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Peng HL, Chen YH, Lee HY, Tsai WY, Chang YL, Lai YH, Chen SC. Factors associated with shame and stigma among head and neck cancer patients: a cross-sectional study. Support Care Cancer 2024; 32:357. [PMID: 38750287 DOI: 10.1007/s00520-024-08568-2] [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: 12/25/2023] [Accepted: 05/10/2024] [Indexed: 06/18/2024]
Abstract
PURPOSE Head and neck cancer (HNC) patients often suffer from shame and stigma due to treatment limitations or due to societal factors. The purpose of this study was to assess perceived body image, depression, physical and psychosocial function, and self-stigma, as well as to identify factors that predicted shame and stigma in patients with HNC. METHODS This cross-sectional study recruited 178 HNC patients from the outpatient radiation department of a medical center in Northern Taiwan. Patients were assessed for patient reported outcomes using the Body Image Scale (BIS), the Hospital Anxiety and Depression Scale-Depression Subscale (HADS-Depression Subscale), the University of Washington Quality of Life Scale (UW-QOL) version 4.0, and the Shame and Stigma Scale (SSS). Data were analyzed by descriptive analysis, Pearson's product-moment correlation, and multiple regression. RESULTS The two top-ranked subscales of shame and stigma were: "speech and social concerns" and "regret". Shame and stigma were positively correlated with a longer time since completion of treatment, more body image concerns, and higher levels of depression. They were negatively correlated with being male and having lower physical function. Multiple regression analysis showed that female gender, a longer time since completing treatment, higher levels of body image concern, greater depression, and less physical function predicted greater shame and stigma. These factors explained 74.7% of the variance in shame and stigma. CONCLUSION Patients' body image concerns, depression, time since completing treatment, and physical function are associated with shame and stigma. Oncology nurses should assess and record psychological status, provide available resources, and refer appropriate HNC patients to counselling.
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Affiliation(s)
- Hsi-Ling Peng
- Department of Nursing, Asia Eastern University of Science and Technology, Taipei, Taiwan
| | - Yen-Hui Chen
- Department of Nursing, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Han-Yen Lee
- Department of Nursing, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Wen-Ying Tsai
- Department of Nursing, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ya-Lan Chang
- Department of Nursing, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Nursing, College of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Yeur-Hur Lai
- School of Nursing, College of Medicine, National Taiwan University, 1 Jen-Ai Rd., Sec. 1, Taipei, 100, Taiwan.
- Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan.
- Department of Nursing, National Taiwan University Cancer Center, Taipei, Taiwan.
| | - Shu-Ching Chen
- School of Nursing and Geriatric and Long-Term Care Research Center, College of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan.
- Department of Radiation Oncology and Proton and Radiation Therapy Center, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
- School of Nursing, College of Nursing, Chang Gung University of Science and Technology, 261, Wen-Hua 1 Road, Guishan, Taoyuan, 333, Taiwan.
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Liao LY, Chen KM, Cheng HR, Hsu HF. Factors of Influence on Diabetes Awareness in Older People With Chronic Obstructive Pulmonary Disease Comorbid With Type 2 Diabetes Mellitus. J Nurs Res 2024; 32:e323. [PMID: 38488165 DOI: 10.1097/jnr.0000000000000602] [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: 03/26/2024] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is a common comorbidity in patients with chronic obstructive pulmonary disease (COPD) and has been associated with an increased risk of mortality in this population. PURPOSE This study was designed to investigate the predictive factors of diabetes awareness (DA), including diabetes knowledge (DK), and diabetes care behaviors (DCB) among older people with both COPD and T2DM. METHODS This was a cross-sectional descriptive correlation study. One hundred thirty-three older-age patients with COPD comorbid with T2DM receiving treatment at a chest hospital were enrolled as participants. Both DK and DCB were utilized to measure DA. The Diabetes Knowledge Questionnaire was utilized to measure DK, and the Summary of Diabetes Self-Care Activities was used to evaluate DCB. RESULTS The average glycated hemoglobin (HbA1c) was 7.68% ( SD = 1.55%), with 74 (55.6%) participants having a level > 7%. The average DA was 46.46% ( SD = 13.34%), the average DK was 53.42% ( SD = 18.91%), and the average DCB was 39.50% ( SD = 16.66%). In terms of demographic variables, age, diabetes education, diabetes shared care, and HbA1c were all significantly associated with DA, DK, and DCB (all p s < .05). The overall variance in DA was significantly explained by diabetes education and HbA1c (all p s < .05). The overall variance in DK was significantly explained by age, diabetes education, and HbA1c. The overall variance in DCB was significantly explained by diabetes education and HbA1c (all p s < .05). CONCLUSIONS/IMPLICATIONS FOR PRACTICE Our study findings indicate that older adult patients with COPD comorbid with T2DM are at elevated risks of poor glycemic control and low DA. Healthcare professionals should be aware of these issues and develop appropriate DA plans to prevent poor glycemic control in this population. Providing accurate information on diabetes to older adults with COPD comorbid with T2DM is important to improving their DK and promoting better DCB.
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Affiliation(s)
- Lin-Yu Liao
- PhD, RN, Head Nurse, Department of Nursing, Chest Hospital, Ministry of Health and Welfare, Taiwan
| | - Kuei-Min Chen
- PhD, RN, FAAN, Professor, College of Nursing, Center for Long-Term Care Research, Kaohsiung Medical University, and Department of Medical Research, Kaohsiung Medical University Hospital, Taiwan
| | - Hsiu-Rong Cheng
- PhD, RN, Associate Professor, Department of Nursing, Chung Hwa University of Medical Technology, Tainan, Taiwan
| | - Hui-Fen Hsu
- PhD, Postdoctoral Fellow, College of Nursing, Kaohsiung Medical University, Taiwan
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Chung CF, Huang BS, Wang YM, Huang YT, Chen SC. Quality of life in patients with nasopharyngeal carcinoma receiving IMRT vs IMPT: a multicenter prospective longitudinal study. Support Care Cancer 2024; 32:203. [PMID: 38430411 DOI: 10.1007/s00520-024-08412-7] [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: 10/04/2023] [Accepted: 02/26/2024] [Indexed: 03/03/2024]
Abstract
PURPOSE Nasopharyngeal carcinoma (NPC) patients may experience symptom distress and depression during and after radiation therapy, which negatively impacts quality of life (QOL). We sought to identify trajectories of symptom distress, depression, social support, and QOL in patients with NPC receiving intensity-modulated radiation therapy (IMRT) vs intensity-modulated proton therapy (IMPT). METHODS A multicenter prospective longitudinal study recruited NPC patients from two leading medical centers in Taiwan. The 121 NPC patients were followed from before RT (T0), at 4 weeks after beginning RT (T1), at 6 weeks of RT or the end of treatment (T2), and at 4 weeks post-RT (T3). Generalized estimating equation analysis was used to identify the factors related to QOL. RESULTS Patients' symptom distress and depression increased from T0, peaked at T2, and decreased at T3. Physical-QOL and psychosocial-QOL decreased from T0 to T2, then increased by T3. Patients who had early-stage cancer, received a lower RT dose, had less symptom distress, and had less depression were more likely to have better QOL. Greater physical-QOL was associated with IMPT receipt, higher education level, early cancer stage, lower radiation dose, less symptom distress, and less depression. Patients who had good physical performance, received a lower radiation dose, had less symptom distress, and had less depression were more likely to have better psychosocial-QOL. CONCLUSION Radiation dose, symptom distress, and depression were the most important factors affecting QOL in patients with NPC. Understanding the factors associated with the trajectory of QOL can guide care during radiation treatment.
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Affiliation(s)
- Ching-Fang Chung
- Department of Nursing, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, Republic of China
| | - Bing-Shen Huang
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China
- Department of Radiation Oncology, and Proton and Radiation Therapy Center, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, Republic of China
| | - Yu-Ming Wang
- Department of Radiation Oncology, and Proton and Radiation Therapy Center, Chang Gung Medical Foundation, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan, Republic of China
- Department of Medicine, College of Medicine, Chang Gung University, Kaohsiung, Taiwan, Republic of China
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China
| | - Yu-Tung Huang
- Center for Big Data Analytics and Statistics, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, Republic of China
| | - Shu-Ching Chen
- Department of Radiation Oncology, and Proton and Radiation Therapy Center, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, Republic of China.
- School of Nursing and Geriatric and Long-Term Care Research Center, College of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan, Republic of China.
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China.
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Aravantinou-Karlatou A, Bouloukaki I, Christodoulakis A, Tsiligianni I. The Influence of Social Support in PROMs of Patients with COPD in Primary Care: A Scoping Review. Healthcare (Basel) 2023; 11:3141. [PMID: 38132031 PMCID: PMC10742576 DOI: 10.3390/healthcare11243141] [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: 11/14/2023] [Revised: 12/05/2023] [Accepted: 12/10/2023] [Indexed: 12/23/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a prevalent and multidimensional disease with symptoms that greatly influence patients' health. Healthcare professionals utilize patient-reported outcome measures (PROMs) to classify and better manage the disease. Despite the value of PROMs, they inadequately represent some important dimensions of COPD, like social support and healthcare access/utilization. This is important, especially for social support, since it can positively influence PROMs results and the overall health of patients with COPD. Therefore, a scoping review was conducted to determine how social support affects PROMs of patients with COPD in primary care. The PRISMA-Scoping approach was adopted, and we sought articles published in MEDLINE and COHRANE. We screened 2038 articles for inclusion and finally included a total of 10 articles. Most of the articles were conducted in the U.S. and Norway. Social support had a strong positive impact on PROMs. Additionally, different types of social support were observed. Moreover, higher levels of social support were linked to better quality of life, mental health, self-care behaviors, self-management, functionality, and less severe COPD. Consequently, this scoping review highlights the value of social support in patients with COPD and its underrepresentation and misrepresentation in PROMs literature.
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Affiliation(s)
- Antonia Aravantinou-Karlatou
- Department of Social Medicine, School of Medicine, University of Crete, Voutes-Stavrakia, 71003 Heraklion, Greece; (I.B.); (A.C.); (I.T.)
| | - Izolde Bouloukaki
- Department of Social Medicine, School of Medicine, University of Crete, Voutes-Stavrakia, 71003 Heraklion, Greece; (I.B.); (A.C.); (I.T.)
| | - Antonios Christodoulakis
- Department of Social Medicine, School of Medicine, University of Crete, Voutes-Stavrakia, 71003 Heraklion, Greece; (I.B.); (A.C.); (I.T.)
- Department of Nursing, School of Health Sciences, Hellenic Mediterranean University, 71410 Heraklion, Greece
| | - Ioanna Tsiligianni
- Department of Social Medicine, School of Medicine, University of Crete, Voutes-Stavrakia, 71003 Heraklion, Greece; (I.B.); (A.C.); (I.T.)
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