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Hughes MC, Vernon E, Egwuonwu C, Afolabi O. Measuring decision aid effectiveness for end-of-life care: A systematic review. PEC INNOVATION 2024; 4:100273. [PMID: 38525314 PMCID: PMC10957449 DOI: 10.1016/j.pecinn.2024.100273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 02/26/2024] [Accepted: 03/11/2024] [Indexed: 03/26/2024]
Abstract
Objective To systematically review research analyzing the effectiveness of decision aids for end-of-life care, including how researchers specifically measure decision aid success. Methods We conducted a systematic review synthesizing quantitative, qualitative, and mixed-methods study results using Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Four databases were searched through February 18, 2023. Inclusion criteria required articles to evaluate end-of-life care decision aids. The review is registered under PROSPERO (#CRD42023408449). Results A total of 715 articles were initially identified, with 43 meeting the inclusion criteria. Outcome measures identified included decisional conflict, less aggressive care desired, knowledge improvements, communication improvements, tool satisfaction, patient anxiety and well-being, and less aggressive care action completed. The majority of studies reported positive outcomes especially when the decision aid development included International Patient Decision Aid Standards. Conclusion Research examining end of life care decision aid use consistently reports positive outcomes. Innovation This review presents data that can guide the next generation of decision aids for end-of-life care, namely using the International Patient Decision Aid Standards in developing tools and showing which tools are effective for helping to prevent the unnecessary suffering that can result when patients' dying preferences are unknown.
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Affiliation(s)
- M. Courtney Hughes
- School of Health Studies, Northern Illinois University, Wirtz Hall 209, DeKalb, IL 60115, USA
| | - Erin Vernon
- Department of Economics, Seattle University, Pigott 522, Seattle, WA 98122, USA
| | - Chinenye Egwuonwu
- School of Health Studies, Northern Illinois University, Wirtz Hall 209, DeKalb, IL 60115, USA
| | - Oluwatoyosi Afolabi
- School of Health Studies, Northern Illinois University, Wirtz Hall 209, DeKalb, IL 60115, USA
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Pointon S, Collins A, Philip J. Introducing palliative care in advanced cancer: a systematic review. BMJ Support Palliat Care 2024:spcare-2023-004442. [PMID: 38307704 DOI: 10.1136/spcare-2023-004442] [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: 06/16/2023] [Accepted: 01/08/2024] [Indexed: 02/04/2024]
Abstract
BACKGROUND Negative perceptions about palliative care (PC), held by patients with cancer and their families, are a barrier to early referral and the associated benefits. This review examines the approaches that support the task of introducing PC to patients and families and describes any evaluations of these approaches. METHODS A systematic review with a systematic search informed by the Preferred Reporting Items for Systemic Reviews and Meta-Analyses guidelines was performed on the online databases MEDLINE, PsychInfo and CINAHL from May 2022 to July 2022. Identified studies were screened by title and abstract, and included if they were empirical studies and described an approach that supported the introduction of PC services for adult patients. A narrative-synthesis approach was used to extract and present the findings. RESULTS Searches yielded 1193 unique manuscripts, which, following title and abstract screening, were reduced to 31 papers subject to full-text review, with a final 12 studies meeting eligibility criteria. A diverse range of included studies described approaches used to introduce palliative care, which may be broadly summarised by four categories: education, clinical communication, building trust and rapport and integrative system approaches. CONCLUSION While educational approaches were helpful, they were less likely to change behaviours, with focused communication tasks also necessary to facilitate PC introduction. An established relationship and trust between patient and clinician were foundational to effective PC discussions. A framework to assist clinicians in this task is likely to be multidimensional in nature, although more quantitative research is necessary to establish the most effective methods and how they may be incorporated into clinical practice.
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Affiliation(s)
- Samuel Pointon
- Department of Medicine, St Vincent's Hospital, The University of Melbourne, Fitzroy, Victoria, Australia
| | - Anna Collins
- Department of Medicine, St Vincent's Hospital, The University of Melbourne, Fitzroy, Victoria, Australia
| | - Jennifer Philip
- Department of Medicine, St Vincent's Hospital, The University of Melbourne, Fitzroy, Victoria, Australia
- Department of Palliative Care, Peter MacCallum Cancer Centre, and Royal Melbourne Hospital, Parkville, Victoria, Australia
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Smith GM, Singh N, Hui F, Sossenheimer PH, Hannah JM, Romano P, Wong HN, Heidari SN, Harman SM. Education About Specialty Palliative Care Among Nonhealthcare Workers: A Systematic Review. J Pain Symptom Manage 2024; 67:e70-e89. [PMID: 37797678 DOI: 10.1016/j.jpainsymman.2023.09.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 08/15/2023] [Accepted: 09/16/2023] [Indexed: 10/07/2023]
Abstract
CONTEXT Despite the expansion of palliative care (PC) services, the public has little knowledge and holds misperceptions about PC, creating barriers to accessing timely specialty PC. OBJECTIVES To systematically review the evidence regarding the efficacy of educational interventions to improve knowledge and attitudes about PC among nonhealthcare workers. METHODS We searched five databases (PubMed/MEDLINE, Embase, CIANHL, Web of Science, and Scopus) for studies investigating educational interventions about specialty PC in adults who identified as patients, caregivers, or members of the public. We included studies that were available in English and had a comparator group. We excluded studies that only sampled health professionals or children. We used the Mixed Methods Appraisal Tool to assess quality and risk of bias. RESULTS Of 12,420 records identified, we screened 5948 abstracts and assessed 526 full texts for eligibility. Twenty-one articles were extracted for analysis, representing 20 unique educational interventions. Common methodologies included quasi-experimental (9, 45%), randomized controlled trial (4, 20%), and nonrandomized trial (2, 10%). Common components of the educational interventions included video presentations (9, 45%), written materials (8, 40%), and lectures (4, 20%). Content included definition (14, 70%) and philosophy (14, 70%) of PC, distinctions between PC and hospice (11, 55%), and eligibility for PC (11, 55%). Fourteen (70%) interventions showed statistically significant positive differences in either knowledge or attitudes about PC. CONCLUSIONS While educational interventions can positively impact knowledge and attitudes about PC among nonhealthcare workers, more research is needed to inform the design, delivery, and evaluation of interventions to increase knowledge and attitudes about PC.
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Affiliation(s)
- Grant M Smith
- Stanford University School of Medicine (G.M.S., N.S., F.H., P.H.S., H.W., S.N.H., S.M.H.), Stanford, CA.
| | - Nainwant Singh
- Stanford University School of Medicine (G.M.S., N.S., F.H., P.H.S., H.W., S.N.H., S.M.H.), Stanford, CA
| | - Felicia Hui
- Stanford University School of Medicine (G.M.S., N.S., F.H., P.H.S., H.W., S.N.H., S.M.H.), Stanford, CA
| | - Philip H Sossenheimer
- Stanford University School of Medicine (G.M.S., N.S., F.H., P.H.S., H.W., S.N.H., S.M.H.), Stanford, CA
| | - Josef M Hannah
- Stanford University School of Medicine (G.M.S., N.S., F.H., P.H.S., H.W., S.N.H., S.M.H.), Stanford, CA
| | - Pablo Romano
- Columbia University Vagelos College of Physicians and Surgeons (P.R.), New York, NY
| | - Hong-Nei Wong
- Stanford University School of Medicine (G.M.S., N.S., F.H., P.H.S., H.W., S.N.H., S.M.H.), Stanford, CA
| | - Shireen N Heidari
- Stanford University School of Medicine (G.M.S., N.S., F.H., P.H.S., H.W., S.N.H., S.M.H.), Stanford, CA
| | - Stephanie M Harman
- Stanford University School of Medicine (G.M.S., N.S., F.H., P.H.S., H.W., S.N.H., S.M.H.), Stanford, CA
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Edwards M, Holland‐Hart D, Mann M, Seddon K, Buckle P, Longo M, Byrne A, Nelson A. Understanding how shared decision-making approaches and patient aids influence patients with advanced cancer when deciding on palliative treatments and care: A realist review. Health Expect 2023; 26:2109-2126. [PMID: 37448166 PMCID: PMC10632651 DOI: 10.1111/hex.13822] [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] [Received: 03/29/2023] [Revised: 06/09/2023] [Accepted: 07/01/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Patients with advanced incurable cancer face difficult decisions about palliative treatment options towards their end of life. However, they are often not provided with the appropriate information and support that is needed to make informed decisions. This review aimed to identify contexts and mechanisms associated with communication tools, patient decision-aids and shared decision-making (SDM) approaches that influence patient outcomes. METHODS We used a realist review method to search for published studies of patients (adults > 18) with advanced cancer who were expected to make a decision about palliative treatment and/or supportive care in consultation with healthcare practitioners. We appraised and synthesised literature describing the contexts of (when and how) decision aids and SDM approaches are used, and how these contexts interact with mechanisms (resources and reasoning) which impact patient outcomes. Stakeholders including academics, palliative healthcare professionals (HCPs) and people with lived experience of supporting people with advanced incurable cancer contributed to identifying explanatory accounts. These accounts were documented, analysed and consolidated to contribute to the development of a programme theory. RESULTS From the 33 included papers, we consolidated findings into 20 explanatory accounts to develop a programme theory that explains key contexts and mechanisms that influence patient and SDM. Contexts include underlying patients' and HCPs' attitudes and approaches. These need to be understood in relation to key mechanisms, including presenting information in multiple formats and providing adequate time and opportunities to prepare for and revisit decisions. Contexts influenced mechanisms which then influence the levels of patient decisional satisfaction, conflict and regret. CONCLUSIONS Our programme theory highlights mechanisms that are important in supporting shared treatment decisions for advanced noncurative cancer. The findings are informative for developing and evaluating interventions to improve understanding and involvement in SDM for patients with advanced incurable cancer. PATIENT AND PUBLIC CONTRIBUTION We included patient and public involvement (PPI) representatives in four stakeholder meetings. PPI helped to define the scope of the review, identify their unique experiences and perspectives, synthesise their perspectives with our review findings, make decisions about which theories we included in our programme theory and develop recommendations for policy and practice and future research.
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Affiliation(s)
- Michelle Edwards
- Division of Population Medicine, Marie Curie Palliative Care Research CentreCardiff UniversityCardiffWalesUK
| | - Daniella Holland‐Hart
- Division of Population Medicine, Marie Curie Palliative Care Research CentreCardiff UniversityCardiffWalesUK
| | - Mala Mann
- Division of Population Medicine, Marie Curie Palliative Care Research CentreCardiff UniversityCardiffWalesUK
| | - Kathy Seddon
- Marie Curie Palliative Care Research CentreWales Cancer Research CentreCardiffWalesUK
| | - Peter Buckle
- Marie Curie Palliative Care Research CentreWales Cancer Research CentreCardiffWalesUK
| | - Mirella Longo
- Division of Population Medicine, Marie Curie Palliative Care Research CentreCardiff UniversityCardiffWalesUK
| | - Anthony Byrne
- Division of Population Medicine, Marie Curie Palliative Care Research CentreCardiff UniversityCardiffWalesUK
| | - Annmarie Nelson
- Division of Population Medicine, Marie Curie Palliative Care Research CentreCardiff UniversityCardiffWalesUK
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Gonçalves do Nascimento N, Venâncio Paes L, Ferreira Raiol Sousa I, Onceição de Lima FC, Conceição Dias Garcez J, Teixeira E, Sousa Ferreira D, Mariany Rêgo Lopes Ueno T. Validação de tecnologia educacional para familiares/cuidadores de pacientes oncológicos elegíveis aos cuidados paliativos no domicílio. REME: REVISTA MINEIRA DE ENFERMAGEM 2023. [DOI: 10.35699/2316-9389.2023.40756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023] Open
Abstract
Objetivo: validar o conteúdo de uma cartilha para melhorar a qualidade de vida no cotidiano de familiares/cuidadores de pacientes oncológicos em cuidados paliativos domiciliares. Métodos: estudo de caráter metodológico. Dados coletados de setembro de 2021 a maio de 2022. Os participantes foram 17 juízes especialistas, sendo 14 da área da saúde e 3 de outras áreas. Estudo mediado por um questionário estruturado de acordo com a escala Likert, possui itens dispostos em objetivos, estrutura, apresentação e relevância. Resultados: dos 21 itens do questionário dos juízes da área da saúde somente três resultaram em escore I (inadequado). Revela-se a tecnologia validada, pois conforme a literatura é necessário obter um índice de validação de conteúdo em pelo menos 70%, e o índice alcançado foi de 88%. Conforme as sugestões dos juízes produziu-se a versão adequação da tecnologia. Conclusão: considera-se que a cartilha está validada e com os ajustes poderá a promover o autocuidado, podendo reduzir desconhecimentos e dar mais qualidade de vida aos familiares/cuidadores de pacientes oncológicos em fim de vida.
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Information Provision, Decision Self-efficacy, and Decisional Conflict in Adopting Health Behaviors Among Patients Treated for Colorectal Cancer: A Cross-sectional Study. Cancer Nurs 2023; 46:45-56. [PMID: 34817417 DOI: 10.1097/ncc.0000000000001040] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Health promotion is necessary to mitigate the negative consequences of colorectal cancer and its treatment. Rates of behavior modification are low in populations of cancer patients. Studies are needed to determine the factors, such as decisional conflict, which influence adoption of healthy behaviors following a cancer diagnosis. OBJECTIVE To examine the effects of information provision, decision self-efficacy, and decisional conflict on the adoption of healthy behaviors among patients with colorectal cancer. METHODS This cross-sectional study focused on 251 patients with colorectal cancer in South Korea. Information provision, decision self-efficacy, and decisional conflict were measured using validated instruments. Patients rated their decisional conflict related to the adoption of behaviors that include regular exercise and a balanced diet. RESULTS Most participants (73%) reported low satisfaction with the amount of information received. Of the participants, 64% had low decision self-efficacy, and 80% experienced decisional conflict. The perception of a higher level of information provision was associated with greater decision self-efficacy (odds ratio, 4.63; 95% confidence interval, 1.61-13.35). Higher decision self-efficacy was associated with lower decisional conflict (odds ratio, 5.19; 95% confidence interval, 2.33-11.59). CONCLUSION Receiving adequate information is important for promoting patients' confidence in making decisions about their health and reducing decisional conflict in the adoption of healthy lifestyle changes following a cancer diagnosis. IMPLICATION FOR PRACTICE Oncology nurses should assess patient information needs and promote decision self-efficacy, thus empowering patients diagnosed with colorectal cancer to make lifestyle decisions that improve their health and quality of life.
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Zhao J, Abdallah M, Sanapala C, Watson E, LoCastro M, Castillo DA, Richardson D, LeBlanc TW, Loh KP. A Systematic Review of Decision Aids in Hematologic Malignancies: What Are Currently Available and What Are We Missing? Oncologist 2022; 28:105-115. [PMID: 36342114 PMCID: PMC9907042 DOI: 10.1093/oncolo/oyac231] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 09/27/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Patient decision aids (PDAs) are tools designed to facilitate decision-making. In this systematic review, we summarized existing studies on the development and evaluation of PDAs for patients with hematologic malignancies. PATIENTS AND METHODS We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched for articles in PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov. We included studies, abstracts, and clinical trial protocols available in English involving PDAs for patients age ≥18 diagnosed with a hematologic malignancy and/or their caregivers. Data were summarized using descriptive statistics. RESULTS Of the 5281 titles/abstracts screened, 15 were included: 1 protocol, 7 abstracts, and 7 full-texts. Six were PDA developmental studies, 6 were pilot studies, and 3 were randomized trials. PDA formats included electronic with web content, videos, and/or audio, questionnaires, bedside instruments, and a combination of various formats. Average participant age ranged from 36.0 to 62.4 years. Patients and caregivers identified efficacy, adverse effects, cost, and quality of life as important decision-making factors. PDAs were associated with increased knowledge and patient satisfaction as well as decreased decisional conflict and attitudinal barriers. Research on PDAs for adult patients with hematologic malignancies and their caregivers is limited. Among the studies, PDAs appear to support patients in shared decision-making. CONCLUSION While current literature examining the use of PDAs for adults with hematologic malignancies is limited, the positive impact of PDAs on shared decision-making and patient outcomes warrants additional research in this field.
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Affiliation(s)
- Janice Zhao
- Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA
| | - Maya Abdallah
- Section of Hematology and Medical Oncology, Boston University School of Medicine, Boston, MA, USA
| | - Chandrika Sanapala
- Section of Hematology and Medical Oncology, Boston University School of Medicine, Boston, MA, USA
| | - Erin Watson
- Department of Psychology, Princeton University, Princeton, NJ, USA
| | - Marissa LoCastro
- School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA
| | - Daniel A Castillo
- Edward G. Miner Library, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Daniel Richardson
- Division of Hematology, Department of Medicine, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Thomas W LeBlanc
- Department of Medicine, Hematologic Malignancies and Cellular Therapy, Duke University School of Medicine Durham, Durham, NC, USA
| | - Kah Poh Loh
- Corresponding author: Kah Poh Loh, MBBCh BAO, MS, Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center, 601 Elmwood Avenue, Box 704, Rochester, NY 14642, USA. Tel: +1 585 276 4353;
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Masoud B, Imane B, Naiire S. Patient awareness of palliative care: systematic review. BMJ Support Palliat Care 2021; 13:136-142. [PMID: 34635546 DOI: 10.1136/bmjspcare-2021-003072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 09/18/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND One of the barriers to the integration of palliative care within the process of patient care and treatment is the lack of awareness of patients about palliative care. In order to develop efficient resources to improve patient awareness, comprehensive information is required to determine the specific aspects of palliative care where a paucity of evidence on patient awareness exists. This review aims to synthesise evidence from previous studies in order to provide a comprehensive information set about the current state of patient awareness of palliative care. METHODS In this systematic literature review, PubMed, Scopus, Web of Science, ProQuest, Magiran, Scientific Information Database(SID) and Islamic Science Citation (ISC) were searched to identify articles published between 2000 and 2021 that considered patients' awareness of palliative care. RESULTS Of the 5347 articles found, 22 studies were retained after quality evaluation; three full-text articles were excluded. Nineteen articles are included in this review. More than half of the patients did not have any information about palliative care or hospice care. Some patients accurately defined hospice care and palliative care; other patients had misunderstandings about palliative care. Patients had limited information about pastoral care, social care and bereavement care. Patients' awareness about individuals or centres providing palliative care or hospice care was limited. Video presentation and distribution of information at the community level indicated that this method would be beneficial in increasing the awareness. CONCLUSION The review points to the need for patient education programmes and interventional studies to increase patients' awareness.
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Affiliation(s)
- Bahrami Masoud
- Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Bagheri Imane
- College of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Salmani Naiire
- Research Center for Nursing and Midwifery Care, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Laryionava K, Schildmann J, Wensing M, Wedding U, Surmann B, Woydack L, Krug K, Winkler E. Development and Evaluation of a Decision Aid to Support Patients' Participatory Decision-Making for Tumor-Specific and Palliative Therapy for Advanced Cancer: Protocol for a Pre-Post Study. JMIR Res Protoc 2021; 10:e24954. [PMID: 34533464 PMCID: PMC8486990 DOI: 10.2196/24954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 06/18/2021] [Accepted: 07/05/2021] [Indexed: 11/21/2022] Open
Abstract
Background To support advanced cancer patients and their oncologists in therapeutic decisions, we aim to develop a decision aid (DA) in a multiphased, bicentric study. The DA aims to help patients to better understand risks and benefits of the available treatment options including the options of standard palliative care or cancer-specific treatment (ie, off-label drug use within an individual treatment plan). Objective This study protocol outlines the development and testing of the DA in a pre-post study targeting a heterogeneous population of advanced cancer patients. Methods In the first step, we will assess patients’ information and decisional needs as well as the views of the health care providers regarding the content and implementation of the DA. Through a scoping review, we aim to analyze specific characteristics of the decision-making process and to specify the treatment options, outcomes, and probabilities. An interdisciplinary research group of experts will develop and review the DA. In the second step, testing of the DA (design and field testing) with patients and oncologists will be conducted. As a last step, we will run a pre-post design study with 70 doctor-patient encounters to assess improvements on the primary study outcome: patients’ level of decisional conflict. In addition, the user acceptance of all involved parties will be tested. Results Interviews with cancer patients, oncologists, and health care providers (ie, nurses, nutritionists) as well as a literature review from phase I have been completed. The field testing is scheduled for April 2021 to August 2021, with the final revision scheduled for September 2021. The pre-post study of the DA and acceptance testing are scheduled to start in October 2021 and shall be finished in September 2022. Conclusions A unique feature of this study is the development of a DA for patients with different types of advanced cancer, which covers a wide range of topics relevant for patients near the end of life such as forgoing cancer-specific therapy and switching to best supportive care. Trial Registration ClinicalTrials.gov NCT04606238; https://clinicaltrials.gov/ct2/show/NCT04606238. International Registered Report Identifier (IRRID) DERR1-10.2196/24954
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Affiliation(s)
- Katsiaryna Laryionava
- Institute for History and Ethics of Medicine, Centre for Health Sciences, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.,Department of Medical Oncology, National Center for Tumor Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Jan Schildmann
- Institute for History and Ethics of Medicine, Centre for Health Sciences, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Michael Wensing
- Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany
| | - Ullrich Wedding
- Palliative Care, Department of Internal Medicine II, University of Jena, Jena, Germany
| | - Bastian Surmann
- Health Economics and Health Care Management, Bielefeld University, Bielefeld, Germany
| | - Lena Woydack
- Department of Medical Oncology, National Center for Tumor Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Katja Krug
- Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany
| | - Eva Winkler
- Department of Medical Oncology, National Center for Tumor Diseases, Heidelberg University Hospital, Heidelberg, Germany
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Guan T, Qan'ir Y, Song L. Systematic review of illness uncertainty management interventions for cancer patients and their family caregivers. Support Care Cancer 2021; 29:4623-4640. [PMID: 33495851 PMCID: PMC8236440 DOI: 10.1007/s00520-020-05931-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 12/02/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE Illness uncertainty pervades individuals' experiences of cancer across the illness trajectory and is associated with poor psychological adjustment. This review systematically examined the characteristics and outcomes of interventions promoting illness uncertainty management among cancer patients and/or their family caregivers. METHODS PubMed, Scopus, PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, and Cochrane Database of Systematic Reviews were systematically searched for relevant literature. We included randomized controlled trials (RCTs) and quasi-experimental studies focusing on interventions for uncertainty management in cancer patients and/or their family caregivers. RESULTS Our database searches yielded 26 studies. Twenty interventions were only offered to cancer patients, who were mostly elder, female, and White. All interventions included informational support. Other intervention components included emotional support, appraisal support, and instrumental support. Most interventions were delivered in person and via telephone (n = 8) or exclusively in person (n = 7). Overall, 18 studies identified positive intervention effects on illness uncertainty outcomes. CONCLUSION This systematic review foregrounds the promising potential of several interventions-and especially multi-component interventions-to promote uncertainty management among cancer patients and their family caregivers. To further improve these interventions' effectiveness and expand their potential impact, future uncertainty management interventions should be tested among more diverse populations using rigorous methodologies.
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Affiliation(s)
- Ting Guan
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Yousef Qan'ir
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lixin Song
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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De Looper M, Damman O, Smets E, Timmermans D, Van Weert J. Adapting Online Patient Decision Aids: Effects of Modality and Narration Style on Patients' Satisfaction, Information Recall and Informed Decision Making. JOURNAL OF HEALTH COMMUNICATION 2020; 25:712-726. [PMID: 33256546 DOI: 10.1080/10810730.2020.1840674] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Audiovisual and narrative information are often used in online decision aids. However, few studies have tested whether these strategies are more effective compared to other types of information. We tested the effect of these strategies on satisfaction with the information, recall and informed decision-making in a 2 (Modality: audiovisual vs. textual) x 2 (Narration style: narrative vs. factual) experimental design. Data was collected in an online experiment among 262 analogue cancer patients. Since most cancer patients are older people, we also assessed if the effectiveness of these strategies differs depending on the patient's age. Data was analyzed using Structural Equation Modeling. Findings showed audiovisual modality had a positive effect on satisfaction. Moreover, audiovisual modality improved recall, both directly and indirectly via satisfaction, which subsequently resulted in better-informed decision-making. Narratives resulted in more satisfaction, but not better recall or informed decision-making. These effects were found in patients of all ages.
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Affiliation(s)
- Melanie De Looper
- Amsterdam School of Communication Research (ASCoR), University of Amsterdam , Amsterdam, The Netherlands
| | - Olga Damman
- Public and Occupational Health, VU University Medical Center/EMGO+ Institute dor Health and Care Research , Amsterdam, The Netherlands
| | - Ellen Smets
- Medical Psychology, Amsterdam UMC , Amsterdam, The Netherlands
| | - Danielle Timmermans
- Public and Occupational Health, VU University Medical Center/EMGO+ Institute dor Health and Care Research , Amsterdam, The Netherlands
| | - Julia Van Weert
- Amsterdam School of Communication Research (ASCoR), University of Amsterdam , Amsterdam, The Netherlands
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Reuter-Oppermann M, Müller-Polyzou R, Wirtz H, Georgiadis A. Influence of the pandemic dissemination of COVID-19 on radiotherapy practice: A flash survey in Germany, Austria and Switzerland. PLoS One 2020; 15:e0233330. [PMID: 32437381 PMCID: PMC7241763 DOI: 10.1371/journal.pone.0233330] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 05/04/2020] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has already changed our globalised world and its long-term impact is not yet known. It is apparent that businesses and institutions are increasingly affected. COVID-19 discussions often focus on intensive care units in hospitals. However, COVID-19 also effects life-saving and -prolonging radiotherapy for patients suffering from cancer. METHOD We have conducted a structured online survey among medical physicists in Germany, Austria and Switzerland from March 23rd to 26th 2020. In total 154 responses (82 completed, 72 partially completed) were analysed in the context of the COVID-19 dissemination. RESULTS 72.4% of the respondent's state that their processes are affected due to COVID-19, while the top three answers are longer processing times (54.2%), patient no-shows (42.5%) and staff reduction (36.7%). 75.8% expect further unavailability of their personnel in the upcoming weeks. All participants have already taken several measures, especially providing information for patients at the entrance (89.6%) or over the phone (73.6%), restricting access for accompanying persons (77.4%) and providing disinfectant at the entrance (72.6%). DISCUSSION The results presented in this article aim to support business continuity and risk management for radiotherapy centres to prepare for future challenges. The results show that most radiotherapy centres has implemented initial contingency measures, applying them pragmatically. The main problem however remains, that is the high risk of infection both for patients and medical personnel along with the associated risk of temporarily loss of personnel and ordered closure of business.
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Affiliation(s)
- Melanie Reuter-Oppermann
- Fachgebiet Wirtschaftsinformatik | Software & Digital Business, Technical University of Darmstadt, Darmstadt, Germany
| | - Ralf Müller-Polyzou
- Institut für Produkt- und Prozessinnovation, Leuphana Universität Lüneburg, Lüneburg, Germany
| | - Holger Wirtz
- Gemeinschaftspraxis für Strahlentherapie Singen-Friedrichshafen, Singen, Germany
| | - Anthimos Georgiadis
- Institut für Produkt- und Prozessinnovation, Leuphana Universität Lüneburg, Lüneburg, Germany
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