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Chi SC, Liu YC, Konara Mudiyanselage SP, Fetzer S, Lin MF. Treatment withdrawal experiences of women with breast cancer: A phenomenological study. J Clin Nurs 2024. [PMID: 38528376 DOI: 10.1111/jocn.17142] [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: 05/02/2023] [Revised: 03/09/2024] [Accepted: 03/18/2024] [Indexed: 03/27/2024]
Abstract
AIM To obtain an in-depth understanding of the lived experiences, values, and beliefs of Taiwanese women with breast cancer who withdrew from cancer treatment. BACKGROUND Fear of side effects, negative experiences and personal beliefs were identified as reasons for withdrawing from cancer treatments. Body-mind consciousness and body autonomy play a crucial role in cancer treatment decisions. DESIGN Descriptive phenomenological approach. METHODS We conducted semi-structured, face-to-face and in-depth interviews with 16 women diagnosed with breast cancer. Participants were purposefully selected from the Cancer Registry database. Employing a phenomenological approach, our aim was to explore the lived experiences of these individuals. Data analysis followed Giorgi's five-step process. To ensure a comprehensive report the COREQ checklist was applied. FINDINGS 'The Determination to Preserve Me' is the essence of treatment withdrawal, identified by three themes and seven sub-themes. 'Raising Body-Mind Consciousness' was generated using body autonomy and preventing repeated psychological trauma from the participant's view. Their lifestyles, maintaining the family role, and returning to a normal trajectory help develop 'Maintaining Stability for Being a Patient and a Family Carer'. 'Self-Defending Against the Body Harm' was generated by concerns about maintaining health and preventing harm. CONCLUSION Women's behaviours became transformed by suffering. Actions were influenced by physical and psychological distress, misconceptions about treatments, and appearance changes by self-determination through self-protection. RELEVANCE TO CLINICAL PRACTICE Healthcare professionals should respect women's autonomy and work collaboratively to ensure their decision-making with accurate information and awareness of the potential risks and benefits of treatment withdrawal need to concern.
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Affiliation(s)
- Shu-Ching Chi
- Nursing Department, E-DA Hospital, Kaohsiung, Taiwan
- Nursing Department, I-Shou University, Kaohsiung, Taiwan
| | - Yu-Chen Liu
- School of Nursing, College of Medicine, National Taiwan University, Taipei City, Taiwan
| | | | - Susan Fetzer
- Department of Nursing, University of new Hampshire, Durham, New Hampshire, USA
| | - Mei-Feng Lin
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Multifactorial Evaluation following Cytoreductive Surgery for Malignant Pleural Mesothelioma in Patients with High Symptom-Burden. J Clin Med 2022; 11:jcm11216418. [DOI: 10.3390/jcm11216418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/19/2022] [Accepted: 10/26/2022] [Indexed: 11/17/2022] Open
Abstract
Mesothelioma has a scant prognosis and a great impact on symptoms and the quality of life. Pleurectomy/decortication and extrapleural pneumonectomy are the two cytoreductive surgical strategies, with different invasiveness, but achieving similar oncological results. Hereafter, the two surgical procedures effects on symptoms and the quality of life are compared in a high symptom-burden population. Between 2003 and 2017, 55 consecutive patients underwent pleurectomy/decortication (n = 26) or extrapleural pneumonectomy (n = 29), both followed by adjuvant chemo-radiotherapy. Cardio-pulmonary function, symptoms and the quality of life (Short-Form-36 and St.George’s questionnaires) were evaluated pre- and 3-, 6-, 12- and 24-months postoperatively. Extrapleural pneumonectomy demonstrated lower pain at 12 months but a higher decrement of forced vital capacity at 24 months than pleurectomy/decortication. Both procedures revealed a 3-months improvement of many symptoms and the quality of life determinants. Improvement in physical, social and pain-related measured parameters lasted for a longer time-spawn in the extrapleural pneumonectomy group. No differences were found in chemotherapy compliance and survival between groups. Age-at-presentation (p = 0.02) and non-epitheliod histology (p = 0.10) were the only significant prognosticators. Surgery, despite poor survival results, improved symptoms and the quality of life in patients with mesothelioma with high symptom-burden at diagnosis. Therefore, extrapleural pneumonectomy demonstrated the most durable effects.
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Chang NT, Chang YH, Huang YT, Chen SC. Factors Associated with Refusal or Discontinuation of Treatment in Patients with Bladder Cancer: A Cohort Population-Based Study in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020618. [PMID: 33450864 PMCID: PMC7828302 DOI: 10.3390/ijerph18020618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 01/11/2021] [Indexed: 12/24/2022]
Abstract
Cancer treatment causes adverse effects that lead to refusal or discontinuation of treatment. The purposes of this study were to identify 1) the factors associated with and 2) the reasons for refusing and discontinuing treatment in patients with bladder cancer (BC). We conducted a retrospective cohort study in patients diagnosed with BC in Taiwan from 1 January 2014 to 30 June 2019 using a linked cancer registry database. Of the 1247 BC patients in the study cohort, 2.1% reported refusing treatment. Patients with less education and those diagnosed at cancer stage II-IV were more likely to refuse treatment. The major reason for refusing treatment was "patient or the family considered patient's poor physical condition (chronic disease or unstable systemic disease), difficulty in enduring any condition likely to cause physical discomfort from disease treatment". A total of 4.3% of BC patients reported discontinuing treatment. Patients not living in the northern region of Taiwan and those diagnosed at cancer stage II-IV were more likely to terminate treatment before completion. The major reason given for discontinuing treatment was inconvenient transportation. Sufficient social resources and supportive care can help BC patients cope with the physical and psychological burden of treatment.
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Affiliation(s)
- Nai-Tan Chang
- Department of Nursing, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan;
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Ying-Hsu Chang
- Department of Urology, New Taipei Municipal Tucheng Hospital Chang Gung Memorial Hospital, New Taipei 236, Taiwan;
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Yu-Tung Huang
- Center for Big Data Analytics and Statistics, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan;
| | - Shu-Ching Chen
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- School of Nursing and Geriatric and Long-Term Care Research Center, College of Nursing, Chang Gung University of Science and Technology, Taoyuan 333, Taiwan
- Department of Radiation Oncology and Proton and Radiation Therapy Center, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan
- Correspondence:
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Kim Y, Krishnan CK, Kim H, Cho HS, Han I. Ambulation Recovery After Surgery for Metastases to the Femur. Oncologist 2020; 25:e178-e185. [PMID: 31387951 PMCID: PMC6964134 DOI: 10.1634/theoncologist.2019-0107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 07/11/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Postoperative ambulation recovery after surgery for femur metastases has significant implications for not only the patient's quality of life but also administration of further cancer treatment. Thus, identification of preoperative predictors of ambulation recovery is necessary to set appropriate expectations and guide treatment. This study aimed to assess ambulation recovery rate and identify predictors of ambulation recovery in patients undergoing surgery for femur metastases. MATERIALS AND METHODS A total of 244 patients who underwent surgery for femur metastases at our institution were reviewed. Patients were considered ambulatory if they were able to walk independently or walk with aids and nonambulatory if they were wheelchair bound or bedridden. The following potential clinicopathologic factors that might predict postoperative ambulation recovery were evaluated: premorbid general status, cancer burden, and local factors. RESULTS A total of 165 patients (68%) regained ambulatory status postoperatively. A multivariate analysis revealed poor Eastern Cooperative Oncology Group (ECOG) performance status (odds ratio [OR], 5.327; p < .001) and nonambulatory premorbid ambulatory status (OR, 7.459; p < .001) as independent predictors of poor ambulation recovery after surgery for femur metastases. Postoperative ambulatory status was significantly associated with postoperative survival time (p < .001). CONCLUSION Postoperative ambulation recovery rate in our cohort was 68%. Premorbid ambulatory status and ECOG performance status are predictors of ambulation recovery in patients undergoing surgery for femur metastases. IMPLICATIONS FOR PRACTICE Postoperative ambulation recovery rate in this cohort was 68%. Premorbid ambulatory status and Eastern Cooperative Oncology Group performance status are predictors of ambulation recovery in patients undergoing surgery for femur metastases.
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Affiliation(s)
- Yongsung Kim
- Department of Orthopaedic Surgery, Seoul National University HospitalSeoulKorea
| | | | - Han‐Soo Kim
- Department of Orthopaedic Surgery, Seoul National University HospitalSeoulKorea
- Department of Orthopaedic Surgery, Seoul National University College of MedicineSeoulKorea
| | - Hwan Seong Cho
- Department of Orthopaedic Surgery, Seoul National University Bundang HospitalSeongnamKorea
| | - Ilkyu Han
- Department of Orthopaedic Surgery, Seoul National University HospitalSeoulKorea
- Department of Orthopaedic Surgery, Seoul National University College of MedicineSeoulKorea
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Kaidarova DR, Kopp MV, Pokrovsky VS, Dzhugashvili M, Akimzhanova ZM, Abdrakhmanov RZ, Babich EN, Bilan EV, Byakhov AV, Gurov SN, Koroleva IA, Mochalova AS, Povaga SS, Raigorodsky MV, Saifullin AS, Sanz E, Petrovskiy FI. Multicomponent nutritional supplement Oncoxin and its influence on quality of life and therapy toxicity in patients receiving adjuvant chemotherapy. Oncol Lett 2019; 18:5644-5652. [PMID: 31641390 PMCID: PMC6798186 DOI: 10.3892/ol.2019.10868] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 07/11/2019] [Indexed: 12/25/2022] Open
Abstract
Treatment of cancer often requires the use of adjuvant chemotherapy (ACT). In real clinical practice, numerous patients suffer from severe toxicity and reduced quality of life (QoL). Hence, there is a need to maintain QoL and to reduce therapy toxicity to comply with recommended chemotherapy (CT) regimens. The present study focused on the effects of the multi-component nutritional supplement Oncoxin (ONCX) on QoL and CT-induced toxicity in patients undergoing ACT. A total of 133 patients aged 50-70 years with gastric cancer IIB-IIIC or non-small cell lung cancer IIB-IIIA were enrolled in the present study: 84 received ONCX, and 49 were included in the control arm and received CT only. It was identified that after 2 weeks of treatment the patients receiving ONCX exhibited clinically meaningful improvement of QoL (measured by Edmonton Symptom Assessment System Questionnaire) compared with those in the control group (odds ratio, 2.07; 95% CI, 1.00-4.29). By the end of a 3 week-period, the albumin level was higher in patients of the ONCX group compared with those in the control group (mean, 38.1; 95% CI, 37.1-39.1 g/l; vs. mean, 35.5; 95% CI, 33.9-37.0; P=0.03; respectively). Furthermore, the use of ONCX substantively reduced the hepatic toxicity of ACT. The present prospective real clinical setting study revealed positive effects of ONCX on QoL and ACT toxicity. The present study was retrospectively registered under the study registration number NCT03550482 at ClinicalTrials.gov (June 8, 2018).
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Affiliation(s)
| | | | - Vadim S Pokrovsky
- Department of Biochemistry, N.N. Blokhin Cancer Research Center, RUDN University, Moscow 115478, Russia
| | - Maia Dzhugashvili
- Department of Oncology Radiology, Murcia University, Murcia 30200, Spain
| | | | | | - Elena Nikolaevna Babich
- Department of Oncology, Khanty-Mansiysk Regional Clinical Hospital, Khanty-Mansiysk 628012, Russia
| | | | - Anton Valeryevich Byakhov
- Department of Chemotherapy, Moscow Clinical Scientific Center n. a. A.S. Loginov, Moscow 111123, Russia
| | | | | | | | - Svetlana Sergeevna Povaga
- Department of Chemotherapy, Russian Railways Hospital at The Station Smolensk, Smolensk 214025, Russia
| | | | | | - Eduardo Sanz
- Scientific Department, Catalysis S.L., Madrid 28016, Spain
| | - Fedor Igorevich Petrovskiy
- Department of Pharmacology and Clinical Pharmacology, Khanty-Mansiysk State Medical Academy, Khanty-Mansiysk 628011, Russia
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Functional loss in daily activity in ovarian cancer patients undergoing chemotherapy. Arch Gynecol Obstet 2018; 299:1063-1069. [DOI: 10.1007/s00404-018-4996-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 11/24/2018] [Indexed: 12/14/2022]
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Douma JAJ, Verheul HMW, Buffart LM. Are patient-reported outcomes of physical function a valid substitute for objective measurements? ACTA ACUST UNITED AC 2018; 25:e475-e479. [PMID: 30464699 DOI: 10.3747/co.25.4080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Background Physical function is important for defining treatment strategies in patients with cancer and can be estimated using patient-reported outcomes (pros). Although pros are subjective, physical activity and fitness can be tested objectively with adequate, but more labour-intensive methods that are rarely used in daily clinical practice. To determine whether pros for physical function (pro-pf) accurately predict physical function, we studied their interrelationships with objective measures of physical activity and fitness in patients with cancer who had completed cancer treatment, including adjuvant or neoadjuvant chemotherapy or autologous stem-cell transplantation. Methods Baseline data from the react (Resistance and Endurance Exercise After Chemotherapy) and exist (Exercise Intervention After Stem-Cell Transplantation) studies were evaluated. In those studies, the effects of an exercise intervention on physical fitness, fatigue, and health-related quality of life in patients with cancer shortly after completion of chemotherapy or stem-cell transplantation were studied. Interrelationships between pro-pf (physical function subscale of the European Organisation for Research and Treatment of Cancer 30-question core Quality of Life Questionnaire), physical activity (accelerometer), and cardiorespiratory fitness (peak oxygen uptake) were assessed using univariable and multivariable multilevel linear mixed-model analyses. Results After adjustment for age, sex, and body mass index, the pro-pf was significantly associated with physical activity (β = 1.75; 95% confidence interval: 1.08 to 2.42) and cardiorespiratory fitness (β = 0.10; 95% confidence interval: 0.06 to 0.13). Standardized coefficients were 0.28 and 0.26 respectively, indicating a weak association. Conclusions The pro-pf is only weakly associated with objective physical activity and fitness evaluation in patients after curative treatment for cancer. The pro-pf cannot, therefore, be used in clinical practice as a substitute for objective measures of physical function.
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Affiliation(s)
- J A J Douma
- Department of Medical Oncology, Cancer Center Amsterdam, Netherlands
| | - H M W Verheul
- Department of Medical Oncology, Cancer Center Amsterdam, Netherlands
| | - L M Buffart
- Department of Medical Oncology, Cancer Center Amsterdam, Netherlands.,Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, Netherlands
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Douma JAJ, Verheul HMW, Buffart LM. Feasibility, validity and reliability of objective smartphone measurements of physical activity and fitness in patients with cancer. BMC Cancer 2018; 18:1052. [PMID: 30373549 PMCID: PMC6206914 DOI: 10.1186/s12885-018-4983-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 10/22/2018] [Indexed: 01/15/2023] Open
Abstract
Background A patient’s physical function plays a leading role in the treatment prescription for patients with cancer. Objective assessments of physical function may be more predictive for treatment tolerability and survival than frequently used subjective measures, such as the Eastern Cooperative Oncology Group/World Health Organization (ECOG/WHO) performance score. The use of smartphones to measure physical activity and fitness may provide an excellent opportunity to objectively estimate a patient’s physical function against low costs and little time. We investigated feasibility, validity and reliability of smartphone measurements of step count and physical fitness in patients with cancer. Methods In total, 72 patients participated. They wore a smartphone for 14 days to measure the mean number of steps per day, concomitant with an accelerometer during the first 7 days. Patients performed a six-minute walk test (6MWT) twice outdoors via a smartphone application and once in a test environment in the hospital. Feasibility was evaluated by the proportion of patients who completed the study as well as smartphone assessments of step count and physical fitness. Validity was assessed with the intraclass correlation coefficient (ICC) between the accelerometer and the first week of the smartphone for step count, and between the 6MWT in the hospital and via the application for physical fitness. Test-retest reliability was assessed with the ICC between step count levels of the first and second week of smartphone assessments, and between the first and second six-minute walk test in the home environment. Results The completeness of smartphone measurements was approximately 90% for step count and 64% for physical fitness assessments. Validity was excellent for step count (ICC = 0.97, p < 0.001) and fair for fitness (ICC = 0.47, p < 0.001). We found excellent test-retest reliability for step count (ICC = 0.91, p < 0.001) and physical fitness (ICC = 0.88, p < 0.001). Conclusions This study showed that objective smartphone measurements of step count in clinical practice are feasible, valid and reliable. These findings indicate that the use of smartphones to objectively assess physical activity in clinical cancer practice is promising and may be used to select patients for treatment and study participation, to monitor patients during treatment and to guide treatment decisions.
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Affiliation(s)
- Joeri A J Douma
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University Medical Centers (Amsterdam UMC), location VU University Medical Center (VUmc), De Boelelaan 1089a, 1081, HV, Amsterdam, The Netherlands
| | - Henk M W Verheul
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University Medical Centers (Amsterdam UMC), location VU University Medical Center (VUmc), De Boelelaan 1089a, 1081, HV, Amsterdam, The Netherlands
| | - Laurien M Buffart
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University Medical Centers (Amsterdam UMC), location VU University Medical Center (VUmc), De Boelelaan 1089a, 1081, HV, Amsterdam, The Netherlands. .,Department of Epidemiology & Biostatistics, Amsterdam Public Health research institute, Amsterdam University Medical Centers (Amsterdam UMC), location VU University medical center (VUmc), Amsterdam, The Netherlands.
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