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Miller D, Nevadunsky N. Palliative Care and Symptom Management for Women with Advanced Ovarian Cancer. Hematol Oncol Clin North Am 2018; 32:1087-1102. [DOI: 10.1016/j.hoc.2018.07.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Abstract
BACKGROUND Caregiver burden associated with caring for women with ovarian cancer has received limited focus. However, these patients often have complex needs, requiring a high level of care at home and imposing substantial burdens on caregivers. OBJECTIVES This pilot study assessed the level of caregiver burden experienced by the primary caregivers of patients with end-stage ovarian cancer and identified variables associated with caregiver burden. METHODS Caregiver burden was assessed using the Caregiver Reaction Assessment. Fifty caregivers completed an anonymous and voluntary survey. Pearson correlations and independent samples t tests were used to analyze data. FINDINGS Most participants were Caucasian, married or living with a partner, and college graduates, with an annual household income of less than $90,000. Caregiver ages ranged from 29-81 years. Participants agreed most with the self-esteem scale, indicating they had pride in caring for their loved ones. Disrupted schedules and financial problems were the most burdensome factors in providing care. Because financial issues affected caregiver burden, nurses should facilitate interdisciplinary support. Future research is needed to determine the impact of nurse-led interventions to reduce caregiver burden.
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Affiliation(s)
| | | | - Nancy Kline
- Heilbrunn Family Center for Research Nursing at Rockefeller University
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Lindemann K, Gibbs E, Åvall-Lundqvist E, dePont Christensen R, Woie K, Kalling M, Auranen A, Grenman S, Hoegberg T, Rosenberg P, Skeie-Jensen T, Hjerpe E, Dørum A, Gebski V, Kristensen G. Chemotherapy vs tamoxifen in platinum-resistant ovarian cancer: a phase III, randomised, multicentre trial (Ovaresist). Br J Cancer 2017; 116:455-463. [PMID: 28118323 PMCID: PMC5318972 DOI: 10.1038/bjc.2016.435] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 11/19/2016] [Accepted: 12/10/2016] [Indexed: 02/03/2023] Open
Abstract
Background: Chemotherapy in platinum-resistant ovarian cancer (PROC) aims for palliation and prolonging of progression-free survival (PFS). This study compares Health-related Quality of Life (HRQoL) and efficacy between single-agent chemotherapy and tamoxifen in PROC. Methods: Patients with PROC were randomised (2 : 1) to chemotherapy (weekly paclitaxel 80 mg m−2 or four weekly pegylated liposomal doxorubicin 40 mg m−2) or tamoxifen 40 mg daily. The primary end point was HRQoL. Secondary end points were PFS by RECIST and overall survival (OS). Results: Between March 2002 and December 2007, 156 and 82 patients were randomised to chemotherapy and tamoxifen, respectively. In the chemotherapy arm, a significantly larger proportion of patients experienced a worsening in their social functioning. There was no difference in the proportion of patients experiencing improvement of gastrointestinal symptoms. Median PFS on tamoxifen was 8.3 weeks (95% CI, 8.0–10.4) compared with 12.7 weeks (95% CI, 9.0–16.3) on chemotherapy (HR, 1.54; 95% CI, 1.16–2.05; log-rank P=0.003). There was no difference in OS between the treatment arms. Conclusions: Patients on chemotherapy had longer PFS but experienced more toxicity and poorer HRQoL compared with tamoxifen. Control over gastrointestinal symptoms was not better on chemotherapy. These data are important for patient counselling and highlight the need to incorporate HRQoL end points in studies of PROC.
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Affiliation(s)
- Kristina Lindemann
- Department of Gynecologic Oncology, Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway.,NHMRC Clinical Trials Centre, University of Sydney, Camperdown, NSW, Australia.,Department of Medical Oncology, Westmead Hospital, Crown Princess Mary Cancer Centre, Wentworthville, NSW, Australia
| | - Emma Gibbs
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, NSW 2050, Australia
| | - Elisabeth Åvall-Lundqvist
- Department of Oncology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.,Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Rene dePont Christensen
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Kathrine Woie
- Department of Gynecologic Oncology, Haukeland University Hospital, Bergen, Norway
| | - Marten Kalling
- Department of Gynecologic Oncology, Skane University Hospital, Lund, Sweden
| | - Annika Auranen
- Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland
| | - Seija Grenman
- Department of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland.,University of Turku, Turku, Finland
| | - Thomas Hoegberg
- Department of Cancer Epidemiology, Skane University Hospital Lund, Lund, Sweden
| | - Per Rosenberg
- Department of Oncology, Linköping University Hospital, Linköping, Sweden
| | - Tone Skeie-Jensen
- Department of Gynecologic Oncology, Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Elisabet Hjerpe
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Anne Dørum
- Department of Gynecologic Oncology, Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Val Gebski
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, NSW 2050, Australia
| | - Gunnar Kristensen
- Department of Gynecologic Oncology, Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway.,Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo and University of Oslo, Oslo, Norway
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Being a caregiver to patients with ovarian cancer: A scoping review of the literature. Gynecol Oncol 2016; 143:184-192. [DOI: 10.1016/j.ygyno.2016.07.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 07/04/2016] [Accepted: 07/05/2016] [Indexed: 11/23/2022]
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Teskereci G, Kulakaç O. Life experiences of caregivers of women with gynaecological cancer: a mixed-methods systematic review. Eur J Cancer Care (Engl) 2016; 27. [DOI: 10.1111/ecc.12456] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2016] [Indexed: 01/27/2023]
Affiliation(s)
| | - O. Kulakaç
- Ondokuz Mayis University School of Health; Samsun Turkey
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Jayde V, Boughton M. ‘Living the tightrope’: The experience of maternal ovarian cancer for adult children in Australia. Eur J Oncol Nurs 2016; 20:184-90. [DOI: 10.1016/j.ejon.2015.08.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Revised: 06/08/2015] [Accepted: 08/16/2015] [Indexed: 11/26/2022]
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Butow PN, Price MA, Bell ML, Webb PM, deFazio A, Friedlander M. Caring for women with ovarian cancer in the last year of life: A longitudinal study of caregiver quality of life, distress and unmet needs. Gynecol Oncol 2014; 132:690-7. [DOI: 10.1016/j.ygyno.2014.01.002] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Revised: 12/21/2013] [Accepted: 01/05/2014] [Indexed: 11/30/2022]
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Outcome assessment instruments in palliative and hospice care—a review of the literature. Support Care Cancer 2012; 20:2879-93. [DOI: 10.1007/s00520-012-1415-x] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2011] [Accepted: 02/14/2012] [Indexed: 11/12/2022]
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Wadhwa D, Burman D, Swami N, Rodin G, Lo C, Zimmermann C. Quality of life and mental health in caregivers of outpatients with advanced cancer. Psychooncology 2011; 22:403-10. [PMID: 22135229 DOI: 10.1002/pon.2104] [Citation(s) in RCA: 135] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2011] [Revised: 10/23/2011] [Accepted: 10/27/2011] [Indexed: 11/12/2022]
Abstract
OBJECTIVE This study evaluates the quality of life (QOL) and mental health (MH) of caregivers of patients with advanced cancer who are receiving ambulatory oncology care and associations with patient, caregiver and care-related characteristics. METHODS Patients with advanced gastrointestinal, genitourinary, breast, lung or gynaecologic cancer, and their caregivers, were recruited from 24 medical oncology clinics for a cluster-randomized trial of early palliative care. Caregivers completed the Caregiver QOL--Cancer scale and the Medical Outcomes Study Short Form, version 2, and a questionnaire including care-related factors such as hours/day providing care and change in work situation. Patients completed a demographic questionnaire and measures of their QOL and symptom severity. Associations of these factors with caregiver QOL and MH were examined using linear regression analyses. RESULTS Of the 191 caregivers, 84% were spouses/partners, 90% cohabited with the patient, half were working and 25% had a change in work situation since the patient's diagnosis. On multiple regression analysis, better caregiver QOL was associated with better caregiver MH and patient physical well-being and with not providing care for other dependents. Worse caregiver MH was associated with female caregiver sex, worse patient emotional well-being, more hours spent caregiving and change in the caregiver's work situation. CONCLUSIONS Caregivers of ambulatory patients with advanced cancer may have compromised QOL and MH associated with worse patient physical and emotional well-being and with simultaneously caring for others and working outside the home. Early palliative care interventions directed at patient symptoms and caregiver support may improve QOL in this population.
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Affiliation(s)
- Deepa Wadhwa
- Division of Medical Oncology and Haematology, Department of Medicine, University of Toronto, Toronto, Canada
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Arriba LN, Fader AN, Frasure HE, von Gruenigen VE. A review of issues surrounding quality of life among women with ovarian cancer. Gynecol Oncol 2010; 119:390-6. [DOI: 10.1016/j.ygyno.2010.05.014] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2010] [Revised: 05/12/2010] [Accepted: 05/14/2010] [Indexed: 11/16/2022]
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Hacialioglu N, Özer N, Yilmaz karabulutlu E, Erdem N, Erci B. The quality of life of family caregivers of cancer patients in the East of Turkey. Eur J Oncol Nurs 2010; 14:211-7. [DOI: 10.1016/j.ejon.2010.01.017] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2009] [Revised: 01/11/2010] [Accepted: 01/13/2010] [Indexed: 10/19/2022]
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Koensgen D, Oskay-Oezcelik G, Katsares I, Walle U, Klapp C, Mustea A, Stengel D, Porzsolt F, Lichtenegger W, Sehouli J. Development of the Berlin Symptom Checklist Ovary (BSCL-O) for the measurement of quality of life of patients with primary and recurrent ovarian cancer: results of a phase I and II study. Support Care Cancer 2009; 18:931-42. [DOI: 10.1007/s00520-009-0733-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2008] [Accepted: 08/20/2009] [Indexed: 11/30/2022]
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Matsushita T, Murata H, Matsushima E, Sakata Y, Miyasaka N, Aso T. Quality of life in gynecological inpatients undergoing surgery. Health Care Women Int 2007; 28:828-42. [PMID: 17907010 DOI: 10.1080/07399330701563210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
This study investigates the changes in the quality of life (QOL) of gynecological patients undergoing surgery, and the relationship between these changes and clinical/demographic factors. Ninety patients were examined on three occasions using the Japanese version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-core30 (EORTC QLQ-C30). Although the global QOL and physical function decreased before discharge, the emotional function was lowest before surgery. There was no difference between the benign and malignancy groups in most QOL subscales. With regard to the relationship between global QOL and physical function before discharge and other demographic/clinical factors, multiple regression analysis suggested that these were explained by employment status, benign/malignancy, region of tumor, chemotherapy, postoperative complication, and psychological symptoms during hospitalization.
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Affiliation(s)
- Toshiko Matsushita
- Section of Liaison Psychiatry & Palliative Medicine, Graduate School of Tokyo Medical & Dental University, Tokyo, Japan.
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Factors associated with quality of life of outpatients with breast cancer and gynecologic cancers and their family caregivers: a controlled study. BMC Cancer 2007; 7:102. [PMID: 17578579 PMCID: PMC1925112 DOI: 10.1186/1471-2407-7-102] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2007] [Accepted: 06/19/2007] [Indexed: 11/10/2022] Open
Abstract
Background Quality of life (QOL) issues are of interest in cancer because effective methods of treatment and detection have led to an increase in the number of long-term survivors. The objectives of the study were: to assess the subjective QOL of stable Sudanese women cancer outpatients and their family caregivers, using the WHO 26-item QOL Instrument; compare with matched general population groups, as well as diabetic and psychiatric patient groups; examine patient-caregiver concordance in ratings; and assess the variables associated with their QOL, with a view to identifying factors that can enhance quality of care. Methods Responses of oncology outpatients with breast cancer (117), cervical cancer (46) and ovarian cancer (18) (aged 44.6, SD 11.5) were compared with those of their family caregivers and matched general population groups. Data were analyzed by univariate and multivariate statistics. Results The cancer groups had similar QOL domain scores, which were significantly lower than those of their caregivers, but higher than the control group as well as those of psychiatric and diabetic patients studied previously. Patients who were married, with higher education, better employment, and with longer duration of illness had higher QOL. Patients on radiotherapy and their caregivers had higher QOL scores. Correlations between patient's ratings and caregiver impression of patient's QOL were high. Caregiver impression was a significant predictor of patient's and caregiver's QOL. Other predictors for the patient were: currently feeling sick and duration of illness; for the caregiver: feeling sick, relationship to patient, and age. Conclusion Cancer patients in stable condition and with psychosocial support can hope to enjoy good QOL with treatment. The findings constitute an evidence base for the country's cancer care program, to boost national health education about prognosis in cancer. Families living with women cancer patients are vulnerable and need support if the patient is recently diagnosed, less educated, single, not formally employed; and the caregiver is female, parent, younger, less educated, unemployed and feels sick. Clinicians need to invest in the education and support of family caregivers. The patient-caregiver dyad should be regarded as a unit for treatment in cancer care.
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Penson RT, Wenzel LB, Vergote I, Cella D. Quality of Life Considerations in Gynecologic Cancer. Int J Gynaecol Obstet 2006; 95 Suppl 1:S247-S257. [PMID: 17161164 DOI: 10.1016/s0020-7292(06)60040-4] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Quality of life (QOL) is a fundamental consideration for patients with life threatening diseases. Major evolving paradigms are discussed: improved QOL with laparoscopic surgery, the impact on QOL of intraperitoneal chemotherapy for optimally cytoreduced ovarian cancer, combination therapy, sexuality, and survivorship. The goals of treatment for many patients with gynecologic tumors remain largely palliative, and patient reported QOL is the primary outcome determining the utility of treatment. Particularly in this area, QOL endpoints are increasingly important in clinical trials. The QOL issues facing gynecologic cancer patients, the use of validated QOL instruments, recent advances in the evaluation of interventions, and changes in concepts related to QOL are reviewed.
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Kitrungroter L, Cohen MZ. Quality of life of family caregivers of patients with cancer: a literature review. Oncol Nurs Forum 2006; 33:625-32. [PMID: 16676018 DOI: 10.1188/06.onf.625-632] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To systematically review literature regarding the quality of life (QOL) of family caregivers of patients with cancer and evaluate the instruments measuring family caregivers' QOL. DATA SOURCES PubMed, CINAHL, PsycINFO, ISI Web of Science, and EBSCO electronic databases; published literature. DATA SYNTHESIS Overall, the QOL of family caregivers of patients with cancer varied. Influences related to family caregivers' QOL were identified. Global and generic measures have been used because of the lack of specific instruments. Comparisons are complicated because several measures were used at different times along the illness trajectory with caregivers caring for people with various types and stages of cancer. CONCLUSIONS A more explicit definition of QOL for family caregivers of patients with cancer and specific instruments suitable for different cultures are needed to enhance knowledge. IMPLICATIONS FOR NURSING Maintaining the QOL of caregivers is important in their ability to provide the care required to keep family members with cancer in the community. Nurses must provide care to maintain caregivers' QOL.
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