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Mack A, Arrigo M, Fink T, Garrity K, Cox D, Kwasnowski L, Wong J. Fatigue and functional outcomes in cancer rehabilitation. Support Care Cancer 2021; 29:8069-8076. [PMID: 34231039 DOI: 10.1007/s00520-021-06405-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 06/26/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Cancer-related fatigue (CRF) is one of the most common symptoms experienced by oncology patients, though its impact on functional outcomes during inpatient rehabilitation is relatively unknown. The purpose of this study is to determine whether CRF severity on admission is related to functional gains following standard rehabilitation care in an inpatient oncology rehabilitation population. METHODS A retrospective cohort study was conducted within an inpatient oncology unit at a long-term acute care hospital. Seventy-six patients admitted to the hospital between April and December 2015 with an oncology diagnosis, planned discharge, and completed standardized assessments of CRF and functional ability were included in this study. Patients received standard interdisciplinary rehabilitation services including physical and occupational therapy. CRF was assessed on admission using the Brief Fatigue Inventory, and functional abilities were assessed on admission and discharge using the basic mobility and daily activity domains of the Activity Measure for Post-Acute Care inpatient short forms (AM-PAC). RESULTS Ninety-seven percent of patients reported CRF, and 57% reported severe CRF upon admission. Patients demonstrated on average a 30% and 14% reduction in functional impairment in basic mobility and daily activity respectively during their admission. There was no significant correlation found between CRF on admission and change in functional impairment. CONCLUSION This study contributes to existing literature in that it found patients who received inpatient rehabilitation services demonstrate significant improvement in their functional status despite reporting CRF upon admission to a long-term acute care hospital oncology unit.
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Affiliation(s)
- Amanda Mack
- Spaulding Hospital for Continuing Medical Care Cambridge, 1575 Cambridge St, Cambridge, MA, 02138, USA. .,MGH Institute of Health Professions, 36 1st Avenue, Charlestown, MA, 02129, USA.
| | - Monica Arrigo
- Spaulding Hospital for Continuing Medical Care Cambridge, 1575 Cambridge St, Cambridge, MA, 02138, USA.,MGH Institute of Health Professions, 36 1st Avenue, Charlestown, MA, 02129, USA
| | - Twyla Fink
- Spaulding Hospital for Continuing Medical Care Cambridge, 1575 Cambridge St, Cambridge, MA, 02138, USA.,Salem State University, 352 Lafayette St, Salem, MA, 01970, USA
| | - Karla Garrity
- Spaulding Hospital for Continuing Medical Care Cambridge, 1575 Cambridge St, Cambridge, MA, 02138, USA
| | - David Cox
- MGH Institute of Health Professions, 36 1st Avenue, Charlestown, MA, 02129, USA
| | - Lauren Kwasnowski
- Spaulding Hospital for Continuing Medical Care Cambridge, 1575 Cambridge St, Cambridge, MA, 02138, USA.,MGH Institute of Health Professions, 36 1st Avenue, Charlestown, MA, 02129, USA
| | - John Wong
- MGH Institute of Health Professions, 36 1st Avenue, Charlestown, MA, 02129, USA
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Al Maqbali M, Gracey J, Dunwoody L, Rankin J, Hacker E, Hughes C. Healthcare professionals knowledge on cancer-related fatigue: A cross-sectional survey in Oman. Nurs Health Sci 2020; 22:732-740. [PMID: 32270899 DOI: 10.1111/nhs.12720] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 03/26/2020] [Accepted: 04/01/2020] [Indexed: 11/27/2022]
Abstract
Cancer-related fatigue is a common and distressing cancer symptom that negatively affects quality of life. The main objective of this study was to determine health professionals' knowledge relating to cancer patients' fatigue in Oman and identify current management practices of cancer-related fatigue. A cross-sectional survey design using Qualtrics® software was performed. The survey had five sections and comprised 32 items. A total of 138 healthcare professionals working in Oman participated in the study (response rate 63.9%). Nearly three quarters of the participants were nurses (74.6%, n = 103). The mean level of knowledge of cancer-related fatigue was 16.6/23, with 50% of participants having the expected level of knowledge above 12. The result indicated that professional discipline and work experience each were significantly associated with overall level of knowledge. Participants identified the need for guidelines, assessment tools, and training for the oncology staff to help improve the quality of life of patients with cancer-related fatigue.
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Affiliation(s)
- Mohammed Al Maqbali
- Institute of Nursing and Health Research, Ulster University, Newtownabbey, UK
| | - Jackie Gracey
- Institute of Nursing and Health Research, Ulster University, Newtownabbey, UK
| | - Lynn Dunwoody
- Psychology Research Institute, Ulster University, Coleraine, UK
| | - Jane Rankin
- Physiotherapy Department, Cancer Centre, Belfast Health and Social Care Trust, Belfast, UK
| | | | - Ciara Hughes
- Institute of Nursing and Health Research, Ulster University, Newtownabbey, UK
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3
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Hutchison NA, Deval N, Rabusch S, Rich H, Kelley T, Flinn N, Banerji N. Physical Therapy–Based Exercise Protocol for Cancer Patients: Evaluating Outcomes for Cardiopulmonary Performance and Cancer‐Related Fatigue. PM R 2019; 11:1178-1183. [DOI: 10.1002/pmrj.12128] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 01/16/2019] [Indexed: 02/06/2023]
Affiliation(s)
- Nancy A Hutchison
- Courage Kenny Rehabilitation Institute, Allina Health, Minneapolis, MN
| | - Nikita Deval
- Courage Kenny Rehabilitation Institute, Allina Health, Minneapolis, MN
| | - Stacey Rabusch
- Courage Kenny Rehabilitation Institute, Allina Health, Minneapolis, MN
| | - Holly Rich
- Courage Kenny Rehabilitation Institute, Allina Health, Minneapolis, MN
| | - Tom Kelley
- Courage Kenny Rehabilitation Institute, Allina Health, Minneapolis, MN
| | - Nancy Flinn
- Courage Kenny Rehabilitation Institute, Allina Health, Minneapolis, MN
| | - Nilanjana Banerji
- Courage Kenny Rehabilitation Institute, Allina Health, Minneapolis, MN
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Marco DJT, White VM. The impact of cancer type, treatment, and distress on health-related quality of life: cross-sectional findings from a study of Australian cancer patients. Support Care Cancer 2019; 27:3421-3429. [PMID: 30661203 DOI: 10.1007/s00520-018-4625-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 12/19/2018] [Indexed: 12/24/2022]
Abstract
PURPOSE This study examined the mediating effects of cancer type, treatment, and distress on health-related quality of life (HRQoL) for early diagnosis cancer patients. Results were interpreted with respect to established thresholds for clinical meaningfulness. METHODS A cross-sectional design was used. Patients completed surveys collecting demographics, cancer type, treatment, comorbid conditions, distress (HADS), and HRQoL (FACT-G). Hierarchical multivariate regressions examined associations between cancer type, treatment, and distress on HRQoL. Established minimum differences were used to identify clinically meaningful changes in HRQoL. RESULTS Of the 1183 patients surveyed, 21% were classified as having elevated anxiety and 13% had elevated depression. Our sample reported significantly lower physical and emotional well-being compared to population norms. Patients with prostate, melanoma, gynaecological, and urological cancers had higher HRQoL scores than those with colorectal cancer. However, when effects for treatment type and distress were considered, differences between cancer types became non-significant. Anxiety and depression were associated with lower HRQoL scores as was chemotherapy. Only depression, anxiety, and chemotherapy were associated with clinically meaningful decreases in HRQoL scores. CONCLUSIONS While statistically significant differences in HRQoL were found between different cancer types, only chemotherapy, anxiety, and depression produced clinically meaningful poorer HRQoL scores. In practice, clinically meaningful differences could promote a shift in resources toward interventions where a positive effect on patient well-being is appreciated by both the patient and health professional.
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Affiliation(s)
- David J T Marco
- Centre for Palliative Care, St Vincent's Hospital, Melbourne, Victoria, 3065, Australia
- Department of Medicine, University of Melbourne, Melbourne, Victoria, 3010, Australia
| | - Victoria M White
- School of Psychology, Deakin University, Melbourne, Victoria, 3125, Australia.
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, 3004, Australia.
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Wong J, Tran LT, Lynch KA, Wood LJ. Dexamethasone exacerbates cytotoxic chemotherapy induced lethargy and weight loss in female tumor free mice. Cancer Biol Ther 2018; 19:87-96. [PMID: 29231783 PMCID: PMC5790388 DOI: 10.1080/15384047.2017.1394549] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 10/15/2017] [Indexed: 02/08/2023] Open
Abstract
Cytotoxic chemotherapy can induce a systemic inflammatory response which has been proposed to be an underlying mechanism of cancer treatment related fatigue. Dexamethasone, a synthetic glucocorticoid that has potent anti-inflammatory effects, is incorporated into chemotherapy regimens to prevent chemotherapy-induced nausea and vomiting (CINV). The purpose of this study was to determine whether by suppressing cytotoxic chemotherapy-induced inflammation, dexamethasone could ameliorate chemotherapy induced fatigue/lethargy in tumor free mice. The effect of dexamethasone (DEX) on Cytoxan-Adriamycin (CA)-induced inflammation was assessed by measuring circulating levels of IL-1β, TNF-α, IL-6, GCSF, KC, and MCP-1 twenty-four-hours post CA injection. Decline in voluntary wheel running activity (VWRA) from baseline (used as a proxy for fatigue/lethargy), body weight and composition, and food intake were monitored in mice administered four cycles of CA every two weeks with or without DEX. CA increased circulating levels of IL-6, GCSF, KC, and MCP-1 and caused a rapid decline in VWRA and body weight immediately following CA-injection. Although the acute CA-induced decline in VWRA and body weight was not evident in mice administered CA + DEX, DEX alone had a suppressive effect on VWRA, and body weight continued to decline in mice administered both CA and DEX while it returned to baseline in CA-treated mice. CA or DEX alone had no long term impact on VWRA but DEX exacerbated lethargy and weight loss in CA-treated mice. Despite dampening the systemic inflammatory response to chemotherapy, dexamethasone failed to ameliorate acute or long term chemotherapy related fatigue/lethargy. Our pre-clinical findings suggest that supportive therapies like dexamethasone used to acutely control nausea and vomiting in cancer patients may actually contribute to overall symptom burden in cancer patients.
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Affiliation(s)
- John Wong
- School of Nursing, MGH Institute of Health Professions, Boston MA, USA
| | - Lisa T. Tran
- School of Nursing, MGH Institute of Health Professions, Boston MA, USA
| | - Kaari A. Lynch
- School of Nursing, MGH Institute of Health Professions, Boston MA, USA
| | - Lisa J. Wood
- School of Nursing, MGH Institute of Health Professions, Boston MA, USA
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Mardanian-Dehkordi L, Kahangi L. The Relationship between Perception of Social Support and Fatigue in Patients with Cancer. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2018; 23:261-266. [PMID: 30034484 PMCID: PMC6034531 DOI: 10.4103/ijnmr.ijnmr_63_17] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: Fatigue is one of the most common issues related to cancer. Social support has direct effects on health status and coping with illness. This study investigated the relationship between the perception of social support and fatigue in patients with cancer. Materials and Methods: This descriptive/correlational study was conducted in Omid Hospital in Isfahan, Iran in 2014. One hundred and twenty-five cancer patients receiving chemotherapy were included in the study. Study participants were selected using consecutive sampling. Data were collected using the Cancer Fatigue Scale (CFS), Perceived Social Support Scale, and a demographic characteristics questionnaire. The collected data were analyzed using descriptive and analytical statistical tests in SPSS software. Results: Mean (SD) of patients’ fatigue and perceived social support scores were 40.63 (11.59) out of 100 and 49.33 (7.85) out of 100, respectively. The Pearson correlation coefficient showed an inverse relationship between fatigue and social support, however, this relationship was not significant. Multiple regression test was used to detect which dimension of perceived social support was a better predictor of the reduction in fatigue score. This test showed that the best predictor was informational support (B = −0.35, p = 0.004). Conclusions: Results showed a negative relationship between fatigue and perceived social support in cancer patients undergoing chemotherapy. Therefore, social support interventions can help reduce fatigue.
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Affiliation(s)
- Leila Mardanian-Dehkordi
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - LeilaSadat Kahangi
- Nursing and Midwifery Sciences Development Research Center, Najafabad Branch, Islamic Azad University, Najafabad, Iran
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Abstract
BACKGROUND The 13-item Symptom Distress Scale (SDS) is a widely used symptom measurement tool, yet a systematic review summarizing the symptom knowledge generated from its use in patients with advanced cancer is nonexistent. OBJECTIVES This was a systematic review of the research literature in which investigators utilized the SDS as the measure of symptoms in patients with advanced cancer. METHODS We searched PubMed, CINAHL, EMBASE, and Web of Science for primary research studies published between 1978 and 2013 that utilized the SDS as the measurement tool in patients with advanced cancer. Nine hundred eighteen documents were found. Applying inclusion/exclusion criteria, 21 articles and 2 dissertations were included. RESULTS The majority of investigators utilized descriptive, cross-sectional research designs conducted with convenience samples. Inconsistent reporting of SDS total scores, individual item scores, age ranges and means, gender distributions, cancer types, cancer stages, and psychometric properties made comparisons difficult. Available mean SDS scores ranged from 17.6 to 38.8. Reports of internal consistency ranged from 0.67 to 0.88. Weighted means indicated fatigue to be the most prevalent and distressing symptom. Appetite ranked higher than pain intensity and pain frequency. CONCLUSIONS The SDS captures the patient's symptom experience in a manner that informs the researcher or clinician about the severity of the respondents' reported symptom distress. IMPLICATIONS FOR PRACTICE The SDS is widely used in a variety of cancer diagnoses. The SDS is a tool clinicians can use to assess 11 symptoms experienced by patients with advanced cancer.
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Stapleton SJ, Holden J, Epstein J, Wilkie DJ. Symptom clusters in patients with cancer in the hospice/palliative care setting. Support Care Cancer 2016; 24:3863-71. [PMID: 27079581 DOI: 10.1007/s00520-016-3210-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 04/05/2016] [Indexed: 11/30/2022]
Abstract
PURPOSE We determined commonly experienced symptoms reported by adult patients with cancer admitted to urban, ethnically diverse hospice settings and identified symptom clusters. METHODS We used hierarchical cluster analysis of 150 patients (41 % male, 20-92 years [M = 59, SD = 13.3], 51 % African American, 37 % Caucasian, 12 % other). Using pen-tablet computers, participants completed the Symptom Distress Scale (SDS), a sleep quality item, and listed analgesics consumed in the previous 24 h. RESULTS Four symptom clusters were identified: cluster 1 (Pain-Fatigue) consisted of pain frequency, fatigue, and pain intensity; cluster 2 (Ingestion-Elimination) consisted of appetite and bowel problems; cluster 3 (General Well-Being) consisted of insomnia, appearance, and outlook; and cluster 4 (Respiratory-Nausea-Concentration) consisting of breathing, cough, nausea frequency, nausea intensity, and concentration. There were no significant differences between Caucasians and African Americans on total SDS scores, analgesic consumption, sleep quality, or most cluster scores. CONCLUSION This is the first symptom cluster analysis in a US sample with a sizeable proportion of minority hospice/palliative care patients with cancer. Further research to determine the stability of identified symptom clusters over time and discovery of the biological interactions of symptoms within the cluster may lead to symptom management therapies designed for the alleviation of all clustered symptoms.
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Affiliation(s)
- Stephen J Stapleton
- Mennonite College of Nursing, Illinois State University, 210 Edwards Hall, Campus Box 5810, Normal, IL, 61790, USA.
| | - Janean Holden
- School of Nursing, University of Michigan, 400 North Ingalls Building, Ann Arbor, MI, 48109-5482, USA
| | - Joel Epstein
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.,City of Hope National Medical Center, 1500 Duarte Rd, Duarte, CA, 91010, USA
| | - Diana J Wilkie
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, 1225 Center Drive, Room 2203, Gainesville, FL, 32610, USA
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Filler K, Lyon D, McCain N, Bennett J, Fernández-Martínez JL, deAndrés-Galiana EJ, Elswick RK, Lukkahatai N, Saligan L. Relationship of Mitochondrial Enzymes to Fatigue Intensity in Men With Prostate Cancer Receiving External Beam Radiation Therapy. Biol Res Nurs 2015; 18:274-80. [PMID: 26584846 DOI: 10.1177/1099800415617848] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
PURPOSE Mitochondrial dysfunction is a plausible biological mechanism for cancer-related fatigue. Specific aims of this study were to (1) describe the levels of mitochondrial oxidative phosphorylation complex (MOPC) enzymes, fatigue, and health-related quality of life (HRQOL) before and at completion of external beam radiation therapy (EBRT) in men with nonmetastatic prostate cancer (PC); (2) examine relationships over time among levels of MOPC enzymes, fatigue, and HRQOL; and (3) compare levels of MOPC enzymes in men with clinically significant and nonsignificant fatigue intensification during EBRT. METHODS Fatigue was measured by the revised Piper Fatigue Scale and the Functional Assessment of Cancer Therapy-Fatigue subscale (FACT-F). MOPC enzymes (Complexes I-V) and mitochondrial antioxidant superoxide dismutase 2 were measured in peripheral blood using enzyme-linked immunosorbent assay at baseline and completion of EBRT. Participants were categorized into high or low fatigue (HF vs. LF) intensification groups based on amount of change in FACT-F scores during EBRT. RESULTS Fatigue reported by the 22 participants with PC significantly worsened and HRQOL significantly declined from baseline to EBRT completion. The HF group comprised 12 men with clinically significant change in fatigue (HF) during EBRT. Although no significant changes were observed in MOPC enzymes from baseline to EBRT completion, there were important differences in the patterns in the levels of MOPC enzymes between HF and LF groups. CONCLUSION Distinct patterns of changes in the absorbance of MOPC enzymes delineated fatigue intensification among participants. Further investigation using a larger sample is warranted.
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Affiliation(s)
- Kristin Filler
- National Institute of Nursing Research (NINR), National Institutes of Health (NIH), Bethesda, MD, USA
| | - Debra Lyon
- University of Florida, Gainesville, FL, USA
| | - Nancy McCain
- Virginia Commonwealth University, Richmond, VA, USA
| | - James Bennett
- Department of Neurology, Virginia Commonwealth University, Richmond, VA, USA
| | | | | | - R K Elswick
- Virginia Commonwealth University, Richmond, VA, USA
| | | | - Leorey Saligan
- National Institute of Nursing Research (NINR), National Institutes of Health (NIH), Bethesda, MD, USA
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10
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Defining cancer-related fatigue for biomarker discovery. Support Care Cancer 2015; 24:5-7. [PMID: 26438143 DOI: 10.1007/s00520-015-2965-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 09/21/2015] [Indexed: 12/28/2022]
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Bryant AL, Deal AM, Walton A, Wood WA, Muss H, Mayer DK. Use of ED and hospital services for patients with acute leukemia after induction therapy: one year follow-up. Leuk Res 2015; 39:406-10. [PMID: 25711944 PMCID: PMC4879586 DOI: 10.1016/j.leukres.2015.01.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 01/07/2015] [Accepted: 01/15/2015] [Indexed: 12/21/2022]
Abstract
Previous studies have documented use of health care services by oncology patients in the Emergency Department (ED), but little is known about the utilization of health services of patients with acute leukemia after induction therapy. The aim of this study was to examine chief reasons for ED and hospital use by patients newly diagnosed with acute leukemia patients after induction therapy up to one year after discharge. A retrospective, longitudinal study of all visits to the ED or unplanned hospital admissions at a single institution for patients with acute leukemia was conducted. Inclusion criteria were patients ≥18 years of age at time of diagnosis, a confirmed diagnosis of AML or ALL, and received and discharged from induction treatment between 2007 and 2010. Donabedian's structure-process-outcome framework guided this study examining health services utilization and assessing patient outcomes. 80 patients met the inclusion criteria; 52 had AML and 28 had ALL; median age was 48 (range: 18-76) and 29% (n=23) were non-Caucasian. 70% (n=56) were discharged from induction in remission. 81% (n=65) had at least 1 ED or hospitalization event, and 44% (n=35) had 2 or more events. Of 137 events in 65 patients, the most common reason was neutropenic fever/infection (55%), bleeding (12%), and GI problems (11%). Mean number of events for ALL was 2.43 compared to 1.33 for AML patients (p=0.02), and 2.23 for <50 years of age compared to 1.20 for those older (p=0.002). 20 patients died within one year of diagnosis. Findings from this study can help inform health services delivery and utilization among patients with acute leukemia after induction therapy. Oncology providers can anticipate discharge needs and enhance follow-up care for those at higher risk for problems needing hospitalization.
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Affiliation(s)
- Ashley Leak Bryant
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
| | - Allison M Deal
- Lineberger Comprehensive Cancer Center Biostatistics Core, The University of North Carolina at Chapel Hill, United States.
| | - AnnMarie Walton
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; Lineberger Comprehensive Cancer Center Biostatistics Core, The University of North Carolina at Chapel Hill, United States; University of Utah College of Nursing, United States.
| | - William A Wood
- Division of Hematology/Oncology, The University of North Carolina at Chapel Hill, United States.
| | - Hyman Muss
- Division of Hematology/Oncology, The University of North Carolina at Chapel Hill, United States.
| | - Deborah K Mayer
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
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Yang EJ, Chung SH, Jeon JY, Seo KS, Shin HI, Hwang JH, Lim JY. Current Practice and Barriers in Cancer Rehabilitation: Perspectives of Korean Physiatrists. Cancer Res Treat 2015; 47:370-8. [PMID: 25672583 PMCID: PMC4506115 DOI: 10.4143/crt.2014.084] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 06/13/2014] [Indexed: 11/24/2022] Open
Abstract
Purpose The purpose of this study was to assess clinical practice and barriers associated with cancer rehabilitation from the perspective of Korean physiatrists. Materials and Methods All active members of the Korean Academy of Rehabilitation Medicine were invited to complete an online survey developed after focus group discussions. Results A total of 97 physiatrists (72 males and 25 females) in Korea completed the survey. Of these, 77% reported familiarity with the term 'cancer survivors.' More than 50% of respondents reported that they provided rehabilitation services for patients with breast cancer (61.9%), brain tumors (64.9%), and spinal tumors (63.9%), whereas 86.6% of respondents reported that they had never or rarely provided rehabilitation programs for patients with gynecological, colorectal, or prostate cancer. Physiatrists who received referrals from a well-organized cooperative referral system reported providing services such as exercise programs for patients with gynecological cancer (odds ratio [OR], 2.16; p=0.044) as well as education regarding lymphedema (OR, 1.81; p=0.047) and neuropathic pain (OR, 1.96; p=0.026). Conclusion Although most of the physiatrists surveyed believed that they should contribute to the management of cancer patients, they considered themselves ill equipped to provide appropriate rehabilitation services. This lack of understanding of the effectiveness of rehabilitation services for cancer patients and absence of a cooperative referral system are the major barriers to providing rehabilitation services to cancer survivors in Korea.
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Affiliation(s)
- Eun Joo Yang
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University, College of Medicine, Seongnam, Korea
| | - Seung Hyun Chung
- Department of Physical Medicine and Rehabilitation, National Cancer Center, Goyang, Korea
| | - Jae-Yong Jeon
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kwan Sik Seo
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Hyung-Ik Shin
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University, College of Medicine, Seongnam, Korea
| | - Ji Hye Hwang
- Department of Physical Medicine and Rehabilitation, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae-Young Lim
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University, College of Medicine, Seongnam, Korea
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Rogers VE, Zhu S, Ancoli-Israel S, Hinds PS. Impairment in circadian activity rhythms occurs during dexamethasone therapy in children with leukemia. Pediatr Blood Cancer 2014; 61:1986-91. [PMID: 25066691 PMCID: PMC7416508 DOI: 10.1002/pbc.25147] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Accepted: 05/21/2014] [Indexed: 12/20/2022]
Abstract
BACKGROUND Circadian rhythm disturbances in adults with cancer are associated with fatigue, time to relapse, and death. This study of circadian activity rhythms (CAR) of children with acute lymphoblastic leukemia (ALL) on continuation chemotherapy aimed to describe CAR before and after starting dexamethasone, and to determine whether fatigue was associated with less robust CAR. PROCEDURE This was a secondary analysis of data from a multi-institutional study in which children with ALL aged 5-18 years wore an actigraph for 10 consecutive 24-hour periods, five before and five during dexamethasone therapy. CAR parameters measured by actigraphy were calculated for each 5-day period, including peak activity, MESOR, amplitude, acrophase, and circadian quotient. Fatigue was measured on study days 2, 5, 7, and 10 by parent-report and self-report for children ≥ 7 years. RESULTS Eighty-two children qualified for CAR analysis, and 87 for analysis of daily peak activity patterns and fatigue. Mean age was 8.8 ± 3.3 years. Peak activity, MESOR, and amplitude significantly decreased during dexamethasone therapy. Children on high-dose dexamethasone (8 or 12 mg/m(2)/d) had significantly higher (better, or more robust) values of several CAR parameters than those on low-dose (6 mg/m(2)/d). There was a significant trend of decreasing daily pattern of peak activity during dexamethasone therapy only. Fatigue increased across the study and was associated with decreasing CAR peak activity, MESOR, and amplitude. CONCLUSIONS Dexamethasone initiation was associated with a decrease in several CAR parameters, and a significant decrease in the trend of daily peak activity. Fatigue was associated with less robust CAR.
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Affiliation(s)
| | | | | | - Pamela S. Hinds
- Children’s National Medical Center, George Washington University
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Sucala M, Schnur JB, Brackman EH, David D, Montgomery GH. The role of specific and core dysfunctional beliefs in breast cancer radiotherapy patients' fatigue. J Health Psychol 2014; 19:957-65. [PMID: 23632136 PMCID: PMC3835755 DOI: 10.1177/1359105313482166] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
The goal of the study was to examine the relationships among fatigue catastrophizing, core dysfunctional beliefs, and fatigue in breast cancer radiotherapy patients. Seventy-eight patients participated in the study (mean age = 56.3, standard deviation = 10.5). Patients completed questionnaires on fatigue catastrophizing, core dysfunctional beliefs, and fatigue in their last week of radiotherapy. Using bootstrapping procedures to obtain estimates and confidence intervals for indirect effects, results showed that core beliefs (Need for Comfort and Demandingness for Fairness) had significant indirect effects on fatigue through fatigue catastrophizing, as indicated by the 95 percent confidence interval (.02-.19 for Need for Comfort; .01-.16 for Demandingness for Fairness).
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Affiliation(s)
- Madalina Sucala
- Icahn School of Medicine at Mount Sinai, USA Babes-Bolyai University, Romania
| | | | | | - Daniel David
- Icahn School of Medicine at Mount Sinai, USA Babes-Bolyai University, Romania
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15
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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: 2.6] [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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Kraft K. CAM for depression, anxiety, grief, and other symptoms in palliative care. PROGRESS IN PALLIATIVE CARE 2013. [DOI: 10.1179/1743291x12y.0000000020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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[Psychosocial issues of long-term cancer survivors]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2012; 55:501-8. [PMID: 22441520 DOI: 10.1007/s00103-012-1458-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Although cancer incidence rates are increasing, recent statistical studies suggest that cancer patients are showing higher cure rates as well as improved overall survival rates for most cancer locations. These advances are explained by improved strategies in early diagnoses as well as improved cancer therapies. Therefore, the number of long-term cancer survivors has also increased, but only few studies, especially within the last years, have focused on psychosocial issues of this subgroup. Some studies show that overall quality of life of long-term cancer survivors is quite high and comparable to that of the normal population. Nevertheless, a substantial percentage of former patients shows reduced quality of life and suffers from various sequelae of cancer and its treatment. This review focuses on the most common psychosocial issue of long-term survivors such as reduced psychological wellbeing, neuropsychological deficits and cancer-related fatigue syndrome. Finally, recommendations for problem-oriented interventions as well as improvement of psychosocial care of long-term survivors are given.
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Bauml J, Xie SX, Penn C, Desai K, Dong KW, Bruner DW, Vapiwala N, Mao JJ. A Pragmatic Evaluation of the National Cancer Institute Physician Data Query (PDQ)®-Based Brief Counseling on Cancer-Related Fatigue among Patients Undergoing Radiation Therapy. ACTA ACUST UNITED AC 2012; 2. [PMID: 29479490 PMCID: PMC5824725 DOI: 10.4172/2165-7386.1000125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Purpose Cancer-Related Fatigue (CRF) negatively affects quality of life among cancer patients. This study seeks to evaluate the outcome and patient receptiveness of a brief counseling program based on National Cancer Institute (NCI) PDQ® information to manage CRF when integrated into Radiation Therapy (RT). Methods We conducted a prospective cohort study among patients undergoing non-palliative RT. Patients with stage I–III tumors and with Karnofsky score 60 or better were given a ten-minute behavioral counseling session during the first two weeks of RT. The Brief Fatigue Inventory (BFI) was administered at baseline/end of RT. Results Of 93 patients enrolled, 89% found the counseling useful and practical. By the end of RT, 59% reported increased exercise, 41.6% sought nutrition counseling, 72.7% prioritized daily activities, 74.4% took daytime naps, and 70.5% talked with other cancer patients. Regarding counseling, patients who had received chemotherapy prior to RT had no change in fatigue (−0.2), those who received RT alone had mild increase in fatigue (0.7, p=0.02), and those who received concurrent chemotherapy experienced a substantial increase in fatigue (3.0 to 5.2, p=0.05). Higher baseline fatigue and receipt of chemotherapy were predictive of worsened fatigue in a multivariate model (both p<0.01). Conclusion Our data suggests that brief behavioral counseling based on NCI guidelines is well accepted by patients showing an uptake in many activities to cope with CRF. Those who receive concurrent chemotherapy and with higher baseline fatigue are at risk for worsening fatigue despite of guideline-based therapy.
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Affiliation(s)
- Joshua Bauml
- Abramson Cancer Center, University of Pennsylvania, 3400 Spruce Street/2 Gates, Philadelphia, Pennsylvania 19104, USA
| | - Sharon X Xie
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, 3400 Spruce Street/2 Gates, Philadelphia, Pennsylvania 19104, USA
| | - Courtney Penn
- Department of Family Medicine and Community Health, University of Pennsylvania, 3400 Spruce Street/2 Gates, Philadelphia, Pennsylvania 19104, USA
| | - Krupali Desai
- Department of Family Medicine and Community Health, University of Pennsylvania, 3400 Spruce Street/2 Gates, Philadelphia, Pennsylvania 19104, USA
| | - Kimberly W Dong
- Department of Family Medicine and Community Health, University of Pennsylvania, 3400 Spruce Street/2 Gates, Philadelphia, Pennsylvania 19104, USA
| | - Deborah Watkins Bruner
- Abramson Cancer Center, University of Pennsylvania, 3400 Spruce Street/2 Gates, Philadelphia, Pennsylvania 19104, USA.,Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street/2 Gates, Philadelphia, Pennsylvania 19104, USA.,Woodruff School of Nursing, University of Emory, Georgia 30322, USA
| | - Neha Vapiwala
- Abramson Cancer Center, University of Pennsylvania, 3400 Spruce Street/2 Gates, Philadelphia, Pennsylvania 19104, USA.,Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street/2 Gates, Philadelphia, Pennsylvania 19104, USA
| | - Jun James Mao
- Abramson Cancer Center, University of Pennsylvania, 3400 Spruce Street/2 Gates, Philadelphia, Pennsylvania 19104, USA.,Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, 3400 Spruce Street/2 Gates, Philadelphia, Pennsylvania 19104, USA.,Department of Family Medicine and Community Health, University of Pennsylvania, 3400 Spruce Street/2 Gates, Philadelphia, Pennsylvania 19104, USA
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de Oliveira Campos MP, Riechelmann R, Martins LC, Hassan BJ, Casa FBA, Giglio AD. Guarana (Paullinia cupana) Improves Fatigue in Breast Cancer Patients Undergoing Systemic Chemotherapy. J Altern Complement Med 2011; 17:505-12. [PMID: 21612429 DOI: 10.1089/acm.2010.0571] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - Rachel Riechelmann
- Department of Medical Oncology and Hematology, ABC School of Medicine, Santo André, Sao Paulo, Brazil
| | | | | | | | - Auro Del Giglio
- Department of Medical Oncology and Hematology, ABC School of Medicine, Santo André, Sao Paulo, Brazil
- Department of Oncology, Albert Einstein Hospital, São Paulo, Brazil
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Mitchell SA. Cancer-Related Fatigue: State of the Science. PM R 2010; 2:364-83. [DOI: 10.1016/j.pmrj.2010.03.024] [Citation(s) in RCA: 114] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2009] [Accepted: 03/21/2010] [Indexed: 01/17/2023]
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