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Escobar Y, Ramchandani A, Salgado M, Castillo-Trujillo A, Martínez de Castro E, Diaz de Corcuera I, Vera R, Lacalle A, Torres I, Pérez Segura P, Hierro C, Soto de Prado D, Cotes A, Marín Zafra G, Marsé Fabregat R, Virizuela J, Villa JC, Borrega P, Jimenez-Fonseca P. What do patients and oncologists think about the evaluation and management of cancer-related anorexia-cachexia? The Quasar_SEOM study. Clin Transl Oncol 2023; 25:3479-3491. [PMID: 37289352 DOI: 10.1007/s12094-023-03212-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 04/29/2023] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Cancer patients often suffer from malnutrition and early detection and raising awareness of nutritional issues is crucial in this population. METHODS The Spanish Oncology Society (SEOM) conducted the Quasar_SEOM study to investigate the current impact of the Anorexia-Cachexia Syndrome (ACS). The study employed questionnaires and the Delphi method to gather input from both cancer patients and oncologists on key issues related to early detection and treatment of ACS. A total of 134 patients and 34 medical oncologists were surveyed about their experiences with ACS. The Delphi methodology was used to evaluate oncologists' perspectives of ACS management, ultimately leading to a consensus on the most critical issues. RESULTS Despite widespread acknowledgement of malnutrition in cancer as a significant issue by 94% of oncologists, the study revealed deficiencies in knowledge and protocol implementation. A mere 65% of physicians reported being trained to identify and treat these patients, with 53% failing to address ACS in a timely manner, 30% not monitoring weight, and 59% not adhering to any clinical guidelines. The lack of experience was identified as the primary hindrance to the use of orexigens in 18% of cases. Furthermore, patients reported concerns and a perception of inadequate attention to malnutrition-related issues from their physicians. CONCLUSION The results of this study point to a gap in the care of this syndrome and a need to improve education and follow-up of cancer patients with anorexia-cachexia.
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Affiliation(s)
- Yolanda Escobar
- Medical Oncology Department, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - Avinash Ramchandani
- Medical Oncology Department, Hospital Universitario Insular de Gran Canaria, Las Palmas, Spain
| | | | - Alfredo Castillo-Trujillo
- Medical Oncology Department, Hospital Universitario Central de Asturias, ISPA, Avenida de Roma s/n, Oviedo, Spain
| | - Eva Martínez de Castro
- Medical Oncology Department, Hospital Universitario Marqués de Valdecilla, IDIBAL, Santander, Spain
| | | | - Ruth Vera
- Medical Oncology Department, Complejo Hospitalario de Navarra, Pamplona, Spain
| | | | - Irene Torres
- Medical Oncology Department, Hospital Clínico Universitario Lozano Bleza, Zaragoza, Spain
| | - Pedro Pérez Segura
- Medical Oncology Department, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - Cinta Hierro
- Medical Oncology Department, Instituto Catalán de Oncología (ICO), Badalona, Spain
| | - Diego Soto de Prado
- Medical Oncology Department, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Almudena Cotes
- Medical Oncology Department, Hospital Universitario de Elda, Elda, Spain
| | - Gema Marín Zafra
- Medical Oncology Department, Hospital General Universitario Morales Meseguer, Murcia, Spain
| | | | - Juan Virizuela
- Medical Oncology Department, Hospital Universitario Virgen de La Macarena, Sevilla, Spain
| | - Jose Carlos Villa
- Medical Oncology Department, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | - Pablo Borrega
- Medical Oncology Department, Hospital San Pedro de Alcántara, Cáceres, Spain
| | - Paula Jimenez-Fonseca
- Medical Oncology Department, Hospital Universitario Central de Asturias, ISPA, Avenida de Roma s/n, Oviedo, Spain.
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Ince Y, Yildirim Usta Y. The Effect on Nausea and Vomiting of Structured Education Given to Male Lung Cancer Patients Receiving Chemotherapy. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2020; 35:788-795. [PMID: 31037505 DOI: 10.1007/s13187-019-01531-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The objective of this study was to investigate the effect on nausea and vomiting of structured education given to male lung cancer patients receiving chemotherapy. This quasi-experimental research study had pre- and post-tests control groups. The estimated sample size was at least 20 subjects per group. Data were collected in the chest diseases clinic and outpatient chemotherapy unit of a university hospital in Turkey. An education booklet and structured education were given 30 mins for each patient before chemotherapy. In post-test 1, nausea severity was significantly lower in the experimental group than in the control group (mean difference - 2.50, 95% CI - 1.46 to - 0.17, d = 0.82, p = 0.05). This was also the case in post-test 2 (mean difference - 2.10, 95% CI - 1.50 to - 0.21, d = 0.85, p = 0.01). According to this, the sizes of Cohen's d effect were large (0.82 and 0.85 for post-test 1 and post-test 2 respectively). However, vomiting frequency did not differ significantly between the experimental group and the control group in either post-test 1 or post-test 2 (p > 0.05). Structured education given by nurses had a positive effect on the severity of nausea. Nurses may be able to raise nausea management in cancer patients to a better level by education intervention.
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Affiliation(s)
- Yasemin Ince
- Sterilization Unit, Izzet Baysal Training and Research Hospital, Bolu Abant Izzet Baysal University, PO 14280, Golkoy/Bolu, Turkey.
| | - Yasemin Yildirim Usta
- Department of Internal Medicine Nursing, Bolu Health School, Bolu Abant Izzet Baysal University, PO 14280, Golkoy/Bolu, Turkey
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Paterson C, Kozlovskaia M, Turner M, Strickland K, Roberts C, Ogilvie R, Pranavan G, Craft P. Identifying the supportive care needs of men and women affected by chemotherapy-induced alopecia? A systematic review. J Cancer Surviv 2020; 15:14-28. [PMID: 32683651 DOI: 10.1007/s11764-020-00907-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 06/14/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE To systematically evaluate evidence regarding the unmet supportive care needs of men and women affected by chemotherapy-induced alopecia (CIA) to inform clinical practice guidelines. METHODS We performed a review of CINAHL, MEDLINE, PsychINFO, Scopus, the Cochrane Library (CCRT and CDSR) controlled trial databases and clinicaltrials.gov from January 1990 to June 2019 according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement. Twenty-seven publications were selected for inclusion in this analysis. RESULTS Included reports used qualitative (ten) and quantitative (17) studies. Across these studies men and women reported the major impact that CIA had on their psychological well-being, quality of life and body image. Hair loss had a negative impact irrespective of gender, which resulted in feelings of vulnerability and visibility of being a "cancer patient". Men and women described negative feelings, often similar, related to CIA with a range of unmet supportive care needs. CONCLUSIONS Some patients are not well-prepared for alopecia due to a lack of information and resources to reduce the psychological burden associated with CIA. Hair loss will affect each patient and their family differently, therefore, intervention and support must be tailored at an individual level of need to optimise psychological and physical well-being and recovery. IMPLICATIONS FOR CANCER SURVIVORS People affected by CIA may experience a range of unmet supportive care needs, and oncology doctors and nurses are urged to use these findings in their everyday consultations to ensure effective, person-centred care and timely intervention to minimise the sequalae associated with CIA.
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Affiliation(s)
- C Paterson
- Faculty of Health, School of Nursing, Midwifery & Public Health, University of Canberra ACT, Canberra, 2601, Australia.
- Australian Capital Territory (ACT) Health & Canberra Health Services, Canberra, Australia.
- SYNERGY Nursing & Midwifery, Research Centre, ACT Health Directorate, Canberra Hospital, Canberra, Australia.
- Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research group, University of Canberra, Canberra, ACT, Australia.
- Robert Gordon University, Aberdeen, Scotland.
| | - M Kozlovskaia
- Faculty of Health, School of Nursing, Midwifery & Public Health, University of Canberra ACT, Canberra, 2601, Australia
- SYNERGY Nursing & Midwifery, Research Centre, ACT Health Directorate, Canberra Hospital, Canberra, Australia
| | - M Turner
- Faculty of Health, School of Nursing, Midwifery & Public Health, University of Canberra ACT, Canberra, 2601, Australia
| | - K Strickland
- Faculty of Health, School of Nursing, Midwifery & Public Health, University of Canberra ACT, Canberra, 2601, Australia
- SYNERGY Nursing & Midwifery, Research Centre, ACT Health Directorate, Canberra Hospital, Canberra, Australia
- Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research group, University of Canberra, Canberra, ACT, Australia
| | - C Roberts
- Faculty of Health, School of Nursing, Midwifery & Public Health, University of Canberra ACT, Canberra, 2601, Australia
- Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research group, University of Canberra, Canberra, ACT, Australia
| | - R Ogilvie
- Faculty of Health, School of Nursing, Midwifery & Public Health, University of Canberra ACT, Canberra, 2601, Australia
- Australian Capital Territory (ACT) Health & Canberra Health Services, Canberra, Australia
- SYNERGY Nursing & Midwifery, Research Centre, ACT Health Directorate, Canberra Hospital, Canberra, Australia
| | - G Pranavan
- Australian Capital Territory (ACT) Health & Canberra Health Services, Canberra, Australia
- Australian National University, Canberra, Australia
| | - P Craft
- Australian Capital Territory (ACT) Health & Canberra Health Services, Canberra, Australia
- Australian National University, Canberra, Australia
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Abdollahi R, Najafi S, Razmpoosh E, Shoormasti RS, Haghighat S, Raji Lahiji M, Chamari M, Asgari M, Cheshmazar E, Zarrati M. The Effect of Dietary Intervention Along with Nutritional Education on Reducing the Gastrointestinal Side Effects Caused by Chemotherapy Among Women with Breast Cancer. Nutr Cancer 2019; 71:922-930. [PMID: 30945949 DOI: 10.1080/01635581.2019.1590608] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Gastrointestinal (GI) side effects caused by chemotherapy in women with breast cancer are common but poorly understood which might be controlled by nutritional intervention. Thus, the major aim of this study was to assess the effect of dietary intervention along with nutritional education on reducing these side effects. The present study is a single-center, single-controlled, and randomized trial. A total of 150 patients with breast cancer undergoing chemotherapy were randomly assigned into intervention group to receive dietary intervention and nutritional education (n = 73) or control group (n = 67) for 10 weeks, after their three sessions of chemotherapy. The primary endpoint was the GI symptoms after each session of chemotherapy that were measured by a designed questionnaire based on ROMIII questionnaire. The severity of GI side effects in the dietary intervention along with nutritional education was decreased significantly in the third session of chemotherapy compared to the first session, which include reflux disorder (P = 0.05), anorexia (P < 0.001), nausea (P = 0.002), constipation (P < 0.001), and diarrhea (P < 0.001). Moreover, significant reductions were observed in the severity of GI side effects in the intervention group compared to control group after the third session (P < 0.001). After adjusting the analysis for baseline values including age, job, education level, weight, and body mass index, significant changes were observed for GI side effects in the intervention group compared to the control group (P < 0.001). This study showed beneficial effects of individualized dietary intervention along with nutritional education on reducing diarrhea, constipation, vomiting, and nausea in women with breast cancer during the chemotherapy.
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Affiliation(s)
- Reihaneh Abdollahi
- a Faculty of Nutrition School of Public Health , Iran University of Medical Sciences , Tehran , Iran
| | - Safa Najafi
- b Breast Disease Department , Motamed Cancer Institute, ACER , Tehran , Iran
| | - Elham Razmpoosh
- c Nutrition and Food Security Research Center , Shahid Sadoughi University of Medical Sciences , Yazd , Iran.,d Department of Nutrition, Faculty of Health , Shahid Sadoughi University of Medical Sciences , Yazd , Iran
| | | | - Shahpar Haghighat
- f Department of Quality of Life, Breast Cancer Research Center, Motamed Cancer Institute, ACECR , Tehran , Iran
| | - Mahsa Raji Lahiji
- a Faculty of Nutrition School of Public Health , Iran University of Medical Sciences , Tehran , Iran
| | - Maryam Chamari
- g Department of Community Nutrition, School of Nutritional Sciences and Dietetics , Tehran University of Medical Science , Tehran , Iran
| | - Marziyeh Asgari
- h Food Security Research Center, School of Nutrition and Food Sciences , Isfahan University of Medical Sciences , Isfahan , Iran.,i Department of Community Nutrition, School of Nutrition and Food Sciences , Isfahan University of Medical Sciences , Isfahan , Iran
| | - Elhameh Cheshmazar
- a Faculty of Nutrition School of Public Health , Iran University of Medical Sciences , Tehran , Iran
| | - Mitra Zarrati
- a Faculty of Nutrition School of Public Health , Iran University of Medical Sciences , Tehran , Iran
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Farrell C, Walshe C, Molassiotis A. Are nurse-led chemotherapy clinics really nurse-led? An ethnographic study. Int J Nurs Stud 2017; 69:1-8. [DOI: 10.1016/j.ijnurstu.2017.01.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 01/10/2017] [Accepted: 01/12/2017] [Indexed: 11/28/2022]
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The Korean version of the Symptom Experience Index: A psychometric study. Int J Nurs Stud 2013; 50:1098-107. [DOI: 10.1016/j.ijnurstu.2012.12.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2012] [Revised: 12/02/2012] [Accepted: 12/13/2012] [Indexed: 11/22/2022]
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Abstract
Cancer-related fatigue (CRF) is a common symptom in patients treated for cancer. For patients receiving chemotherapy, the prevalence is 75% to 90%; in those receiving radiation, 65%. The management of CRF is difficult because its nature is not yet fully explained and it has a variety of causes. The purpose of the review is to identify interventions that can be used by nurses successfully to reduce fatigue during cancer treatment. A search of the medical (PubMed) and nursing (CINAHL) literature (1995 to February 2005) produced 18 studies. In two-thirds of the studies, the populations were breast cancer patients. Half of the studies had a sample size of less then 30 patients. The studies included dealt with sleep promotion (1), instruction and education (5), exercise (10), and distraction and relaxation (2). Significant effects were found in studies promoting exercise. For interventions on sleep promotion and on education and counseling, a positive result was found, but this was not significant. For distraction and relaxation, only an effect until a few hours after the intervention was found. Given the multidimensional nature of CRF, a combination of interventions is most likely to be effective. Thus far, such an approach by nurses during cancer treatment has not been tested.
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Fu MR, McDaniel RW, Rhodes VA. Measuring symptom occurrence and symptom distress: development of the symptom experience index. J Adv Nurs 2007; 59:623-34. [PMID: 17672849 DOI: 10.1111/j.1365-2648.2007.04335.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM This paper is a report of a study to assess reliability and construct validity of revised and refined version of the Adapted Symptom Distress Scale: the Symptom Experience Index (SEI). BACKGROUND The development of the SEI, a 41-item Likert Scale assessing 20 symptoms, was based on self-regulation theory and an integrative conceptual analysis of symptom assessment and management. The model emphasizes the difference between the occurrence of a symptom (or multiple symptoms) and the distress (emotional) response to the occurrence of a symptom. It is the distress from symptom occurrence that promotes a person to take action and use known coping strategies to prevent the symptom occurrence or alleviate the distress from the symptom. METHOD A contrast-group and test-retest approach was used to assess construct validity and reliability with a convenience sample of 158 patients at United States of America in 2003-2004. RESULTS The SEI demonstrated reasonable internal consistency with a Cronbach's alpha of 0.91 for symptom experience, 0.85 for symptom occurrence and 0.84 for symptom distress. Test-retest reliability was supported by high intra-class correlation coefficients (symptom experience r = 0.93; symptom occurrence r = 0.94; symptom distress, r = 0.92). Construct validity was supported by statistically significant differences between patients and healthy adults. CONCLUSION The SEI can be used as a baseline and outcome measure to assess the impact of multiple symptoms on patients, and the effectiveness of interventions to manage these symptoms.
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Affiliation(s)
- Mei R Fu
- College of Nursing, New York University, New York, USA.
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Piredda M, De Marinis MG, Rocci L, Gualandi R, Tartaglini D, Ream E. Meeting information needs on cancer-related fatigue: an exploration of views held by Italian patients and nurses. Support Care Cancer 2007; 15:1231-1241. [PMID: 17375340 DOI: 10.1007/s00520-007-0240-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2006] [Accepted: 02/15/2007] [Indexed: 10/23/2022]
Abstract
BACKGROUND Interest in cancer-related fatigue has been growing over the last two decades and efforts have been dedicated to investigate this topic. However, research addressing the adequacy of educational resources for patients with this distressing and common symptom is lacking. Only one study has been undertaken and this explored Swiss and British patients' views. MATERIALS AND METHODS The current study replicated and extended the study previously undertaken in the United Kingdom (UK) and Switzerland. It sought views on the adequacy of materials on cancer-related fatigue available to patients with cancer living in Italy, and to determine the educational preferences and needs of Italian patients with cancer-related fatigue. These were attained through conduct of two focus groups. One was undertaken with Italian patients and the other with a group of Italian nurses. MAIN RESULTS Findings from this study supported patients' desire for timely, accurate and individualised information. Barriers to effective fatigue education included the limited dialogue regarding fatigue initiated in clinical settings. It appeared that nurses and patients held different priorities in symptom management. Further, it was acknowledged that there was often insufficient time to inform patients adequately about fatigue. Participants considered written materials as helpful complements to oral information, thus supporting the provision of information in both forms. However, it was clear that fewer written resources concerning cancer-related fatigue were available in Italy compared to either in Switzerland or in the UK. CONCLUSION The study supported the view within the current literature that whilst cancer-related fatigue is recognised as a frequent and disruptive symptom, patient education about this symptom and its management still needs to be enhanced. The resources available to educate patients about cancer-related fatigue should be improved and made more accessible to patients who experience it.
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Affiliation(s)
- Michela Piredda
- Università Campus Bio-Medico, Corso di Laurea per Infermieri, Via Longoni, 69, 00155, Roma, Italy.
- Università Campus Bio-Medico, Via Longoni, 69, 00155, Roma, Italy.
| | - Maria Grazia De Marinis
- Università Campus Bio-Medico, Corso di Laurea per Infermieri, Via Longoni, 69, 00155, Roma, Italy
| | - Laura Rocci
- Università Campus Bio-Medico, Corso di Laurea per Infermieri, Via Longoni, 69, 00155, Roma, Italy
| | - Raffaella Gualandi
- Università Campus Bio-Medico, Corso di Laurea per Infermieri, Via Longoni, 69, 00155, Roma, Italy
| | - Daniela Tartaglini
- Università Campus Bio-Medico, Corso di Laurea per Infermieri, Via Longoni, 69, 00155, Roma, Italy
| | - Emma Ream
- Florence Nightingale School of Nursing and Midwifery, King's College London, 5th Floor Waterloo Bridge Wing, Franklin Wilkins Building, 150 Stamford Street, London, 2SE1 9NN, UK
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Strasser F, Binswanger J, Cerny T, Kesselring A. Fighting a losing battle: eating-related distress of men with advanced cancer and their female partners. A mixed-methods study. Palliat Med 2007; 21:129-37. [PMID: 17344261 DOI: 10.1177/0269216307076346] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Anorexia/cachexia is a frequent complication of advanced cancer with poorly understood psychosocial impact or eating-related distress (ERD) on both patients and family members. To assist palliative care practitioners manage this important psychosocial aspect of care, we aimed to discover and describe elements of ERD, focusing on male patients with advanced cancer and their female partners. METHODS Nineteen male patients and their partners were systematically investigated by (1) focus group interviews and data analysis inspired by Grounded Theory, and (2) a comparative survey with categorical questions. RESULTS For patients, eating-related distress was characterised by obstruction to eating, poor and capricious appetite, a disconnection of oral intake and ability to gain weight, and continuous efforts to eat. Partners expressed feelings of deep concern, frustration, and insufficiency in their loving and innovative efforts to prepare appealing food. Partners were more concerned about patients' weight loss than patients themselves (P =0.002). Patients felt more pressure to eat from partners than they estimated (P =0.007). CONCLUSION Anorexia/cachexia of male cancer patients affects the cooking at home, a couple's daily eating routines, and their spousal relationship. Identification of ERD may trigger targeted psychosocial interventions.
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Affiliation(s)
- F Strasser
- Department of Internal Medicine, Cantonal Hospital, St. Gallen, Switzerland.
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Abstract
Alopecia is a common side effect of chemotherapy treatments for cancer; for some individuals this results in complete hair loss. The extent of this depends on many factors including the type or combination of drugs administered, and their doses. Further, it can in some cases be lessened through use of scalp cooling techniques. This method of reducing hair loss has been available since the 1970s. However, previous evidence suggests that nurses are apathetic about its use, which in turn might mean that patients are not always offered this intervention. This small exploratory study investigated perceptions held by nurses administering chemotherapy towards alopecia and its management through scalp cooling. It entailed completion of a survey questionnaire by 13 nurses that regularly administered intravenous chemotherapy. These data were then augmented by those attained from follow-up, semi-structured interviews that were conducted with three of the sample. It determined that perceptions of scalp cooling were influenced by individuals' subjective notions of its efficacy constructed from their experiences of having administered scalp cooling. Furthermore, attempts to prevent hair loss were mediated by their cognitions of the experience of hair loss itself. This study determined that views held about scalp cooling varied considerably, and that it was unlikely to be offered to all suitable patients or administered in a systematic manner. Such variation in provision has implications both for patients wishing to access this treatment and for nurses wishing to audit its use and efficacy.
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Affiliation(s)
- J Randall
- Sir John McMichael Centre, Hammersmith Hospitals NHS Trust, London, UK
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12
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Uitterhoeve R, Duijnhouwer E, Ambaum B, van Achterberg T. Turning toward the psychosocial domain of oncology nursing: a main problem analysis in the Netherlands. Cancer Nurs 2003; 26:18-27. [PMID: 12556709 DOI: 10.1097/00002820-200302000-00003] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The purpose of this descriptive exploratory study by the Dutch Oncology Nursing Society was to describe the problem areas in the care of patients who are receiving chemotherapy as perceived by patients and professional caregivers as well as to explore differences between the perceptions of patients and professional caregivers. Three independent samples of 120 patients who are being treated with chemotherapy, 42 chemotherapy prescribing medical specialists, and 68 oncology nurses who are involved in the daily bedside care of the patients undergoing chemotherapy participated in the study. Patients and professional caregivers completed a 69- and a 58-item self-administered questionnaire, respectively. Results show that patients were satisfied with the medical and nursing care they received. Furthermore, results suggest that professional caregivers perceive the experience of patients with chemotherapy differently than patients, eg, patients perceive chemotherapy as reassuring that something is being done; whereas caregivers think that patients experience chemotherapy as something to fear or be anxious or uncertain about. It further seems that professional caregivers are more prone to act upon the medical-technical aspects of the treatment than to act on psychosocial sequelae of the treatment.
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Affiliation(s)
- Ruud Uitterhoeve
- Department of Medical Oncology, University Medical Center Nijmegen, The Netherlands
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13
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Poole K, Froggatt K. Loss of weight and loss of appetite in advanced cancer: a problem for the patient, the carer, or the health professional? Palliat Med 2002; 16:499-506. [PMID: 12465697 DOI: 10.1191/0269216302pm593oa] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This paper aims to examine the loss of weight and loss of appetite as 'problems' experienced by patients with advanced cancer and those that care for them. It reports the results of a systematic search of the literature and presents the findings as a narrative review. Research to date has focused upon charting the prevalence and incidence of these symptoms, but little empirical work has been conducted to investigate how patients and carers experience these problems. There is some evidence to suggest that anorexia may be more distressing for those caring for the patient than the person suffering from the symptom itself. Understanding the reason for this anguish requires an appreciation of the meaning of food refusal and constitutes the first step towards informing the development of effective interventions. Such exploratory work is mandatory if health professionals wish to move beyond speculation and deliver interventions that provide meaningful benefits for the cancer patient and their family.
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Affiliation(s)
- Karen Poole
- Macmillan Practice Development Unit, Centre for Cancer and Palliative Care Studies, Institute of Cancer Research, London, UK
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Borbasi S, Cameron K, Quested B, Olver I, To B, Evans D. More than a sore mouth: patients' experience of oral mucositis. Oncol Nurs Forum 2002; 29:1051-7. [PMID: 12183754 DOI: 10.1188/02.onf.1051-1057] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To explore patients' experience of chemotherapy-induced oral mucositis. DESIGN Interpretive descriptive, phenomenologic. SETTING The cancer center of a metropolitan teaching hospital in South Australia. SAMPLE A purposive sample of six participants undergoing intensive cytotoxic therapy associated with autologous hematopoietic stem cell transplantation. METHODS Patients were interviewed at different stages of their treatment trajectory and asked to relate their experience of oral mucositis as it developed and resolved. FINDINGS Participants' reports indicated three distinct phases representing linear time in the course of their mucositis: the preparatory phase, the peak phase, and the persisting phase. Five themes further abstracted were the presence of nurses, therapeutic interventions, manifestations of mucositis, the distress of eating (and not eating), and whether the treatment was worthwhile. CONCLUSIONS Oral mucositis is much more than a sore mouth. The effects of mucositis are widespread and can have a marked effect on patients' psychological well-being. IMPLICATIONS FOR NURSING Care centers often focus on pain control through pharmacologic intervention and overlook the effects of other sequelae. Nurses' role in helping patients to cope with mucositis should encompass more than providing pharmacologic pain relief.
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Affiliation(s)
- Sally Borbasi
- School of Nursing and Midwifery, Flinders University, Adelaide, Australia.
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Pearce S, Kelly D, Stevens W. 'More than just money' -- widening the understanding of the costs involved in cancer care. J Adv Nurs 2001; 33:371-9. [PMID: 11251724 DOI: 10.1046/j.1365-2648.2001.01673.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIM This paper examines the literature relating to the wider concept of cost in cancer care and the implications this has for the development of services particularly within the changing context of cancer care. BACKGROUND Cancer remains a major cause of morbidity and mortality in the United Kingdom (UK), treatment is often complex and expensive; both in financial and human terms. Service patterns for cancer care are shifting away from traditional inpatient, hospital settings towards short stay/day-care and home care models. This is in response to developments in health care policy, but it is also because of the availability of better tolerated treatments and demand for more patient-focused health care. REVIEW OF THE LITERATURE The databases of Cinhahl and Medline were accessed using the keywords of costs, treatment, outpatients, home care and cancer. Additional sources of literature were also accessed through hand searching key journals. The paper explores the literature in three themes. First, the cost-effectiveness of cancer treatment; second, the often invisible indirect or 'out of pocket' costs incurred by patients and their families during cancer treatment and finally, the 'human costs' of a cancer diagnosis and cancer therapy. CONCLUSIONS In view of recent calls to improve the effectiveness of cancer care in the UK, we suggest that research is needed to address all the dimensions of cost. It is only by exploring total costs from this broad perspective that appropriate, effective and holistic services can be planned for the future.
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Affiliation(s)
- S Pearce
- Practice Development and Research, Cancer Care, Meyerstein Institute of Oncology, UCL Hospitals, London, UK.
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Magnusson K, Möller A, Ekman T, Wallgren A. A qualitative study to explore the experience of fatigue in cancer patients. Eur J Cancer Care (Engl) 1999; 8:224-32. [PMID: 10889620 DOI: 10.1046/j.1365-2354.1999.00168.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Fatigue--which is a complex, multicausal, and multidimensional subjective experience--is today the most frequently reported symptom from patients with cancer. The aim of this study was to explore the experience of fatigue in cancer patients and to describe the categories and dimensions of the symptoms. A qualitative method--grounded theory--was used. Unstructured, tape-recorded interviews with 15 cancer patients were used for data collection. The categories found in this study illustrate fatigue as a process. Three major categories were found: (1) experiences (of loss, need, malaise, psychological stress, emotional affection, abnormal weakness, difficulties in taking the initiative); (2) consequences (social limitation, affected self-esteem, affected quality of life); and (3) actions (coping). The categories were constructed on the basis of dimensions with subordinated qualities. Knowledge concerning the different expressions of fatigue is important in caring for patients with cancer. The results from this study may contribute to a better understanding of how a cancer patient can experience and express fatigue and how the symptoms may affect the patient.
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Affiliation(s)
- K Magnusson
- Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden.
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Abstract
The role of chemotherapy for patients with advanced cancer is likely to expand, as new cytotoxic drugs and routes of administration are developed, and adverse effects are better controlled. The move towards integration of acute and palliative cancer care services should facilitate the use of chemotherapy to alleviate symptoms of advanced cancer, where appropriate and acceptable for individual patients. As the boundaries traditionally perceived between phases of cancer care become blurred, new challenges will arise for oncology and palliative care nurses.
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Affiliation(s)
- Gaye McPhail
- Cancer Nursing, Nursing and Midwifery School, University of Glasgow, Scotland
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Affiliation(s)
- Alison Richardson
- Cancer Services, Bromley Hospitals NHS Trust, Chartwell Unit, Farnborough Hospital, Orpington, Ken
| | - Emma Ream
- King’s College London, Cornwall House, Waterloo Road, London
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