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Zhang Y, Chen X, Li R, Wang Y, Sun Z, Li Q. Interventions strategies and their efficacy in illness perceptions in patients with cancer: A systematic review and meta-analysis. Eur J Oncol Nurs 2024; 70:102599. [PMID: 38810586 DOI: 10.1016/j.ejon.2024.102599] [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: 01/19/2024] [Revised: 04/20/2024] [Accepted: 04/25/2024] [Indexed: 05/31/2024]
Abstract
PURPOSES To identify intervention strategies for improving illness perception (IP) of cancer patients and/or family caregivers; and to examine the effects of IP interventions by meta-analysis. METHODS A systematic search was performed to identify literature that focused on improving the IP of cancer patients and/or family caregivers from the establishment of eight databases to August 2023. Manual screening was also applied. The IP intervention strategies for cancer populations were synthesized basing the CSM. Meta-analysis was conducted to assess the effects of IP interventions on health outcomes. Multiple subgroup analyses of the same intervention conditions were conducted to explore the optimal IP-focused intervention. RESULTS 18 studies were included. 11 studies were conducted in a meta-analysis. No studies on family caregivers' IP were identified. Compared to general care, subgroup analysis revealed that IP interventions had favorable effects on cancer patients' IP as well as quality of life and other outcomes. Six IP intervention strategies (information support, cognitive reframing, emotion adjustment, active coping, effective appraisal, and self-social identification) were generated. Meta-analysis showed that compared with theory-less studies (Z = 8.64, p < 0.01) and single delivery formats (Z = 3.66, p < 0.01), the theory-based interventions (Z = 10.86, p < 0.01) and mixed delivery formats (Z = 7.15, p < 0.01) had higher positive effects on IP outcomes. CONCLUSIONS The positive outcomes of IP intervention focusing on cancer patients were highlighted. IP traits and patients' and their caregivers' needs in coping with specific cancer types should be explored before the intervention design. More IP interventions targeting cancer dyads are warranted to develop in the future.
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Affiliation(s)
- Yi Zhang
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Xuan Chen
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Rongyu Li
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Ye Wang
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Zheng Sun
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Qiuping Li
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China; Affiliated Hospital of Jiangnan University, Wuxi, China.
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Shi Y, Howe TH, Halpin PF, Hu L, Wu B. Dyadic analysis of illness perceptions among individuals with stroke and their caregivers: effects on activity engagement in community living. Disabil Rehabil 2023:1-13. [PMID: 37602644 DOI: 10.1080/09638288.2023.2246378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 07/31/2023] [Accepted: 08/03/2023] [Indexed: 08/22/2023]
Abstract
PURPOSE To explore the relationship between activity engagement and dyadic illness perceptions of community-dwelling individuals with stroke and their caregivers. METHODS We performed a secondary analysis on a cross-sectional study encompassing eight rehabilitation settings. Participants were recruited from June to December 2019 via the distribution of flyers, use of admission databases, and direct onsite interactions. Activity engagement of individuals with stroke was measured by the Assessment of Life Habits. Dyadic illness perceptions were measured using the Stroke-Specific Illness Perceptions Questionnaire-Revised. RESULTS Data from 202 dyads of individuals with stroke (mean age 61.3 ± 8.3 years; 76.7% male; stroke duration 314.3 ± 170.5 days), and caregivers (mean age 52.6 ± 11.6 years; 73.3% female) were analyzed. Results show that individuals with stroke who shared similar optimistic illness perceptions with their caregivers concerning the consequences of stroke had a higher level of activity engagement (ΔR2 = .020, F(2,193) = 5.42, p = .005). Gender differences were found in the dyadic illness perception components concerning acute/chronic and cyclical timeline (ΔR2 = .017, F(2,191) = 4.72, p = .01; ΔR2 = .02, F(2,190) = 3.45, p = .034) and illness coherence (ΔR2 = .012, F(2,191) = 3.42, p = .035). CONCLUSIONS Illness perceptions and post-stroke activity engagement with gender differences should be considered at a dyadic level, as the individuals with stroke and their caregivers influence each other's beliefs.
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Affiliation(s)
- Yun Shi
- Department of Occupational Therapy, Steinhardt School of Cultural, Education, and Human Development, New York University, New York, NY, USA
| | - Tsu-Hsin Howe
- Department of Occupational Therapy, Steinhardt School of Cultural, Education, and Human Development, New York University, New York, NY, USA
| | - Peter F Halpin
- School of Education, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lu Hu
- Department of Population Health, Grossman School of Medicine, New York University, New York, NY, USA
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York, NY, USA
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3
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Pera MC, Coratti G, Casiraghi J, Bravetti C, Fedeli A, Strika M, Albamonte E, Antonaci L, Rossi D, Pane M, Sansone VA, Mercuri E. Caregivers' Expectations on Possible Functional Changes following Disease-Modifying Treatment in Type II and III Spinal Muscular Atrophy: A Comparative Study. J Clin Med 2023; 12:4183. [PMID: 37445216 DOI: 10.3390/jcm12134183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/15/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023] Open
Abstract
Background: The primary aim of this study was to explore current caregivers' expectations on possible functional changes following treatment in comparison to data obtained in the pre-pharmacological era. Methods: A questionnaire, previously used in 2016, was administered to caregivers of type II and III SMA patients of age between 3 and 71 years, and to patients over the age of 13 years. The questionnaire focuses on (1) caregivers and patients expectations, (2) meaningfulness of the changes observed on the functional motor scales, and (3) their willingness to be enrolled in a clinical trial. A comparative study was performed with data obtained using the same questionnaire soon before the advent of disease-modifying therapies. Results: We administered the questionnaire to 150 caregivers. When comparing current caregiver data to those obtained in 2016, the most obvious differences were related to disease perception over the last year (stability: 16.5% in 2016 vs. 43.6% in 2022; deterioration 70.5% vs. 12.8%, and improvement: 12.9% vs. 43.6%) and expectations from clinical trials with higher expectations in 2022 compared to 2016 (p < 0.001). Forty-five of the 150 in the current study were caregivers of patients above the age of 13. In these 45 the questionnaire was also administered to the patient. No difference was found in responses between patients and their caregivers. Conclusions: Both carers and patients reported that even small changes on functional scales, similar to those reported by clinical studies and real-world data, are perceived as meaningful. Comparing the recent responses to those obtained in 2016, before pharmacological treatment was available, we found significant changes in caregivers' perception with increased expectations. These findings will provide a better understanding of the patients' expectations and facilitate discussion with regulators.
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Affiliation(s)
- Maria Carmela Pera
- Department of Life Science and Public Health, Pediatric Neurology, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- The NEMO Center in Rome, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Giorgia Coratti
- Department of Life Science and Public Health, Pediatric Neurology, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- The NEMO Center in Rome, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Jacopo Casiraghi
- The NEMO Center in Milan, Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, 20162 Milan, Italy
| | - Chiara Bravetti
- Department of Life Science and Public Health, Pediatric Neurology, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- The NEMO Center in Rome, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Alessandro Fedeli
- The NEMO Center in Milan, Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, 20162 Milan, Italy
| | - Milija Strika
- The NEMO Center in Milan, Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, 20162 Milan, Italy
| | - Emilio Albamonte
- The NEMO Center in Milan, Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, 20162 Milan, Italy
| | - Laura Antonaci
- The NEMO Center in Rome, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Diletta Rossi
- The NEMO Center in Rome, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Marika Pane
- Department of Life Science and Public Health, Pediatric Neurology, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- The NEMO Center in Rome, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Valeria Ada Sansone
- Department of Life Science and Public Health, Pediatric Neurology, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- The NEMO Center in Rome, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Eugenio Mercuri
- Department of Life Science and Public Health, Pediatric Neurology, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- The NEMO Center in Rome, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
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Herzog K, Schepper F, Pletschko T, Herrmann J, Budich M, Christiansen H, Suttorp M, Martini J. Illness perceptions, fear of progression and health-related quality of life during acute treatment and follow-up care in paediatric cancer patients and their parents: a cross-sectional study. BMC Psychol 2023; 11:44. [PMID: 36782336 PMCID: PMC9926758 DOI: 10.1186/s40359-023-01078-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 02/06/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND This study examines the role of illness perceptions and fear of progression (FoP) in paediatric cancer patients and their parents for patient's health-related quality of life (HRQoL), controlling for sociodemographic and medical variables. 4-18-year-old patients in acute treatment or follow-up care and one parent were examined. METHODS N = 46 patient-parent dyads in acute treatment and n = 84 dyads in follow-up care completed measures on illness perceptions (Illness-Perceptions-Questionnaire for 12-18-year-old patients and parents or as age-adapted puppet interview for 4-11-year-old patients) and FoP (Fear-of-Progression-Questionnaire for 7-18-year-old patients and parents). Patients also completed the KINDL-R to measure HRQoL. Hierarchical multiple regression analyses were calculated. RESULTS In acute treatment, patient's perceptions of symptoms and cyclicity of their illness explained variation in their HRQoL in addition to sociodemographic and medical variables. In follow-up care, patient's FoP and parent's perception of consequences explained additional variation in patient's HRQoL. Overall, sociodemographic and medical variables explained less variation in HRQoL in follow-up care than in acute treatment. CONCLUSIONS Our results stress the importance of psychological factors for the well-being of paediatric cancer patients, particularly in follow-up care, where sociodemographic and medical variables play a lesser role. We recommend screening for illness perceptions and FoP during and after acute treatment to support patients and parents. Furthermore, standardized interventions focussed on changing maladaptive illness perceptions should be developed and evaluated. As parents' perceptions, thoughts, and feelings may also play an important role for the well-being of the patients, interventions should be family-focussed and include parents. Trial registration The study has been pre-registered at the German Clinical Trials Register (registered 30/06/2020; DRKS00022034) and at the Open Science Framework ( https://osf.io/3uwrx ).
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Affiliation(s)
- Kristina Herzog
- Department of Psychiatry and Psychotherapy, Faculty of Medicine of the Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany. .,Department of Paediatric Oncology, Haematology and Haemostaseology, Leipzig University, Leipzig, Germany.
| | - Florian Schepper
- grid.9647.c0000 0004 7669 9786Department of Paediatric Oncology, Haematology and Haemostaseology, Leipzig University, Leipzig, Germany
| | - Thomas Pletschko
- grid.22937.3d0000 0000 9259 8492Department of Paediatric and Adolescent Medicine, Medical University Vienna, Vienna, Austria
| | - Jessy Herrmann
- Elternhilfe für krebskranke Kinder e.V. Leipzig, Leipzig, Germany
| | - Mihaela Budich
- grid.412282.f0000 0001 1091 2917Department of Paediatrics, Paediatric Haematology and Oncology, University Hospital Carl Gustav Carus Dresden, Dresden, Germany
| | - Holger Christiansen
- grid.9647.c0000 0004 7669 9786Department of Paediatric Oncology, Haematology and Haemostaseology, Leipzig University, Leipzig, Germany
| | - Meinolf Suttorp
- grid.4488.00000 0001 2111 7257Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Julia Martini
- grid.4488.00000 0001 2111 7257Department of Psychiatry and Psychotherapy, Faculty of Medicine of the Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany
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5
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Murali CN, Lalani SR, Azamian MS, Miyake CY, Smith HS. Quality of life, illness perceptions, and parental lived experiences in TANGO2-related metabolic encephalopathy and arrhythmias. Eur J Hum Genet 2022; 30:1044-1050. [PMID: 35691983 PMCID: PMC9436934 DOI: 10.1038/s41431-022-01127-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 04/02/2022] [Accepted: 05/26/2022] [Indexed: 11/08/2022] Open
Abstract
TANGO2 disorder is a rare genetic disease with multi-system effects that causes episodic crises. Quality of life and psychosocial effects of this rare disease have not previously been studied. To examine health-related quality of life (HRQoL), illness perceptions, and lived experience, we surveyed 16 children and 31 parents of children with TANGO2 disorder identified via a disease-specific social media group and research foundation email distribution list. We assessed HRQoL by parent proxy-report and child self-report using the Pediatric Quality of Life Inventory (PedsQL™). Parental perceptions of their child's condition were assessed using the revised illness perceptions questionnaire adapted for TANGO2 disorder (IPQ-R-TANGO2). To collect qualitative data on parents' lived experience, we used novel open-ended survey questions. Parent proxy-reported (n = 29) physical (78.4 (21)) and psychosocial health (73.4 (12.8)) were highest among toddlers with TANGO2 disorder. Parent proxy-reported physical health was lowest in young adults (34.4 (35.4)), and psychosocial health was lowest in teens (40.8 (10.8)). When compared to previously published PedsQL™ scores in healthy children, parent-proxy reported summary and scale scores for TANGO2 patients were significantly lower (all p < 0.001). Parents' IPQ-R-TANGO2 responses (n = 26) suggested that parents perceived significant negative consequences of the disease. Parents' open-ended survey responses (n = 21) highlighted that they derived support from the TANGO2 community. This study characterizes HRQoL in patients with TANGO2 disorder across a range of ages, identifies potential targets for HRQoL improvement, and provides valuable insight into the psychosocial effects of TANGO2 disorder on patients and their families.
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Affiliation(s)
- Chaya N Murali
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA.
| | - Seema R Lalani
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Mahshid S Azamian
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Christina Y Miyake
- Department of Pediatrics, Division of Cardiology, Texas Children's Hospital, Houston, TX, USA
- Department of Molecular Physiology and Biophysics, Baylor College of Medicine, Houston, TX, USA
| | - Hadley Stevens Smith
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, USA
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6
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Herzog K, Schepper F, Kamm R, Engelhardt‐Lohrke C, Kreisch A, Pletschko T, Hauer J, Christiansen H, Suttorp M, Kiel J, Martini J. Illness perceptions in patients and parents in paediatric oncology during acute treatment and follow‐up care. Psychooncology 2022; 31:950-959. [DOI: 10.1002/pon.5883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 01/04/2022] [Accepted: 01/06/2022] [Indexed: 11/08/2022]
Affiliation(s)
- Kristina Herzog
- Department of Psychiatry and Psychotherapy Faculty of Medicine of the Technische Universität Dresden Germany
- Department of Paediatric Oncology Haematology and Haemostaseology Leipzig University Germany
| | - Florian Schepper
- Department of Paediatric Oncology Haematology and Haemostaseology Leipzig University Germany
| | - Remo Kamm
- Sonnenstrahl e.V. Dresden – Förderkreis für krebskranke Kinder und Jugendliche Germany
| | | | - Andrea Kreisch
- Department of Paediatrics Paediatric Haematology and Oncology University Hospital Carl Gustav Carus Dresden Germany
| | - Thomas Pletschko
- Department of Paediatric and Adolescent Medicine Medical University Vienna Austria
| | - Julia Hauer
- Department of Paediatrics Paediatric Haematology and Oncology University Hospital Carl Gustav Carus Dresden Germany
| | - Holger Christiansen
- Department of Paediatric Oncology Haematology and Haemostaseology Leipzig University Germany
| | - Meinolf Suttorp
- Faculty of Medicine of the Technische Universität Dresden Germany
| | - Julia Kiel
- Department of Psychiatry and Psychotherapy Faculty of Medicine of the Technische Universität Dresden Germany
| | - Julia Martini
- Department of Psychiatry and Psychotherapy Faculty of Medicine of the Technische Universität Dresden Germany
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Delalibera D, Carvalho ACR, Thesolim BL, Rezende LFD. Quality of Life of the Patient with Head and Neck Cancer Submitted to Radiotherapy and the Overload of Their Caregivers. Int Arch Otorhinolaryngol 2021; 25:e536-e544. [PMID: 34765029 PMCID: PMC8575606 DOI: 10.1055/s-0040-1718963] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 08/30/2020] [Indexed: 11/21/2022] Open
Abstract
Introduction
Esthetic and functional changes are frequent in patients with head and neck cancer, and they can be caused by both tumor and treatment. Physical and functional impairment often requires the need of a caregiver, who may feel overwhelmed with the tasks of care.
Objective
This study aims to evaluate the quality of life of patients with head and neck cancer submitted to radiotherapy and the overload of their caregivers.
Method
This is a quantitative cross-sectional study with 42 patients with head and neck cancer and 17 caregivers evaluated during the radiotherapy treatment. Patients responded to the following questionnaires: Functional Assessment of Cancer Therapy for Head and Neck Cancer (FACT-H&N) and Shame and Stigma Scale (SSS), while the caregivers responded to the Zarit Burden Interview Scale (ZBI) and Palliative Performance Scale (PPS).
Results
Head and neck cancer patients showed a decline in the quality of life in all FACT-H&N domains, with the domain of additional concerns having the worst outcome. Among the feelings reported by patients, the most important was penitence. Less than half of the patients needed caregivers. It was observed that the greater the degree of commitment of the patient, the greater the degree of overload of the caregiver.
Conclusion
Therefore, the quality of life of the patient with head and neck cancer is an important aspect to be considered during the therapeutic choice and in the follow-up of the patient, since it has influenced both the patient and his caregiver.
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Affiliation(s)
- Daniela Delalibera
- Centro Universitário das Faculdades Associadas de Ensino (UNIFAE), São João da Boa Vista, SP, Brazil
| | | | - Bruna Luiza Thesolim
- Centro Universitário das Faculdades Associadas de Ensino (UNIFAE), São João da Boa Vista, SP, Brazil
| | - Laura Ferreira de Rezende
- Centro Universitário das Faculdades Associadas de Ensino (UNIFAE), São João da Boa Vista, SP, Brazil
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Kassir ZM, Li J, Harrison C, Johnson JT, Nilsen ML. Disparity of perception of quality of life between head and neck cancer patients and caregivers. BMC Cancer 2021; 21:1127. [PMID: 34670507 PMCID: PMC8527693 DOI: 10.1186/s12885-021-08865-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 10/07/2021] [Indexed: 11/25/2022] Open
Abstract
Background Caregivers are invaluable sources of support for individuals recovering from head and neck cancer (HNC). Accordingly, minimizing caregiver distress is essential to promote the well-being of both caregivers and their patients. This study assessed if psychosocial distress (i.e., anxiety and depression) among HNC caregivers is associated with a difference in how caregivers and their patients perceive patients’ quality of life (QOL) after treatment completion. Methods Caregivers’ and patients’ perceptions of patient QOL were assessed using the University of Washington QOL Questionaire (UWQOL), a validated HNC-specific health-related QOL questionnaire. The survey is interpreted in terms of its two composite scores: a physical QOL score and a social-emotional QOL score with higher scores indicating better QOL. Caregiver anxiety was assessed using the Generalized Anxiety Questionaire-7 (GAD-7) and caregiver depression was assessed using the Patient Health Questionaire 8 (PHQ-8). Patients completed the UWQOL as part of clinic intake while caregivers were asked to complete the UWQOL for their patients in addition to the PHQ-8 and GAD-7 in private. Linear regression was used to analyze the association between differences in caregivers’ and patients’ QOL scores (both social-emotional and physical QOL subscale scores) and GAD-7 and PHQ-8 scores. Results Of 47 caregivers recruited, 42.6% (n = 20) viewed patients’ social-emotional QOL more negatively than patients themselves, while 31.9% viewed patients’ physical QOL more negatively. After controlling for covariates, differences in perception of social-emotional QOL (p = .01) and differences in perception of physical QOL (p = .007) were significantly associated with caregiver depression, but not anxiety. Caregivers who disagreed with patients regarding patients’ social-emotional QOL scored 6.80 points higher on the PHQ8 than agreeing caregivers. Caregivers who disagreed regarding patients’ physical QOL scored 6.09 points higher. Conclusion Caregivers commonly view patients’ QOL more negatively than patients themselves. These caregivers tend to have greater psychosocial distress than caregivers who agree with their patients. Interventions designed to identify and aid at-risk caregivers are critically needed. We propose screening for differences in perception of patient QOL as a way of identifying distressed caregivers as well as provider-facilitated communication between patients and caregivers as possible interventions that should be examined in future research. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-021-08865-7.
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Affiliation(s)
- Zachary M Kassir
- Department of Otolaryngology, University of Pittsburgh School of Medicine, Eye & Ear Institute, 203 Lothrop Street, Pittsburgh, PA, 15213, USA
| | - Jinhong Li
- Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, 130 De Soto Street, Pittsburgh, PA, 15261, USA
| | - Christine Harrison
- Department of Otolaryngology, University of Pittsburgh School of Medicine, Eye & Ear Institute, 203 Lothrop Street, Pittsburgh, PA, 15213, USA
| | - Jonas T Johnson
- Department of Otolaryngology, University of Pittsburgh School of Medicine, Eye & Ear Institute, 203 Lothrop Street, Pittsburgh, PA, 15213, USA
| | - Marci L Nilsen
- Department of Otolaryngology, University of Pittsburgh School of Medicine, Eye & Ear Institute, 203 Lothrop Street, Pittsburgh, PA, 15213, USA. .,Department of Acute and Tertiary Care, University of Pittsburgh School of Nursing, 318A Victoria Building, 3500 Victoria Street, Pittsburgh, PA, 15261, USA.
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Karampela M, Porat T, Mylonopoulou V, Isomursu M. Rehabilitation Needs of Head and Neck Cancer Patients and Stakeholders: Case Study. Front Oncol 2021; 11:670790. [PMID: 34631516 PMCID: PMC8499693 DOI: 10.3389/fonc.2021.670790] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 08/25/2021] [Indexed: 11/13/2022] Open
Abstract
Background The incidents of Head and Neck Cancer (HNC) are rising worldwide, suggesting that this type of cancer is becoming more common. The foreseen growth of incidents signifies that future rehabilitation services will have to meet the needs of a wider population. Objective The aim of this paper is to explore the needs of patients, caregivers and healthcare professionals during HNC rehabilitation. Methods This paper reports the empirical findings from a case study that was conducted in a cancer rehabilitation center in Copenhagen to elicit the needs of HNC cancer patients, informal caregivers and healthcare professionals. Results Four areas of needs during the rehabilitation process were identified: service delivery, emotional, social and physical needs. Service delivery needs and emotional needs have been identified as the most prevalent. Conclusions Stakeholders' needs during the rehabilitation process were found to be interrelated. All stakeholders faced service delivery challenges in the form of provision and distribution of information, including responsibilities allocation between municipalities, hospitals and rehabilitation services. Emotional and social needs have been reported by HNC patients and informal caregivers, underlining the importance of inclusion of all actors in the design of future healthcare interventions. Connected Health (CH) solutions could be valuable in provision and distribution of information.
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Affiliation(s)
- Maria Karampela
- Faculty of Information Technology and Electrical Engineering, University of Oulu, Oulu, Finland
| | - Talya Porat
- Faculty of Engineering, Dyson School of Design Engineering, Imperial College London, London, United Kingdom
| | - Vasiliki Mylonopoulou
- Department Of Applied Information Technology, Division of Human Computer Interaction, University of Gothenburg, Gothenburg, Sweden
| | - Minna Isomursu
- Faculty of Information Technology and Electrical Engineering, University of Oulu, Oulu, Finland
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10
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Dodd RH, Forster AS, Marlow LAV, Waller J. Psychosocial impact of human papillomavirus-related head and neck cancer on patients and their partners: A qualitative interview study. Eur J Cancer Care (Engl) 2019; 28:e12999. [PMID: 30677190 PMCID: PMC6559265 DOI: 10.1111/ecc.12999] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 11/18/2018] [Accepted: 12/22/2018] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Increasing numbers of patients face the psychosocial challenge of a diagnosis of oropharyngeal squamous cell carcinoma (OSCC) caused by human papillomavirus (HPV). We explored the psychosocial impact of an HPV-OSCC diagnosis for patients and their partners. METHODS In-depth interviews were conducted with patients (n = 20) and a subset of their partners (n = 12), identified through medical records at two UK hospitals. Interviews were recorded, transcribed verbatim and analysed using thematic Framework Analysis. RESULTS Only 12/20 patients interviewed (and five partners) were aware of their HPV status and the main analysis focused on this sub-sample. In discussing the cause of their cancer, patients and their partners talked about not wanting to know; whether they disclosed the cause of their cancer to others; their reactions to being diagnosed with HPV; the prognosis information they were given and the questions they had about HPV. Most concerns were cancer-related rather than HPV-related, but some patients (n = 3) described feelings of embarrassment and perceived stigma about HPV. CONCLUSION Some patients and partners who are told HPV is the cause of their OSCC have questions about HPV and seek further information. Concerns and uncertainties about the sexually transmitted nature of HPV need to be addressed by health professionals.
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Affiliation(s)
- Rachael H. Dodd
- The University of Sydney, Faculty of Medicine and HealthSchool of Public HealthSydneyNew South WalesAustralia
- Department of Behavioural Science and HealthUniversity College LondonLondonUK
| | - Alice S. Forster
- Department of Behavioural Science and HealthUniversity College LondonLondonUK
| | - Laura A. V. Marlow
- Department of Behavioural Science and HealthUniversity College LondonLondonUK
| | - Jo Waller
- Department of Behavioural Science and HealthUniversity College LondonLondonUK
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Lee Y, Baek JM, Jeon YW, Im EO. Illness perception and sense of well-being in breast cancer patients. Patient Prefer Adherence 2019; 13:1557-1567. [PMID: 31571838 PMCID: PMC6754328 DOI: 10.2147/ppa.s225561] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 09/02/2019] [Indexed: 11/26/2022] Open
Abstract
PURPOSE The objective of the study was to explore breast cancer patients' illness perception, its relationship to perceived sense of well-being, and the role of perceived social support. METHODS Women with diagnosed breast cancer were recruited from the two university hospitals in South Korea between January and April 2018. The questionnaires included the Illness Perception Questionnaire-Revised (IPQ-R) and the Functional Assessment of Cancer Therapy for Breast cancer (FACT-B). A total of 321 participants' data was analyzed using descriptive analyses, multiple regression, and structural equation modeling. RESULTS Negative illness perception was greater in participants currently receiving chemotherapy (p=0.044) or had received chemotherapy in the past (p=0.006). Positive illness perception was lower in older participants (p=0.001) or those who had received chemotherapy (p=0.018). Negative illness perception had a direct effect on a low sense of well-being (p<0.001). Perceived social support had a significant mediation effect on the relationship between negative/positive illness perception and sense of well-being (p<0.001). CONCLUSION Significant relationships between illness perception and sense of well-being were observed in breast cancer patients. Strengthening patients' perceived social support would be helpful in improving their sense of well-being.
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Affiliation(s)
- Yaelim Lee
- Department of Nursing, Red Cross College of Nursing, Chung-Ang University, Dongjak-gu, Seoul, Republic of Korea
- Correspondence: Yaelim Lee Department of Nursing, Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul06974, Republic of KoreaTel +82 10 9950 2731 Email
| | - Jong-Min Baek
- Department of Surgery, Yeouido St. Mary’s Hospital, Seoul, Republic of Korea
| | - Ye-Won Jeon
- Department of Surgery, St. Vincent’s Hospital, Gyeonggi-do, Republic of Korea
| | - Eun-Ok Im
- Department of Nursing, School of Nursing, Duke University, Durham, NC, USA
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12
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Papadakos J, Agarwal A, Charow R, Quartey NK, D'souza A, Giuliani M, Millar BA, Massey C, Shultz D, Chung C. Informational needs of brain metastases patients and their caregivers. Neurooncol Pract 2018; 6:47-60. [PMID: 31386069 DOI: 10.1093/nop/npy008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background In response to a dearth of formal health information targeted towards patients with brain metastases and their caregivers, a formal informational and supportive care needs assessment was conducted. Methods Brain metastases patients and caregivers who attended a clinic focused on the treatment of brain metastases at a tertiary medical center completed a self-report survey to assess informational needs across 6 domains: medical, physical, practical, social, emotional, and spiritual informational needs. Univariate and multivariate analyses of associations between variables was conducted using linear regression models. Results A total of 109 patients and 77 caregivers participated. Patients and caregivers both prioritized medical and physical informational domains, with a large focus on symptoms and side-effect profiles, significance of brain metastases locations and their implications, available treatment options and their risks and benefits, prognoses and follow-ups if treatment is completed, and end-of-life experiences and supports. One-on-one counseling was preferred by both caregivers and patients for these domains, as well as for practical informational needs; while patients preferred pamphlets to address social, emotional and spiritual informational needs, caregivers preferred one-on-one counseling for the former two domains as well. Conclusions Brain metastases patients and their caregivers prioritize medical and physical informational needs, with one-on-one counseling and pamphlets being the most preferred modalities for information provision. Further exploration regarding existing non-validated resources and the development of tailored resources to address the unique needs of these patient and caregiver populations are warranted.
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Affiliation(s)
- Janet Papadakos
- Cancer Education Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.,Patient Education, Cancer Care Ontario, Toronto, ON
| | - Arnav Agarwal
- Cancer Education Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.,Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Rebecca Charow
- Cancer Education Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Naa Kwarley Quartey
- Cancer Education Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Anna D'souza
- Cancer Education Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Meredith Giuliani
- Cancer Education Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.,Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, ON
| | - Barbara-Ann Millar
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, ON
| | - Christine Massey
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - David Shultz
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, ON
| | - Caroline Chung
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Division of Radiation Oncology, MD Anderson Cancer Centre, Houston, Texas
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13
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A Self-Regulatory Intervention for Patients with Head and Neck Cancer: Pilot Randomized Trial. Ann Behav Med 2018; 51:629-641. [PMID: 28244003 DOI: 10.1007/s12160-017-9885-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Research is yet to investigate whether psychological interventions delivered early after diagnosis can benefit patients with head and neck cancer (HNC). PURPOSE The aim of this study was to investigate the effectiveness of a brief self-regulatory intervention (targeting illness perceptions and coping) at improving HNC patient health-related quality of life (HRQL). METHODS A pilot randomized controlled trial was conducted, in which 64 patients were assigned to receive three sessions with a health psychologist in addition to standard care or standard care alone. Participants completed questionnaires assessing HRQL, general distress, and illness perceptions at baseline and again 3 and 6 months later. RESULTS Compared to the control group, patients who received the intervention had increased treatment control perceptions at 3 months (p = .01), and increased social quality of life at 6 months (p = .01). The intervention was particularly helpful for patients exhibiting distress at baseline. CONCLUSION A brief psychological intervention following HNC diagnosis can improve patient perceptions of treatment and social quality of life over time. Such interventions could be targeted to patients who are distressed in order to confer the greatest benefit. TRIAL REGISTRATION NUMBER 12614000813684.
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14
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Padmaja G, Vanlalhruaii C, Rana S, Kopparty S. Quality of Life of Patients with Cancer: A Determinant of the Quality of Life of Their Family Caregivers. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2017; 32:655-661. [PMID: 26867554 DOI: 10.1007/s13187-016-1000-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Cancer disrupts the quality of life of both the patients and their family caregivers. This study attempted to explore the relationship between the quality of life of cancer patients and their family caregivers and to examine whether the quality of life, age, and gender of the patients contributed to the quality of life of their family caregivers. This correlational study involved 206 pairs of participants consisting of cancer patients and their corresponding family caregivers. The European Organization for the Treatment and Research of Quality of Life Questionnaire C-30 (version 3) was administered on the patients and the Caregiver Quality of Life-Cancer was administered on their family caregivers. The result revealed that social functioning, appetite loss, physical functioning, and gender of the patients contributed significantly to the quality of life of their family caregivers. Implications, shortcomings, and future directions were discussed.
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Affiliation(s)
- Gadiraju Padmaja
- Centre for Health Psychology, University of Hyderabad, Central University Campus PO, Gachibowli, Hyderabad, 500046, Telangana, India
| | - C Vanlalhruaii
- Centre for Health Psychology, University of Hyderabad, Central University Campus PO, Gachibowli, Hyderabad, 500046, Telangana, India
| | - Suvashisa Rana
- Centre for Health Psychology, University of Hyderabad, Central University Campus PO, Gachibowli, Hyderabad, 500046, Telangana, India.
| | - Swarajya Kopparty
- Centre for Health Psychology, University of Hyderabad, Central University Campus PO, Gachibowli, Hyderabad, 500046, Telangana, India
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15
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Sterba KR, Zapka J, Armeson KE, Shirai K, Buchanan A, Day TA, Alberg AJ. Physical and emotional well-being and support in newly diagnosed head and neck cancer patient-caregiver dyads. J Psychosoc Oncol 2017; 35:646-665. [PMID: 28459393 DOI: 10.1080/07347332.2017.1323817] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The purpose of this study was to examine the physical and emotional well-being and social support in newly diagnosed head and neck cancer (HNC) patients and caregivers and identify sociodemographic, clinical, and behavioral risk factors associated with compromised well-being in patients and caregivers. Newly diagnosed HNC patients and their primary caregivers (N = 72 dyads) completed questionnaires before treatment assessing physical and mental well-being, depression, cancer worry, and open-ended support questions. Patients reported worse physical well-being than caregivers (p < 0.05) but similar levels of mental well-being. Caregivers reported providing emotional and instrumental support most frequently with an emphasis on nutrition and assistance with speech, appearance, and addictions. Both patients and their caregivers reported suboptimal mental well-being and depression. Smoking was associated with compromised well-being in patients, caregivers, and dyads. Compromised well-being in patients and their caregivers was more likely when patients were younger, had worse symptoms, and smoked/consumed alcohol (p < 0.05). While patients face more physical strain than caregivers, both equally confront emotional challenges. Results highlight risk factors for compromised well-being in both patients and their caregivers that should be assessed at diagnosis to guide identification of needed dyadic-focused supportive care resources.
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Affiliation(s)
- Katherine R Sterba
- a Hollings Cancer Center , Medical University of South Carolina , Charleston , SC , USA
| | - Jane Zapka
- a Hollings Cancer Center , Medical University of South Carolina , Charleston , SC , USA
| | - Kent E Armeson
- a Hollings Cancer Center , Medical University of South Carolina , Charleston , SC , USA
| | - Keisuke Shirai
- a Hollings Cancer Center , Medical University of South Carolina , Charleston , SC , USA
| | - Amy Buchanan
- a Hollings Cancer Center , Medical University of South Carolina , Charleston , SC , USA
| | - Terry A Day
- a Hollings Cancer Center , Medical University of South Carolina , Charleston , SC , USA
| | - Anthony J Alberg
- a Hollings Cancer Center , Medical University of South Carolina , Charleston , SC , USA
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16
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Rigoni L, Bruhn RF, De Cicco R, Kanda JL, Matos LL. Quality of life impairment in patients with head and neck cancer and their caregivers: a comparative study. Braz J Otorhinolaryngol 2016; 82:680-686. [PMID: 27133907 PMCID: PMC9444724 DOI: 10.1016/j.bjorl.2015.12.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 12/08/2015] [Indexed: 11/29/2022] Open
Abstract
Introduction Head and neck cancer represents 3% of all the types of malignant neoplasms and squamous cell carcinoma (SCC) is responsible for 90% of these cases. There have been some studies evaluating the quality of life of these patients, but little is known about the physical and emotional effects on their caregivers. Objective To evaluate the quality of life of patients with head and neck cancer and their caregivers by applying validated questionnaires. Methods Thirty patients with advanced tumors (SCC stage III or IV) and their 30 caregivers were included. Specific questionnaires (Coop/Wonca, EORTC QLQ–C30, EORTC H&N35, Coop/Wonca, and Caregiver Strain Index – CSI) were applied during routine medical consultations. Results Of the 30 patients, 28 were males and 25 had stage IV tumors, with mean age of 56.6 years. 36.7% had the primary tumor in the oropharynx and 70% reported pain. The functional cognitive, physical, and emotional scales were the most affected. Pain, fatigue, and sleep disorders were the most prevalent symptoms. Of the 30 caregivers, 23 were females and 70% were the primary caregivers. 36.7% of the caregivers had high levels of stress, mainly related to the feeling of incapacity. The comparison between patients and caregivers demonstrated that the two groups had similar quality of life impairment: physical fitness (p = 0.487), mental health (p = 0.615), daily activities (p = 0.793), social activities (p = 0.301), changes in health (p = 0.649), and overall health (p = 0.168). Conclusion Quality of life impairment is similar between patients and their caregivers. This result demonstrates that not only the patients show quality of life impairment, but their caregivers also have it and at similar proportions.
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Affiliation(s)
- Laís Rigoni
- Faculdade de Medicina do ABC, Santo André, SP, Brazil.
| | - Raphaella Falco Bruhn
- Faculdade de Medicina do ABC, Disciplina de Cirurgia de Cabeça e Pescoço, Santo André, SP, Brazil
| | - Rafael De Cicco
- Faculdade de Medicina do ABC, Disciplina de Cirurgia de Cabeça e Pescoço, Santo André, SP, Brazil
| | - Jossi Ledo Kanda
- Faculdade de Medicina do ABC, Disciplina de Cirurgia de Cabeça e Pescoço, Santo André, SP, Brazil
| | - Leandro Luongo Matos
- Faculdade de Medicina do ABC, Disciplina de Saúde Coletiva (Curso de Bioestatística), Santo André, SP, Brazil
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17
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Richardson AE, Morton RP, Broadbent EA. Changes over time in head and neck cancer patients' and caregivers' illness perceptions and relationships with quality of life. Psychol Health 2016; 31:1203-19. [PMID: 27315836 DOI: 10.1080/08870446.2016.1203686] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE This study investigated changes in illness perceptions from diagnosis to six months later in patients with head and neck cancer (HNC) and their caregivers. The study also examined whether discrepancy in patient and caregiver perceptions at diagnosis predicted patient health-related quality of life (HRQL) at six months. DESIGN Forty-two patient-caregiver dyads completed the Brief Illness Perception Questionnaire (Brief IPQ) at diagnosis and again six months later. Patients also completed a HRQL questionnaire at both time points. Analyses were performed using the Actor-Partner Interdependence Model. MAIN OUTCOME MEASURE Total patient HRQL assessed by the Functional Assessment of Cancer Therapy (FACT-H&N). RESULTS Perceptions of emotional impact and illness concern reduced over time in patients and caregivers. Perceptions of treatment control and identity increased in caregivers only. After controlling for the effects of baseline HRQL, and the individual contribution of patient and caregiver illness perceptions, greater discrepancy in perceptions of timeline, personal control, and illness identity among dyads at diagnosis predicted lower patient HRQL at six-month follow-up. CONCLUSION Patients' and their caregivers' perceptions of HNC are dynamic over time. Greater discrepancy between patients' and caregivers' illness perceptions at diagnosis predict poorer subsequent patient HRQL.
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Affiliation(s)
- Amy E Richardson
- a Faculty of Medical and Health Sciences, Department of Psychological Medicine , University of Auckland , Auckland , New Zealand
| | - Randall P Morton
- b Faculty of Medical and Health Sciences, Department of Surgery , University of Auckland , Auckland , New Zealand
| | - Elizabeth A Broadbent
- a Faculty of Medical and Health Sciences, Department of Psychological Medicine , University of Auckland , Auckland , New Zealand
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18
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Balfe M, Maguire R, Hanly P, Butow P, O'Sullivan E, Timmons A, Gooberman-Hill R, Sharp L. Distress in long-term head and neck cancer carers: a qualitative study of carers' perspectives. J Clin Nurs 2016; 25:2317-27. [DOI: 10.1111/jocn.13242] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Myles Balfe
- National Cancer Registry of Ireland; Cork Airport Business Park; Cork Ireland
| | | | - Paul Hanly
- National College of Ireland; Dublin Ireland
| | - Phyllis Butow
- Centre for Medical Psychology; University of Sydney; Sydney NSW Australia
| | | | - Aileen Timmons
- National Cancer Registry of Ireland; Cork Airport Business Park; Cork Ireland
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