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Dyer NL, Surdam J, Srinivasan R, Agarwal A, Dusek JA. The Impact of Individualized Complementary and Integrative Health Interventions Provided in Clinical Settings on Quality of Life: A Systematic Review of Practice-Based Research. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2022; 28:618-640. [PMID: 35834609 PMCID: PMC9419987 DOI: 10.1089/jicm.2021.0413] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Background: The goal of this systematic review was to evaluate the impact of individualized complementary and integrative health (CIH) interventions on quality-of-life outcomes as collected in CIH outpatient clinics. Methods: A systematic review was conducted using PubMed, OVID, Cochrane, Web of Science, Scopus, and Embase through December 2020. Inclusion criteria were as follows: individualized CIH treatment, longitudinal effectiveness design, patient-reported outcomes, outpatient CIH clinic setting, participants aged ≥18 years, sample size of ≥25, and English full text. The study was listed in the PROSPERO database (CRD42020159193), and PRISMA guidelines were used. The variables extracted from articles focused on study details/demographics, CIH intervention characteristics, and outcome characteristics. Results: The literature search yielded 3316 records with 264 assessed for full-text review. Of these, 19 studies (including ∼14,002 patients) were specific to quality of life (or well-being) as a main outcome. Most studies included were multidisciplinary studies (n = 12), followed by acupuncture (n = 4), chiropractic (n = 3), and massage or reflexology (n = 1). The short-form group of questionnaires (SF-12, SF-36, SF-8) were the most used quality-of-life/well-being questionnaire, comprising 37% of studies (n = 7), and the Patient Reported Outcomes Measurement Information System (PROMIS) measures comprised 21% (n = 4). Both questionnaires are normed to U.S. population, allowing for comparison. The average improvement across the comparable SF and PROMIS measures for Physical Health was 6% (range 2%-20%) and for Mental Health was 5% (range 1%-11%), demonstrating clinical significance. Improvements in the observational studies are comparable to improvements reported from randomized controlled trials. Conclusions: Results from this systematic review indicate that CIH therapies largely have positive effects on health-related quality of life and well-being for various patient populations seen in CIH clinical settings. Direct comparisons across studies were limited due to the variability in study design and incomplete reporting in some of the publications. Suggestions for improving the design and reporting for future practice-based research are provided.
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Affiliation(s)
- Natalie L. Dyer
- Connor Whole Health, University Hospitals, Cleveland, OH, USA
| | - Jessica Surdam
- Connor Whole Health, University Hospitals, Cleveland, OH, USA
| | | | - Ankita Agarwal
- Department of Nutrition, Case Western Reserve University, Cleveland, OH, USA
| | - Jeffery A. Dusek
- Connor Whole Health, University Hospitals, Cleveland, OH, USA
- Department of Family Medicine and Community Health, Case Western Reserve University, Cleveland, OH, USA
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Lingens SP, Schulz H, Bleich C. Evaluations of psychosocial cancer support services: A scoping review. PLoS One 2021; 16:e0251126. [PMID: 33945585 PMCID: PMC8096026 DOI: 10.1371/journal.pone.0251126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 04/20/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND A diagnosis of cancer leaves most patients with cancer and their relatives with an increased psychological burden. Throughout the course of the illness, social, occupational or legal changes may lead to psychological distress. Psychosocial cancer support services offer psychological, social and legal support. However, little is known about the effectiveness of psychosocial support services implemented in health care. Therefore, this scoping review aims to provide an overview of current literature evaluating out-patient psychosocial support services. METHODS Databases searched were PubMed, PsycINFO, PSYNDEX, PsycArticle, Medline, Web of Science, Google Scholar, Cochrane, and Embase. Two independent researchers conducted the systematic search. We included studies that were published in English and assessed at least one patient reported outcome measure. Studies that assessed psychotherapy, online support or telephone counselling were excluded. The review was reported according to PRISMA-ScR guidelines. A search of the databases identified 2104 articles. After excluding duplicates, screening titles, abstracts and full-texts, 12 studies matching the criteria were identified. RESULTS One study was an RCT, six were prospective with no control group and five studies were cross-sectional with one measurement point. The most common outcome measures across studies were well-being, concerns and satisfaction with the support services. CONCLUSION While the included studies indicate some improvements to well-being for patients with cancer, the low number and lack of high quality of studies indicate these findings should be interpreted with caution. However, high-quality research on the effectiveness of psychosocial support services is needed to determine that the interventions are effective.
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Affiliation(s)
- Solveigh P. Lingens
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Holger Schulz
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Christiane Bleich
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
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Stie M, Jensen LH, Delmar C, Nørgaard B. Open dialogue about complementary and alternative medicine (CAM) integrated in conventional oncology care, characteristics and impact. A systematic review. PATIENT EDUCATION AND COUNSELING 2020; 103:2224-2234. [PMID: 32563705 DOI: 10.1016/j.pec.2020.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 05/27/2020] [Accepted: 06/01/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To systematically review evidence on the characteristics, experiences and impact of an open dialogue about complementary and alternative medicine (CAM) integrated in oncology care. METHODS We searched MEDLINE, EMBASE, AMED, Scopus, ProQuest Dissertations and Thesis, Cochrane Central Register, clinicaltrials.gov, forskningsdatabase.dk and PROSPERO. Two reviewers screened title, abstract and full-text articles. Each study was appraised using the Critical Appraisal Skills Programme (CASP) and synthesized narratively. PROSPERO registration CRD42019112242. RESULTS We retrieved 4736 articles and included 5; 3 received 9 ½, 1 received 9, and 1 received 5 points on the CASP score. Predominately, the open dialogue was one or two individual, patient-centered, face-to-face consultations led by oncology physicians. In one study, it was a tele-phone consultation and in another it was structured counseling led by pharmacists. Integrated information and recommendations about CAM contributed to high level of satisfaction and improvement in concerns, quality of life and well-being. CONCLUSION Integration of open dialogue about CAM in oncology care including acknowledging patients' preferences, values, wishes and knowledge, and providing information about CAM expands the opportunities for improving patients' health, quality of life and well-being. PRACTICE IMPLICATIONS Open dialogue about CAM has potentials, but research on how it specifically helps patients, is needed.
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Affiliation(s)
- Mette Stie
- Department of Oncology, Vejle Hospital, University Hospital of Southern Denmark, Vejle, Denmark; Institute of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
| | - Lars Henrik Jensen
- Department of Oncology, Vejle Hospital, University Hospital of Southern Denmark, Vejle, Denmark; Institute of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Charlotte Delmar
- Department of Nursing Science, Health Faculty, Aarhus University, Aarhus, Denmark
| | - Birgitte Nørgaard
- Department of Public Health, University of Southern Denmark, Odense, Denmark
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Dadkhah B, Anisi E, Mozaffari N, Amani F, Pourghasemian M. Effect of Music Therapy with Periorbital Massage on Chemotherapy-Induced Nausea and Vomiting In Gastrointestinal Cancer: A Randomized Controlled Trail. J Caring Sci 2019; 8:165-171. [PMID: 31598509 PMCID: PMC6778310 DOI: 10.15171/jcs.2019.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 08/14/2019] [Indexed: 12/13/2022] Open
Abstract
Introduction: Music and massage therapy are among the approaches of complementary medicine. Patients with cancer have been hugely encouraged in recent years to use complementary medicine to relieve chemotherapy-induced nausea and vomiting. The present study was conducted to determine the effect of music and periorbital massage therapy on chemotherapy-induced nausea and vomiting in patients with gastrointestinal cancers. Methods: The present single-blind clinical trial study was conducted on 60 patients with gastrointestinal cancer undergoing chemotherapy who were randomly assigned to control and music plus massage therapy groups. Two interventions were concurrently carried out on patients in music plus massage therapy group while receiving chemotherapy medication, but the control group received no intervention. Rhodes questionnaire was used to assess nausea and vomiting before and 24 hours after chemotherapy. Data were analyzed using descriptive and analytical statistical tests (Chi-square and t-tests). Results: Music plus periorbital massage therapy significantly reduced nausea and vomiting in patients undergoing chemotherapy compared to the control group. Conclusion: According to the results, using music plus periorbital massage improves nausea and vomiting in patients undergoing chemotherapy, and can be considered as a complementary medicine method in conjunction with other medicinal therapies to relieve symptoms of patients with cancer.
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Affiliation(s)
- Behrouz Dadkhah
- Department of Nursing, Faculty of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Elham Anisi
- Department of Nursing, Faculty of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Naser Mozaffari
- Department of Nursing, Faculty of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Firouz Amani
- Department of Epidemiology and Biostatistics, Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mehdi Pourghasemian
- Department of Internal Medicine, Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
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What can a third sector organisation provide for people with breast cancer that public health services cannot? Developing support services in response to service evaluation. Eur J Integr Med 2019. [DOI: 10.1016/j.eujim.2019.100943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Jolliffe RC, Durrant JR, Seers HE, Churchward SF, Griffiths M, Naidoo M, Ben-Arye E, Polley MJ, Zollman C. Impact of Penny Brohn UK's Living Well Course on Informal Caregivers of People with Cancer. J Altern Complement Med 2018; 24:974-980. [PMID: 30247959 DOI: 10.1089/acm.2018.0195] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES This study evaluated the change in the concerns, wellbeing, and lifestyle behaviors of informal caregivers of people with cancer attending Penny Brohn UK's Living Well Course (LWC), a self-management education intervention. DESIGN A pre-postcourse design collected self-reported quantitative and qualitative data from informal caregivers attending a LWC. SETTING/LOCATION Penny Brohn UK is a United Kingdom-based charity (not-for-profit) providing specialist integrative, whole person support, free of charge, to people affected by cancer. SUBJECTS Informal caregivers taking part in a Penny Brohn UK LWC between June 2014 and May 2016 attending alongside the person with cancer. INTERVENTION The LWC is a structured 15 h, multimodal group self-management educational course, designed to help people affected by cancer learn tools and techniques to help build resilience. Trained facilitators deliver LWCs to around 12 people with various types and stages of cancer and their informal caregivers. OUTCOME MEASURES Measure Yourself Concern and Wellbeing (MYCaW) completed precourse and at 6 weeks postcourse; and bespoke 6-week follow-up Patient Reported Experience Measure. RESULTS Four hundred eighty informal caregivers attended a LWC June 2014 to May 2016. One hundred eighteen completed a 6-week follow-up MYCaW: MYCaW Concerns 1 and 2 showed statistically significant improvements (p < 0.0001), there was no significant improvement in wellbeing. Informal caregivers' most reported concerns relating to themselves were psychological and emotional issues (59%). The primary concern of the caregiver for the care recipient was related to the physical health of the person with cancer (40%). Eighty-seven percent of responding informal caregivers stated that the LWC enabled health self-management. CONCLUSIONS The LWC was followed by an improvement in informal caregivers' concerns, and increased self-management of their own health needs. More studies, with larger sample size, are needed to explore if better self-management by informal caregivers may also lead to improvements in patients' health and wellbeing.
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Affiliation(s)
| | | | | | | | | | | | - Eran Ben-Arye
- 2 Integrative Oncology Program, The Oncology Service and Lin Medical Center , Clalit Health Services, Haifa, Israel .,3 Faculty of Medicine, Technion-Israel Institute of Technology , Haifa, Israel
| | - Marie J Polley
- 4 Department of Life Sciences, Faculty of Science and Technology, University of Westminster , London, United Kingdom
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Browne N, Bush P, Cabo F. Relieving pressure – An evaluation of Shiatsu treatments for cancer & palliative care patients in an NHS setting. Eur J Integr Med 2018. [DOI: 10.1016/j.eujim.2018.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Cowen VS, Tafuto B. Integration of Massage Therapy in Outpatient Cancer Care. Int J Ther Massage Bodywork 2018; 11:4-10. [PMID: 29593842 PMCID: PMC5868898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Massage therapy can be helpful in alleviating cancer-related symptoms and cancer treatment-related symptoms. While surveys have noted that cancer patients seek out massage as a nonpharmacologic approach during cancer treatment, little is known about the integration of massage in outpatient cancer care. PURPOSE The purpose of this study was to examine the extent to which massage is being integrated into outpatient cancer care at NCI-designated Cancer Centers. SETTING This study used descriptive methods to analyze the integration of massage in NCI-designated Cancer Centers providing clinical services to patients (n = 62). DESIGN Data were collected from 91.1% of the centers (n = 59) using content analysis and a telephone survey. A dataset was developed and coded for analysis. MAIN OUTCOME MEASURE The integration of massage was assessed by an algorithm that was developed from a set of five variables: 1) acceptance of treatment as therapeutic, 2) institution offers treatment to patients, 3) clinical practice guidelines in place, 4) use of evidence-based resources to inform treatment, and 5) shared knowledge about treatment among health care team. All centers were scored against all five variables using a six-point scale, with all variables rated equally. RESULTS The integration of massage ranged from not at all (0) to very high (5) with all five levels of integration evident. Only 11 centers (17.7% of total) rated a very high level of integration; nearly one-third of the centers (n = 22) were found to have no integration of massage at all-not even provision of information about massage to patients through the center website. CONCLUSIONS The findings of this analysis suggest that research on massage is not being leveraged to integrate massage into outpatient cancer care.
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Affiliation(s)
- Virginia S. Cowen
- Department of Primary Care, Rutgers University, School of Health Professionals, Newark, NJ, USA,Corresponding author: Virginia S. Cowen, PhD, LMT, Department of Primary Care, Rutgers School of Health Professionals, 65 Bergen St., Newark, NJ 07107-1709, USA,
| | - Barbara Tafuto
- Department of Health Informatics, Rutgers University, School of Health Professions, Newark, NJ, USA
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Charlesworth E, Hughes J, Plant H, Carballo L. Complementary therapy for people with cancer; the patient’s perspective. Eur J Integr Med 2018. [DOI: 10.1016/j.eujim.2017.10.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Blignault I, McDonnell L, Aspinall D, Yates R, Reath J. Beyond diagnosis and survivorship: findings from a mixed-methods study of a community-based cancer support service. Aust J Prim Health 2017; 23:391-396. [PMID: 28514993 DOI: 10.1071/py16067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 02/06/2017] [Indexed: 11/23/2022]
Abstract
This consumer-led research investigated the client experiences and the individual and community benefits of a community-based cancer support service operating in a regional setting. The study included cross-sectional surveys, focus group discussions and key-informant interviews. In total, 114 clients, 28 carers and 20 therapists were surveyed; three client focus groups were conducted and five directors and staff were interviewed. For many clients and carers, the warm welcome experienced at first contact sets the tone for a long-term association with the organisation. The feeling of being cared for extends to the broader community and living with cancer becomes more than survivorship. Integral to the organisational model are opportunity (second-hand) shops that enable subsidised complementary therapies and other services, offer a way of giving back and assist disadvantaged community members. The organisational model has benefits, not only for people living with cancer and their families, but also for the wider community.
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Affiliation(s)
- Ilse Blignault
- Centre for Health Research, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
| | - Louise McDonnell
- Department of General Practice, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
| | - Diana Aspinall
- Nepean Blue Mountains PHN, Locked Bag 1797, Penrith, NSW 2751, Australia
| | - Robyn Yates
- Blue Mountains Cancer Help, PO Box 18, Katoomba, NSW 2780, Australia
| | - Jennifer Reath
- Department of General Practice, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
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Porter D, Cochrane S, Zhu X. Current Usage of Traditional Chinese Medicine for Breast Cancer-A Narrative Approach to the Experiences of Women with Breast Cancer in Australia-A Pilot Study. MEDICINES 2017; 4:medicines4020020. [PMID: 28930235 PMCID: PMC5590056 DOI: 10.3390/medicines4020020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Revised: 04/10/2017] [Accepted: 04/10/2017] [Indexed: 01/06/2023]
Abstract
Background: The use of Traditional Chinese Medicine (TCM) by breast cancer patients is growing. Few studies have examined the complexity of breast cancer survivors' attitudes, lived experiences, barriers, and perceptions in using TCM as part of their treatment journey. This article examines breast cancer survivors' experiences, perceptions of, and benefits (or not) in using TCM. Methods: Qualitative research, using semi-structured interviews, was the chosen methodology. Results: Participants used TCM as a form of self-help and as a complement, not an alternative, to standard care. Overall, 100% of the participants used acupuncture, 62% used Chinese herbal medicine, 23% used Qigong, and 23% used Chinese dietary therapy. Participants reported perceived outcomes and health benefits from TCM usage ranging from increased coping mechanisms, relieving stress and side-effects of standard treatment, the desire to be pro-active in the treatment journey, and to have a locus of control. Some cited the need to have "time-out" and the therapeutic relationship with the practitioner as being important. Conclusion: There is a clear need to understand breast cancer survivors' needs for physical and psychological support as they aim to regain control over their life through their experience of illness. More studies are needed to measure and evaluate these outcomes and to help identify breast cancer survivors' healthcare seeking behaviours, during and after the acute treatment stage that addresses their physical, emotional, and spiritual needs. These results aim to inform future research design and evaluate and develop support services that are patient-centred and focus on whole health outcomes, shared decision-making, and quality of life.
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Affiliation(s)
- Dianna Porter
- National Institute of Complementary Medicine, Western Sydney University, Penrith 2751, Australia.
| | - Suzanne Cochrane
- National Institute of Complementary Medicine, Western Sydney University, Penrith 2751, Australia.
| | - Xiaoshu Zhu
- School of Science and Health, Western Sydney University, Penrith 2751, Australia.
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The Effect of Self-Efficacy and Outcome Expectations Training on the Enhancement of Physical Activities Among Women Suffering From Breast Cancer: An Evidence-Based Intervention. IRANIAN RED CRESCENT MEDICAL JOURNAL 2016. [DOI: 10.5812/ircmj.28081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Whatley J, Street R, Kay S, Harris PE. Use of reflexology in managing secondary lymphoedema for patients affected by treatments for breast cancer: A feasibility study. Complement Ther Clin Pract 2016; 23:1-8. [DOI: 10.1016/j.ctcp.2016.01.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Revised: 12/09/2015] [Accepted: 01/12/2016] [Indexed: 10/22/2022]
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Polley MJ, Jolliffe R, Boxell E, Zollman C, Jackson S, Seers H. Using a Whole Person Approach to Support People With Cancer: A Longitudinal, Mixed-Methods Service Evaluation. Integr Cancer Ther 2016; 15:435-445. [PMID: 27060342 PMCID: PMC5739159 DOI: 10.1177/1534735416632060] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 12/23/2015] [Accepted: 01/14/2016] [Indexed: 12/29/2022] Open
Abstract
Introduction. Improved models of care are needed to meet all the support needs of people with cancer, which encompass psychological, emotional, physical, spiritual, sexual, occupational, social and existential needs. The aim of this article is to (a) evaluate short- and long-term impacts of using a whole person approach to support people with cancer on the Living Well with the Impact of Cancer Course (LWC) and (b) use these data to inform strategic decisions about future service provision at Penny Brohn UK. Methods. Longitudinal mixed-methods service evaluation (n = 135). Data collected included health-related quality of life (HRQoL) (FACIT-SpEx); Concerns (types and severity–MYCaW); lifestyle behavior (bespoke questionnaire), and participants’ experiences over 12 months postcourse. Results. Statistically and clinically significant improvements from baseline to 12 months in severity of MYCaW Concerns (n = 64; P < .000) and mean total HRQoL (n = 66; P < .000). The majority of MYCaW concerns were “psychological and emotional” and about participants’ well-being. Spiritual, emotional, and functional well-being contributed most to HRQoL improvements at 12 months. Barriers to maintaining healthy lifestyle changes included lack of support from family and friends, time constraints, and returning to work. Three to 6 months postcourse was identified as the time when more support was most likely to be needed. Conclusions. Using a whole person approach for the LWC enabled the needs of participants to be met, and statistically and clinically significant improvements in HRQoL and MYCaW Concerns were reported. Qualitative data analysis explored how experiencing whole person support enabled participants to make and sustain healthy lifestyle changes associated with improved survivorship. Barriers experienced to making health behavior change were also identified. These data then informed wider and more person-centered clinical provision to increase the maintenance of positive long-term behavior changes. Comparison of whole person approaches to cancer treatment and support and standard care are now urgently needed.
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Jolliffe R, Seers H, Jackson S, Caro E, Weeks L, Polley MJ. The Responsiveness, Content Validity, and Convergent Validity of the Measure Yourself Concerns and Wellbeing (MYCaW) Patient-Reported Outcome Measure. Integr Cancer Ther 2014; 14:26-34. [DOI: 10.1177/1534735414555809] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Objective. Measure Yourself Concerns and Wellbeing (MYCaW) is a patient-centered questionnaire that allows cancer patients to identify and quantify the severity of their “concerns” and “wellbeing,” as opposed to using a predetermined list. MYCaW administration is brief and aids in prioritizing treatment approaches. Our goal was to assess the convergent validity and responsiveness of MYCaW scores over time, the generalizability of the existing qualitative coding framework in different complementary and integrative oncology settings and content validity. Methods. Baseline and 6-week follow-up data (n = 82) from MYCaW and FACIT-SpEx questionnaires were collected for a service evaluation of the Living Well with the Impact of Cancer course at Penny Brohn Cance Care. MYCaW convergent validity was determined using Spearman’s rank correlation test, and responsiveness indices assessed score changes over time. The existing qualitative coding framework was reviewed using a new data set (n = 158) and coverage of concern categories compared with items of existing outcome measures. Results. Good correlation between MYCaW and FACIT-SpEx score changes were achieved ( r = −0.57, P ≥ .01). MYCaW Profile and Concern scores were highly responsive to change: standardized response mean = 1.02 and 1.08; effect size = 1.26 and 1.22. MYCaW change scores showed the anticipated gradient of change according to clinically relevant degrees of change. Categories, including “spirituality,” “weight change,” and “practical concerns” were added to the coding framework to improve generalizability. Conclusions. MYCaW scores were highly responsive to change, allowing personalized patient outcomes to be quantified; the qualitative coding framework appears generalizable across different integrative oncology settings and has broader coverage of patient-identified concerns compared with existing cancer-related patient-reported outcome measures.
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Affiliation(s)
| | | | | | | | - Laura Weeks
- Ottawa Integrative Cancer Centre, Ottawa, Ontario, Canada
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How to capture patients’ concerns and related changes: Comparing the MYCaW questionnaire, semi-structured interview and a priority list of outcome areas. Complement Ther Med 2014; 22:690-700. [DOI: 10.1016/j.ctim.2014.06.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Revised: 06/20/2014] [Accepted: 06/25/2014] [Indexed: 11/17/2022] Open
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Weeks L, Seely D, DeGrasse C, Verma S, Boon H, Verhoef M, Stacey D. Developing an operational model for an integrative oncology program: a qualitative descriptive feasibility study. Support Care Cancer 2013; 22:731-9. [DOI: 10.1007/s00520-013-2028-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Accepted: 10/18/2013] [Indexed: 11/29/2022]
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Effects of back massage on chemotherapy-related fatigue and anxiety: Supportive care and therapeutic touch in cancer nursing. Appl Nurs Res 2013; 26:210-7. [DOI: 10.1016/j.apnr.2013.07.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Revised: 07/12/2013] [Accepted: 07/23/2013] [Indexed: 11/23/2022]
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Liao GS, Apaya MK, Shyur LF. Herbal medicine and acupuncture for breast cancer palliative care and adjuvant therapy. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2013; 2013:437948. [PMID: 23840256 PMCID: PMC3694462 DOI: 10.1155/2013/437948] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Revised: 05/14/2013] [Accepted: 05/21/2013] [Indexed: 11/17/2022]
Abstract
Breast cancer is a life-threatening disease among women worldwide with annual rates of reported incidence and death increasing alarmingly. Chemotherapy is a recommended and effective treatment option for breast cancer; however, the narrow therapeutic indices and varied side effects of currently approved drugs present major hurdles in increasing its effectiveness. An increasing number of literature evidence indicate that complementary and alternative medicine (CAM) used in treatment-related symptom control and alleviation of side effects plays an important role in increasing survival rate and quality of life in breast cancer patients. This review focuses on the use of herbal medicines and acupuncture in palliative care and as adjuvants in the treatment of breast cancer. Herbal medicinal treatments, the correlation of clinical use with demonstrated in vitro and in vivo mechanisms of action, and the use of certain acupoints in acupuncture are summarized. The aim of this review is to facilitate an understanding of the current practice and usefulness of herbal medicine and acupuncture as adjuvants in breast cancer therapy.
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Affiliation(s)
- Guo-Shiou Liao
- Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
| | - Maria Karmella Apaya
- Agricultural Biotechnology Research Center, Academia Sinica, No. 128, Section 2, Academia Road, Nankang, Taipei 115, Taiwan
| | - Lie-Fen Shyur
- Agricultural Biotechnology Research Center, Academia Sinica, No. 128, Section 2, Academia Road, Nankang, Taipei 115, Taiwan
- Graduate Institute of Pharmacognosy, Taipei Medical University, Taipei 110, Taiwan
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Baker BS, Harrington JE, Hoffman CJ. A service evaluation of The Haven at Home as a support programme for breast cancer survivors. Eur J Integr Med 2013. [DOI: 10.1016/j.eujim.2012.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Ben-Arye E, Schiff E, Zollman C, Heusser P, Mountford P, Frenkel M, Bar-Sela G, Lavie O. Integrating complementary medicine in supportive cancer care models across four continents. Med Oncol 2013; 30:511. [PMID: 23435989 DOI: 10.1007/s12032-013-0511-1] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Accepted: 02/15/2013] [Indexed: 12/01/2022]
Abstract
The need to integrate complementary medicine (CM) consultation in supportive care of patients with cancer is acknowledged by oncologists owing to the ongoing research on CM efficacy and awareness of its potential risks. In this article, we aim to provide oncologists with models for CM integration within supportive care. Descriptive analysis of key elements which facilitate CM integration is presented by physicians leading six integrative cancer care programs across four continents. Perspectives of integration are supplemented by a literature review, quantitative data on the clinical activity in each center, and qualitative narrative-based citations of seven oncology patients and healthcare providers. It is recommended that CM consultation be provided by physicians with extensive CM training. The following key elements were identified as essential for integrative program design within oncological supportive care: (1) Location of the integrative physician (IP) room within the oncology department area, (2) Required oncologist referral to CM consultation, (3) Allocated time to IP-oncologist communication, (4) Research-based integrative practice, (5) Inclusion of paid professional CM practitioners, (6) Institutional cost covered service. Integration of CM consultation within oncological supportive care needs to take in account six key elements that ensure high-quality evidence-based concomitant integrative practice.
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Affiliation(s)
- Eran Ben-Arye
- Integrative Oncology Program, The Oncology Service, Lin Medical Center, Clalit Health Services, 35 Rothschild St., Haifa, Western Galilee, Israel.
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Seely DM, Weeks LC, Young S. A systematic review of integrative oncology programs. ACTA ACUST UNITED AC 2013; 19:e436-61. [PMID: 23300368 DOI: 10.3747/co.19.1182] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This systematic review set out to summarize the research literature describing integrative oncology programs. METHODS Searches were conducted of 9 electronic databases, relevant journals (hand searched), and conference abstracts, and experts were contacted. Two investigators independently screened titles and abstracts for reports describing examples of programs that combine complementary and conventional cancer care. English-, French-, and German-language articles were included, with no date restriction. From the articles located, descriptive data were extracted according to 6 concepts: description of article, description of clinic, components of care, administrative structure, process of care, and measurable outcomes used. RESULTS Of the 29 programs included, most were situated in the United States (n = 12, 41%) and England (n = 10, 34%). More than half (n = 16, 55%) operate within a hospital, and 7 (24%) are community-based. Clients come through patient self-referral (n = 15, 52%) and by referral from conventional health care providers (n = 9, 31%) and from cancer agencies (n = 7, 24%). In 12 programs (41%), conventional care is provided onsite; 7 programs (24%) collaborate with conventional centres to provide integrative care. Programs are supported financially through donations (n = 10, 34%), cancer agencies or hospitals (n = 7, 24%), private foundations (n = 6, 21%), and public funds (n = 3, 10%). Nearly two thirds of the programs maintain a research (n = 18, 62%) or evaluation (n = 15, 52%) program. CONCLUSIONS The research literature documents a growing number of integrative oncology programs. These programs share a common vision to provide whole-person, patient-centred care, but each program is unique in terms of its structure and operational model.
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Affiliation(s)
- D M Seely
- Ottawa Integrative Cancer Centre, Ottawa, ON. ; Canadian College of Naturopathic Medicine, Toronto, ON. ; Ottawa Hospital Research Institute, Ottawa, ON
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Baker BS, Harrington JE, Choi BS, Kropf P, Muller I, Hoffman CJ. A randomised controlled pilot feasibility study of the physical and psychological effects of an integrated support programme in breast cancer. Complement Ther Clin Pract 2012; 18:182-9. [PMID: 22789796 DOI: 10.1016/j.ctcp.2012.03.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2012] [Accepted: 03/16/2012] [Indexed: 12/31/2022]
Abstract
A pilot study was conducted to assess recruitment and effectiveness of an integrated support programme in women with breast cancer. Twelve participants were randomised to receive medical care with or without the support programme. Psychosocial questionnaires and immune/hormonal assays were completed at baseline, three and six months. Recruitment was problematic. In the intervention group, mental fatigue was significantly improved (p = 0.016) compared to controls; increased NK cell activity suggested an improvement in immune function. Total stress (p = 0.009), anxiety (p = 0.032) and endocrine-specific (p = 0.032) symptoms were significantly improved in the controls. A large-scale randomisation trial appears warranted, dependent upon effective recruitment.
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