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Yusuf R, Ng DQ, Torno L, Chan A. Current evidence of integrative oncology modalities for managing adverse effects and survivorship issues among adolescents and young adult (AYA) cancer patients and survivors. Curr Opin Oncol 2024; 36:211-222. [PMID: 38842014 DOI: 10.1097/cco.0000000000001033] [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: 06/07/2024]
Abstract
PURPOSE OF REVIEW Symptom burden of cancer diagnosis and treatment has led adolescents and young adult cancer patients (AYAC) and survivors to seek different self-management strategies including integrative oncology (IO) modalities. IO holds great promise to improve survivorship issues in adolescents and young adult (AYA) cancer survivors. This review aims to encompass the current evidence of IO modalities and to analyze the efficacy of IO for managing survivorship issues among AYA cancer patients and survivors. RECENT FINDINGS Nineteen randomized controlled trials included in this review evaluated mind and body modalities including both physical and psychological (74%) and psychological only (26%) modalities. Most assessed IO modalities were physical activity (PA) (37%) and structured exercise (10%). Most effective IO modalities found were PA, massage, mindfulness-based stress reduction (MBSR) and light therapy for treating AYA symptom burden. The Cochrane risk of bias (RoB-2) concluded 21% studies had high risk, 58% possessed some concerns and 21% had low risk. SUMMARY Although evidence has shown that a number of IO modalities may improve survivorship among AYA cancer survivors, more rigorous study designs are needed in order for these modalities to be routinely recommended for use in clinical practice.
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Affiliation(s)
- Rukh Yusuf
- Department of Clinical Pharmacy Practice, School of Pharmacy & Pharmaceutical Sciences, University of California, Irvine
| | - Ding Quan Ng
- Department of Clinical Pharmacy Practice, School of Pharmacy & Pharmaceutical Sciences, University of California, Irvine
| | - Lilibeth Torno
- Division of Oncology, Children's Hospital of Orange County, Orange, USA
| | - Alexandre Chan
- Department of Clinical Pharmacy Practice, School of Pharmacy & Pharmaceutical Sciences, University of California, Irvine
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Twivy E, Griffiths H, Knight MTD. Evaluating end of treatment care of young people with cancer. Clin Child Psychol Psychiatry 2024; 29:661-673. [PMID: 37773596 PMCID: PMC10945980 DOI: 10.1177/13591045231204073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/01/2023]
Abstract
BACKGROUND Existing literature implies there may be gaps in post-treatment support for young people with cancer. This service evaluation explored the needs and experiences of young people when ending cancer treatment in a UK children's hospital to inform service provisions. METHODS Semi-structured interviews were conducted with nine young people, aged 13-18 years, who had finished active cancer treatment and were receiving follow-up care. The data was analysed using thematic analysis. RESULTS Four main themes were developed: being in the dark (i.e. limited awareness of what happens when treatment ends); separation from the hospital (i.e. the loss of valued support from staff); consequences of cancer (i.e. managing ongoing psychological and physical effects); and getting back to normal life (i.e. shifting from hospital to everyday life). CONCLUSIONS Recommendations for improving clinical practice were made. Greater preparedness for ending treatment could be achieved by clearly setting out ongoing care arrangements, providing resource packs, having opportunities to mark the end of treatment, and offering peer support. To identify specific post-treatment needs, there should be an end of treatment multidisciplinary review and space for young people to share how they are feeling in follow-up medical appointments.
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Affiliation(s)
- Eve Twivy
- Oxford Institute of Clinical Psychology Training and Research, Oxford Health NHS Foundation Trust, University of Oxford, UK
| | - Helen Griffiths
- Oxford Children’s Hospital, Oxford University Hospitals NHS Foundation Trust, UK
| | - Matthew TD Knight
- Oxford Institute of Clinical Psychology Training and Research, Oxford Health NHS Foundation Trust, University of Oxford, UK
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Stegenga K, Erickson JM, Linder L, Macpherson CF, Elswick RK, Ameringer S. Development and psychometric evaluation of the Symptom Self-Management Behaviors Tool for adolescents/young adults with cancer. Palliat Support Care 2024; 22:274-280. [PMID: 37387259 DOI: 10.1017/s1478951523000810] [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] [Indexed: 07/01/2023]
Abstract
OBJECTIVES Adolescents and Young Adults (AYAs) with cancer experience symptoms related to disease and treatment. To manage these symptoms, they need to develop self-management behaviors, yet no tool exists to assess these behaviors. The Symptom Self-Management Behaviors Tool (SSMBT) was developed to meet this need. METHODS The study consisted of 2 phases. Phase 1 evaluated content validity, and Phase 2 evaluated reliability and validity. The SSMBT initially contained 14 items with 2 dimensions: (1) behaviors used to Manage Symptoms and (2) behaviors used to communicate with providers regarding symptoms. Four oncology professionals and 5 AYAs with cancer assessed the content validity. Evaluation of reliability and validity involved 61 AYAs with cancer. Reliability was evaluated using Cronbach's alpha. Construct validity was assessed with factor analysis. Discriminant validity was assessed using associations with symptom severity and distress. RESULTS Content validity evaluation supported the importance of the items. Factor analysis supported a two-factor structure: Manage Symptoms (8 items) and Communicate with Healthcare Providers (4 items) subscales. Internal consistency reliability for the total SSMBT was acceptable with Cronbach's alpha = 0.74. Cronbach's alpha value for the Manage Symptoms subscale was α = 0.69 and for the Communicate with Healthcare Providers subscale was α = 0.78. The SSMBT total and the Manage Symptoms subscale scores were moderately correlated with symptom severity (r = 0.35, p = 0.014; r = 0.44, p = 0.002, respectively), partially supporting discriminant validity. SIGNIFICANCE OF RESULTS Systematic assessment of behaviors AYAs use is critical for clinical practice and evaluate interventions to improve self-management. The SSMBT demonstrates initial reliability and validity but requires further evaluation for clinical interpretation and future use.
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Affiliation(s)
- Kristin Stegenga
- Children's Mercy Hospital, Division of Hematology/Oncology and BMT, Kansas City, MO, USA
| | - Jeanne M Erickson
- College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Lauri Linder
- University of Utah College of Nursing and Primary Children's Hospital, Center for Cancer and Blood Disorders, Salt Lake City, UT, USA
| | | | - R K Elswick
- School of Nursing, Virginia Commonwealth University, Richmond, VA, USA
| | - Suzanne Ameringer
- School of Nursing, Virginia Commonwealth University, Richmond, VA, USA
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Ayvat İ, Atli Ozbas A. Is There a Difference in Unmet Supportive Care Needs Between Older and Younger Outpatients Receiving Chemotherapy? J Palliat Care 2024; 39:115-121. [PMID: 34665068 DOI: 10.1177/08258597211044248] [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] [Indexed: 11/16/2022]
Abstract
Objective: This study investigated whether there was a difference in unmet supportive care needs between older and younger cancer patients who receive chemotherapy. Background: Physiological, physical, cognitive, and social functions, which play a key role in coping with cancer, are impaired due to aging. Age-related physiological changes and psychosocial factors and comorbid medical conditions make some of the needs of older cancer patients unique and complex. At the heart of meeting these needs lies the concept of supportive care. First step of meeting their needs is to determine these needs. Study Design and Methods: The study was conducted in the Daytime Treatment Unit of the oncology hospital of a university in Ankara, Turkey. The study sample consisted of 93 patients aged 65 years or older and 93 patients under 65 years of age. Both groups were similar in terms of sex, cancer type, and chemotherapy protocols. Data were collected using a Patient Information Form and Supportive Care Needs Scale-Short Turkish Version and analyzed using descriptive statistics, Mann-Whitney U test, Kruskal-Wallis H test, and Bonferroni correction. Results: Participants had a median total score of 1.92. Their "daily life needs" and "sexuality needs" subscale scores were highest and lowest, respectively. Older patients had lower median total scores than younger patients. Younger patients had higher median "health care and information needs" and "sexuality needs" subscale scores than older patients. Conclusion: Elderly patients reported fewer unmet needs than younger patients. This may be due to age-related cultural factors as they may have difficulty expressing their needs. Implications: Results suggest to focus on the fact that patients' needs change with age and that they have difficulty expressing their needs.
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Affiliation(s)
- İrem Ayvat
- Faculty of Nursing, Psychiatric Nursing Department, Hacettepe University, Turkey
| | - Azize Atli Ozbas
- Faculty of Nursing, Psychiatric Nursing Department, Hacettepe University, Turkey
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Manglani HR, Lovette BC, Grunberg VA, Frieder J, Vranceanu AM, Greenberg J. "I Wish I Had That!": A Qualitative Analysis of Psychosocial Treatment Preferences Among Young Adults With Recent Concussion and Anxiety. Arch Phys Med Rehabil 2024:S0003-9993(24)00808-6. [PMID: 38369228 DOI: 10.1016/j.apmr.2024.01.024] [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: 08/31/2023] [Revised: 01/15/2024] [Accepted: 01/25/2024] [Indexed: 02/20/2024]
Abstract
OBJECTIVE To assess psychosocial treatment preferences and factors that may affect treatment participation among young adults with a recent concussion and co-occurring anxiety. DESIGN In-depth, semi-structured individual qualitative interviews, followed by thematic analysis using a hybrid deductive-inductive approach. SETTING Academic medical center in the US Northeast. PARTICIPANTS Seventeen young adults (18-24y) who sustained a concussion within the past 3-10 weeks and reported at least mild anxiety (≥5 on the Generalized Anxiety Disorder-7 questionnaire). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Primary outcomes include preferences for program content (eg, topics and skills), delivery modality, format, and barriers and facilitators to participation. RESULTS We identified 4 domains characterizing participants' perceptions of and preferences for treatment. (1) Program content: Participants preferred a program early after injury that included psychoeducation and coping skills (eg, activity pacing, deep breathing, mindfulness). (2) Therapeutic processes: Participants preferred a person-centered approach in which clinicians normalized anxiety postconcussion and reassured them of recovery. (3) Program logistics: Participants endorsed that a brief, virtual program would be acceptable. They preferred access to program components through multiple modalities (eg, audio, video) and accommodations to manage concussion symptoms. (4) Barriers and facilitators to participation: Barriers included acute concussion symptoms (eg, screen sensitivity), time constraints, and forgetting sessions. Facilitators included a program that is flexible (format, scheduling), personalized (self-chosen mode for reminders, measure of accountability), and accessible (ie, advertising through health care professionals or social media). CONCLUSIONS Participants need psychosocial support that normalizes their experiences and provides education and coping tools. Treatments should be accessible, flexible, and person centered. Psychosocial treatments meeting these preferences may help optimize the recovery of young adults with recent concussion and anxiety.
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Affiliation(s)
- Heena R Manglani
- Center for Health Outcomes and Interdisciplinary Research (CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - Brenda C Lovette
- Center for Health Outcomes and Interdisciplinary Research (CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA; MGH Institute of Health Professions, Boston, MA
| | - Victoria A Grunberg
- Center for Health Outcomes and Interdisciplinary Research (CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA; Division of Newborn Medicine, Massachusetts General Hospital for Children, Boston, MA
| | | | - Ana-Maria Vranceanu
- Center for Health Outcomes and Interdisciplinary Research (CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - Jonathan Greenberg
- Center for Health Outcomes and Interdisciplinary Research (CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA.
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van der Meer DJ, van der Graaf WTA, van de Wal D, Karim-Kos HE, Husson O. Long-term second primary cancer risk in adolescent and young adult (15-39 years) cancer survivors: a population-based study in the Netherlands between 1989 and 2018. ESMO Open 2024; 9:102203. [PMID: 38171190 PMCID: PMC10837779 DOI: 10.1016/j.esmoop.2023.102203] [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: 09/24/2023] [Revised: 11/16/2023] [Accepted: 11/17/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Few studies have comprehensively investigated the long-term second cancer risk among adolescent and young adult (AYA, aged 15-39 years) cancer survivors. This study investigated the long-term second cancer risk by including the full range of first and second cancer combinations with at least 10 observations in the Netherlands between 1989 and 2018. MATERIALS AND METHODS First and second primary cancer data of all 6-month AYA cancer survivors were obtained from the nationwide population-based Netherlands Cancer Registry. Excess cancer risk compared to the general population was assessed with standardized incidence ratio (SIR) and absolute excess risk (AER) statistics up to 25 years after diagnosis. Cumulative incidences were estimated, using death as a competing risk factor. Analyses were carried out with and without applying multiple cancer rules. RESULTS The cohort included 99 502 AYA cancer survivors. Male survivors had a 2-fold higher risk of developing any cancer compared to the general population, whereas this was around 1.3-fold in females. AERs were 17.5 and 10.1 per 10 000 person-years for males and females. The long-term excess risk of cancer was significantly higher for most first and second primary cancer combinations, but comparable and lower risk estimates were also observed. Application of the multiple cancer rules resulted in a noticeable risk underestimation in melanoma, testicular, and breast cancer survivors. Risk outcomes remained similar in most cases otherwise. The cumulative incidence of second cancer overall increased over time up to 8.9% in males and 10.3% in females at 25 years' follow-up. Highest long-term cumulative incidences were observed among lymphoma survivors (13.3% males and 18.9% females). CONCLUSIONS AYA cancer survivors have a higher cancer risk compared to the general population for most cancers up to 25 years after their initial cancer diagnosis. Additional studies that investigate risk factors for the specific cancer type combinations are needed to develop personalized follow-up strategies.
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Affiliation(s)
- D J van der Meer
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam; Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam; Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam.
| | - W T A van der Graaf
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam; Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam
| | - D van de Wal
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam
| | - H E Karim-Kos
- Princess Máxima Center for Pediatric Oncology, Utrecht; Department of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht
| | - O Husson
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam; Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam; Department of Surgical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
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Jin AH, Simon PJ, Clayton A, Benedict C, Liedtke M, Muffly L, Schapira L, Smith SM. Implementation of a Pilot Clinic for Pediatric to Adult Cancer Survivorship Transitions. J Adolesc Young Adult Oncol 2023; 12:918-922. [PMID: 37615593 DOI: 10.1089/jayao.2023.0041] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023] Open
Abstract
Childhood cancer survivors are recommended to have lifelong survivorship care, yet many become disengaged during pediatric to adult care transitions. We implemented a pilot clinic for adult survivors of pediatric or adolescent and young adult (AYA) leukemia transitioning to adult-focused survivorship care. The clinic featured AYA-specific care, bidirectional communication with primary care, and a quality improvement (QI) cycle. During the 1-year QI period, 27 patients were seen and 21 completed postvisit interviews. The clinic was positively received by patients and primary care providers, showed promise for improving self-management and care coordination, and highlighted the need for novel approaches to connect survivors with primary care.
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Affiliation(s)
| | - Pamela J Simon
- Lucile Salter Packard Children's Hospital at Stanford, Stanford Adolescent and Young Adult Cancer Program, Palo Alto, California, USA
| | - Alison Clayton
- Lucile Salter Packard Children's Hospital at Stanford, Stanford Adolescent and Young Adult Cancer Program, Palo Alto, California, USA
| | - Catherine Benedict
- Department of Psychiatry and Behavioral Science, Stanford University School of Medicine, Palo Alto, California, USA
| | - Michaela Liedtke
- Divisions of Hematology, Department of Medicine, Stanford Health Care, Stanford, California, USA
| | - Lori Muffly
- Blood and Marrow Transplantation and Cellular Therapy, Department of Medicine, Stanford Health Care, Stanford, California, USA
| | - Lidia Schapira
- Oncology, Department of Medicine, Stanford Health Care, Stanford, California, USA
- Stanford Cancer Institute, Stanford, California, USA
| | - Stephanie M Smith
- Division of Pediatric Hematology, Oncology, Stem Cell Transplantation & Regenerative Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California, USA
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Tsuchiya M, Tazaki M, Fujita R, Kodama S, Takata Y. A mixed-method systematic review of unmet care and support needs among Japanese cancer survivors. J Cancer Surviv 2023:10.1007/s11764-023-01439-5. [PMID: 37531042 DOI: 10.1007/s11764-023-01439-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 07/24/2023] [Indexed: 08/03/2023]
Abstract
PURPOSE To synthesize published studies regarding Japanese cancer survivors' needs/unmet needs of care/support, change of unmet needs over time, and preferred care/support providers. METHODS A mixed-method systematic review was conducted. MEDLINE, PsycINFO, CINAHL, and Ichu-shi were searched from inception to May 2022. Quantitative and qualitative studies were separately analyzed using narrative synthesis and meta-ethnography. Each finding was synthesized using a line of argument. RESULTS Twenty-four studies (13 quantitative and 11 qualitative studies) were included. Six quantitative studies reported unmet needs in survivors of adolescent and young adult (n=1) and adulthood (n=5) cancer. No longitudinal studies regarding changes in unmet needs were identified. One study reported that adults preferred care/support providers. The quantitative studies identified more help in physical (48.2-51.0%, n=2) and psychological issues (17.4-78.8%, n=5), information (27.9-58.0%, n=3), and healthcare services (25.3-67.1%, n=2) among adults. The qualitative studies emphasized more tailor-made information about life events for young cancer survivors. More empathic and trustworthy interactions with surrounding people, including healthcare professionals, were demanded, regardless of age. A line of argument illustrated that cancer survivors had insufficient resources for activities and empowerment to face life with cancer at all phases. CONCLUSIONS Japanese cancer survivors' unmet needs are diverse. More information and resources for psychological care/support and local healthcare services post-treatment are needed, which may hinder the optimal transition to survivorship. IMPLICATIONS FOR CANCER SURVIVORS The synthesized evidence should be utilized to implement a comprehensive care/support system in practice and educate people surrounding cancer survivors, regardless of age.
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Affiliation(s)
- Miyako Tsuchiya
- Research Institute of Nursing, Musashino University, 3-3-3, Ariake, Koto-ku, Tokyo, 135-8181, Japan.
- Former Division of Healthcare Delivery, Survivorship and Policy Research, Institute of Cancer Control, National Cancer Center, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
| | - Makiko Tazaki
- Former Division of Healthcare Delivery, Survivorship and Policy Research, Institute of Cancer Control, National Cancer Center, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
- Graduate School of Nursing, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8672, Japan
| | - Risako Fujita
- Former Division of Healthcare Delivery, Survivorship and Policy Research, Institute of Cancer Control, National Cancer Center, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
- Shirokanetakanawa Clinic, 1-13-11, Shirokane, Minato-ku, Tokyo, 108-0072, Japan
| | - Shoko Kodama
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8577, Japan
| | - Yoshinori Takata
- Department of Nursing, Japanese Red Cross College of Nursing, 4-1-3 Hiroo, Shibuya City, Tokyo, 150-0012, Japan
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Nekhlyudov L, Snow C, Knelson LP, Dibble KE, Alfano CM, Partridge AH. Primary care providers' comfort in caring for cancer survivors: Implications for risk-stratified care. Pediatr Blood Cancer 2023; 70:e30174. [PMID: 36583466 DOI: 10.1002/pbc.30174] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 11/28/2022] [Accepted: 12/05/2022] [Indexed: 12/31/2022]
Abstract
Personalized, risk-stratified care aims to "right size" the involvement of primary care providers (PCPs), oncology and specialized practitioners in caring for cancer survivors. Our survey found limited comfort among PCPs in cancer surveillance and management of treatment-related effects. In hypothetical case scenarios, PCPs reported least comfort in caring for a survivor of childhood cancer, followed by young adult-onset cancer, and greater comfort in caring for a survivor of adult-onset breast cancer. While education and training of PCPs is essential, risk-stratification strategies need to identify patients who may transition to primary care and those who may require ongoing survivorship-focused follow-up.
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Affiliation(s)
- Larissa Nekhlyudov
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Craig Snow
- Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Lauren P Knelson
- Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Kate E Dibble
- Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Catherine M Alfano
- Cancer Care Management and Research, Northwell Health Cancer Institute, New York, New York, USA
| | - Ann H Partridge
- Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
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Cherven B, Kelling E, Lewis RW, Pruett M, Meacham L, Klosky JL. Fertility-related worry among emerging adult cancer survivors. J Assist Reprod Genet 2022; 39:2857-2864. [PMID: 36447078 PMCID: PMC9790831 DOI: 10.1007/s10815-022-02663-1] [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: 07/12/2022] [Accepted: 11/17/2022] [Indexed: 12/03/2022] Open
Abstract
PURPOSE Cancer survivors with a history of gonadotoxic treatment are at risk for future infertility and reproductive concerns, including worry about infertility. The purpose of this study was to describe factors associated with fertility-related worry among emerging adult survivors of childhood cancer. METHODS This chart review included patients aged 18.00-25.99 years and > 1 year from cancer treatment completion with a history of gonadotoxic treatment. Survivors were offered structured fertility-focused discussions at age ≥ 18 years, which assessed worry about future infertility. Data from this discussion (i.e., reported fertility-related worry (yes/no), sociodemographic, and clinical characteristics were abstracted from the medical record. Multivariable logistic regression with backwards elimination was used to calculate odds ratios (OR) and 95% confidence intervals (95%CI) for factors associated with fertility-related worry. RESULTS Survivors (N = 249) were a mean age of 19.1 ± 1.2 years at initial fertility discussion; 55.8% were male, 58.2% non-Hispanic White, and 27.3% were at high risk for future treatment-related infertility. Fertility-related worry was reported by 66.3% of survivors. Factors related to worry on multivariable analysis included female sex (OR: 2.64, 95%CI: 1.44-4.96, p = .002), solid tumor diagnosis (OR: 2.31, 95%CI: 1.15-4.71, p = .019), moderate and high risk of infertility (OR: 2.94, 95%CI: 1.23-7.64, p = .02; OR: 3.25, 95%CI: 1.55-7.17, p = .002), and ≥ 2 fertility discussions during survivorship care OR: 2.71, 95%CI: 1.46-5.20, p = .002). CONCLUSIONS Two-thirds of emerging adult cancer survivors expressed worry about future infertility, which has been linked to a variety of adverse quality of life outcomes. Survivors who are worried about infertility may benefit from psychological interventions.
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Affiliation(s)
- Brooke Cherven
- Aflac Cancer and Blood Disorders Center at Children's Healthcare of Atlanta, 2015 Uppergate Dr, 4th Fl, Atlanta, GA, 30322, USA.
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA.
| | - Erin Kelling
- Aflac Cancer and Blood Disorders Center at Children's Healthcare of Atlanta, 2015 Uppergate Dr, 4th Fl, Atlanta, GA, 30322, USA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Rebecca Williamson Lewis
- Aflac Cancer and Blood Disorders Center at Children's Healthcare of Atlanta, 2015 Uppergate Dr, 4th Fl, Atlanta, GA, 30322, USA
| | - Megan Pruett
- Aflac Cancer and Blood Disorders Center at Children's Healthcare of Atlanta, 2015 Uppergate Dr, 4th Fl, Atlanta, GA, 30322, USA
| | - Lillian Meacham
- Aflac Cancer and Blood Disorders Center at Children's Healthcare of Atlanta, 2015 Uppergate Dr, 4th Fl, Atlanta, GA, 30322, USA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - James L Klosky
- Aflac Cancer and Blood Disorders Center at Children's Healthcare of Atlanta, 2015 Uppergate Dr, 4th Fl, Atlanta, GA, 30322, USA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
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Aagesen M, Pilegaard MS, Hauken MA, Wæhrens EEE, la Cour K. Users' perspective on rehabilitation interventions for young adult cancer survivors: A group concept mapping study. Eur J Cancer Care (Engl) 2022; 31:e13734. [PMID: 36218020 PMCID: PMC9786878 DOI: 10.1111/ecc.13734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 09/09/2022] [Accepted: 09/22/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE We aim to identify and prioritise rehabilitation interventions to strengthen participation in everyday life for young adult cancer survivors (YACS) between 18 and 39 years, involving the perspectives of YACS and relevant stakeholders. METHODS A group concept mapping study was conducted in Denmark from 2019 to 2020. Online, participants generated and sorted ideas followed by rating their importance. Multidimensional scaling followed by hierarchical cluster analyses were applied to generate a cluster rating map of the prioritised interventions, which participants validated at a face-to-face meeting. Finally, a concluding conceptual model of prioritised rehabilitation intervention for YACS was developed. RESULTS The study involved 25 YACS, three family members and 31 professionals working with YACS. The conceptual model included 149 ideas classified into eight intervention components created by the participants: (1) Treatment and possibilities within the social and healthcare system, (2) Rights and Finance, (3) Education and Work, (4) Psychological problems, (5) Body and Everyday Life, (6) Peer-to-peer, (7) Sexuality and Relationships and (8) Family and Friends. All components were rated equally important, whereby 17 ideas across the eight components were rated very important. CONCLUSION This study indicates that rehabilitation of YACS should be composed of eight equally important intervention components requiring an interdisciplinary approach.
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Affiliation(s)
- Maria Aagesen
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Department of Clinical ResearchUniversity of Southern DenmarkOdenseDenmark
| | - Marc Sampedro Pilegaard
- The Research Unit for User Perspectives and Community‐based Interventions, the Research Group for Occupational Science, Department of Public HealthUniversity of Southern DenmarkOdenseDenmark,OPEN, Open Patient data Explorative NetworkOdense University HospitalOdenseDenmark
| | - May Aasebø Hauken
- Centre for Crisis Psychology, Faculty of PsychologyUniversity of BergenBergenNorway
| | - Eva Elisabet Ejlersen Wæhrens
- The Research Unit for User Perspectives and Community‐based Interventions, the Research Group for Occupational Science, Department of Public HealthUniversity of Southern DenmarkOdenseDenmark,The Parker Institute, Copenhagen University Hospitals Bispebjerg–FrederiksbergFrederiksbergDenmark
| | - Karen la Cour
- The Research Unit for User Perspectives and Community‐based Interventions, the Research Group for Occupational Science, Department of Public HealthUniversity of Southern DenmarkOdenseDenmark
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Paterson C, Toohey K, Bacon R, Kavanagh PS, Roberts C. What Are the Unmet Supportive Care Needs of People Affected by Cancer: An Umbrella Systematic Review. Semin Oncol Nurs 2022:151353. [DOI: 10.1016/j.soncn.2022.151353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 09/16/2022] [Accepted: 10/12/2022] [Indexed: 11/24/2022]
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13
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Kerba J, Demers C, Bélanger V, Napartuk M, Bouchard I, Meloche C, Morel S, Prud’homme N, Gélinas I, Higgins J, Curnier D, Sultan S, Laverdière C, Sinnett D, Marcil V. Needs, Barriers and Facilitators of Adolescents Participating in a Lifestyle Promotion Program in Oncology: Stakeholders, Adolescents and Parents’ Perspective. CHILDREN 2022; 9:children9091340. [PMID: 36138649 PMCID: PMC9497682 DOI: 10.3390/children9091340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/17/2022] [Accepted: 08/30/2022] [Indexed: 11/28/2022]
Abstract
Treatments for adolescent cancer can cause debilitating side effects in the short- and long-term such as nausea and malnutrition but also cardiometabolic disturbances. Although the risk for cardiometabolic complications is greater for adolescents with cancer than younger ones, adolescents typically respond poorly to family-oriented health promotion programs. This study aims to assess the needs, barriers and facilitators to healthy lifestyle promotion interventions for adolescents with cancer and how to best adapt these interventions for them. Interviews were held with adolescents treated for cancer (n = 9) and parents (n = 6), focus groups were conducted with stakeholders working in oncology (n = 12) and self-report questionnaires were sent to stakeholders involved in a health promotion intervention (n = 6). At the time of interview, mean age of adolescent participants (40% female) was 17.0 ± 1.9 years (mean age at diagnosis: 14.6 ± 1.6 years). Verbatim and responses to questionnaires were coded and analyzed using qualitative methods. Stakeholder stated that adolescents with cancer need to access activities adapted to their age, to communicate with peers going through a similar experience, and to preserve their schooling and friendships. Barriers to intervention reported by adolescents, parents and stakeholders include lack of motivation, schedule conflicts, fatigue and treatment side effects. Some of the barriers mentioned by adolescents and parents include pain, post-surgery problems, school, physical deconditioning, and lack of time. Facilitators mentioned by adolescents and parents comprise trust in stakeholders’ expertise, personalized approaches, scheduling flexibility. Stakeholders recommended to build trust in the relationship, favoring non-moralizing teachings, adapt interventions to adolescents’ limited attention span and avoiding the use of long-term health benefits as a motivator.
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Affiliation(s)
- Johanne Kerba
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- Department of Nutrition, Université de Montreal, Montreal, QC H3T 1A8, Canada
- Cardiometabolic Health, Diabetes, and Obesity Research Network (CMDO), Montreal, QC J1H 5N4, Canada
| | - Catherine Demers
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, QC H3G 1Y5, Canada
| | - Véronique Bélanger
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- Department of Nutrition, Université de Montreal, Montreal, QC H3T 1A8, Canada
- Cardiometabolic Health, Diabetes, and Obesity Research Network (CMDO), Montreal, QC J1H 5N4, Canada
- Institute of Nutrition and Functional Food, Quebec City, QC G1V 0A6, Canada
| | - Mélanie Napartuk
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- Department of Nutrition, Université de Montreal, Montreal, QC H3T 1A8, Canada
- Cardiometabolic Health, Diabetes, and Obesity Research Network (CMDO), Montreal, QC J1H 5N4, Canada
- Institute of Nutrition and Functional Food, Quebec City, QC G1V 0A6, Canada
| | - Isabelle Bouchard
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
| | - Caroline Meloche
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
| | - Sophia Morel
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- Department of Nutrition, Université de Montreal, Montreal, QC H3T 1A8, Canada
- Cardiometabolic Health, Diabetes, and Obesity Research Network (CMDO), Montreal, QC J1H 5N4, Canada
- Institute of Nutrition and Functional Food, Quebec City, QC G1V 0A6, Canada
| | - Nicolas Prud’homme
- Division of Hematology-Oncology, CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
| | - Isabelle Gélinas
- School of Physical and Occupational Therapy, McGill University, Montreal, QC H3G 1Y5, Canada
| | - Johanne Higgins
- School of Rehabilitation, Université de Montréal, Montreal, QC H3N 1X7, Canada
| | - Daniel Curnier
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- School of Kinesiology and Physical Activity Sciences, Université de Montréal, Montreal, QC H3T 1J4, Canada
| | - Serge Sultan
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- Department of Psychology, Université de Montréal, Montreal, QC H3C 3J7, Canada
| | - Caroline Laverdière
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- Department of Pediatrics, Université de Montréal, Montreal, QC H3T 1C5, Canada
| | - Daniel Sinnett
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- Department of Pediatrics, Université de Montréal, Montreal, QC H3T 1C5, Canada
| | - Valérie Marcil
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- Department of Nutrition, Université de Montreal, Montreal, QC H3T 1A8, Canada
- Cardiometabolic Health, Diabetes, and Obesity Research Network (CMDO), Montreal, QC J1H 5N4, Canada
- Institute of Nutrition and Functional Food, Quebec City, QC G1V 0A6, Canada
- Correspondence: ; Tel.: +1-514-345-4931-(3272)
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Recruiting Adolescent and Young Adult Cancer Survivors for Patient-Reported Outcome Research: Experiences and Sample Characteristics of the SURVAYA Study. Curr Oncol 2022; 29:5407-5425. [PMID: 36005166 PMCID: PMC9406992 DOI: 10.3390/curroncol29080428] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/13/2022] [Accepted: 07/26/2022] [Indexed: 11/24/2022] Open
Abstract
Background: Participation of Adolescents and Young Adults with cancer (AYAs: 18–39 years at time of diagnosis) in patient-reported outcome studies is warranted given the limited knowledge of (long-term) physical and psychosocial health outcomes. We examined the representativeness of AYAs participating in the study, to observe the impact of various invitation methods on response rates and reasons for non-participation. Methods: A population-based, cross-sectional cohort study was performed among long-term (5–20 years) AYA cancer survivors. All participants were invited using various methods to fill in a questionnaire on their health outcomes, including enclosing a paper version of the questionnaire, and sending a reminder. Those who did not respond received a postcard in which they were asked to provide a reason for non-participation. Results: In total, 4.010 AYAs (response 36%) participated. Females, AYAs with a higher socio-economic status (SES), diagnosed more than 10 years ago, diagnosed with a central nervous system tumor, sarcoma, a lymphoid malignancy, stage III, or treated with systemic chemotherapy were more likely to participate. Including a paper questionnaire increased the response rate by 5% and sending a reminder by 13%. AYAs who did not participate were either not interested (47%) or did want to be reminded of their cancer (31%). Conclusions: Study participation was significantly lower among specific subgroups of AYA cancer survivors. Higher response rates were achieved when a paper questionnaire was included, and reminders were sent. To increase representativeness of future AYA study samples, recruitment strategies could focus on integrating patient-reported outcomes in clinical practice and involving AYA patients to promote participation in research.
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15
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van de Graaf DL, Vlooswijk C, Bol N, Krahmer EJ, Bijlsma R, Kaal S, Sleeman SHE, van der Graaf WTA, Husson O, van Eenbergen MC. AYAs' online information and eHealth needs: A comparison with healthcare professionals' perceptions. Cancer Med 2022; 12:2016-2026. [PMID: 35879825 PMCID: PMC9883566 DOI: 10.1002/cam4.5048] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 03/15/2022] [Accepted: 07/07/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Adolescents and young adults (AYAs) diagnosed with cancer fulfill their cancer-related information needs often via the Internet. Healthcare professionals (HCPs) have a crucial role in guiding patients in finding appropriate online information and eHealth sources, a role that is often overlooked. Misperceptions of AYAs' needs by HCPs may lead to suboptimal guidance. We aimed to examine the extent to which AYAs' online information and eHealth needs corresponded with HCPs' perceptions of these needs. METHODS Two cross-sectional online surveys (AYAs, n = 299; HCP, n = 80) on online information and eHealth needs were conducted. HCPs provided indications of their perceptions of AYA's needs. RESULTS AYAs reported significantly more online information needs compared with HCPs' perceptions regarding: survival rates (AYA = 69%, HCP = 35%, p < 0.001), treatment guidelines (AYA = 65%, HCP = 41%, p < 0.001), return of cancer (AYA = 76%, HCP = 59%, p = 0.004), "what can I do myself" (AYA = 68%, HCP = 54%, p = 0.029), and metastases (AYA = 64%, HCP = 50%, p = 0.040). Significantly more unmet eHealth needs were reported by AYAs compared with HCPs relating to access to own test results (AYA = 25, HCP = 0%, p < 0.001), request tests (AYA = 30%, HCP = 7%, p < 0.001), medical information (AYA = 22%, HCP = 0%, p = 0.001), e-consult with nurses (AYA = 30%, HCP = 10%, p < 0.001), e-consult with physicians (AYA = 38%, HCP = 13%, p = 0.001), and request prescriptions (AYA = 33%, HCP = 21%, p = 0.009). CONCLUSION AYAs' online information and eHealth needs are partially discrepant with the impression HCPs have, which could result in insufficient guidance related to AYAs' needs. AYAs and HCPs should get guidance regarding where to find optimal information in a language they understand. This may contribute to AYAs' access, understanding, and satisfaction regarding online information and eHealth.
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Affiliation(s)
- Daniëlle L. van de Graaf
- CoRPS ‐ Center of Research on Psychological disorders and Somatic diseases, Department of Medical and Clinical PsychologyTilburg UniversityTilburgThe Netherlands,Department of Research and DevelopmentNetherlands Comprehensive Cancer Organisation (IKNL)UtrechtThe Netherlands
| | - Carla Vlooswijk
- Department of Research and DevelopmentNetherlands Comprehensive Cancer Organisation (IKNL)UtrechtThe Netherlands
| | - Nadine Bol
- Tilburg Center for Cognition and Communication (TiCC)Tilburg UniversityTilburgThe Netherlands
| | - Emiel J. Krahmer
- Tilburg Center for Cognition and Communication (TiCC)Tilburg UniversityTilburgThe Netherlands
| | - Rhodé Bijlsma
- Department of Medical OncologyUniversity Medical CenterUtrechtThe Netherlands
| | - Suzanne Kaal
- Department of Medical OncologyRadboud University Medical CenterNijmegenThe Netherlands
| | | | - Winette T. A. van der Graaf
- Department of Surgical OncologyNetherlands Cancer InstituteAmsterdamThe Netherlands,Department of Medical OncologyErasmus MC Cancer Institute, Erasmus MCRotterdamThe Netherlands
| | - Olga Husson
- Division of Psychosocial Research and EpidemiologyNetherlands Cancer InstituteAmsterdamThe Netherlands,Department of Surgical OncologyErasmus MC Cancer Institute, Erasmus MCRotterdamThe Netherlands,Division of Clinical StudiesInstitute of Cancer ResearchLondonUK
| | - Mies C. van Eenbergen
- Department of Research and DevelopmentNetherlands Comprehensive Cancer Organisation (IKNL)UtrechtThe Netherlands,Tilburg Center for Cognition and Communication (TiCC)Tilburg UniversityTilburgThe Netherlands
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16
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Bradford NK, McDonald FEJ, Bibby H, Kok C, Patterson P. Psychological, functional and social outcomes in adolescent and young adult cancer survivors over time: A systematic review of longitudinal studies. Psychooncology 2022; 31:1448-1458. [PMID: 35734846 PMCID: PMC9544373 DOI: 10.1002/pon.5987] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 06/15/2022] [Accepted: 06/19/2022] [Indexed: 11/12/2022]
Abstract
Objective Most adolescents and young adults (AYA) can expect to survive a cancer diagnosis and treatment, but all will be left with the potential of long‐term negative effects that can impact their ability to reach their full potential in life. Understanding aspects of psychological, functional, and social health and well‐being outcomes, is pivotal for optimising long‐term well‐being. Methods We completed a systematic review of longitudinal studies reporting outcomes after anti‐cancer treatment for Adolescents and Young Adults diagnosed between the age of 12–29 years according to established systematic review processes. The protocol was registered with PROSPERO (ID: CRD 42020203116). Results Thirteen reports from 10 studies met eligibility criteria representing 17,645 individuals (50.3% female, mean age at diagnosis 22 years, and 26 years at last, follow up). Eleven reports were from eight quantitative studies that relied on self‐report surveys and two were qualitative studies. Psychological outcomes were reported to improve over time, as were functional health outcomes, although reported health behaviours were inconsistent between studies. Neurocognitive deficits were reported to affect the ability to return to work and impacts on fertility and sexuality were sustained over time. Conclusions While some outcomes for AYA are reported to improve over time, particularly for physical functioning, and anxiety and depression, the long‐term impact of cancer on many important domains remains largely unknown. Specifically, the evidence to understand what changes occur over time, and when, remains underdeveloped. Adolescents and young adults have a long time to live as survivors of cancer, and the negative effects of disease and treatment can compromise long‐term well‐being Longitudinal research is important for understanding changes in outcomes over time While a wide range of outcomes have been studied, the evidence to understand what changes occur and when remains underdeveloped
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Affiliation(s)
- Natalie K Bradford
- Cancer and Palliative Care Outcomes Centre at Centre for Children's Health Research, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Fiona E J McDonald
- Research, Evaluation and Social Policy Canteen Australia, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Helen Bibby
- Research, Evaluation and Social Policy Canteen Australia, Sydney, New South Wales, Australia
| | - Cindy Kok
- Research, Evaluation and Social Policy Canteen Australia, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Pandora Patterson
- Research, Evaluation and Social Policy Canteen Australia, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
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17
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Al-Omari A, Al-Rawashdeh N, Damsees R, Ammar K, Alananzeh I, Inserat B, Al-Rimawi D, Tbayshat S, Ababneh H, Alishreim H, Abu Serhan H, Al-Noaaimi F, Abdel-Razeq H. Supportive Care Needs Assessment for Cancer Survivors at a Comprehensive Cancer Center in the Middle East: Mending the Gap. Cancers (Basel) 2022; 14:cancers14041002. [PMID: 35205749 PMCID: PMC8870293 DOI: 10.3390/cancers14041002] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 02/02/2022] [Accepted: 02/09/2022] [Indexed: 12/31/2022] Open
Abstract
Simple Summary There are knowledge gaps regarding supportive care needs of cancer survivors in Jordan and the Arab region. Assessing unmet needs is crucial to achieving quality cancer care and patient satisfaction. In this study, we aimed to identify gaps in supportive care needs among adult cancer survivors seen at King Hussein Cancer Center in Amman, Jordan, explore predictors of unmet needs and assess the relationship between unmet supportive care needs and quality of life of adult cancer survivors. We confirmed the presence of several unmet needs in this population of cancer survivors that were evident in many domains. Late-stage diagnosis and quality of life as reported by study participants provided additional and independent information for unmet needs in several domains. Overall, this needs assessment identified problem areas for targeting interventions across the Jordanian cancer survivor population and understanding these findings highlights opportunities for intervention to address gaps in care. Abstract Background: Cancer survivors are often underprepared for what to expect post-treatment, and there are knowledge gaps regarding cancer survivors’ supportive care needs in Jordan and neighboring Arab countries. This study aimed to identify gaps in supportive care needs among adult cancer survivors seen at King Hussein Cancer Center in Amman, Jordan, and explore predictors of unmet needs. Methods: This was an observational cross-sectional study using a modified version of the Supportive Care Needs Survey 34 item short form (SCNS-SF34). Results: Two hundred and forty adult cancer survivors completed the study questionnaire. The assessed needs were highest in the financial domain, including covering living expenses, managing cancer treatment adverse effects and co-morbidities. The least prevalent reported needs were in sexuality and reproductive consultations. Late-stage diagnosis was independently associated with higher physical, psychological, health system/information, financial and overall need scores, with p-values of 0.032, 0.027, 0.052, 0.002 and 0.024, respectively. The overall quality of life score was independently and inversely associated with physical, psychological, health system/information, financial and overall need domains, with p-values of 0.015, <0.0001, 0.015, 0.004 and 0.0003, respectively. Conclusions: This needs assessment identified problem areas for targeting interventions across the Jordanian cancer survivor population, and understanding these findings highlights opportunities for intervention to address gaps in care.
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Affiliation(s)
- Amal Al-Omari
- The Office of Scientific Affairs and Research, King Hussein Cancer Center, Amman 11941, Jordan; (N.A.-R.); (R.D.); (K.A.); (B.I.); (D.A.-R.); (H.A.); (H.A.); (H.A.S.); (F.A.-N.)
- Correspondence: ; Tel.: +962-6-5300460
| | - Nedal Al-Rawashdeh
- The Office of Scientific Affairs and Research, King Hussein Cancer Center, Amman 11941, Jordan; (N.A.-R.); (R.D.); (K.A.); (B.I.); (D.A.-R.); (H.A.); (H.A.); (H.A.S.); (F.A.-N.)
| | - Rana Damsees
- The Office of Scientific Affairs and Research, King Hussein Cancer Center, Amman 11941, Jordan; (N.A.-R.); (R.D.); (K.A.); (B.I.); (D.A.-R.); (H.A.); (H.A.); (H.A.S.); (F.A.-N.)
| | - Khawlah Ammar
- The Office of Scientific Affairs and Research, King Hussein Cancer Center, Amman 11941, Jordan; (N.A.-R.); (R.D.); (K.A.); (B.I.); (D.A.-R.); (H.A.); (H.A.); (H.A.S.); (F.A.-N.)
| | - Ibrahim Alananzeh
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia;
| | - Bayan Inserat
- The Office of Scientific Affairs and Research, King Hussein Cancer Center, Amman 11941, Jordan; (N.A.-R.); (R.D.); (K.A.); (B.I.); (D.A.-R.); (H.A.); (H.A.); (H.A.S.); (F.A.-N.)
| | - Dalia Al-Rimawi
- The Office of Scientific Affairs and Research, King Hussein Cancer Center, Amman 11941, Jordan; (N.A.-R.); (R.D.); (K.A.); (B.I.); (D.A.-R.); (H.A.); (H.A.); (H.A.S.); (F.A.-N.)
| | - Shrouq Tbayshat
- Department of Internal Medicine, King Hussein Cancer Center, Amman 11941, Jordan; (S.T.); (H.A.-R.)
| | - Hazim Ababneh
- The Office of Scientific Affairs and Research, King Hussein Cancer Center, Amman 11941, Jordan; (N.A.-R.); (R.D.); (K.A.); (B.I.); (D.A.-R.); (H.A.); (H.A.); (H.A.S.); (F.A.-N.)
| | - Haneen Alishreim
- The Office of Scientific Affairs and Research, King Hussein Cancer Center, Amman 11941, Jordan; (N.A.-R.); (R.D.); (K.A.); (B.I.); (D.A.-R.); (H.A.); (H.A.); (H.A.S.); (F.A.-N.)
| | - Hashem Abu Serhan
- The Office of Scientific Affairs and Research, King Hussein Cancer Center, Amman 11941, Jordan; (N.A.-R.); (R.D.); (K.A.); (B.I.); (D.A.-R.); (H.A.); (H.A.); (H.A.S.); (F.A.-N.)
| | - Faisal Al-Noaaimi
- The Office of Scientific Affairs and Research, King Hussein Cancer Center, Amman 11941, Jordan; (N.A.-R.); (R.D.); (K.A.); (B.I.); (D.A.-R.); (H.A.); (H.A.); (H.A.S.); (F.A.-N.)
| | - Hikmat Abdel-Razeq
- Department of Internal Medicine, King Hussein Cancer Center, Amman 11941, Jordan; (S.T.); (H.A.-R.)
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Kim HY, Kang KA, Han SJ, Chun J. Web-Based Research Trends on Child and Adolescent Cancer Survivors Over the Last 5 Years: Text Network Analysis and Topic Modeling Study. J Med Internet Res 2022; 24:e32309. [PMID: 35103615 PMCID: PMC8848247 DOI: 10.2196/32309] [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: 07/22/2021] [Revised: 10/06/2021] [Accepted: 12/08/2021] [Indexed: 11/13/2022] Open
Abstract
Background Being diagnosed with cancer during childhood or adolescence can disrupt important periods in an individual’s physical, psychosocial, and spiritual development and potentially reduce the quality of life (QOL) after treatment. Research is urgently required to improve the QOL for child and adolescent cancer survivors, and it is necessary to analyze the trends in prior research reported in international academic journals to identify knowledge structures. Objective This study aims to identify the main keywords based on network centrality, subgroups (clusters) of keyword networks by using a cohesion analysis method, and the main theme of child and adolescent cancer survivor–related research abstracts through topic modeling. This study also aims to label the subgroups by comparing the results of the cohesion and topic modeling. Methods A text network analysis method and topic modeling were used to explore the main trends in child and adolescent cancer survivor research by structuring a network of keyword (semantic morphemes) co-occurrence in the abstracts of articles published in 5 major web-based databases from 2016 to 2020. A total of 1677 child and adolescent cancer survivor–related studies were used for data analyses. Data selection, processing, and analyses were also conducted. Results The top 5 keywords in terms of degree and eigenvector centrality were risk, control interval, radiation, childhood cancer treatment, and diagnosis. Of the 1677 studies used for data analyses, cluster 1 included 780 (46.51%) documents under risk management, cluster 2 contained 557 (33.21%) articles under health-related QOL and supportive care, and cluster 3 consisted of 340 (20.27%) studies under cancer treatment and complications. Conclusions This study is significant in that it confirms the knowledge structure based on the main keywords and cross-disciplinary trends in child and adolescent cancer survivor research published in the last 5 years worldwide. The primary goal of child and adolescent cancer survivor research is to prevent and manage the various aspects of the problems encountered during the transition to a normal life and to improve the overall QOL. To this end, it is necessary to further revitalize the study of the multidisciplinary team approach for the promotion of age-specific health behaviors and the development of intervention strategies with increased feasibility for child and adolescent cancer survivors.
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Affiliation(s)
- Hyun-Yong Kim
- Logos Health Design Institute, Sahmyook University, Seoul, Republic of Korea
| | - Kyung-Ah Kang
- College of Nursing, Sahmyook University, Seoul, Republic of Korea
| | - Suk-Jung Han
- College of Nursing, Sahmyook University, Seoul, Republic of Korea
| | - Jiyoung Chun
- College of Nursing, Sahmyook University, Seoul, Republic of Korea
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19
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Improving the Quality of Life of Cancer Survivors in School: Consensus Recommendations Using a Delphi Study. CHILDREN 2021; 8:children8111021. [PMID: 34828734 PMCID: PMC8618439 DOI: 10.3390/children8111021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 10/23/2021] [Accepted: 10/31/2021] [Indexed: 11/16/2022]
Abstract
Successful school re-entry is important for children following cancer treatment. However, this process is a challenge for teachers. Objectives: To identify (1) the difficulties and needs that teachers have in helping youth cancer survivors be successful in school, (2) the most effective resources that teachers are currently using for helping them, and (3) the ideal contents for a program that could help teachers in this area. Methods: Twenty-eight teachers participated in a Delphi study. Results: A lack of knowledge regarding how to best help and having to deal with the student’s problems were identified as difficulties. Specific training, psychological support, and advice from health professionals were the most commonly reported needs. Maintaining contact with the family and the students and providing personalized attention were viewed as the most useful resources. Finally, knowledge about the disease itself and how to facilitate successful school re-entry were identified as important program components. Conclusion: The findings provide important new information regarding the lack of both resources and support for teachers who seek to help youth cancer survivors. The findings can be used to inform the development of an intervention to help teachers become more successful in facilitating successful school re-entry.
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20
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Lidington E, Darlington AS, Din A, Stanway S, Banerjee S, Szucs Z, Gonzalez M, Sharma A, Sirohi B, van der Graaf WTA, Husson O. Describing Unmet Supportive Care Needs among Young Adults with Cancer (25-39 Years) and the Relationship with Health-Related Quality of Life, Psychological Distress, and Illness Cognitions. J Clin Med 2021; 10:jcm10194449. [PMID: 34640467 PMCID: PMC8509768 DOI: 10.3390/jcm10194449] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 09/08/2021] [Accepted: 09/22/2021] [Indexed: 12/16/2022] Open
Abstract
Few studies describe supportive care needs among young adults (YAs) with cancer ages 25 to 39 using validated questionnaires. Previous findings identified the need for psychological and information support and suggest that gender, age, psychological distress, and coping may be associated with greater need for this support. To substantiate these findings, this study aimed to (1) describe the supportive care needs of YAs in each domain of the Supportive Care Needs Survey and (2) explore the relationship between unmet supportive care needs and clinical and demographic factors, health-related quality of life, psychological distress, illness cognitions, and service needs using latent class analysis. Clinical teams from six hospitals in England invited eligible patients to a cross-sectional survey by post. A total of 317 participants completed the survey online or on paper. YAs expressed the most need in the psychological and sexuality domains. Using latent class analysis, we identified three classes of YAs based on level of supportive care need: no need (53.3%), low need (28.3%), and moderate need (18.4%). In each class, median domain scores in each domain were similar. Low and moderate need classes were associated with worse health-related quality of life and greater helplessness. Unmet service needs were associated with the moderate-need class only. Patients with unmet supportive care needs should be offered holistic care across supportive care domains.
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Affiliation(s)
- Emma Lidington
- The Royal Marsden NHS Foundation Trust, 203 Fulham Road, London SW3 6JJ, UK; (E.L.); (S.S.); (S.B.); (W.T.A.v.d.G.)
| | - Anne-Sophie Darlington
- Health Sciences, University of Southampton, University Road, Highfield, Southampton SO17 1BJ, UK; (A.-S.D.); (A.D.)
| | - Amy Din
- Health Sciences, University of Southampton, University Road, Highfield, Southampton SO17 1BJ, UK; (A.-S.D.); (A.D.)
| | - Susannah Stanway
- The Royal Marsden NHS Foundation Trust, 203 Fulham Road, London SW3 6JJ, UK; (E.L.); (S.S.); (S.B.); (W.T.A.v.d.G.)
| | - Susana Banerjee
- The Royal Marsden NHS Foundation Trust, 203 Fulham Road, London SW3 6JJ, UK; (E.L.); (S.S.); (S.B.); (W.T.A.v.d.G.)
- Division of Clinical Studies, Institute of Cancer Research, 15 Cotswold Road, Sutton SM2 5NG, UK
| | - Zoltan Szucs
- East Suffolk and North Essex NHS Foundation Trust, Ipswich Hospital, Health Road, Ipswich IP4 5PD, UK;
| | - Michael Gonzalez
- Imperial College Healthcare NHS Trust, Charing Cross Hospital, Fulham Palace Road, Hammersmith, London W6 8RF, UK;
| | - Anand Sharma
- Mount Vernon Cancer Centre, Rickmansworth Road, Northwood HA6 2RN, UK;
| | - Bhawna Sirohi
- Barts Health NHS Trust, St Bartholomew’s Hospital, W Smithfield, London EC1A 7BE, UK;
- Apollo Proton Cancer Centre, 4/661, Dr Vikram Sarabai Instronic Estate 7th St., Dr. Vasi Estate, Phase II, Tharamani, Chennai 600096, India
| | - Winette T. A. van der Graaf
- The Royal Marsden NHS Foundation Trust, 203 Fulham Road, London SW3 6JJ, UK; (E.L.); (S.S.); (S.B.); (W.T.A.v.d.G.)
- Department of Medical Oncology, Netherlands Cancer Institute–Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - Olga Husson
- Division of Clinical Studies, Institute of Cancer Research, 15 Cotswold Road, Sutton SM2 5NG, UK
- Department of Medical Oncology, Netherlands Cancer Institute–Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
- Correspondence:
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21
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Barlow KH, van der Pols JC, Ekberg S, Johnston EA. Cancer survivors' perspectives of dietary information provision after cancer treatment: A scoping review of the Australian context. Health Promot J Austr 2021; 33:232-244. [PMID: 33890348 DOI: 10.1002/hpja.496] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 04/16/2021] [Indexed: 01/25/2023] Open
Abstract
ISSUE ADDRESSED To support survivor-centred care in Australia, this review maps current knowledge regarding adult cancer survivors' perspectives of dietary information provision post-treatment. METHODS A scoping review of research conducted in Australia within the past decade reported using PRISMA-ScR guidelines. Seven databases were searched (01/01/2009-05/06/2020) and records were independently screened by two researchers using eligibility criteria. Papers in the peer-reviewed literature with dietary information post-treatment as a primary and secondary outcome were eligible for inclusion. Data charting included participant characteristics, study methodology and cancer survivors' reports of dietary information provision post-treatment. RESULTS Of 531 records identified, 12 met eligibility criteria. Most studies included breast (58%) and colorectal (42%) cancer survivors within 5 years post-diagnosis (84%). Three studies were conducted amongst specific ethnic groups (Indigenous Australians, Chinese-Australians, Greek-Australians). Participants in the included studies commonly reported limited or ineffective dietary information from healthcare providers post-treatment. Cancer survivors identified a need for individualised information regarding dietary strategies to manage ongoing symptoms, professional support for weight management, and practical skills for healthy eating. Amongst ethnic groups, there was a need for dietary information that considers traditional foods and cultural beliefs, and is available in their native language. Cancer survivors valued ongoing dietary follow-up and support post-treatment, and suggested a variety of face-to-face and online delivery modes. Those residing in rural and remote areas reported barriers to accessing dietary information post-treatment including time, cost, and availability of local services. CONCLUSIONS There is scope to improve dietary information provision after cancer treatment in Australia. SO WHAT?: Dietary guidance post-treatment should consider individual needs, cultural background, and opportunity for ongoing follow-up and support.
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Affiliation(s)
- Katherine H Barlow
- Faculty of Health, School of Exercise and Nutrition Sciences, Queensland University of Technology (QUT), Brisbane, Australia
| | - Jolieke C van der Pols
- Faculty of Health, School of Exercise and Nutrition Sciences, Queensland University of Technology (QUT), Brisbane, Australia
| | - Stuart Ekberg
- Faculty of Health, School of Psychology and Counselling, Queensland University of Technology (QUT), Brisbane, Australia
| | - Elizabeth A Johnston
- Faculty of Health, School of Exercise and Nutrition Sciences, Queensland University of Technology (QUT), Brisbane, Australia
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22
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Sender A, Friedrich M, Leuteritz K, Stuckenberg E, Richter D, Stöbel-Richter Y, Lordick F, Geue K. Psychosocial aftercare of adolescent and young adult cancer survivors in Germany: Awareness, utilisation, satisfaction and associated factors. Psychooncology 2021; 30:1311-1321. [PMID: 33739567 DOI: 10.1002/pon.5678] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 02/02/2021] [Accepted: 02/25/2021] [Indexed: 11/10/2022]
Abstract
AIM This study systematically assesses the awareness of, utilisation of and satisfaction with psychosocial care for adolescents and young adult (AYA) cancer survivors in aftercare. METHODS Survivors between 18 and 39 years were surveyed in aftercare. Awareness of, utilisation of and satisfaction with psychological counselling (PC), social-legal counselling (SLC) and other psychosocial care (OPC) were measured using self-developed questionnaires. Multivariate analyses were conducted to determine factors correlated with awareness and use of psychosocial care. RESULTS Five hundred and fourteen survivors participated; the mean age at diagnosis was 29.6 years (SD = 6.14). 54% of cancer survivors were aware of PC, 45% of SLC and 24% of OPC. Those who possessed knowledge about these services used it to a considerable extent (63%-74%), and the majority (66%-75%) was highly satisfied. No common factors could be found that increase the likelihood of being aware of these three services (R2 = 0.028-0.138). Female gender (OR = 2.08-2.18) and high anxiety (OR = 1.19-1.38) were identified as common factors that increase the likelihood of utilising psychosocial services (R2 = 0.160-0.395). CONCLUSION AYA who are aware of psychosocial services in aftercare are motivated to use them and express high satisfaction with use. For the utilisation of psychosocial services, anxiety and female gender can be identified as common factors. The visibility of psychosocial services for aftercare should be increased given the high number of unaware AYA survivors. The active and repeated addressing of psychosocial issues and regular provision of information (e.g., written guides on survivorship) by caregivers should be made a standard of care for AYA cancer survivors.
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Affiliation(s)
- Annekathrin Sender
- Department of Mental Health, Medical Psychology & Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Michael Friedrich
- Department of Mental Health, Medical Psychology & Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Katja Leuteritz
- Department of Mental Health, Medical Psychology & Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Erik Stuckenberg
- St. Elisabeth and St. Barbara Hospital, Medical Clinic II, Halle (Saale), Germany
| | - Diana Richter
- Department of Mental Health, Medical Psychology & Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Yve Stöbel-Richter
- University of Leipzig, Integrated Research and Treatment Center, Behavioral Medicine, Leipzig, Germany.,University of Zittau/Goerlitz, Faculty of Managerial and Cultural Studies, Goerlitz, Germany
| | - Florian Lordick
- University of Leipzig, Medical Center, University Cancer Center Leipzig, Leipzig, Germany
| | - Kristina Geue
- Department of Mental Health, Medical Psychology & Medical Sociology, University of Leipzig, Leipzig, Germany
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23
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Telles CM. A scoping review of literature: What has been studied about adolescents and young adults (AYAs) with cancer? Cancer Treat Res Commun 2021; 27:100316. [PMID: 33545568 DOI: 10.1016/j.ctarc.2021.100316] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 01/12/2021] [Accepted: 01/14/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE To map, organize and analyze the articles published in the last five years about AYAs with cancer. METHODS CAPES database and Google Scholar were searched to identify relevant studies from 2015 to February 2020. Eligible articles included empirical or theoretical research, quantitative and/or qualitative studies, targeted AYAs with cancer, addressed different topics related to AYAs such as unmet needs, hospital challenges, interventions or tools based on evidence, as well as political and socioeconomic aspects. RESULTS Of the 161 articles analyzed, 74 (46%) discussed the health system, including hospital dynamics, treatment and interventions during treatment; 63 (39.1%) discussed aspects or interventions that influence the quality of life and mental health of AYAs with cancer; 14 (8.7%) discussed issues related to sexual health; and 10 (6.2%) addressed social, economic and demographic problems of AYAs with cancer. Three types of purposes have been identified in the articles: 118 (73.3%) investigated variables in areas related to AYAs with cancer, aiming to increase the understanding of the phenomenon and the needs of AYAs; 18 (11.2%) intervened on the needs of AYAs with cancer through pilot studies or evidence-based interventions; and 22 (13.7%) aimed to evaluate an intervention previously performed or to evaluate an intervention based on evidence. CONCLUSION There is still much to be researched within the last two categories. In the last three years, these categories have been growing gradually and on a small scale.
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Affiliation(s)
- Camila M Telles
- Graduating in Psychology - Senior year, Positivo University - Curitiba, Paraná, Brazil (Student); Teen Cancer America - Los Angeles, California, the United States of America (Intern Pro Cancer).
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24
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Okamura M, Fujimori M, Sato A, Uchitomi Y. Unmet supportive care needs and associated factors among young adult cancer patients in Japan. BMC Cancer 2021; 21:17. [PMID: 33402126 PMCID: PMC7786954 DOI: 10.1186/s12885-020-07721-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 12/09/2020] [Indexed: 12/18/2022] Open
Abstract
Background Young adult cancer patients often face unique challenges and have potential unmet needs. This study aimed (1) to describe unmet supportive care needs among young adults with cancer in Japan, and (2) to identify its associated factors. Methods In a cross-sectional web-based survey, 206 young adults with cancer were assessed for supportive care needs. Multiple regression analysis examined whether demographics, clinical variables and social support were associated with unmet supportive care needs. Results A total of 206 patients (180 female) with a mean age of 33.7 years (SD = 4.3, range: 22–39) participated. One hundred and fifty-eight participants (76.7%) reported at least one unmet supportive care needs. The top 20 unmet needs included 9 of the 10 psychological needs, 3 of the 5 physical and daily living needs, 8 of the 11 health system and information needs and 1 of the 5 sexuality needs. Multiple regression analysis revealed that perceived poorer PS, experience of change in work/school after a cancer diagnosis and poor social support were significantly associated with higher supportive care needs. The total score of supportive care needs was significantly associated with both psychological distress and QOL. Conclusions More than 70% of young adult cancer patients reported unmet supportive care needs and most of those were psychological needs. The findings suggest potential opportunities for intervention in addressing psychological needs rather than physical and information needs.
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Affiliation(s)
- Masako Okamura
- Division of Behavioral Science Research, Behavioral Sciences and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center, 5-1-1 Tsukiji, Tokyo, 104-0045, Japan.,Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Tokyo, Japan
| | - Maiko Fujimori
- Division of Behavioral Science Research, Behavioral Sciences and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center, 5-1-1 Tsukiji, Tokyo, 104-0045, Japan. .,Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Tokyo, Japan.
| | - Ayako Sato
- Division of Behavioral Science Research, Behavioral Sciences and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center, 5-1-1 Tsukiji, Tokyo, 104-0045, Japan.,Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Tokyo, Japan
| | - Yosuke Uchitomi
- Division of Behavioral Science Research, Behavioral Sciences and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center, 5-1-1 Tsukiji, Tokyo, 104-0045, Japan.,Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Tokyo, Japan
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25
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Incidence, Survival, and Mortality Trends of Cancers Diagnosed in Adolescents and Young Adults (15-39 Years): A Population-Based Study in The Netherlands 1990-2016. Cancers (Basel) 2020; 12:cancers12113421. [PMID: 33218178 PMCID: PMC7698904 DOI: 10.3390/cancers12113421] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/13/2020] [Accepted: 11/16/2020] [Indexed: 02/06/2023] Open
Abstract
Simple Summary Adolescents and young adults (AYAs, aged 15–39 years) with cancer form a distinct patient population within the oncology care setting that is often overlooked in favour of paediatric and older adult patients. As such, specific knowledge on AYAs and their distinct spectrum of cancers is limited. Worldwide, cancer is increasing and it is among the major causes of death among AYAs. Cancer prognosis among AYAs has also been shown to lag behind that of younger and older patients suffering from similar diseases. To address these problems, better understanding of AYA cancers is needed. This study aims to provide an overview of the specific cancer trends among AYAs and the changes that have occurred in the Netherlands since 1990 in terms of incidence, survival, and mortality. This information will provide a solid foundation from which to guide future studies upon, aimed at acquiring more detailed cancer knowledge within the AYA domain. Abstract Adolescent and young adult (AYA) cancer patients, aged 15–39 years at primary cancer diagnosis, form a distinct, understudied, and underserved group in cancer care. This study aimed to assess long-term trends in incidence, survival, and mortality of AYA cancer patients within the Netherlands. Data on all malignant AYA tumours diagnosed between 1990–2016 (n = 95,228) were obtained from the Netherlands Cancer Registry. European age-standardised incidence and mortality rates with average annual percentage change (AAPC) statistics and five-year relative survival rates were calculated. The overall cancer incidence increased from 54.6 to 70.3 per 100,000 person-years (AAPC: +1.37%) between 1990–2016, and increased for both sexes individually and for most cancer types. Five-year relative survival overall improved from 73.7% in 1990–1999 to 86.4% in 2010–2016 and improved for both sexes and most cancer types. Survival remained poor (<60%) for rhabdomyosarcoma, lung, stomach, liver, bladder, and pancreatic carcinomas, among others. Mortality rates among male AYAs overall declined from 10.8 to 6.6 (AAPC: −1.64%) and from 14.4 to 10.1 per 100,000 person-years (AAPC: −1.81%) for female AYAs since 1990. Mortality rates remained unchanged for male AYAs aged 20–24 and 25–29 years. In conclusion, over the past three decades, there has been a considerable increase in cancer incidence among AYAs in the Netherlands. Meanwhile, the survival improved and the mortality overall declined. Survival at five-years now well exceeds above 80%, but did not do so for all cancer types.
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26
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Expósito-Vizcaíno S, Sánchez-Rodríguez E, Miró J. The role of physical, cognitive and social factors in pain interference with activities of daily living among individuals with chronic cancer pain. Eur J Cancer Care (Engl) 2019; 29:e13203. [PMID: 31825154 DOI: 10.1111/ecc.13203] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 11/13/2019] [Accepted: 11/21/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVES The aim of this study was to better understand the role that physical, cognitive and social factors play in pain interference with activities of daily living among individuals with cancer and chronic pain. METHOD In this cross-sectional study, interviews with 156 patients with chronic cancer pain were conducted across five tertiary level hospitals in the province of Tarragona (Spain). Participants were interviewed individually and provided information about the presence and characteristics of pain, fatigue, catastrophic thinking, social support and the impact of pain on their daily activities. RESULTS Pain intensity (β = 0.23, p = .003), fatigue (β = 0.26, p < .001) and pain catastrophising (β = 0.39, p < .001) were significantly and positively associated with pain interference in daily activities. Pain interference scores were not explained by social support (β = 0.12 p = .090) or socio-demographic factors (R2 = .005; p = .94). CONCLUSION This study provides important new findings regarding the association between physical, cognitive and social factors and function of individuals with cancer and chronic pain, thus supporting a biopsychosocial approach to the management of chronic pain in individuals with cancer.
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Affiliation(s)
- Sonia Expósito-Vizcaíno
- Haematology Service, Joan XXIII University Hospital of Tarragona, Tarragona, Spain.,Unit for the Study and Treatment of Pain - ALGOS, Research Centre for Behaviour Assessment (CRAMC), Department of Psychology, Universitat Rovira i Virgili, Catalonia, Spain.,Institut d'Investigació Sanitària Pere Virgili, Catalonia, Spain
| | - Elisabet Sánchez-Rodríguez
- Unit for the Study and Treatment of Pain - ALGOS, Research Centre for Behaviour Assessment (CRAMC), Department of Psychology, Universitat Rovira i Virgili, Catalonia, Spain.,Institut d'Investigació Sanitària Pere Virgili, Catalonia, Spain
| | - Jordi Miró
- Unit for the Study and Treatment of Pain - ALGOS, Research Centre for Behaviour Assessment (CRAMC), Department of Psychology, Universitat Rovira i Virgili, Catalonia, Spain.,Institut d'Investigació Sanitària Pere Virgili, Catalonia, Spain
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27
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Sender A, Friedrich M, Leuteritz K, Nowe E, Stöbel-Richter Y, Mehnert A, Geue K. Unmet supportive care needs in young adult cancer patients: associations and changes over time. Results from the AYA-Leipzig study. J Cancer Surviv 2019; 13:611-619. [PMID: 31273638 DOI: 10.1007/s11764-019-00780-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 06/21/2019] [Indexed: 12/13/2022]
Abstract
PURPOSE Coping with cancer at a young adult age (AYA) is a challenge for many patients and raises support needs. We aim to examine unmet supportive care needs and to investigate predictors of and changes in unmet needs over time. METHODS We surveyed AYAs (18-39 years at time of diagnosis, diagnosis < 4 years) at two time points (t2 = 12 months after t1) using the Supportive Care Needs Survey (SCNS-SF34) among other validated measures. We conducted multiple hierarchical regressions to identify sociodemographic, medical and psychosocial predictors of unmet needs. RESULTS A total of 514 AYAs (386 women) with a mean age of 29.6 years participated at both times. Psychological needs (Mt1 = 35.7; Mt2 = 32.09; p = 0.001) and informational needs (Mt1 = 32.18; Mt2 = 29.04; p = 0.021) were the most often reported unmet needs at both measurements and decreased slightly at t2. All other SCNS domains, except for patient care, remained stable over time. Higher supportive needs were associated with greater levels of effort to cope with the disease at both times in all domains. Older age and female gender were significantly associated with two and one of six domains, respectively, at t1 and t2. CONCLUSIONS AYAs reported primarily unmet psychological and informational needs, which were stable over time and indicated that AYAs do not have sufficient access to the support they need. The degree of effort to cope with cancer plays a key role in terms of unmet support needs. IMPLICATIONS FOR CANCER SURVIVORS Regular screening for this variable in acute and especially follow-up care settings could pave the way for clinicians to offer more targeted support.
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Affiliation(s)
- Annekathrin Sender
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany.
| | - Michael Friedrich
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany
| | - Katja Leuteritz
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany
| | - Erik Nowe
- Medical Clinic II, Hospital St. Elisabeth and St. Barbara, Mauerstr. 5, 06110, Halle (Saale), Germany
| | - Yve Stöbel-Richter
- Faculty of Managerial and Cultural Studies, University of Zittau/Goerlitz, 30 06 48, Goerlitz, Germany
- Integrated Research and Treatment Center (IFB), University Medical Center, Leipzig, Germany
| | - Anja Mehnert
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany
| | - Kristina Geue
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany
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28
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Murphy-Banks R, Blanch-Hartigan D, Boehm L, Hamel PC, Parsons SK. Personal Narrative: Raising Awareness of Adolescent and Young Adult Cancer Survivors in Similarly Aged University Students. J Adolesc Young Adult Oncol 2019; 8:434-441. [PMID: 31038376 DOI: 10.1089/jayao.2018.0131] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: As part of a programmatic educational initiative, we developed a personal narrative presentation, embedded with evidence-based data, to raise awareness of adolescents and young adults (AYAs) who have been diagnosed with cancer between the ages of 15 and 39 years among similarly aged university students. The narrative encompassed the cancer care continuum from signs of the disease through survivorship and incorporated psychosocial aspects of the experience. Methods: The presenter, diagnosed with lymphoma at the age of 25 years in 2007, interwove AYA data with her narrative in a series of 26 invited lectures given over 2 academic years, 2016-2017 and 2017-2018. Students were asked to provide anonymous open-ended feedback. Six hundred thirteen forms were collected and retrospectively dually coded and analyzed. Results: The majority of students (97%) referenced at least one of the presentation's three objectives: (1) build awareness of the AYA demographic; (2) encourage a personal health care focus; and (3) expand awareness of the far-reaching impact of cancer (i.e., psychological, social, and medical) both during and beyond the treatment phase. Format- and/or content-related suggestions and potential benefits of hearing the narrative also were reported. Conclusion: The use of personal narrative to raise awareness of the AYA cancer experience in an academic setting is both feasible and effective. Students demonstrated a new or enhanced understanding of AYA cancer and its biopsychosocial implications. We provide evidence to inform the design of awareness interventions directed at similarly aged university students.
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Affiliation(s)
- Rachel Murphy-Banks
- 1Reid R. Sacco Adolescent and Young Adult Cancer Program at Tufts Medical Center, Boston, Massachusetts
| | | | - Lauren Boehm
- 1Reid R. Sacco Adolescent and Young Adult Cancer Program at Tufts Medical Center, Boston, Massachusetts
| | - Pauline C Hamel
- 3Bouve College of Health Sciences, Northeastern University, Boston, Massachusetts
| | - Susan K Parsons
- 1Reid R. Sacco Adolescent and Young Adult Cancer Program at Tufts Medical Center, Boston, Massachusetts
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29
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Stark D, Fern LA, Gibson F, Hawkins M, Hough R, McCabe MG, Taylor R. Transitioning adolescent and young adult cancer care research out of its adolescence. Eur J Cancer Care (Engl) 2018; 27:e12962. [DOI: 10.1111/ecc.12962] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- Dan Stark
- Department of Cancer Medicine; Leeds UK
- UK NCRI clinical studies group in Teenagers and Young Adults with cancer and Germ Cell Tumours; London UK
| | - Lorna A. Fern
- National Cancer Research Institute Teenage, Young Adult and Germ Cell Clinical Studies Group, Cancer Division; University College London Hospitals NHS Foundation Trust; London UK
| | - Faith Gibson
- Child Health and Cancer Care; Great Ormond Street Hospital for Children NHS Foundation Trust and University of Surrey; London UK
| | - Mike Hawkins
- Centre for Childhood Cancer Survivor Studies; University of Birmingham; Birmingham UK
| | - Rachael Hough
- Haematology and Haemopoietic Stem Cell Transplantation; UCL, London UK
- University College London Hospital’s NHS Foundation Trust; London UK
- NHS England Clinical Reference Group for Children and Young People with Cancer; London UK
| | - Martin G. McCabe
- Manchester Academic Health Science Centre; University of Manchester; Manchester UK
| | - Rachel Taylor
- Cancer Clinical Trials Unit; CNMR, University College London Hospitals NHS Foundation Trust; London UK
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30
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McDonald FEJ, Patterson P, Kim B, White K. Working beyond the patient and cancer for adolescents and young adults. Eur J Cancer Care (Engl) 2018; 27:e12967. [DOI: 10.1111/ecc.12967] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Fiona E. J. McDonald
- CanTeen; Sydney New South Wales Australia
- Cancer Nursing Research Unit; The University of Sydney; Sydney New South Wales Australia
| | - Pandora Patterson
- CanTeen; Sydney New South Wales Australia
- Cancer Nursing Research Unit; The University of Sydney; Sydney New South Wales Australia
| | - Bora Kim
- Cancer Nursing Research Unit; The University of Sydney; Sydney New South Wales Australia
| | - Kathryn White
- Cancer Nursing Research Unit; The University of Sydney; Sydney New South Wales Australia
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31
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van Veen MR, Winkels RM, Janssen SHM, Kampman E, Beijer S. Nutritional Information Provision to Cancer Patients and Their Relatives Can Promote Dietary Behavior Changes Independent of Nutritional Information Needs. Nutr Cancer 2018. [DOI: 10.1080/01635581.2018.1446092] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Merel R. van Veen
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | - Renate M. Winkels
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | - Silvie H. M. Janssen
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | - Ellen Kampman
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | - Sandra Beijer
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
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32
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Nathan PC, Nachman A, Sutradhar R, Kurdyak P, Pole JD, Lau C, Gupta S. Adverse mental health outcomes in a population-based cohort of survivors of childhood cancer. Cancer 2018; 124:2045-2057. [DOI: 10.1002/cncr.31279] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 12/20/2017] [Accepted: 01/04/2018] [Indexed: 12/20/2022]
Affiliation(s)
- Paul C. Nathan
- Division of Hematology/Oncology; The Hospital for Sick Children; Toronto Ontario Canada
- Institute of Health Policy, Management, and Evaluation; University of Toronto; Ontario Canada
| | - Alex Nachman
- Division of Hematology/Oncology; The Hospital for Sick Children; Toronto Ontario Canada
| | - Rinku Sutradhar
- Institute of Health Policy, Management, and Evaluation; University of Toronto; Ontario Canada
- Institute for Clinical Evaluative Sciences; Toronto Ontario Canada
- Dalla Lana School of Public Health; University of Toronto; Ontario Canada
| | - Paul Kurdyak
- Institute for Clinical Evaluative Sciences; Toronto Ontario Canada
- Centre for Addiction and Mental Health; Toronto Ontario Canada
| | - Jason D. Pole
- Pediatric Oncology Group of Ontario; Toronto Ontario Canada
- Dalla Lana School of Public Health; University of Toronto; Ontario Canada
| | - Cindy Lau
- Institute for Clinical Evaluative Sciences; Toronto Ontario Canada
| | - Sumit Gupta
- Division of Hematology/Oncology; The Hospital for Sick Children; Toronto Ontario Canada
- Institute of Health Policy, Management, and Evaluation; University of Toronto; Ontario Canada
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33
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Gorman JR, Standridge D, Lyons KS, Elliot DL, Winters-Stone K, Julian AK, Weprin J, Storksdieck M, Hayes-Lattin B. Patient-centered communication between adolescent and young adult cancer survivors and their healthcare providers: Identifying research gaps with a scoping review. PATIENT EDUCATION AND COUNSELING 2018; 101:185-194. [PMID: 28882546 DOI: 10.1016/j.pec.2017.08.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 08/23/2017] [Accepted: 08/30/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To conduct a scoping literature review to identify practices or programs that promote AYA patient-centered communication. METHODS Between January and May of 2016, we applied standard scoping review methodology to systematically review articles. We considered peer-reviewed, English language articles written at any phase of intervention research. Both qualitative and quantitative studies were eligible, and no additional search restrictions were applied. We retained articles that included explicit or implicit outcomes for one of the six functions of patient-centered communication in cancer care. At least two independent reviewers assessed the articles. RESULTS We screened a total of 4072 titles and abstracts, retaining 27 for full-text review. Ultimately, eight titles met the review's inclusion criteria. We categorized each publication by the action or setting used to improve patient-centered communication, resulting in five categories. Most studies were not included because they did not include a patient-centered communication outcome. CONCLUSION This area of research is still emerging, as indicated by the small number of eligible studies and predominance of qualitative, descriptive, pilot, and feasibility studies with small sample sizes. PRACTICE IMPLICATIONS Our results suggest a clear need to develop and evaluate interventions focused on improving patient-centered communication between AYA survivors and their healthcare providers.
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Affiliation(s)
- Jessica R Gorman
- School of Social and Behavioral Health Sciences, Oregon State University, Corvallis, USA.
| | - Daniel Standridge
- School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR, USA.
| | - Karen S Lyons
- School of Nursing, Oregon Health & Science University, Portland, USA.
| | - Diane L Elliot
- Department of Medicine, Oregon Health & Science University, Portland, USA.
| | | | - Anne K Julian
- School of Social and Behavioral Health Sciences, Oregon State University, Corvallis, USA.
| | - Jennifer Weprin
- School of Nursing, Oregon Health & Science University, Portland, USA.
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Kaal SE, Husson O, van Dartel F, Hermans K, Jansen R, Manten-Horst E, Servaes P, van de Belt TH, Engelen LJ, Prins JB, Verberne S, van der Graaf WT. Online support community for adolescents and young adults (AYAs) with cancer: user statistics, evaluation, and content analysis. Patient Prefer Adherence 2018; 12:2615-2622. [PMID: 30584285 PMCID: PMC6287522 DOI: 10.2147/ppa.s171892] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Peer support is an important unmet need among adolescent and young adult (AYA) cancer patients. This study was conducted to describe the use and evaluation of a Dutch secure online support community for AYA diagnosed with cancer between 18 and 35 years. METHODS User statistics were collected with Google analytics. Community members were asked to complete questionnaires on the usefulness of the community. A content analysis using Linguistic Inquiry and Word Count was conducted. RESULTS Between 2010 and 2017, the community received 433 AYA members (71% female; mean age at diagnosis 25.7 years; 52 Dutch hospitals represented). The mean time since diagnosis when subscribing to the community was 2.7 years (SD 4.4). Questionnaire data among 30 AYA community members indicated that the use of the community resulted in acknowledgment and advice regarding problems (56%) and the feeling of being supported (63%). Almost half of the respondents felt less lonely, 78% experienced recognition in stories of other AYA. Anonymized content analysis (n=14) showed that the majority of the online discussions encompassed emotional and cognitive expressions, and emotional support. CONCLUSION The secure Dutch online AYA community can help AYA cancer patients to express feelings, exchange information, address peer support, and has been found helpful in coping with cancer. As AYA cancer patients often lack the option of meeting each other in person, the AYA community is helpful in establishing peer support. Its use would benefit from promotion by health care professionals.
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Affiliation(s)
- Suzanne Ej Kaal
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands,
- Dutch AYA "Young and Cancer" Platform, AYA Platform Radboudumc, Radboud University Medical Center, Nijmegen, the Netherlands,
| | - Olga Husson
- Dutch AYA "Young and Cancer" Platform, AYA Platform Radboudumc, Radboud University Medical Center, Nijmegen, the Netherlands,
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, the Netherlands
- Division of Clinical Studies, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK,
| | - Fleur van Dartel
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Karin Hermans
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands,
- Dutch AYA "Young and Cancer" Platform, AYA Platform Radboudumc, Radboud University Medical Center, Nijmegen, the Netherlands,
| | - Rosemarie Jansen
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands,
- Dutch AYA "Young and Cancer" Platform, AYA Platform Radboudumc, Radboud University Medical Center, Nijmegen, the Netherlands,
| | - Eveliene Manten-Horst
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands,
- Dutch AYA "Young and Cancer" Platform, AYA Platform Radboudumc, Radboud University Medical Center, Nijmegen, the Netherlands,
| | - Petra Servaes
- Dutch AYA "Young and Cancer" Platform, AYA Platform Radboudumc, Radboud University Medical Center, Nijmegen, the Netherlands,
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Tom H van de Belt
- Radboud REshape and Innovation Center, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Lucien Jlpg Engelen
- Radboud REshape and Innovation Center, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Judith B Prins
- Dutch AYA "Young and Cancer" Platform, AYA Platform Radboudumc, Radboud University Medical Center, Nijmegen, the Netherlands,
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Suzan Verberne
- Leiden Institute for Advanced Computer Science, Leiden University, Leiden, the Netherlands
| | - Winette Ta van der Graaf
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands,
- Dutch AYA "Young and Cancer" Platform, AYA Platform Radboudumc, Radboud University Medical Center, Nijmegen, the Netherlands,
- Division of Clinical Studies, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK,
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Adolescent-young adults (AYA) with cancer seeking integrative oncology consultations: demographics, characteristics, and self-reported outcomes. Support Care Cancer 2017; 26:1161-1167. [DOI: 10.1007/s00520-017-3937-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 10/16/2017] [Indexed: 10/18/2022]
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Yanamandra U, Saini N, Chauhan P, Sharma T, Khadwal A, Prakash G, Varma N, Lad D, Varma S, Malhotra P. AYA-Myeloma: Real-World, Single-Center Experience Over Last 5 Years. J Adolesc Young Adult Oncol 2017; 7:120-124. [PMID: 28829925 DOI: 10.1089/jayao.2017.0034] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
INTRODUCTION Multiple myeloma (MM) is considered as a disease of the old with the reported median age of 60-70 years. The disease occurred a decade earlier in the Indian subcontinent. The literature on MM in adolescents and young adult (AYA) is limited. We studied the disease characteristics and outcomes of the AYA-MM in the real-world setting. PATIENTS AND METHODS It is a retrospective single-center study conducted at a tertiary care center from North India. Records of all consecutive patients with AYA-MM (15-39 years of age) who were managed from January 1, 2010, to December 30, 2015, were reviewed. Survival was assessed from the date of start of treatment to the last follow-up date or death due to any cause. RESULTS A total of 415 patients managed for MM were included in the study. The frequency of the AYA-MM was 9.6% (40/415) of whom 5 patients were younger than 30 years. There was male preponderance with a median age of the patients being 38 years. The main presenting features were bone pain (55%), fatigue (45%), extramedullary plasmacytomas (20%), and infections (12%) and referral from the peripheral hospital as renal dysfunction (58%). On the evaluation of patients, hypercalcemia, renal impairment, anemia, and lytic lesions were seen in 24.32%, 30%, 52.5%, and 59.25% of patients, respectively. The majority had the high-risk disease (International Staging System [ISS]-III: 75%). Only 22.5% patients were transplanted. The 3-year median overall survival of the study population was 80.21%. CONCLUSION AYA-MM patients have a higher prevalence of extramedullary disease and high-risk disease.
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Affiliation(s)
- Uday Yanamandra
- 1 Clinical Hematology Division , Department of Internal Medicine, PGIMER, Chandigarh, India
| | - Neha Saini
- 1 Clinical Hematology Division , Department of Internal Medicine, PGIMER, Chandigarh, India
| | - Pooja Chauhan
- 1 Clinical Hematology Division , Department of Internal Medicine, PGIMER, Chandigarh, India
| | - Tanya Sharma
- 2 Department of Internal Medicine, Government Medical College and Hospital (GMCH) , Chandigarh, Punjab, India
| | - Alka Khadwal
- 1 Clinical Hematology Division , Department of Internal Medicine, PGIMER, Chandigarh, India
| | - Gaurav Prakash
- 1 Clinical Hematology Division , Department of Internal Medicine, PGIMER, Chandigarh, India
| | - Neelam Varma
- 3 Department of Hematology, PGIMER, Chandigarh, India
| | - Deepesh Lad
- 1 Clinical Hematology Division , Department of Internal Medicine, PGIMER, Chandigarh, India
| | - Subhash Varma
- 1 Clinical Hematology Division , Department of Internal Medicine, PGIMER, Chandigarh, India
| | - Pankaj Malhotra
- 1 Clinical Hematology Division , Department of Internal Medicine, PGIMER, Chandigarh, India
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