can be applied to other high-risk health decisions. IMPLICATIONS FOR PRACTICE Healthcare providers have the greatest influence on PrCA treatment decision-making. Using a shared decision-making approach, providers should take into account a patient's personal characteristics and values, in addition to clinical presentation, to help patients with treatment decisions.
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Affiliation(s)
- Otis L Owens
- Author Affiliations: College of Social Work (Dr Owens) and College of Nursing (Dr Dawson), University of South Carolina, Columbia; and Department of Health Sciences, College of Health and Behavioral Studies, James Madison University, Harrisonburg, Virginia (Dr Thomas)
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7
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Kelly EP, Myers B, Henderson B, Sprik P, White KB, Pawlik TM. The Influence of Patient and Provider Religious and Spiritual Beliefs on Treatment Decision Making in the Cancer Care Context. Med Decis Making 2021; 42:125-134. [PMID: 34196249 DOI: 10.1177/0272989x211022246] [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] [Indexed: 11/16/2022]
Abstract
BACKGROUND Providers often underestimate the influence of patient religious and spiritual (R&S) needs. The current study sought to determine the influence of R&S beliefs on treatment decision making among patients and providers in the context of cancer care. METHODS We conducted a systematic review of the literature using web-based search engines and discipline-specific databases. Search terms included a combination of the following Medical Subject Headings and key terms: "cancer,""spirituality,""religion," and "decision making." We used Covidence to screen relevant studies and extracted data into Microsoft Excel. RESULTS Among 311 screened studies, 32 met inclusion/exclusion criteria. Most studies evaluated the patient perspective (n = 29), while 2 studies evaluated the provider perspective and 1 study examined both. In assessing patient R&S relative to treatment decision making, we thematically characterized articles according to decision-making contexts, including general (n = 11), end-of-life/advance care planning (n = 13), and other: specific (n = 8). Specific contexts included, but were not limited to, clinical trial participation (n = 2) and use of complementary and alternative medicine (n = 4). Within end-of-life/advance care planning, there was a discrepancy regarding how R&S influenced treatment decision making. The influence of R&S on general treatment decision making was both active and passive, with some patients wanting more direct integration of their R&S beliefs in treatment decision making. In contrast, other patients were less aware of indirect R&S influences. Patient perception of the impact of R&S on treatment decision making varied relative to race/ethnicity, being more pronounced among Black patients. CONCLUSION Most articles focused on R&S relative to treatment decision making at the end of life, even though R&S appeared important across the care continuum. To improve patient-centered cancer care, providers need to be more aware of the impact of R&S on treatment decision making.
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Affiliation(s)
| | - Brian Myers
- The Ohio State University, Columbus, OH, USA
| | | | - Petra Sprik
- Department of Supportive Oncology, Levine Cancer Institute, Charlotte, NC, USA
| | - Kelsey B White
- Department of Health Management & System Sciences, University of Louisville, Louisville, KY, USA
| | - Timothy M Pawlik
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
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8
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[Complementary medicine in uro-oncology]. Urologe A 2021; 60:953-962. [PMID: 34129061 DOI: 10.1007/s00120-021-01584-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2021] [Indexed: 10/21/2022]
Abstract
Complementary and alternative medicine (CAM) is widespread in oncology patients with a user rate of approximately 40-50%. An accompanying supportive effect can arise through improved adherence, especially in long-term (e.g. endocrine) therapies through active patient involvement. When assessing the evidence on frequently requested methods, there is no high-quality evidence that homeopathy or anthroposophy leads to an improved prognosis. Mistletoe therapy can be considered to improve the quality of life, although the data quality is weak. In prostate cancer, pomegranate has an influence on the prostate-specific antigen. It is currently unclear whether this will also result in an improved prognosis. In contrast the evidence on selenium and vitamin D speaks in favor of integration into the aftercare concept. Supplementation is recommended after the serum level has been determined.
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Gonzalez-Mercado VJ, Marrero S, Marrero-Falcon MA, Saligan LN. Factors Affecting the Severity of Fatigue during Radiotherapy for Prostate Cancer; an Exploratory Study. UROLOGIC NURSING 2020; 40:129-138. [PMID: 34220179 PMCID: PMC8248518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Limited studies have examined potential risk factors associated with the fatigue experience of a sample of Puerto Rican men treated with radiotherapy for non-metastatic prostate cancer. Identifying these factors may provide initial information about targets for individualized interventions, leading to more effective management of fatigue in this population. PURPOSE To examine the relationship of age, body max index, depressive symptoms, physical activity, and sleep disturbance with fatigue during radiotherapy for prostate cancer. METHODS Twenty six participants completed five inventories: demographic intake, health form, the Functional Assessment of Cancer-Therapy-fatigue, Patient-Reported Outcome Measures Information System-Sleep disturbance, and the International Physical Activity Questionnaire-Short Form before, middle/days 19-21 and completion/days 38-42 of radiotherapy. The principal investigator rated the Hamilton depression scale. Descriptive statistics were performed. Interactions and influence of variables on fatigue were assessed using bivariate correlation and multiple linear regression, respectively. RESULTS At each study time point, sleep disturbance and depressive symptoms were strongly correlated with each other and fatigue. The linear combination of sleep disturbance and depressive symptoms was significantly related to fatigue. CONCLUSION Given the high association of sleep disturbance and depressive symptoms with fatigue, clinicians should assess and develop interventions to manage these symptoms altogether.
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Affiliation(s)
| | - Sara Marrero
- University of South Florida College of Arts and Sciences, Tampa, FL, United States
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10
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Gall TL, Bilodeau C. The role of positive and negative religious/spiritual coping in women’s adjustment to breast cancer: A longitudinal study. J Psychosoc Oncol 2019; 38:103-117. [DOI: 10.1080/07347332.2019.1641581] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Puchalski CM, Sbrana A, Ferrell B, Jafari N, King S, Balboni T, Miccinesi G, Vandenhoeck A, Silbermann M, Balducci L, Yong J, Antonuzzo A, Falcone A, Ripamonti CI. Interprofessional spiritual care in oncology: a literature review. ESMO Open 2019; 4:e000465. [PMID: 30962955 PMCID: PMC6435249 DOI: 10.1136/esmoopen-2018-000465] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 12/10/2018] [Accepted: 12/11/2018] [Indexed: 01/08/2023] Open
Abstract
Spiritual care is recognised as an essential element of the care of patients with serious illness such as cancer. Spiritual distress can result in poorer health outcomes including quality of life. The American Society of Clinical Oncology and other organisations recommend addressing spiritual needs in the clinical setting. This paper reviews the literature findings and proposes recommendations for interprofessional spiritual care.
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Affiliation(s)
- Christina M Puchalski
- George Washington Institute for Spirituality and Health, School of Medicine and Health Sciences, The George Washington University, Washington, DC, USA
| | - Andrea Sbrana
- Department of Translational Research, Polo Oncologico, Azienda Ospedaliero-Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Betty Ferrell
- Division of Nursing Research and Education City of Hope, Duarte, California, USA
| | - Najmeh Jafari
- George Washington Institute for Spirituality and Health, School of Medicine and Health Sciences, The George Washington University, Washington, DC, USA
| | - Stephen King
- Spiritual Health, Child Life, and Clinical Patient Navigators, Seattle Cancer Care Alliance, Seattle, Washington, USA
| | - Tracy Balboni
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Initiative on Health, Religion, and Spirituality-Harvard University, Boston, Massachusetts, USA
| | - Guido Miccinesi
- Clinical Epidemiology Unit, Cancer Network, Prevention and Research Institute-ISPRO, Florence, Italy
| | - Anna Vandenhoeck
- European Research Institute for Chaplains in Healthcare, Theology and Religious Studies KU Leuven, Leuven, Belgium
| | | | - Lodovico Balducci
- Moffitt Cancer Center, University of South Florida College of Medicine, Tampa, Florida, USA
| | - Julianna Yong
- College of Nursing, WHO Collaborating Centre for Training in Hospice and Palliative Care, The Catholic University of Korea, Seoul, Korea
| | - Andrea Antonuzzo
- Polo Oncologico, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Alfredo Falcone
- Department of Translational Research, Polo Oncologico, Azienda Ospedaliero-Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Carla Ida Ripamonti
- Oncology-Supportive Care Unit, Department of Oncology-Haematology, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy
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12
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Improving spiritual well-being among cancer patients: implications for clinical care. Support Care Cancer 2019; 27:3403-3409. [PMID: 30648209 DOI: 10.1007/s00520-019-4636-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Accepted: 01/07/2019] [Indexed: 12/12/2022]
Abstract
PURPOSE This study aimed to explore the associated factors of spiritual well-being among cancer patients and the relationship between spiritual well-being (SWB) and quality of life (QOL). METHODS This cross-sectional study was conducted in 200 Chinese cancer patients in a tertiary cancer hospital. Functional Assessment of Cancer Therapy-General (FACT-G) and the Functional Assessment of Chronic Illness Therapy-Spiritual Well-being (FACIT-Sp) were used to measure SWB and QOL levels of participants. Multiple regression analyses were performed to determine the relationship between SWB and QOL. RESULTS The mean score of QOL was 59.8 (SD 13.1) with a range of 27-106. The mean score of SWB was 24.4 (SD 6.5), with a range of 8-48. Hospitalization frequency was the only variable associated with SWB. In terms of the relationship between SWB and QOL, the meaning and peace subscales were significantly related to overall QOL. It was also observed that the meaning subscale was positively related to social/family well-being, emotional well-being, and functional well-being. The peace subscale was related to the physical well-being, social/family well-being, and functional well-being. Faith was negatively related to physical and emotional well-being, but it had a positive effect on functional well-being. CONCLUSIONS Given that the meaning and peace subscales are related to a higher QOL level, it is important to find ways to improve these dimensions of spiritual well-being among cancer inpatients during treatment.
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Andkhoie M, Meyer D, Szafron M. Factors underlying treatment decision-making for localized prostate cancer in the U.S. and Canada: A scoping review using principal component analysis. Can Urol Assoc J 2018; 13:E220-E225. [PMID: 30472985 DOI: 10.5489/cuaj.5538] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The purpose of this research is to gather, collate, and identify key factors commonly studied in localized prostate cancer (LPC) treatment decision-making in Canada and the U.S. METHODS This scoping review uses five databases (Medline, EMBASE, CINAHL, AMED, and PsycInfo) to identify relevant articles using a list of inclusion and exclusion criteria applied by two reviewers. A list of topics describing the themes of the articles was extracted and key factors were identified using principal component analysis (PCA). A word cloud of titles and abstracts of the relevant articles was created to identify complementary results to the PCA. RESULTS This review identified 77 relevant articles describing 32 topics related to LPC treatment decision-making. The PCA grouped these 32 topics into five key factors commonly studied in LPC treatment decision-making: 1) treatment type; 2) socioeconomic/demographic characteristics; 3) personal reasons for treatment choice; 4) psychology of treatment decision experience; and 5) level of involvement in the decision-making process. The word cloud identified common phrases that were complementary to the factors identified through the PCA. CONCLUSIONS This research identifies several possible factors impacting LPC treatment decision-making. Further research needs to be completed to determine the impact that these factors have in the LPC treatment decision-making experience.
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Affiliation(s)
- Mustafa Andkhoie
- School of Public Health, University of Saskatchewan, Saskatoon, SK, Canada
| | - Desneige Meyer
- School of Public Health, University of Saskatchewan, Saskatoon, SK, Canada
| | - Michael Szafron
- School of Public Health, University of Saskatchewan, Saskatoon, SK, Canada
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Abdoljabbari M, Sheikhzakaryaee N, Atashzadeh- Shoorideh F. Taking Refuge in Spirituality, a Main Strategy of Parents of Children with Cancer: a Qualitative Study. Asian Pac J Cancer Prev 2018; 19:2575-2580. [PMID: 30256063 PMCID: PMC6249483 DOI: 10.22034/apjcp.2018.19.9.2575] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background: Due to the rise in prevalence of childhood cancer the impact on family caregivers is increasing. Spirituality may be an alleviating factor for improving the quality of parent life. There is a lack of organized spiritual care in health care facilities, so that this aspect needs more emphasis. Thus this study aimed to evaluate the spiritual strategy of parents of children with cancer. Materials: This qualitative study was conducted with a conventional content analysis approach. Fifteen parents of hospitalized children with cancer at the Oncology and Hematology departments of governmental pediatric hospitals nationwide were purposefully selected. Semi-structured in-depth interviews were conducted for data collection and inductive content analysis. Results: Eleven sub-themes were extracted in the data analysis, which resulted in the generation of three themes: “spiritual strategy,” “spiritual escape” and “spiritual growth”. Conclusion: The spiritual approach of parents of children with cancer had a significant influence on spiritual care and consequently the acceptance of disease and coping with the associated conditions. Spiritual care clearly should be introduced into the health care system of Iran, particular for the parents of children with cancer.
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Affiliation(s)
- Morteza Abdoljabbari
- Department of Islamic Education, Center for the Study of Religion and Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Kates JM. Treatment-related Decisional Conflict, Quality of Life, and Comorbidity in Older Adults with Cancer. Asia Pac J Oncol Nurs 2018; 5:421-429. [PMID: 30271826 PMCID: PMC6103206 DOI: 10.4103/apjon.apjon_32_18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Objective: The present study aims to examine the relationships between and among cancer treatment-related decisional conflict, quality of life, and comorbidity in older adults with cancer. Methods: A convenience sample of 200 older adults was recruited from outpatient medical oncology and radiation oncology practices in the northeastern United States. A cross-sectional, descriptive, correlational study design was used employing a survey method. Survey instruments included the Decisional Conflict scale (DCS) (with five subscales, including informed, values clarity, support, uncertainty, and effective decision); Self-administered comorbidity questionnaire (SCQ); European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (including five function scales, three symptom scales, a global health/quality of life scale, and six single items); and an investigator-developed demographic form. Results: The mean total DCS score was 22.1 (±12.5). The uncertainty subscale had the highest mean of the subscales (29.2 ± 18.2). The mean score for global health status/quality of life was 44.2 (±20.7). The mean score of the SCQ was low (9.6 ± 4.1). Significant positive relationships were identified between decisional conflict and quality of life (P = 0.009) and quality of life and comorbidity (P = 0.001). Multiple linear regression analysis found statistically significant relationships for total decisional conflict score and the five decisional conflict scale subscales. Conclusions: Results may suggest a relationship between decisional conflict and quality of life, as well as the quality of life and comorbidity. In addition, there are several physical, emotional, and spiritual factors that may positively or negatively impact decisional conflict.
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Affiliation(s)
- Jeannette M Kates
- College of Nursing, Thomas Jefferson University, Philadelphia, PA, USA
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Decisional control preferences of patients with advanced cancer receiving palliative care. Palliat Support Care 2017; 16:544-551. [DOI: 10.1017/s1478951517000803] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
ABSTRACTObjective:Understanding patients' decisional control preferences (DCPs) is important to improving the quality of care and the satisfaction of patients who have advanced cancer with their care. In addition to passive decisional control (i.e., the patient prefers his/her doctor or family caregiver to make a decision on their behalf) and active decisional control (i.e., the patient decides alone), shared decisional control, where patients and caregivers decide together, could be more appropriate. The primary aim of our study was to describe the decision-making process and the DCPs of patients with advanced cancer receiving palliative care in France.Method:We conducted a prospective survey with advanced cancer patients referred to a palliative care team in an outpatient setting. We collected information about patients' demographic and clinical characteristics using the Decision Control Preference Scale, the Satisfaction with the Decisions and Care questionnaire, and the Understanding of Illness questionnaire.Results:A total of 200 patients were evaluable. The median age was 63.5 years and 53.5% female. The cancers most commonly represented were gastrointestinal and breast. A total of 72 patients (36.2%) preferred active decisional control, 52 (26.1%) preferred shared decisional control, and 75 (37.7%) preferred passive decisional control. Younger age (p = 0.003), higher education (p < 0.001), and employment status (p = 0.046) were found to be associated with active or shared DCPs. Some 82% of patients were satisfied with the decision-making process, 35% of whom expressed wishes that did not match the actual decision-making process. Only 23% of patients thought they could be cured of their illness, and 47% thought that their treatment would “get rid of ” their disease.Significance of Results:The decision-making processes are shared in the three models of DCPs in our cohort of French patients with advanced cancer. Further prospective studies are needed.
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Influence of Men's Personality and Social Support on Treatment Decision-Making for Localized Prostate Cancer. BIOMED RESEARCH INTERNATIONAL 2017; 2017:1467056. [PMID: 28785574 PMCID: PMC5529637 DOI: 10.1155/2017/1467056] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 05/31/2017] [Accepted: 06/11/2017] [Indexed: 11/24/2022]
Abstract
Background Optimal treatment for localized prostate cancer (LPC) is controversial. We assessed the effects of personality, specialists seen, and involvement of spouse, family, or friends on treatment decision/decision-making qualities. Methods We surveyed a population-based sample of men ≤ 75 years with newly diagnosed LPC about treatment choice, reasons for the choice, decision-making difficulty, satisfaction, and regret. Results Of 160 men (71 black, 89 white), with a mean age of 61 (±7.3) years, 59% chose surgery, 31% chose radiation, and 10% chose active surveillance (AS)/watchful waiting (WW). Adjusting for age, race, comorbidity, tumor risk level, and treatment status, men who consulted friends during decision-making were more likely to choose curative treatment (radiation or surgery) than WW/AS (OR = 11.1, p < 0.01; 8.7, p < 0.01). Men who saw a radiation oncologist in addition to a urologist were more likely to choose radiation than surgery (OR = 6.0, p = 0.04). Men who consulted family or friends (OR = 2.6, p < 0.01; 3.7, p < 0.01) experienced greater decision-making difficulty. No personality traits (pessimism, optimism, or faith) were associated with treatment choice/decision-making quality measures. Conclusions In addition to specialist seen, consulting friends increased men's likelihood of choosing curative treatment. Consulting family or friends increased decision-making difficulty.
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Orom H, Underwood W, Cheng Z, Homish DL, Scott I. Relationships as Medicine: Quality of the Physician-Patient Relationship Determines Physician Influence on Treatment Recommendation Adherence. Health Serv Res 2016; 53:580-596. [PMID: 27981559 DOI: 10.1111/1475-6773.12629] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To determine whether quality of physician-patient relationships influences uptake of physician treatment recommendations in men with clinically localized prostate cancer (PCa). STUDY SETTING Data were collected July 2010 to August 2014 at two cancer centers and three community facilities. STUDY DESIGN Analyses were prospective and cross-sectional. We modeled associations between quality of the patient-physician relationship and influence of physician recommendations on treatment choice using generalized estimating equations (GEE). DATA COLLECTION Data were collected via survey and medical record abstraction. PRINCIPAL FINDINGS Participants (N = 1166) were 14.7 percent minority; 37.1 percent had low-, 47.5 percent had intermediate-, and 15.4 percent had high-risk PCa. Those reporting a better physician-patient relationship perceived that their physician's treatment recommendation was more influential (RR = 1.05, 95 percent CI = 1.04-1.05, p < .001) and were more likely to choose the recommended treatment (OR = 2.92, 95 percent CI = 2.39, 3.58, p < .001). A pattern of interactions emerged indicating that quality of the physician-patient relationship was more strongly associated with influence of recommendations for more, versus less aggressive treatment in those with low-risk, but not intermediate-risk disease. CONCLUSIONS Prioritizing quality of the physician-patient relationship through training, practice change, and patient feedback may increase adherence. However, strategies need to align with efforts to reduce physician recommendations for inefficacious treatments to prevent overtreatment.
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Affiliation(s)
- Heather Orom
- Department of Community Health and Health Behavior, University at Buffalo, Buffalo, NY
| | - Willie Underwood
- Department of Urology, Roswell Park Cancer Institute, Buffalo, NY
| | - Zinan Cheng
- Touro College of Osteopathic Medicine, Middletown, NY
| | - D Lynn Homish
- Department of Community Health and Health Behavior, University at Buffalo, Buffalo, NY
| | - I'Yanna Scott
- Department of Community Health and Health Behavior, University at Buffalo, Buffalo, NY
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Mollica MA, Underwood W, Homish GG, Homish DL, Orom H. Spirituality is associated with less treatment regret in men with localized prostate cancer. Psychooncology 2016; 26:1839-1845. [PMID: 27530290 DOI: 10.1002/pon.4248] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 07/26/2016] [Accepted: 08/14/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND Some patients with prostate cancer regret their treatment choice. Treatment regret is associated with lower physical and mental quality of life. We investigated whether, in men with prostate cancer, spirituality is associated with lower decisional regret 6 months after treatment and whether this is, in part, because men with stronger spiritual beliefs experience lower decisional conflict when they are deciding how to treat their cancer. METHODS One thousand ninety three patients with prostate cancer (84% white, 10% black, and 6% Hispanic; mean age = 63.18; SD = 7.75) completed measures of spiritual beliefs and decisional conflict after diagnosis and decisional regret 6 months after treatment. We used multivariable linear regression to test whether there is an association between spirituality and decisional regret and structural equation modeling to test whether decisional conflict mediated this relationship. RESULTS Stronger spiritual beliefs were associated with less decisional regret (b = -0.39, 95% CI = -0.53, -0.26, P < .001, partial η2 = 0.024, confidence interval = -0.55, 39%, P < .001, partial η2 = 0.03), after controlling for covariates. Decisional conflict partially (38%) mediated the effect of spirituality on regret (indirect effect: b = -0.16, 95% CI = -0.21, -0.12, P < .001). CONCLUSIONS Spirituality may help men feel less conflicted about their cancer treatment decisions and ultimately experience less decisional regret. Psychosocial support post-diagnosis could include clarification of spiritual values and opportunities to reappraise the treatment decision-making challenge in light of these beliefs.
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Affiliation(s)
- Michelle A Mollica
- Division of Cancer Control and Population Sciences, Healthcare Delivery Research Program, National Cancer Institute, Bethesda, MD, USA
| | | | - Gregory G Homish
- Research Institute on Addictions, University at Buffalo, The State University of New York, Buffalo, NY, USA
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