1
|
Li L, Liu X, Zhou W, Zhang Y, Zhang X. Information needs preferences of Chinese colorectal cancer patients receiving chemotherapy: A discrete choice experiment. Asia Pac J Oncol Nurs 2024; 11:100551. [PMID: 39220145 PMCID: PMC11364270 DOI: 10.1016/j.apjon.2024.100551] [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: 04/30/2024] [Accepted: 06/27/2024] [Indexed: 09/04/2024] Open
Abstract
Objective The study aims to investigate the information needs and preferences of colorectal cancer (CRC) patients undergoing chemotherapy using a discrete choice experiment (DCE) to optimize and improve the information support strategy for these patients. Methods Between May and July 2023, 165 patients with CRC who were receiving chemotherapy at a single hospital in China completed the questionnaire. The survey instruments included a general information questionnaire, a DCE questionnaire, and the Brief Health Literacy Screening Scale. A conditional logit model was used with Stata 16.0 software to analyze patients' preferences. Results A total of 159 valid questionnaires were collected, and the questionnaire response rate was 96.4%. All 7 included attributes had an impact on patients' information needs preference (P < 0.05). Among them, information providers, knowledge content, and social support had high relative importance, which were 12.16%, 7.57% and 2.25%, respectively. Patients showed a preference for attending doctors (β = 1.9439, P < 0.05) and primary nurses (β = 1.7985, P < 0.05). Providing knowledge related to disease basis, treatment, and health promotion also had a significant impact (β = 1.6224, P < 0.05). Conclusions Healthcare professionals should be the primary information source for patients and improve the accessibility of information by establishing professional information platforms or identifying reliable channels. It is recommended to provide continuous information on treatment and health promotion to CRC patients at various stages of chemotherapy. Attention should be paid to identifying and providing measures to alleviate the economic and psychological burden and to meet the social support needs of patients.
Collapse
Affiliation(s)
- Linlin Li
- School of Nursing, Anhui Medical University, Hefei, China
| | - Xueli Liu
- School of Nursing, Anhui Medical University, Hefei, China
| | - Wanjun Zhou
- School of Nursing, Anhui Medical University, Hefei, China
| | - Yawen Zhang
- School of Nursing, Anhui Medical University, Hefei, China
| | - Xinqiong Zhang
- School of Nursing, Anhui Medical University, Hefei, China
| |
Collapse
|
2
|
Mehnert-Theuerkauf A, Springer F. [Psycho-oncology-psychosocial distress and supportive care needs]. UROLOGIE (HEIDELBERG, GERMANY) 2024; 63:878-885. [PMID: 38995422 DOI: 10.1007/s00120-024-02395-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/26/2024] [Indexed: 07/13/2024]
Abstract
The number of patients living with or after cancer is constantly increasing due to improved diagnostics and care as well as the ageing society. This is particularly true for the group of older cancer survivors with complex health and supportive care needs. For many of those affected and their relatives, the disease and its treatment are accompanied by high levels of emotional stress, an impaired quality of life, and a variety of psychosocial challenges. Psychosocial distress, such as depression and anxiety, sometimes persists for years after treatment has ended. The most common unmet supportive care needs of patients include psychological and emotional needs as well as information needs. Therefore, it is essential to implement effective psychosocial screening and low-threshold needs-based referral to evidence-based psycho-oncological support services. Around a third of all cancer patients express a desire for professional psycho-oncological support. Although there is compelling evidence that psycho-oncological interventions can reduce psychosocial distress and improve quality of life, there is a need for further research into the design and effectiveness of intervention services for specific subgroups, such as prostate cancer patients.
Collapse
Affiliation(s)
- Anja Mehnert-Theuerkauf
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universitätsklinikum Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Deutschland.
| | - Franziska Springer
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universitätsklinikum Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Deutschland
| |
Collapse
|
3
|
Franzoi MA, Pages A, Papageorgiou L, Di Meglio A, Laparra A, Martin E, Barbier A, Renvoise N, Arvis J, Scotte F, Vaz-Luis I. Evaluating the Implementation of Integrated Proactive Supportive Care Pathways in Oncology: Master Protocol for a Cohort Study. JMIR Res Protoc 2024; 13:e52841. [PMID: 39186774 PMCID: PMC11384181 DOI: 10.2196/52841] [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: 09/17/2023] [Revised: 02/13/2024] [Accepted: 03/07/2024] [Indexed: 08/28/2024] Open
Abstract
BACKGROUND Supportive care (SC) refers to the prevention and management of complications of cancer and its treatment. While it has long been recognized as an important cancer care delivery component, a high proportion of patients face unaddressed SC needs, calling for innovative approaches to deliver SC. OBJECTIVE The objective of this master protocol is to evaluate the implementation of different integrated proactive SC pathways across the cancer care continuum in our institution (Gustave Roussy, Villejuif, France). Pathways studied in this master protocol may occur shortly after diagnosis to prevent treatment-related burden; during treatment to monitor the onset of toxicities and provide timely symptom management; and after treatment to improve rehabilitation, self-management skills, and social reintegration. METHODS This study is guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework. The primary objective is to evaluate the impact of SC pathways on patients' distress and unmet needs after 12 weeks, measured by the National Comprehensive Cancer Network's Distress Thermometer and Problem List. Secondary objectives will focus on the pathways (macrolevel) and each SC intervention (microlevel), evaluating their reach (administrative data review of the absolute number and proportion of clinical and sociodemographic characteristics of patients included in the pathways); short-term and long-term efficacy through their impact on quality of life (EQ-5D-5L and the 30-item European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire) and symptom burden (MD Anderson Symptom Inventory, Hospital Anxiety and Depression Scale, Insomnia Severity Index, and 22-item European Organization for Research and Treatment of Cancer Sexual Health Questionnaire); adoption by patients and providers (administrative data review of SC referrals and attendance or use of SC strategies); barriers to and leverage for implementation (surveys and focus groups with patients, providers, and the hospital organization); and maintenance (cost-consequence analysis). Pilot evaluations with a minimum of 70 patients per pathway will be performed to generate mean Distress Thermometer scores and SDs informing the calculation of formal sample size needed for efficacy evaluation (cohorts will be enriched accordingly). RESULTS The study was approved by the ethics committee, and as of February 2024, a total of 12 patients were enrolled. CONCLUSIONS This study will contribute toward innovative models of SC delivery and will inform the implementation of integrated SC pathways of care. TRIAL REGISTRATION ClinicalTrials.gov NCT06479057; https://clinicaltrials.gov/study/NCT06479057. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/52841.
Collapse
Affiliation(s)
| | - Arnaud Pages
- Department of Biostatistics and Epidemiology, Gustave Roussy, Villejuif, France
| | - Loula Papageorgiou
- Interdisciplinary Department for the Organization of Patient Pathways - DIOPP, Gustave Roussy, Villejuif, France
| | - Antonio Di Meglio
- Cancer Survivorship Group (INSERM U981), Gustave Roussy, Villejuif, France
| | - Ariane Laparra
- Interdisciplinary Department for the Organization of Patient Pathways - DIOPP, Gustave Roussy, Villejuif, France
| | - Elise Martin
- Cancer Survivorship Group (INSERM U981), Gustave Roussy, Villejuif, France
| | - Aude Barbier
- Cancer Survivorship Group (INSERM U981), Gustave Roussy, Villejuif, France
| | - Nathalie Renvoise
- Interdisciplinary Department for the Organization of Patient Pathways - DIOPP, Gustave Roussy, Villejuif, France
| | - Johanna Arvis
- Cancer Survivorship Group (INSERM U981), Gustave Roussy, Villejuif, France
| | - Florian Scotte
- Interdisciplinary Department for the Organization of Patient Pathways - DIOPP, Gustave Roussy, Villejuif, France
| | - Ines Vaz-Luis
- Cancer Survivorship Group (INSERM U981), Gustave Roussy, Villejuif, France
| |
Collapse
|
4
|
Toohey K, Mizrahi D, Hart NH, Singh B, Lopez P, Hunter M, Newton RU, Schmitz KH, Adams D, Edbrooke L, Hayes S. Exercise in cancer care for people with lung cancer: A narrative synthesis. J Sci Med Sport 2024:S1440-2440(24)00263-9. [PMID: 39155211 DOI: 10.1016/j.jsams.2024.08.002] [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: 01/13/2024] [Revised: 05/24/2024] [Accepted: 08/02/2024] [Indexed: 08/20/2024]
Abstract
OBJECTIVES Lung cancer is the second most common cancer diagnosed worldwide, resulting in significant physical and psychological consequences. In this narrative review, we explore the role of exercise as an adjunct therapy to counteract health issues experienced by people before, during and after treatment for lung cancer, and offer recommendations for exercise prescription and future research. DESIGN Narrative cornerstone review. METHODS A narrative review was conducted to explore the role of exercise in cancer care for people diagnosed with lung cancer. RESULTS Improvements in fitness, strength and quality of life have been demonstrated in people with lung cancer following participation in exercise programmes before, during and post treatment. Whilst combined aerobic (50-100 % heart rate maximum) and resistance (50-85 % of 1 repetition maximum) training, 2-5 times per week across the cancer continuum is typically prescribed, few people with lung cancer currently access exercise services. 'Optimal' exercise prescription is unclear, although is likely individual-specific. The immediate priority is to identify a tolerable starting exercise dosage, with the side effects of lung cancer and its treatment on the respiratory system, particularly shortness of breath (dyspnoea), likely driving the initial maximum threshold for session mode, duration and intensity. To date, exercise safety for people with lung cancer has been poorly evaluated and reported - few trials report it, but those that do report small numbers of serious adverse events. CONCLUSIONS Recommendations for health professionals prescribing exercise therapy to people with lung cancer are provided, with consideration of the strengths and limitations of the current evidence base.
Collapse
Affiliation(s)
- Kellie Toohey
- Physical Activity, Sport, and Exercise Research Theme, Faculty of Health, Southern Cross University, Australia; Faculty of Health, University of Canberra, Australia.
| | - David Mizrahi
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Australia; Discipline of Exercise and Sport Science, Faculty of Medicine and Health, The University of Sydney, Australia
| | - Nicolas H Hart
- Human Performance Research Centre, INSIGHT Research Institute, University of Technology Sydney (UTS), Australia; Exercise Medicine Research Institute, School of Medical and Health Sciences, Edith Cowan University, Australia; Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Australia; Cancer and Palliative Care Outcomes Centre, Faculty of Health, Queensland University of Technology (QUT), Australia; Institute for Health Research, The University of Notre Dame Australia, Australia
| | - Ben Singh
- Allied Health & Human Performance, University of South Australia, Australia
| | - Pedro Lopez
- Grupo de Pesquisa em Exercício para Populações Clínicas (GPCLIN), Universidade de Caxias do Sul, Brazil; Pleural Medicine Unit, Institute for Respiratory Health, Australia; Medical School, Faculty of Health & Medical Sciences, University of Western Australia, Australia
| | | | - Robert U Newton
- Exercise Medicine Research Institute, School of Medical and Health Sciences, Edith Cowan University, Australia; School of Human Movement and Nutrition Sciences, The University of Queensland, Australia
| | - Kathryn H Schmitz
- Division of Hematology and Oncology, Hillman Cancer Center, University of Pittsburgh, USA
| | - Diana Adams
- Macarthur Cancer Therapy Centre, Campbelltown Hospital, Australia
| | - Lara Edbrooke
- Department of Physiotherapy, The University of Melbourne, Australia; Department of Health Services Research, The Peter MacCallum Cancer Centre, Australia
| | - Sandi Hayes
- Menzies Health Institute Queensland, Griffith University, Australia; Viertel Cancer Research Centre, Cancer Council Queensland, Australia
| |
Collapse
|
5
|
Torbjörnsson E, Nilsson O. Development of an Education Material Targeting Patients Undergoing Lower Extremity Amputation due to Severe Limb Ischemia-A Qualitative Study. J Surg Res 2024; 299:205-212. [PMID: 38772269 DOI: 10.1016/j.jss.2024.04.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 02/29/2024] [Accepted: 04/24/2024] [Indexed: 05/23/2024]
Abstract
INTRODUCTION Critical limb-threatening ischemia (CLTI) is associated with a high risk of amputation, yet patients undergoing amputation due to CLTI have little knowledge of the amputation process and the rehabilitation that awaits. The aim of the present study was to develop and validate information material for patients undergoing amputation. METHODS Nine participants were included in the study. Two focus group interviews were performed with seven patients who had undergone lower extremity amputation due to CLTI within the past 2 y. Additionally, two individual interviews were carried out. A semistructured interview guide was used, and the interviews were transcribed verbatim and analysed using qualitative content analysis with a deductive approach. RESULTS Three themes were identified as essential for the design of the written information: Perspectives on design and formatting, Providing information to enhance participation in care, and Accessibility to information and support. The prototyped information leaflet was perceived as acceptable, useable, relevant, and comprehensible by the participants. CONCLUSIONS For patients to actively engage in their care, it is vital that their information needs are met and that they are provided with psychosocial support when needed. Written and oral information should be provided by a trusted healthcare professional.
Collapse
Affiliation(s)
- Eva Torbjörnsson
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden; Department of Surgery, Södersjukhuset, Stockholm, Sweden.
| | - Olga Nilsson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; Department of Vascular Surgery, Karolinska University Hospital, Stockholm, Sweden
| |
Collapse
|
6
|
Akduran F, Karaca A, Eroglu SA. Effects of the supportive care needs of patients with cancer on their comfort levels. Int J Palliat Nurs 2024; 30:295-306. [PMID: 38913641 DOI: 10.12968/ijpn.2024.30.6.295] [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: 06/26/2024]
Abstract
BACKGROUND Providing supportive care to patients with cancer and improving their comfort levels can promote their adjustment to the disease, compliance with treatment and improve their quality of life. AIM The aim of this cross-sectional, descriptive study was to identify the effects of the supportive care needs of cancer patients on their comfort levels. METHODS The study was performed in the oncology department of a university hospital. A total of 153 cancer patients undergoing chemotherapy constituted the sample. The data collection procedure included the Supportive Care Needs Survey (SCNS) and the General Comfort Questionnaire (GCQ). RESULTS The SCNS scores of the patients were low (Mean±SD: 75.13±27.93). The socio-cultural dimension of the GCQ was the most adversely influenced area of comfort. There was a negative relationship between needs and comfort levels (rs=-0.69, p<0.01). Lower scores of comfort were associated with higher scores of SCNS (ß=-0.487; ß=-0.316; ß=-0.958, respectively). CONCLUSIONS Cancer patients undergoing chemotherapy were supported in meeting their physical and psychological needs and performing their activities of daily living and care during their hospital stay. Patients with higher support needs had lower comfort levels.
Collapse
Affiliation(s)
- Funda Akduran
- Assistant Professor, Sakarya University Faculty of Health Sciences Nursing Department, Turkey
| | - Anita Karaca
- Assistant Professor, Biruni University Faculty of Health Sciences Nursing Department, Turkey
| | - Semiha Akin Eroglu
- Professor, University of Health Sciences, Hamidiye Faculty of Nursing, Turkey
| |
Collapse
|
7
|
Abdelrahman H, Qadire MA, Zehry H. Reliability and Validity of the Arabic Version of the Short Form Supportive Care Needs Survey Questionnaire (SCNS-SF34-A). Semin Oncol Nurs 2024; 40:151646. [PMID: 38735783 DOI: 10.1016/j.soncn.2024.151646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 04/05/2024] [Accepted: 04/10/2024] [Indexed: 05/14/2024]
Abstract
OBJECTIVE This study aimed to assess the psychometric properties of the Arabic version of the Supportive Care Needs Survey Short Form 34 (SCNS-SF34-A) among heterogonous group of cancer patients. METHOD This was a multicenter, prospective, descriptive-correlational survey that included 297 cancer patients recruited from two hospitals. The tool construct validity, internal consistency, and test-retest reliability were evaluated. RESULTS The participants comprised 60.6% females, with ages ranging from 18 to 82 years. The majority were married (71.7%) and had mainly breast cancer (28.3%). Exploratory factor analysis supported a four-factor structure that are: health system information and patient support domain, psychological domain, physical and daily living domain, and sexuality domain. This tool explained 64.2% of the variance. The SCNS-SF34-A demonstrated excellent internal consistency for the whole scale (Cronbach's alpha = 0.954) and high test-retest reliability (ICC = 0.954) for the subscales (Cronbach's alpha ranged from 0.82 to 0.95 and ICC ranged from 0.950 to 0.960. CONCLUSION SCNS-SF34-A exhibits robust psychometric properties and holds promise for enhancing cancer care in the Arab world, contributing to a more tailored and effective approach to addressing patients' supportive care needs. The four-factor structure aligns with international studies, emphasizing the nuanced nature of variations. Further validation in diverse Arabic-speaking populations and the exploration of additional forms of validity are recommended. IMPLICATIONS FOR NURSING PRACTICE The SCNS-SF34-A presents a reliable, culturally adapted, and sensitive assessment tool for the diverse supportive care needs of cancer patients in Oman and the Arab world. It contributes to the improvement of the quality of cancer care and patient-centered approach in clinical practice.
Collapse
Affiliation(s)
- Hanan Abdelrahman
- College of Nursing, Sultan Qaboos University, Muscat, Sultanate of Oman, Oman; Faculty of Nursing, Suez Canal University, Egypt; Principles and Practice of Clinical Research, Harvard T.H. Chan School of Public Health, Boston, MA.
| | - Mohammad Al Qadire
- College of Nursing, Sultan Qaboos University, Muscat, Sultanate of Oman, Oman; Faculty of Nursing, Al Al-Bayt University, Mafraq, Jordan
| | | |
Collapse
|
8
|
Askjær T, Juhl CB, Maribo T, Christiansen AF, Oestergaard LG. Telephone consultation for cancer survivors with unclarified need for rehabilitation in a primary healthcare setting: a mixed methods process evaluation. Disabil Rehabil 2024; 46:2901-2909. [PMID: 37480338 DOI: 10.1080/09638288.2023.2238599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 07/06/2023] [Accepted: 07/15/2023] [Indexed: 07/24/2023]
Abstract
PURPOSE To evaluate the implementation of telephone consultations to assess cancer patients' needs for rehabilitation, with focus on patients' acceptance, health professionals' experience and contextual factors. METHODS A mixed methods process evaluation was conducted at a primary healthcare rehabilitation clinic. Cancer survivors above 18 years of age with an unclarified rehabilitation need at discharge from hospital, was offered a telephone consultation provided by health professionals. Data on implementation and acceptability were collected using medical records systems, data collection forms and semi-structured interviews with six patients and two health professionals. RESULTS Eighty-one cancer survivors were referred to the intervention, and 54% continued to further rehabilitation. The telephone consultations were executed approximately eight days after referral and took on average 44 min to deliver. Overall, the patients found that the telephone consultation addressed what they considered the most important topics, and the health professionals found the intervention to be acceptable. Both patients and health professionals reported challenges regarding the referral process. CONCLUSION Patient acceptance of the intervention was high, and the telephone consultation was implemented to a high degree, resulting in more than half of the patients continuing to further rehabilitation. Patients' and health professionals' perspectives provided valuable insights about contextual factors.
Collapse
Affiliation(s)
- Tenna Askjær
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Department of Public Health, Health and Care, Municipality of Aarhus, Aarhus, Denmark
- Centre for Rehabilitation Research, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Carsten B Juhl
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital, Herlev and Gentofte, Denmark
| | - Thomas Maribo
- Centre for Rehabilitation Research, Department of Public Health, Aarhus University, Aarhus, Denmark
- DEFACTUM, Central Denmark Region, Aarhus, Denmark
| | | | - Lisa Gregersen Oestergaard
- Centre for Rehabilitation Research, Department of Public Health, Aarhus University, Aarhus, Denmark
- DEFACTUM, Central Denmark Region, Aarhus, Denmark
| |
Collapse
|
9
|
Chung H, Hyatt A, Webber K, Kosmider S, Krishnasamy M. Value in care: The contribution of supportive care to value-based lung cancer services-A qualitative semistructured interview study. Health Expect 2024; 27:e14089. [PMID: 38769867 PMCID: PMC11106590 DOI: 10.1111/hex.14089] [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: 06/16/2023] [Revised: 04/01/2024] [Accepted: 05/12/2024] [Indexed: 05/22/2024] Open
Abstract
INTRODUCTION Despite significant advances in the management of lung cancer, patients continue to experience a high burden of unmet need impacting quality of life and outcomes of care. Achieving value-based health care, where investment is targeted to services that deliver optimal experience and outcomes of care relative to the cost of delivering that care, requires attention to what people value most in meeting their needs. To date there has been little attention to what matters most to patients with lung cancer (i.e., what they value) as a component of achieving value-based cancer care. This qualitative study was undertaken to investigate components of care valued by people with lung cancer in Australia. METHODS This qualitative study used semistructured interviews with 23 people with lung cancer. Participants were recruited using a purposive sampling strategy from two metropolitan tertiary public health services. Data collected included demographic characteristics and patient perspectives regarding their priority concerns and components of care identified as most valuable in meeting their needs. Demographic characteristics of participants were analysed descriptively, and qualitative data were analysed thematically using Interpretive Description. RESULTS Data analysis generated three key themes: valued components of care; benefits of receiving valued care components and consequences of missed opportunities for care. The components of care valued by patients reflect the core dimensions of cancer supportive care, with particular emphasis on ongoing opportunities for consultation (screening for unmet needs) and provision of person-centred information. The facilitation of trust between patients and their treating team, as a consequence of having these valued components evident in their care, was identified as a key characteristic of value-based care. CONCLUSIONS This study has identified valued components of care described by people with lung cancer. Importantly, the care components identified have been proven to improve access to and coordination of care, and demonstrate the importance of integrating supportive care into care provision to achieve value-based cancer care. PATIENT OR PUBLIC CONTRIBUTION This study was informed by perspectives of lung cancer patients who participated in semistructured interviews. We acknowledge that this contribution does not meet the criteria for patient and public involvement in research as defined by Health Expectations, but this study forms part of a larger program of cancer supportive care work being undertaken by this team, where comprehensive consumer engagement and co-design approaches are embedded in our work.
Collapse
Affiliation(s)
- Holly Chung
- Academic Nursing UnitPeter MacCallum Cancer CentreParkvilleVictoriaAustralia
- Department of Health Services ResearchPeter MacCallum Cancer CentreMelbourneVictoriaAustralia
| | - Amelia Hyatt
- Department of Health Services ResearchPeter MacCallum Cancer CentreMelbourneVictoriaAustralia
- Sir Peter MacCallum Department of OncologyUniversity of MelbourneMelbourneVictoriaAustralia
- Department of NursingUniversity of MelbourneMelbourneVictoriaAustralia
| | - Kate Webber
- Oncology DepartmentMonash HealthClaytonVictoriaAustralia
- Faculty of Medicine, Nursing and Health Sciences, School of Clinical SciencesMonash UniversityClaytonVictoriaAustralia
| | - Suzanne Kosmider
- Cancer Services, Sunshine HospitalWestern HealthSt AlbansVictoriaAustralia
| | - Meinir Krishnasamy
- Academic Nursing UnitPeter MacCallum Cancer CentreParkvilleVictoriaAustralia
- Sir Peter MacCallum Department of OncologyUniversity of MelbourneMelbourneVictoriaAustralia
- Department of NursingUniversity of MelbourneMelbourneVictoriaAustralia
- Victorian Comprehensive Cancer Centre AllianceMelbourneVictoriaAustralia
| |
Collapse
|
10
|
Sebri V, Marzorati C, Dorangricchia P, Monzani D, Grasso R, Prelaj A, Provenzano L, Mazzeo L, Dumitrascu AD, Sonnek J, Szewczyk M, Watermann I, Trovò F, Dollis N, Sarris E, Garassino MC, Bestvina CM, Pedrocchi A, Ambrosini E, Kosta S, Felip E, Soleda M, Roca AA, Rodríguez‐Morató J, Nuara A, Lourie Y, Fernandez‐Pinto M, Aguaron A, Pravettoni G. The impact of decision tools during oncological consultation with lung cancer patients: A systematic review within the I3LUNG project. Cancer Med 2024; 13:e7159. [PMID: 38741546 PMCID: PMC11091486 DOI: 10.1002/cam4.7159] [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: 11/10/2023] [Revised: 03/17/2024] [Accepted: 03/22/2024] [Indexed: 05/16/2024] Open
Abstract
INTRODUCTION To date, lung cancer is one of the most lethal diagnoses worldwide. A variety of lung cancer treatments and modalities are available, which are generally presented during the patient and doctor consultation. The implementation of decision tools to facilitate patient's decision-making and the management of their healthcare process during medical consultation is fundamental. Studies have demonstrated that decision tools are helpful to promote health management and decision-making of lung cancer patients during consultations. The main aim of the present work within the I3LUNG project is to systematically review the implementation of decision tools to facilitate medical consultation about oncological treatments for lung cancer patients. METHODS In the present study, we conducted a systematic review following the PRISMA guidelines. We used an electronic computer-based search involving three databases, as follows: Embase, PubMed, and Scopus. 10 articles met the inclusion criteria and were included. They explicitly refer to decision tools in the oncological context, with lung cancer patients. RESULTS The discussion highlights the most encouraging results about the positive role of decision aids during medical consultations about oncological treatments, especially regarding anxiety, decision-making, and patient knowledge. However, no one main decision aid tool emerged as essential. Opting for a more recent timeframe to select eligible articles might shed light on the current array of decision aid tools available. CONCLUSION Future review efforts could utilize alternative search strategies to explore other lung cancer-specific outcomes during medical consultations for treatment decisions and the implementation of decision aid tools. Engaging with experts in the fields of oncology, patient decision-making, or health communication could provide valuable insights and recommendations for relevant literature or research directions that may not be readily accessible through traditional search methods. The development of guidelines for future research were provided with the aim to promote decision aids focused on patients' needs.
Collapse
Affiliation(s)
- Valeria Sebri
- Applied Research Division for Cognitive and Psychological ScienceIEO, European Institute of Oncology IRCCSMilanItaly
| | - Chiara Marzorati
- Applied Research Division for Cognitive and Psychological ScienceIEO, European Institute of Oncology IRCCSMilanItaly
| | - Patrizia Dorangricchia
- Applied Research Division for Cognitive and Psychological ScienceIEO, European Institute of Oncology IRCCSMilanItaly
| | - Dario Monzani
- Laboratory of Behavioral Observation and Research on Human Development, Department of Psychology, Educational Science and Human MovementUniversity of PalermoPalermoItaly
| | - Roberto Grasso
- Applied Research Division for Cognitive and Psychological ScienceIEO, European Institute of Oncology IRCCSMilanItaly
- Department of Oncology and Hemato‐OncologyUniversity of MilanMilanItaly
| | - Arsela Prelaj
- Thoracic Oncology Unit, Medical Oncology Department 1Fondazione IRCCS Istituto Nazionale TumoriMilanItaly
- Department of Electronics, Information, and BioengineeringPolitecnico di MilanoMilanItaly
| | - Leonardo Provenzano
- Medical Oncology DepartmentFondazione IRCCS Istituto Nazionale dei Tumori di MilanoMilanItaly
| | - Laura Mazzeo
- Thoracic Oncology Unit, Medical Oncology Department 1Fondazione IRCCS Istituto Nazionale TumoriMilanItaly
- Department of Electronics, Information, and BioengineeringPolitecnico di MilanoMilanItaly
| | - Andra Diana Dumitrascu
- Thoracic Oncology Unit, Medical Oncology Department 1Fondazione IRCCS Istituto Nazionale TumoriMilanItaly
| | - Jana Sonnek
- Lungen Clinic Grosshansdorf, Airway Research Center NorthGerman Center for Lung ResearchGrosshansdorfGermany
| | - Marlen Szewczyk
- Lungen Clinic Grosshansdorf, Airway Research Center NorthGerman Center for Lung ResearchGrosshansdorfGermany
| | - Iris Watermann
- Lungen Clinic Grosshansdorf, Airway Research Center NorthGerman Center for Lung ResearchGrosshansdorfGermany
| | | | | | | | - Marina Chiara Garassino
- Knapp Center for Biomedical DiscoveryUniversity of Chicago Medicine & Biological SciencesChicagoIllinoisUSA
| | - Christine M. Bestvina
- Knapp Center for Biomedical DiscoveryUniversity of Chicago Medicine & Biological SciencesChicagoIllinoisUSA
| | - Alessandra Pedrocchi
- Department of Electronics, Information and BioengineeringNeuroengineering and Medical Robotics Laboratory NearLabMilanItaly
| | - Emilia Ambrosini
- Department of Electronics, Information and BioengineeringNeuroengineering and Medical Robotics Laboratory NearLabMilanItaly
| | - Sokol Kosta
- Department of Electronic SystemsAalborg UniversityCopenhagenDenmark
| | - Enriqueta Felip
- Vall d'Hebron University HospitalBarcelonaSpain
- Vall d'Hebron Institute of OncologyBarcelonaSpain
| | | | | | | | | | | | | | | | - Gabriella Pravettoni
- Applied Research Division for Cognitive and Psychological ScienceIEO, European Institute of Oncology IRCCSMilanItaly
- Department of Oncology and Hemato‐OncologyUniversity of MilanMilanItaly
| |
Collapse
|
11
|
Justafré S, Marino P, Touzani R, Dupeyre-Alvarez F, Dantin P, Viens P, Vey N, Calvin S. Construction and preliminary validation of a tool to measure the needs of adolescents and young adults (AYA) diagnosed with cancer: the QUestionnaire nEEd Cancer AYAs: QUEEC-AYAs. Health Qual Life Outcomes 2024; 22:36. [PMID: 38649987 PMCID: PMC11036591 DOI: 10.1186/s12955-024-02249-8] [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: 04/19/2023] [Accepted: 04/02/2024] [Indexed: 04/25/2024] Open
Abstract
CONTEXT In France, 2300 adolescents and young adults (AYAs, 15-25 years old) are diagnosed with cancer each year. As soon as the disease is diagnosed, a number of physical, psychological and social needs may arise. The aim of this study is to develop a tool to measure unmet needs that will allow the specificities of AYAs to be understood while allowing health care staff to mobilise the necessary actors to resolve them. METHODS We developed the Questionnaire nEEd Cancer AYAs (QUEEC-AYAs questionnaire), from two existing questionnaires: the Cancer Needs Questionnaire Young People and the Needs Assessment & Service Bridge. A main sample of 103 AYAs then received and completed the questionnaire in order to conduct an exploratory factor analysis. RESULTS The final structure of the QUEEC-AYAs is composed of 7 dimensions and 48 items: information (8 items), cancer care team (6 items), Physical health (4 items), Emotional health (14 items), Sexual & reproductive health (6 items), Health behaviors & wellness (4 items), Daily life (6 items). The questionnaire has a good acceptability and all domains have a Cronbach's alphas value above 0.80. CONCLUSION The QUEEC-AYAs is the first measure of the psychosocial needs of AYAs available in French. Its systematic use in health care services should improve the coordination of care required by AYAs during and after treatment. TRIAL REGISTRATION This study was approved by the ethics committee of the Paoli-Calmettes Institute (IRB # IPC 2021-041, 2021 May 20).
Collapse
Affiliation(s)
- S Justafré
- Management Sport Cancer Laboratory UR20122035V, Aix Marseille University and Paoli Calmettes Institute, Marseille, France.
| | - P Marino
- Institut Paoli-Calmettes, Aix-Marseille Univ, IRD, SESSTIM, Inserm, Marseille, France
| | - R Touzani
- Institut Paoli-Calmettes, Aix-Marseille Univ, IRD, SESSTIM, Inserm, Marseille, France
| | | | - P Dantin
- Management Sport Cancer Laboratory UR20122035V, Aix Marseille University and Paoli Calmettes Institute, Marseille, France
| | - P Viens
- Management Sport Cancer Laboratory UR20122035V, Aix Marseille University and Paoli Calmettes Institute, Marseille, France
- Paoli Calmettes Institute, Marseille, France
| | - N Vey
- Paoli Calmettes Institute, Marseille, France
| | - S Calvin
- Management Sport Cancer Laboratory UR20122035V, Aix Marseille University and Paoli Calmettes Institute, Marseille, France
| |
Collapse
|
12
|
Springer F, Mehnert-Theuerkauf A, Gebhardt C, Stolzenburg JU, Briest S. Unmet supportive care needs among cancer patients: exploring cancer entity-specific needs and associated factors. J Cancer Res Clin Oncol 2024; 150:190. [PMID: 38607426 PMCID: PMC11009727 DOI: 10.1007/s00432-024-05715-4] [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: 01/19/2024] [Accepted: 03/19/2024] [Indexed: 04/13/2024]
Abstract
PURPOSE Recognizing unmet care needs among cancer patients is crucial for improving a person-centered and tailored approach to survivorship care. This study aimed to explore the prevalence of unmet supportive care needs, pinpointing entity-specific areas of burden, and to identify factors associated with unmet needs within a diverse sample of cancer patients. METHODS In this cross-sectional sub-study of a large multicenter study, 944 adult cancer patients reported supportive care needs via the well-validated SCNS. Most frequent diagnoses included breast (n = 276), prostate (n = 237), hematological (n = 90) and gynecological cancer (n = 74), which were analyzed for entity-specific care needs. RESULTS Across most cancer entities, health system and information, and psychological needs were most commonly reported, with fear of the cancer spreading and information regarding cancer control/diminishment ranking as the most prevalent individual concerns. Notable differences in entity-specific needs emerged for gynecological cancer patients, who exhibited more psychological (p = 0.007, OR = 2.01) and physical needs (p = 0.005, OR = 2.02), and prostate cancer patients, who showed higher sexuality needs (p < 0.001, OR = 2.95) but fewer psychological (p < 0.001, OR = 0.55), physical (p < 0.001, OR = 0.31) and patient care needs (p = 0.006, OR = 0.62). Non-distressed participants had fewer supportive care needs in each domain (all p < 0.001). Patients with functional impairments and female respondents reported increased unmet needs across most domains. CONCLUSION The high prevalence of patients feeling inadequately informed about their disease and care aspects, particularly among those with functional impairments, reflects a key challenge in the healthcare system. Specific interventions and improvements in patient-doctor communication are essential to address cancer entity-specific care needs.
Collapse
Affiliation(s)
- Franziska Springer
- Department of Medical Psychology and Medical Sociology, Comprehensive Cancer Center Central Germany (CCCG), University Medical Center Leipzig, Leipzig, Germany.
| | - Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, Comprehensive Cancer Center Central Germany (CCCG), University Medical Center Leipzig, Leipzig, Germany
| | - Claudia Gebhardt
- Department of Medical Psychology and Medical Sociology, Comprehensive Cancer Center Central Germany (CCCG), University Medical Center Leipzig, Leipzig, Germany
| | - Jens-Uwe Stolzenburg
- Department of Urology, Comprehensive Cancer Center Central Germany (CCCG), University Medical Center Leipzig, Leipzig, Germany
| | - Susanne Briest
- Department of Gynecology, Comprehensive Cancer Center Central Germany (CCCG), University Medical Center Leipzig, Leipzig, Germany
| |
Collapse
|
13
|
Schubach K, Niyonsenga T, Turner M, Paterson C. Identifying the supportive care needs of people affected by non-muscle invasive bladder cancer: An integrative systematic review. J Cancer Surviv 2024:10.1007/s11764-024-01558-7. [PMID: 38520600 DOI: 10.1007/s11764-024-01558-7] [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: 12/20/2023] [Accepted: 02/22/2024] [Indexed: 03/25/2024]
Abstract
PURPOSE To understand supportive care needs among people with non-muscle invasive bladder cancer (NMIBC). METHODS An integrative systematic review was reported using the Preformed Reporting Items for Systematic Review and Meta-analyses (PRISMA) guidelines. Seven electronic databases were searched for relevant studies, including all quantitative, qualitative, and mixed methods studies, irrespective of research design. The review process was managed by Covidence systematic review software. Two reviewer authors independently performed data extraction using eligibility criteria. Quality appraisal was conducted, and a narrative synthesis was performed. RESULTS A total of 1129 articles were screened, of which 21 studies met the inclusion criteria. The findings revealed that the frequency of supportive care needs reported by NMIBC participants included psychological/emotional (16/21:76%), physical (16/21:76%), practical (8/21:38%), interpersonal/intimacy (7/21:33%), family-related (7/21:33%), health system/information (5/21:23%), social (4/21:19%), patient-clinician communication (3/21:14%), spiritual (1/21:5%) and daily needs (1/21:5%). CONCLUSION People affected by NMIBC experience anxiety, depression, uncertainty, and fear of recurrence. The physical symptoms reported included urinary issues, pain, sleeping disorders and fatigue. These supportive care needs persist throughout the participants' treatment trajectory and can impact their quality of life. IMPLICATIONS FOR CANCER SURVIVORS Identifying supportive care needs within the NMIBC population will help inform future interventions to provide patient-centred care to promote optimal well-being and self-efficacy for people diagnosed with NMIBC.
Collapse
Affiliation(s)
- Kathryn Schubach
- Caring Futures Institute, Flinders University, Adelaide, Australia.
| | - Theo Niyonsenga
- Faculty of Health, University of Canberra, Bruce, ACT, Australia
| | - Murray Turner
- Faculty of Health, University of Canberra, Bruce, ACT, Australia
| | - Catherine Paterson
- Caring Futures Institute, Flinders University, Adelaide, Australia
- Central Adelaide Local Health Network, Adelaide, Australia
- Robert Gordon University, Aberdeen, Scotland, UK
| |
Collapse
|
14
|
Zeng K, Zhong Y, Chen X, Zhang L. Perceived communication efficacy and unmet needs for chemotherapy-associated symptom management in patients with lung and colorectal cancer: a cross-sectional study. BMC Palliat Care 2024; 23:71. [PMID: 38481297 PMCID: PMC10936018 DOI: 10.1186/s12904-024-01376-9] [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: 07/23/2023] [Accepted: 02/05/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Understanding cancer patients' unmet needs for chemotherapy-related symptom management will assist clinicians in developing tailored intervention programs. Little is known about the association between perceived communication efficacy and unmet care needs for symptom management in patients with lung and colorectal cancer. OBJECTIVES To examine the unmet care needs for symptom management of patients with lung and colorectal cancer and their association with perceived communication efficacy. METHODS A cross-sectional survey was conducted in a tertiary hospital in China from July to November 2020. A convenience sample of 203 patients with lung and colorectal cancer undergoing chemotherapy completed survey questionnaires, including the MD Anderson Symptom Inventory Scale and the Perceived Efficacy in Patient‒Physician Interactions Scale. RESULTS Approximately 43% of participants had at least one symptom with unmet needs. Fatigue was reported as the symptom with the highest occurrence (66%), the highest demand for supportive care (36%), and the highest prevalence of unmet needs (19%). Low levels of perceived communication efficacy independently predicted participants' unmet needs for symptom management (β=-0.13, p = 0.011). CONCLUSIONS This study highlights the necessity of introducing clinical assessment tools and guidelines to address fatigue and other chemotherapy-induced symptoms in patients with lung and colorectal cancer. Clinical programs designed to actively engage cancer patients to voice their needs and strengthen their communication efficacy are also warranted.
Collapse
Affiliation(s)
- Kai Zeng
- School of Nursing, Southern Medical University, No.1023-1063 Shatai South Road, Baiyun District, Guangzhou, 510515, China
| | - Yaping Zhong
- Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Xiaofang Chen
- The Third Affiliated Hospital, Southern Medical University, Guangzhou, China
| | - Lili Zhang
- School of Nursing, Southern Medical University, No.1023-1063 Shatai South Road, Baiyun District, Guangzhou, 510515, China.
| |
Collapse
|
15
|
Luo X, Zhang N, Guo L, Zhou L, Jiang H, Cui RS. Comprehensive needs, social support, and disease perception in lung cancer patients treated with immune checkpoint inhibitors: a cross-sectional study. Support Care Cancer 2024; 32:166. [PMID: 38372773 DOI: 10.1007/s00520-024-08348-y] [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: 07/19/2023] [Accepted: 01/30/2024] [Indexed: 02/20/2024]
Abstract
PURPOSE The aim of this study was to investigate the comprehensive needs of lung cancer patients treated with immune checkpoint inhibitors and to explore the relationships between comprehensive needs and social support and disease perception, moreover, to analyse associated factors of comprehensive needs. METHODS The study was conducted in a teaching hospital in Jiaxing Province, China. A total of 141 patients with lung cancer completed a battery of self-report questionnaires, including the Comprehensive Needs Assessment Tool in Cancer for Patients (CNAT), Social Supportive Rating Scale (SSRS), Brief Illness Perception Questionnaire (BIPQ), and demographic and clinical characteristics questionnaire. RESULTS The level of comprehensive needs was highest in the domain "medical demand" (42.17 ± 26.57), and the item with the highest level of comprehensive needs was "I need information about the financial support for my medical expenses" (2.00 ± 1.07). Statistically significant correlations were identified between the comprehensive needs score, social support, and disease perception. The multiple regression analysis showed that immunotherapy course, whether irAEs occur, social support, and disease perception were factors influencing patients' comprehensive needs. CONCLUSIONS The most prevalent needs in lung cancer patients were found in the "medical needs" domain. Additionally, immunotherapy course, whether irAEs occur, disease perception, and social support were associated with comprehensive needs among lung cancer patients. It is essential to combine the associated factors to accurately evaluate patient needs. We should pay more attention to proposing the comprehensive measures for these patients and providing more individualized supportive care during the lengthy treatment period.
Collapse
Affiliation(s)
- Xiaoyan Luo
- Department of Nursing, Medical College, Jiaxing College, No.899, Guangdome Road, Nanhu District, Jiaxing, Zhejiang Province, China
| | - Ningning Zhang
- Department of Medical Oncology, The First Hospital of Jiaxing, South Zhonghuan Road, Jiaxing, 1882314001, Zhejiang Province, China
| | - Lingru Guo
- Department of Nursing, Medical College, Jiaxing College, No.899, Guangdome Road, Nanhu District, Jiaxing, Zhejiang Province, China
| | - Li Zhou
- Department of Nursing, Medical College, Jiaxing College, No.899, Guangdome Road, Nanhu District, Jiaxing, Zhejiang Province, China
| | - Haiying Jiang
- Department of Nursing, Medical College, Jiaxing College, No.899, Guangdome Road, Nanhu District, Jiaxing, Zhejiang Province, China
| | - Ren-Shan Cui
- Department of Nursing, Medical College, Jiaxing College, No.899, Guangdome Road, Nanhu District, Jiaxing, Zhejiang Province, China.
| |
Collapse
|
16
|
Miniotti M, Botto R, Soro G, Olivero A, Leombruni P. A Critical Overview of the Construct of Supportive Care Need in the Cancer Literature: Definitions, Measures, Interventions and Future Directions for Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:215. [PMID: 38397704 PMCID: PMC10887927 DOI: 10.3390/ijerph21020215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/26/2024] [Accepted: 01/29/2024] [Indexed: 02/25/2024]
Abstract
The growing amount of evidence about the role of supportive care in enhancing cancer patients' outcomes has made healthcare providers more sensitive to the need for support that they experience during cancer's trajectory. However, the lack of a consensus in the definition of supportive care and lack of uniformity in the theoretical paradigm and measurement tools for unmet needs does not allow for defined guidelines for evidence-based best practices that are universally accepted. Contemporary cancer literature confirms that patients continue to report high levels of unmet supportive care needs and documents the low effectiveness of most of the interventions proposed to date. The aim of this critical review is to consolidate the conceptual understanding of the need for supportive care, providing definitions, areas of expertise and a careful overview of the measurement tools and intervention proposals developed to date. The possible reasons why the currently developed interventions do not seem to be able to meet the needs, and the issues for future research were discussed.
Collapse
Affiliation(s)
- Marco Miniotti
- ‘Rita Levi Montalcini’ Department of Neuroscience, University of Turin, 10126 Turin, Italy; (R.B.); (G.S.); (A.O.); (P.L.)
| | | | | | | | | |
Collapse
|
17
|
Salz T, Chimonas S, Jinna S, Brens J, Kriplani A, Salner A, Rabinowits G, Currier B, Daly B, Korenstein D. Pain management for post-treatment survivors of complex cancers: a qualitative study of opioids and cannabis. Pain Manag 2024; 14:87-99. [PMID: 38318666 PMCID: PMC10918509 DOI: 10.2217/pmt-2023-0067] [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: 07/11/2023] [Accepted: 12/01/2023] [Indexed: 02/07/2024] Open
Abstract
Aim: We aimed to understand experiences with opioids and cannabis for post-treatment cancer survivors. Patients & methods: We conducted seven focus groups among head and neck and lung cancer survivors, using standard qualitative methodology to explore themes around 1) post-treatment pain and 2) utilization, perceived benefits and perceived harms of cannabis and opioids. Results & conclusion: Survivors (N = 25) experienced addiction fears, stigma and access challenges for both products. Opioids were often perceived as critical for severe pain. Cannabis reduced pain and anxiety for many survivors, suggesting that anxiety screening, as recommended in guidelines, would improve traditional pain assessment. Opioids and cannabis present complex harms and benefits for post-treatment survivors who must balance pain management and minimizing side effects.
Collapse
Affiliation(s)
- Talya Salz
- Memorial Sloan Kettering Cancer Center, Department of Epidemiology & Biostatistics, New York, NY 10017, USA
| | - Susan Chimonas
- Memorial Sloan Kettering Cancer Center, Department of Epidemiology & Biostatistics, New York, NY 10017, USA
| | - Sankeerth Jinna
- Memorial Sloan Kettering Cancer Center, Department of Epidemiology & Biostatistics, New York, NY 10017, USA
| | - Jessica Brens
- Memorial Sloan Kettering Cancer Center, Department of Advanced Practice Providers, New York, NY 10065, USA
| | - Anuja Kriplani
- Memorial Sloan Kettering Cancer Center, Department of Medicine, New York, NY 10065, USA
| | - Andrew Salner
- Hartford Hospital, Department of Radiation Oncology, Hartford, CT 06106, USA
| | - Guilherme Rabinowits
- Moffit Cancer Center, Department of Head and Neck-Endocrine Oncology, Tampa, FL 33612, USA
| | - Beatriz Currier
- Miami Cancer Institute, Department of Medicine, Miami, FL 33176, USA
| | - Bobby Daly
- Memorial Sloan Kettering Cancer Center, Department of Medicine, New York, NY 10065, USA
| | - Deborah Korenstein
- Mount Sinai Hospital, Department of Internal Medicine, New York, NY 10001, USA
| |
Collapse
|
18
|
Wang K, Chu JN, Oh DL, Shariff‐Marco S, Allen L, Kuo M, Wong C, Bui H, Chen J, Li FM, Ma C, Truong A, Gomez SL, Nguyen TT, Tsoh JY. Correlates of supportive care needs among Asian Americans with colorectal, liver, or lung cancer from a web-based patient navigation portal intervention: The Patient COUNTS study. Cancer Rep (Hoboken) 2024; 7:e1971. [PMID: 38351528 PMCID: PMC10864727 DOI: 10.1002/cnr2.1971] [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: 05/24/2023] [Revised: 11/30/2023] [Accepted: 12/28/2023] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Cancer is the leading cause of death among Asian Americans, who often face barriers to cancer care. Cancer supportive care needs among Asian Americans remain understudied. AIMS We examined cancer supportive care needs and participant factors correlated with these needs, identified profiles of supportive care needs, and examined whether needs profiles are associated with quality of life among Asian American adults. METHODS AND RESULTS We recruited 47 Asian American adults with colorectal, liver, or lung cancer who spoke Chinese, English, or Vietnamese, and were starting or undergoing cancer treatment. We assessed cancer supportive care needs in four domains: cancer information, daily living, behavioral health, and language assistance. Hierarchical cluster analysis was used to identify clusters of participants based on their supportive need profiles to further examine the association between need profiles and quality of life (QoL) assessed by the Functional Assessment of Cancer Therapy. Participants (mean age = 57.6) included 72% males and 62% spoke English less than very well. Older participants (age ≥ 65) and those with annual income <$50K reported higher daily living needs. Men and younger participants (age < 50) reported higher behavioral health needs. We found three clusters displaying distinct cancer supportive need profiles: Cluster 1 (28% of the sample) displayed high needs across all domains; Cluster 2 (51%) had low needs across all domains; and Cluster 3 (21%) had high needs for cancer information and daily living. Cluster 1 participants reported the lowest QoL. CONCLUSION Cancer supportive care needs among Asian American patients with colorectal, liver, and lung cancer were associated with patient characteristics and QoL. Understanding cancer supportive care needs will inform future interventions to improve care and QoL for Asian American patients with cancer. CLINICALTRIALS gov Identifier: NCT03867916.
Collapse
Affiliation(s)
- Katarina Wang
- Asian American Research Center on Health, University of CaliforniaSan Francisco
- Department of Epidemiology & BiostatisticsUniversity of CaliforniaSan Francisco
| | - Janet N. Chu
- Asian American Research Center on Health, University of CaliforniaSan Francisco
- Division of General Internal MedicineUniversity of CaliforniaSan Francisco
| | - Debora L. Oh
- Department of Epidemiology & BiostatisticsUniversity of CaliforniaSan Francisco
| | - Salma Shariff‐Marco
- Department of Epidemiology & BiostatisticsUniversity of CaliforniaSan Francisco
- Helen Diller Family Comprehensive Cancer Center, University of CaliforniaSan Francisco
| | - Laura Allen
- Department of Epidemiology & BiostatisticsUniversity of CaliforniaSan Francisco
| | - Mei‐Chin Kuo
- Department of Epidemiology & BiostatisticsUniversity of CaliforniaSan Francisco
| | - Ching Wong
- Asian American Research Center on Health, University of CaliforniaSan Francisco
- Division of General Internal MedicineUniversity of CaliforniaSan Francisco
- Helen Diller Family Comprehensive Cancer Center, University of CaliforniaSan Francisco
| | - Hoan Bui
- Asian American Research Center on Health, University of CaliforniaSan Francisco
- Division of General Internal MedicineUniversity of CaliforniaSan Francisco
| | - Junlin Chen
- Division of General Internal MedicineUniversity of CaliforniaSan Francisco
| | - Feng Ming Li
- Asian American Research Center on Health, University of CaliforniaSan Francisco
- Department of Psychiatry and Behavioral SciencesUniversity of CaliforniaSan Francisco
| | - Carmen Ma
- Asian American Research Center on Health, University of CaliforniaSan Francisco
- Department of Psychiatry and Behavioral SciencesUniversity of CaliforniaSan Francisco
| | - Angeline Truong
- Asian American Research Center on Health, University of CaliforniaSan Francisco
| | - Scarlett L. Gomez
- Department of Epidemiology & BiostatisticsUniversity of CaliforniaSan Francisco
- Helen Diller Family Comprehensive Cancer Center, University of CaliforniaSan Francisco
| | - Tung T. Nguyen
- Asian American Research Center on Health, University of CaliforniaSan Francisco
- Division of General Internal MedicineUniversity of CaliforniaSan Francisco
- Helen Diller Family Comprehensive Cancer Center, University of CaliforniaSan Francisco
| | - Janice Y. Tsoh
- Asian American Research Center on Health, University of CaliforniaSan Francisco
- Helen Diller Family Comprehensive Cancer Center, University of CaliforniaSan Francisco
- Department of Psychiatry and Behavioral SciencesUniversity of CaliforniaSan Francisco
| |
Collapse
|
19
|
Muliira JK, Kizza IB, Al-Kindi SN. Determinants of quality of life among Omani family caregivers of adult patients with cancer pain. Palliat Support Care 2024; 22:70-79. [PMID: 36472250 DOI: 10.1017/s1478951522001626] [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] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The study aimed to explore the determinants of quality of life (QoL) among Omani family caregivers (FCGs) of adult patients with cancer pain. METHODS A descriptive cross-sectional design, measures of caregiver reaction, knowledge about cancer pain, self-efficacy for cancer pain and other symptom management, QoL, and patient functional status were used to collect data from 165 FCGs and patients. Descriptive, correlation, and regression analyses were performed. RESULTS Most patients had intermittent (83%) and severe (50.9%) cancer pain. The FCGs had low QoL (58.44 ± 17.95), and this mostly impacted support and positive adaptation (55.2%). Low QoL was associated with low self-rated health, low confidence in the ability to control the patient's pain, low self-efficacy, high perceived distress due to patient pain, and a high impact of caregiving on physical health. The level of caregiver distress due to the patient's pain (p < 0.01), patient's functional status (p < 0.01), and perceived impact of caregiving on health (p < 0.05) were significant predictors of overall QoL. CONCLUSION Omani FCGs of patients with cancer pain suffer a negative impact on their QoL, and this is related to the patient's level of pain and functional status, caregiver's health, and self-efficacy in cancer pain and symptom management. The FCGs' QoL may be enhanced by augmenting their skills and self-efficacy in cancer pain and symptom management and by health promotion programs.
Collapse
Affiliation(s)
| | - Irene B Kizza
- School of Nursing, University of Wisconsin - Madison, Madison, WI, USA
| | - Sumaiya N Al-Kindi
- Department of Adult Health & Critical Care, College of Nursing, Sultan Qaboos University, Muscat, Oman
| |
Collapse
|
20
|
Roseleur J, Edney LC, Jung J, Karnon J. Prevalence of unmet supportive care needs reported by individuals ever diagnosed with cancer in Australia: a systematic review to support service prioritisation. Support Care Cancer 2023; 31:676. [PMID: 37934313 PMCID: PMC10630245 DOI: 10.1007/s00520-023-08146-y] [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: 07/08/2023] [Accepted: 10/26/2023] [Indexed: 11/08/2023]
Abstract
PURPOSE Improved health outcomes for individuals ever diagnosed with cancer require comprehensive, coordinated care that addresses their supportive care needs. Implementing interventions to address these is confounded by a lack of evidence on population needs and a large pool of potential interventions. This systematic review estimates the point prevalence of different supportive care needs stratified by the tool used to measure needs and cancer type in Australia. METHODS We searched MEDLINE, Embase, and Scopus from 2010 to April 2023 to identify relevant studies published on the prevalence of supportive care needs in Australia. RESULTS We identified 35 studies that met the inclusion criteria. The highest prevalent unmet need across all cancers was 'fear of cancer spreading' (20.7%) from the Supportive Care Needs Survey Short-Form 34 (SCNS-SF34), ranging from 9.4% for individuals ever diagnosed with haematological cancer to 36.3% for individuals ever diagnosed with gynaecological cancer, and 'concerns about cancer coming back' (17.9%) from the Cancer Survivors' Unmet Needs (CaSUN), ranging from 9.7% for individuals ever diagnosed with prostate cancer to 37.8% for individuals ever diagnosed with breast cancer. Two studies assessed needs in Aboriginal and Torres Strait Islander populations, reporting the highest needs for financial worries (21.1%). CONCLUSIONS Point prevalence estimates presented here, combined with estimates of the costs and effects of potential interventions, can be used within economic evaluations to inform evidence-based local service provision to address the supportive care needs of individuals ever diagnosed with cancer. IMPLICATIONS FOR CANCER SURVIVORS Local health services can use local evidence to prioritise the implementation of interventions targeted at unmet needs.
Collapse
Affiliation(s)
- Jackie Roseleur
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.
| | - Laura Catherine Edney
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Jayda Jung
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Jonathan Karnon
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| |
Collapse
|
21
|
Yang Y, Chen X, Pan X, Tang X, Fan J, Li Y. The unmet needs of patients in the early rehabilitation stage after lung cancer surgery: a qualitative study based on Maslow's hierarchy of needs theory. Support Care Cancer 2023; 31:677. [PMID: 37934256 DOI: 10.1007/s00520-023-08129-z] [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: 05/04/2023] [Accepted: 10/19/2023] [Indexed: 11/08/2023]
Abstract
PURPOSE This study aimed to explore the unmet needs of lung cancer patients in early rehabilitation, based on Maslow's hierarchy of needs theory. METHODS Information on the experiences of 20 patients was collected through semi-structured interviews. The interviews were conducted in the surgical nursing clinic within 1 week of discharge from hospital. The data were analysed using a combination of deductive (theory-driven) and inductive (data-driven) methods, using Maslow's Hierarchy of Needs as a framework for identifying and organising themes. RESULTS Patients had a mean age of 50.92 years (SD 11.88); n = 11 (55%) were female. Major themes aligned with the dimensions of Maslow's hierarchy of needs model. Five major themes with 12 corresponding sub-themes emerged: (1) physiological needs, including "self-care and independence in life", "return to pre-operative status as soon as possible", "increase exercise under specialist guidance" and "reduce cough and pain and improve sleep quality"; (2) safety and security needs, such as "symptom management", "regulation of the emotions of worry and fear" and "access accurate treatment information"; (3) love and belonging needs, including "accompany family members" and "chat with friends";(4)Esteem needs: "live with dignity";(5) Self-actualization, such as "accept and submit to the reality of cancer" and "live meaningfully". CONCLUSIONS The findings of this study indicated that there were many unmet needs for patients during the early recovery period after lung cancer surgery. An overview of the different areas of need identified in this study may guide future research and development of interventions to improve patients' quality of life during the home rehabilitation phase.
Collapse
Affiliation(s)
- Yingzi Yang
- School of Medicine, Tongji University, 1239 Siping Road, Shanghai, 200092, People's Republic of China
- Department of Nursing, Huadong Sanatorium, No. 67, Dajishan, Wuxi City, Jiangsu Province, 214100, People's Republic of China
| | - Xinxin Chen
- School of Medicine, Tongji University, 1239 Siping Road, Shanghai, 200092, People's Republic of China
- Department of Nursing, Shanghai Pulmonary Hospital, Tongji University, No.507, Zhengmin Road, Shanghai, 200433, People's Republic of China
| | - Xiaoting Pan
- School of Medicine, Tongji University, 1239 Siping Road, Shanghai, 200092, People's Republic of China
| | - Xuefeng Tang
- Department of Nursing, Huadong Sanatorium, No. 67, Dajishan, Wuxi City, Jiangsu Province, 214100, People's Republic of China
| | - Jiaxin Fan
- School of Medicine, Tongji University, 1239 Siping Road, Shanghai, 200092, People's Republic of China
| | - Yumei Li
- Department of Nursing, Shanghai Pulmonary Hospital, Tongji University, No.507, Zhengmin Road, Shanghai, 200433, People's Republic of China.
| |
Collapse
|
22
|
Borrayo EA, Juarez-Colunga E, Kilbourn K, Waxmonsky J, Jacobson M, Okuyama S, Swaney R, Wamboldt FS, Karam S, Lopez Alvarez S, Jin X, Nguyen J. Stepped-care to improve mental health outcomes among underserved patients with lung and head and neck cancer. Psychooncology 2023; 32:1718-1726. [PMID: 37772984 DOI: 10.1002/pon.6223] [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: 04/06/2023] [Revised: 09/13/2023] [Accepted: 09/17/2023] [Indexed: 09/30/2023]
Abstract
BACKGROUND The comparative effectiveness study (ClinicalTrials.gov, NCT03016403) assessed the effects of a stepped-care intervention versus usual care on mental health outcomes, including anxiety, depression, coping self-efficacy, emotional distress (anxiety and depression combined), health-related quality of life (HRQoL), and perceived stress among underserved patients (i.e., low-income, uninsured, underinsured) with lung cancer (LC) and head-and-neck cancer (HNC). METHODS In a randomized controlled trial, we investigated if 147 patients who received the stepped-care intervention had better mental health outcomes compared to 139 patients who received usual care. Using an intent-to-treat approach, we analyzed outcomes with linear mixed models. RESULTS For the primary outcomes estimated mean differences (denoted by "Δ"), depression (Δ = 1.75, 95% CI = 0.52, 2.98, p = 0.01) and coping self-efficacy (Δ = -15.24, 95% CI = -26.12, -4.36, p = 0.01) were better for patients who received the intervention compared to patients who received usual care, but anxiety outcomes were not different. For secondary outcomes, emotional distress (Δ = 1.97, 95% CI: 0.68, 3.54, p =< 0.01) and HRQoL (Δ = -4.16 95% CI: -7.45, -0.87, p = 0.01) were better for patients who received the intervention compared to usual care patients, while perceived stress was not different across groups. CONCLUSIONS The stepped-care intervention influenced depression and coping self-efficacy, important outcomes for patients with acute illnesses like LC and HNC. Although differences in emotional distress met the minimally important differences (MID) previously reported, depression and HRQoL were not above the MID threshold. Our study is among a few to report differences in mental health outcomes for underserved LC and HNC patients after receiving a psychological intervention. CLINICALTRIALS GOV IDENTIFIER NCT03016403.
Collapse
Affiliation(s)
- Evelinn A Borrayo
- Department of Community & Behavioral Health, Colorado School of Public Health, Aurora, Colorado, USA
- Latino Research and Policy Center, Colorado School of Public Health, Denver, Colorado, USA
| | - Elizabeth Juarez-Colunga
- Department of Biostatistics & Informatics, Colorado School of Public Health, Aurora, Colorado, USA
| | - Kristin Kilbourn
- Department of Psychology, College of Liberal Arts and Sciences, Denver, Colorado, USA
| | - Jeanette Waxmonsky
- Department of Family Medicine, School of Medicine, Aurora, Colorado, USA
| | - Marty Jacobson
- Veterans Administration Medical Center, Grand Junction, Colorado, USA
| | - Sonia Okuyama
- Hematology-Oncology, Denver Health and Hospital Authority, Denver, Colorado, USA
| | - Robert Swaney
- Medical Oncology, Ascension St. Vincent Evansville Cancer Center, Newburgh, IN, USA
| | | | - Sana Karam
- Radiation Oncology, School of Medicine, Aurora, Colorado, USA
| | - Samantha Lopez Alvarez
- Latino Research and Policy Center, Colorado School of Public Health, Denver, Colorado, USA
| | - Xin Jin
- Department of Biostatistics & Informatics, Colorado School of Public Health, Aurora, Colorado, USA
| | - Jennifer Nguyen
- Latino Research and Policy Center, Colorado School of Public Health, Denver, Colorado, USA
| |
Collapse
|
23
|
Weng Y, Lin J, Yang T, Lin YA, Chen H, Chen W, Huang F. The dyadic relationship of supportive care needs with quality of life in lung cancer survivor and spousal caregiver couples. Asia Pac J Oncol Nurs 2023; 10:100300. [PMID: 37908225 PMCID: PMC10613913 DOI: 10.1016/j.apjon.2023.100300] [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: 06/10/2023] [Accepted: 08/23/2023] [Indexed: 11/02/2023] Open
Abstract
Objective This study aimed to explore the dyadic interrelationships between supportive care needs (SCNs) and quality of life (QOL) among lung cancer (LC) survivors and their spousal caregivers. Methods In this cross-sectional study, 443 dyads were recruited from three tertiary hospitals in two cities (Fuzhou and Putian) in Fujian Province, China, between May 2020 and May 2021. The study shows that participants completed a sociodemographic information sheet, the SCNs survey, and answered the Chinese version of the World Health Organization Quality of Life-BREF questionnaire by telephone. The data were analyzed using descriptive statistics and Pearson's correlations. This study used the actor-partner interdependence model (APIM) with dyad analysis to examine the effect of LC survivors and spouses unmet SCNs on QOL. Results LC survivor's and spouse's QOL levels were influenced by the level of unmet SCNs (the actor effect). LC survivors unmet SCNs were significantly negatively associated with their spouse's QOL (the partner effect). There were no partner effects between the spouse's unmet SCNs and the LC survivor's QOL. The APIM model produced an acceptable model fit [χ2/df = 2.84 (147), comparative fit index (CFI) = 0.94, Tucker-Lewis index (TLI) = 0.93, root mean square error of approximation (RMSEA) = 0.07]. Conclusions The level of unmet SCNs significantly affected QOL in survivor and spouse dyads. Although partner effects were weaker than actor effects, healthcare providers should develop tailored LC dyadic self- and family-management interventions to provide SCN-driven care to LC survivors and their spouses.
Collapse
Affiliation(s)
- Yunqin Weng
- Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, China
- School of Nursing, Fujian Medical University, Fuzhou, China
| | - Jialing Lin
- School of Nursing, Fujian Medical University, Fuzhou, China
| | - Tianbao Yang
- Affiliated Hospital of Putian University, Putian, Fujian, China
| | - Yu-An Lin
- School of Nursing, Fujian Medical University, Fuzhou, China
| | - Huiping Chen
- Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, China
| | - Weiti Chen
- University of California, Los Angeles, CA, USA
| | - Feifei Huang
- School of Nursing, Fujian Medical University, Fuzhou, China
| |
Collapse
|
24
|
Goni-Fuste B, Pergolizzi D, Monforte-Royo C, Alonso-Babarro A, Belar A, Crespo I, Güell E, Julià-Torras J, Moreno-Alonso D, Nabal Vicuña M, Pascual A, Porta-Sales J, Rocafort J, Rodríguez-Prat A, Rodríguez D, Sala C, Serrano-Bermúdez G, Serna J, Balaguer A. Development of a Guide to Multidimensional Needs Assessment in the Palliative Care Initial Encounter (MAP). J Pain Symptom Manage 2023; 66:361-369.e6. [PMID: 37468050 DOI: 10.1016/j.jpainsymman.2023.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 06/23/2023] [Accepted: 07/12/2023] [Indexed: 07/21/2023]
Abstract
CONTEXT Ensuring patient-centered palliative care requires a comprehensive assessment of needs beginning in the initial encounter. However, there is no generally accepted guide for carrying out this multidimensional needs assessment as a first step in palliative intervention. OBJECTIVES To develop an expert panel-endorsed interview guide that would enable proactive and systematic Multidimensional needs Assessment in the Palliative care initial encounter (MAP). METHODS A preliminary version of the MAP guide was drafted based on a published literature review, published semistructured interviews with 20 patients, 20 family carers, and 20 palliative care professionals, and a nominal group process with palliative care professionals and a representative of the national patient's association. Consensus regarding its content was obtained through a modified Delphi process involving a panel of palliative care physicians from across Spain. RESULTS The published systematic literature review and qualitative study resulted in the identification of 55 needs, which were sorted and grouped by the nominal group. Following the Delphi process, the list of needs was reduced to 47, linked to six domains: Clinical history and medical conditions (n = 8), Physical symptoms (n = 17), Functional and cognitive status (n = 4), Psycho-emotional symptoms (n = 5), Social issues (n = 8), and Spiritual and existential concerns (n = 5). CONCLUSION MAP is an expert panel-endorsed semi-structured clinical interview guide for the comprehensive, systematic, and proactive initial assessment to efficiently assess multiple domains while adjusting to the needs of each patient. A future study will assess the feasibility of using the MAP guide within the timeframe of the palliative care initial encounter.
Collapse
Affiliation(s)
- Blanca Goni-Fuste
- Department of Nursing, School of Medicine and Health Sciences (B.G-F., C.M-R.), Universitat Internacional de Catalunya, Sant Cugat del Vallés (Barcelona), Spain
| | - Denise Pergolizzi
- School of Medicine and Health Sciences (D.P., J.J-T., D.M-A., J.P-S., A.B.), Universitat Internacional de Catalunya, Sant Cugat del Vallés (Barcelona), Spain
| | - Cristina Monforte-Royo
- Department of Nursing, School of Medicine and Health Sciences (B.G-F., C.M-R.), Universitat Internacional de Catalunya, Sant Cugat del Vallés (Barcelona), Spain.
| | | | - Alazne Belar
- Instituto Cultura y Sociedad (A.B.), Universidad de Navarra, IdiSNA, Pamplona, Spain
| | - Iris Crespo
- Department of Basic Sciences (I.C.), School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Ernest Güell
- Hospital Universitari Sant Pau (E.G., A.P.), Barcelona, Spain
| | - Joaquim Julià-Torras
- School of Medicine and Health Sciences (D.P., J.J-T., D.M-A., J.P-S., A.B.), Universitat Internacional de Catalunya, Sant Cugat del Vallés (Barcelona), Spain; Department of Palliative Care (J.J-T.), Institut Català d'Oncologia Badalona, Badalona, Spain
| | - Deborah Moreno-Alonso
- School of Medicine and Health Sciences (D.P., J.J-T., D.M-A., J.P-S., A.B.), Universitat Internacional de Catalunya, Sant Cugat del Vallés (Barcelona), Spain; Institut Català d'Oncologia L'Hospitalet (D.M-A., G.S-B.), L'Hospitalet, Barcelona, Spain
| | - Maria Nabal Vicuña
- Hospital Universitari Arnau de Vilanova (M.N.V.), Lleida, Spain; Faculty of Medicine (M.N.V.), Universidad de Lleida, Lleida, Spain
| | - Antonio Pascual
- Hospital Universitari Sant Pau (E.G., A.P.), Barcelona, Spain
| | - Josep Porta-Sales
- School of Medicine and Health Sciences (D.P., J.J-T., D.M-A., J.P-S., A.B.), Universitat Internacional de Catalunya, Sant Cugat del Vallés (Barcelona), Spain
| | - Javier Rocafort
- Fundación Vianorte-Laguna (J.R.), Madrid, Spain; School of Medicine (J.R.), Francisco de Vitoria University, Madrid, Spain
| | - Andrea Rodríguez-Prat
- Department of Humanities (A.R-P.), School of Humanities, Universitat Internacional de Catalunya, Barcelona, Spain
| | | | - Carme Sala
- Consorci Sanitari de Terrassa (C.S.), Terrassa, Spain
| | - Gala Serrano-Bermúdez
- Institut Català d'Oncologia L'Hospitalet (D.M-A., G.S-B.), L'Hospitalet, Barcelona, Spain
| | - Judith Serna
- Hospital Universitari Vall d'Hebron (J.S.), Barcelona, Spain
| | - Albert Balaguer
- School of Medicine and Health Sciences (D.P., J.J-T., D.M-A., J.P-S., A.B.), Universitat Internacional de Catalunya, Sant Cugat del Vallés (Barcelona), Spain
| |
Collapse
|
25
|
Hussain M, Chau S, Turner M, Paterson C. Scan-Associated Distress in People Affected by Cancer: A Qualitative Systematic Review. Semin Oncol Nurs 2023; 39:151502. [PMID: 37735038 DOI: 10.1016/j.soncn.2023.151502] [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: 05/18/2023] [Revised: 07/26/2023] [Accepted: 08/23/2023] [Indexed: 09/23/2023]
Abstract
OBJECTIVE The term "scanxiety" has been coined to describe the anxiety commonly associated with individuals undergoing cancer-related imaging. Despite the prevalence and severity of scanxiety across various clinical and demographic populations, there remains a significant lack of qualitative insights from existing studies that effectively capture patients' experiences of scanxiety in their own words. Therefore, this review addresses the following research question: What are the experiences of scanxiety distress among people affected by cancer across the cancer care continuum? DATA SOURCES Following the PRISMA methodology, a meta-aggregation of qualitative studies was performed, encompassing patients of all age groups who had been diagnosed with cancer or were indicated for a cancer-related scan. Of the 556 articles screened, 15 were deemed eligible for inclusion in the analysis. CONCLUSION The three overarching themes of 1) experience of "scan-itis," 2) experience of "patient-clinician support," and 3) development of self-management strategies reveal the complex and interconnected factors that influence scanxiety in individuals undergoing cancer-related imaging. These findings emphasized distress experienced by patients during the waiting period for scan results, the act of viewing the results, and even the delivery of "bad" news. Consequently, patients expressed a strong desire for increased information, communication, and empathy from attending healthcare providers. Patients also report a myriad of self-coping strategies to manage their scanxiety well before, during, and after their scan appointment. IMPLICATIONS FOR NURSING PRACTICE The study highlights the need for targeted interventions for those undergoing cancer-related scans, including increased awareness and education for health professionals regarding scanxiety.
Collapse
Affiliation(s)
- M Hussain
- Faculty of Health, University of Canberra, Bruce ACT, Australia
| | - S Chau
- Caring Futures Institute, Flinders University, Australia
| | - M Turner
- Faculty of Health, University of Canberra, Bruce ACT, Australia
| | - C Paterson
- Faculty of Health, University of Canberra, Bruce ACT, Australia; Caring Futures Institute, Flinders University, Australia; Central Adelaide Local Health Network, Adelaide; Robert Gordon University, Aberdeen, Scotland, UK; Flinders Medical Centre, Adelaide, Australia.
| |
Collapse
|
26
|
Yang L, Liu J, Liu Q, Wang Y, Yu J, Qin H. The relationships among symptom experience, family support, health literacy, and fear of progression in advanced lung cancer patients. J Adv Nurs 2023; 79:3549-3558. [PMID: 37139634 DOI: 10.1111/jan.15692] [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: 07/22/2022] [Revised: 04/07/2023] [Accepted: 04/23/2023] [Indexed: 05/05/2023]
Abstract
AIMS Fear of progression of cancer patients can affect their psychological well-being, while research on fear of progression of advanced lung cancer patients is limited. This study aimed to describe fear of progression among advanced lung cancer patients and explore the relationships among symptom experience, family support, health literacy, and fear of progression. DESIGN This study was a cross-sectional study. METHODS Convenience sampling was used to select advanced lung cancer patients from September 2021 to January 2022. The Chinese version of the Fear of Progression Questionnaire-Short Form, Lung Cancer Module of the MD Anderson Symptom Inventory, Family Support Questionnaire, and Health Literacy Scale for Patients with Chronic Disease were used to collect data. The structural equation modelling was used to analyse the relationships among symptom experience, family support, health literacy, and fear of progression. RESULTS Of 220 patients, 31.8% had dysfunctional fear of progression. Better symptom experience, higher family support, and higher health literacy were correlated directly with lower fear of progression. Higher health literacy was associated indirectly with lower fear of progression through the mediation of better symptom experience. CONCLUSION Fear of progression among advanced lung cancer patients needs attention. Strengthening symptom management, building a strong system of family support, and improving patients' health literacy may be effective strategies to reduce fear of progression. IMPACT The research aimed to increase our understanding of the relationships among symptom experience, family support, health literacy, and fear of progression. Fear of progression screening should be integrated into the healthcare trajectory of advanced lung cancer patients. The results emphasize that improving symptom management, family support, and health literacy is important to alleviate fear of progression. Further interventions are warranted to relieve fear of progression for advanced lung cancer patients. PATIENT OR PUBLIC CONTRIBUTION No public or patient involvement.
Collapse
Affiliation(s)
- Limin Yang
- School of Nursing, Sun Yat-Sen University, Guangzhou, P.R. China
| | - Jiali Liu
- Department of Nursing, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, P.R. China
| | - Qi Liu
- School of Nursing, Sun Yat-Sen University, Guangzhou, P.R. China
| | - Yalan Wang
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, P.R. China
| | - Juan Yu
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, P.R. China
| | - Huiying Qin
- Department of Nursing, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, P.R. China
| |
Collapse
|
27
|
Park J, Jung W, Lee G, Kang D, Shim YM, Kim HK, Jeong A, Cho J, Shin DW. Unmet Supportive Care Needs after Non-Small Cell Lung Cancer Resection at a Tertiary Hospital in Seoul, South Korea. Healthcare (Basel) 2023; 11:2012. [PMID: 37510453 PMCID: PMC10378778 DOI: 10.3390/healthcare11142012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/10/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023] Open
Abstract
The aim of this study is to identify the prevalence and predictors of unmet needs of non-small cell lung cancer (NSCLC) patients undergoing surgical resection in Seoul, South Korea. A total of 949 patients who completed survey questionnaires that included the Cancer Survivors' Unmet Needs Korean version (CaSUN-K), fear of cancer recurrence (FCR) inventory-short form, and European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30) were recruited from January to October 2020. Multivariable logistic regression was used to determine the potential correlation of significant unmet needs, defined as any moderate or strong need, for each domain of CaSUN-K. Of the 949 participants, the mean age was 63.4 ± 8.8 years old, and 529 (55.7%) were male. Overall, 91.8% of participants reported one or more unmet need. The highest domains of moderate-to-strong unmet needs were existential survivorship (59.1%), comprehensive cancer care (51.2%), and information (49.7%). High FCR and poor emotional function were associated with moderate-to-strong unmet needs across all domains of CaSUN-K. NSCLC survivors with a recent diagnosis had more frequent disease-related unmet needs. Interventions to reduce the unmet needs of NSCLC patients should focus on relieving FCR and improving emotional functioning. Furthermore, emphasis should be placed on decreasing disease-related needs, particularly for early survivors of lung cancer during the re-entry phase.
Collapse
Affiliation(s)
- Junhee Park
- Department of Family Medicine & Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
| | - Wonyoung Jung
- Department of Family Medicine, Kangdong Sacred Heart Hospital, Hallym University, Seoul 05355, Republic of Korea
| | - Genehee Lee
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Seoul 06351, Republic of Korea
- Patient-Centered Outcomes Research Institute, Samsung Medical Center, Seoul 06351, Republic of Korea
| | - Danbee Kang
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Seoul 06351, Republic of Korea
| | - Young Mog Shim
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Seoul 06351, Republic of Korea
| | - Hong Kwan Kim
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Seoul 06351, Republic of Korea
| | - Ansuk Jeong
- Department of Psychology, DePaul University, Chicago, IL 60604, USA
| | - Juhee Cho
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Seoul 06351, Republic of Korea
- Cancer Education Center, Samsung Medical Center, Seoul 06351, Republic of Korea
| | - Dong Wook Shin
- Department of Family Medicine & Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Seoul 06351, Republic of Korea
- Department of Digital Health, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University School of Medicine, Seoul 06355, Republic of Korea
| |
Collapse
|
28
|
Fan R, Wang L, Bu X, Wang W, Zhu J. Unmet supportive care needs of breast cancer survivors: a systematic scoping review. BMC Cancer 2023; 23:587. [PMID: 37365504 DOI: 10.1186/s12885-023-11087-8] [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: 02/21/2023] [Accepted: 06/19/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Breast cancer is the most common type of cancer in women worldwide. Though improved treatments and prolonged overall survival, breast cancer survivors (BCSs) persistently suffer from various unmet supportive care needs (USCNs) throughout the disease. This scoping review aims to synthesize current literature regarding USCNs among BCSs. METHODS This study followed a scoping review framework. Articles were retrieved from Cochrane Library, PubMed, Embase, Web of Science, and Medline from inception through June 2023, as well as reference lists of relevant literature. Peer-reviewed journal articles were included if USCNs among BCSs were reported. Inclusion/exclusion criteria were adopted to screen articles' titles and abstracts as well as to entirely assess any potentially pertinent records by two independent researchers. Methodological quality was independently appraised following Joanna Briggs Institute (JBI) critical appraisal tools. Content analytic approach and meta-analysis were performed for qualitative and quantitative studies respectively. Results were reported according to the PRISMA extension for scoping reviews. RESULTS A total of 10,574 records were retrieved and 77 studies were included finally. The overall risk of bias was low to moderate. The self-made questionnaire was the most used instrument, followed by The Short-form Supportive Care Needs Survey questionnaire (SCNS-SF34). A total of 16 domains of USCNs were finally identified. Social support (74%), daily activity (54%), sexual/intimacy (52%), fear of cancer recurrence/ spreading (50%), and information support (45%) were the top unmet supportive care needs. Information needs and psychological/emotional needs appeared most frequently. The USCNs was found to be significantly associated with demographic factors, disease factors, and psychological factors. CONCLUSION BCSs are experiencing a large number of USCNs in fearing of cancer recurrence, daily activity, sexual/intimacy, psychology and information, with proportions ranging from 45% to 74%. Substantial heterogeneity in study populations and assessment tools was observed. There is a need for further research to identify a standard evaluation tool targeted to USCNs on BCSs. Effective interventions based on guidelines should be formulated and conducted to decrease USCNs among BCSs in the future.
Collapse
Affiliation(s)
- Rongrong Fan
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, No.37, Guoxue Lane, Wuhou District, Chengdu, Sichuan, China
| | - Lili Wang
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, No.37, Guoxue Lane, Wuhou District, Chengdu, Sichuan, China
| | - Xiaofan Bu
- The School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Wenxiu Wang
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, No.37, Guoxue Lane, Wuhou District, Chengdu, Sichuan, China
| | - Jing Zhu
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, No.37, Guoxue Lane, Wuhou District, Chengdu, Sichuan, China.
| |
Collapse
|
29
|
Yen CJ, Hsu HT, Hsieh HF, Chen YJ, Huang MS, Lin PC. Supportive Care Needs Trajectories in Patients With Advanced Non-Small-Cell Lung Cancer Receiving Chemotherapy: A Longitudinal Study. J Nurs Res 2023; 31:e275. [PMID: 37167615 DOI: 10.1097/jnr.0000000000000556] [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: 05/13/2023] Open
Abstract
BACKGROUND The supportive care needs trajectories in patients with advanced non-small-cell lung cancer (NSCLC) during chemotherapy and the related factors have yet to be explored or addressed in the literature. PURPOSE This study was designed to investigate supportive care needs trajectories in patients with advanced NSCLC receiving chemotherapy and the association between the sociodemographic and disease characteristics of these patients over the four cycles of chemotherapy. METHODS For this longitudinal study, 95 patients with advanced NSCLC were recruited using convenience sampling at a medical center in Taiwan. The supportive care needs of the participants were assessed in each of the four chemotherapy cycles using the Needs Evaluation Questionnaire-Chinese version (NEQ-C) with 23 dichotomous items on the day before and the seventh day after the end of each cycle. Group-based trajectory modeling was applied to identify the classes of supportive care needs trajectories, whereas chi-square tests were used to examine the factors related to these classes. RESULTS Seventy-one participants completed all eight questionnaire sessions across the four cycles. The mean NEQ-C scores for these participants ranged between 14.4 and 14.6. Three classes of supportive care needs trajectories (low, moderate, and high) were identified for the entire NEQ-C and for each domain. Marital status was found to be associated with the classes of trajectories related to supportive care and assistance/care needs, spouse as the primary caregiver was found to be associated with the classes of trajectories related to information needs, and educational level was found to be associated with the classes of trajectories related to psychoemotional support needs. CONCLUSIONS The results of this study indicate that marital status and spouse as primary caregiver relate significantly to supportive care needs trajectories in patients with advanced NSCLC during chemotherapy. Healthcare professionals should provide continuous, tailored supportive care interventions that address the needs of patients and their spouses/partners.
Collapse
Affiliation(s)
- Chun-Ju Yen
- MSN, RN, NP, Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan
| | - Hsin-Tien Hsu
- PhD, RN, Professor, School of Nursing, Kaohsiung Medical University; and Deputy Director, Department of Nursing, and Adjunct Researcher Fellow, Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan
| | - Hsiu-Fen Hsieh
- PhD, RN, Associate Professor, School of Nursing, Kaohsiung Medical University, Taiwan; and Supervisor, Department of Nursing, and Adjunct Researcher Fellow, Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan
| | - Ying-Ju Chen
- BSN, RN, NP, Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan
| | - Ming-Shyan Huang
- PhD, Professor, Department of Respiratory Medicine, E-Da Cancer Hospital, Kaohsiung, Taiwan
| | - Pei-Chao Lin
- PhD, RN, Associate Professor, College of Nursing, and Center for Long-Term Care Research, Kaohsiung Medical University, Taiwan; Adjunct Researcher, Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan; Co-appointed Associate Professor, Institute of Medical Science and Technology, National Sun Yat-Sen University, Taiwan; and Co-appointed Associate Professor, Department of Biomechatronics Engineering, National Pingtung University of Science and Technology, Pingtung, Taiwan
| |
Collapse
|
30
|
Yong ASJ, Cheong MWL, Hamzah E, Teoh SL. A qualitative study of lived experiences and needs of advanced cancer patients in Malaysia: Gaps and steps forward. Qual Life Res 2023:10.1007/s11136-023-03401-5. [PMID: 36964453 PMCID: PMC10038386 DOI: 10.1007/s11136-023-03401-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2023] [Indexed: 03/26/2023]
Abstract
PURPOSE Due to the high burden of cancer-related suffering, it is paramount to understand the gaps in cancer care that lead to suffering. Advanced cancer patients have unmet needs and challenges that differ from those with early-stage cancer due to the rapid disease progression. By exploring advanced cancer patients' lived experiences and needs from the physical, psychological, social, and spiritual aspects, this study aims to identify gaps in the Malaysian health system and propose contextualised measures to improve cancer care. METHODS Semi-structured, in-depth interviews were conducted to explore advanced cancer patients' lived experiences and needs from the physical, psychological, social, and spiritual aspects. The interviews were then transcribed and coded. Themes were developed from the codes using iterative thematic approach. RESULTS The lived experiences and needs of nineteen patients converged into four major themes: disruption to daily lives, psychosocial and spiritual support system, information needs, and financial needs. This study described predominantly how cancer impacted patients' lives and livelihood, how patients coped with their psychological conditions after diagnosis, the need for effective communication and trust in a multicultural society, and how finance affected access to and experience of cancer care. CONCLUSION Advanced cancer patients had different needs beyond receiving medical treatments. A concerted effort is required from clinicians, allied health professionals, social workers, support groups, and family members to understand and fulfil these needs.
Collapse
Affiliation(s)
- Alene Sze Jing Yong
- School of Pharmacy, Monash University Malaysia, Subang Jaya, Selangor, Malaysia
| | | | | | - Siew Li Teoh
- School of Pharmacy, Monash University Malaysia, Subang Jaya, Selangor, Malaysia.
| |
Collapse
|
31
|
Taylor S, Stanworth M, Eastwood C, Gomes F, Khatoon B, Yorke J. Understanding the experiences of lung cancer patients during the COVID-19 pandemic: a qualitative interview study. Qual Life Res 2023; 32:701-711. [PMID: 36342627 PMCID: PMC9638463 DOI: 10.1007/s11136-022-03283-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE The study explores experiences of lung cancer patients during COVID-19 and considers how changes to care delivery and personal lives affected patient needs. METHODS Semi-structured telephone interviews were conducted to explore experiences of lung cancer patients during COVID-19. Interviews were audio-recorded, transcribed verbatim and analysed thematically. Interview participants were purposively selected based on age, gender, treatment status, timing of diagnosis (pre/post first COVID-19 lockdown) from a sample of lung cancer patients (any histological subtype/any cancer stage/any point in treatment) who had completed a questionnaire exploring how participants' lives were impacted by the pandemic and their thoughts on clinical care and remote communication. RESULTS Thirty lung cancer patients who participated in the questionnaire study were approached and participated in an interview. Three themes were identified: (1) Adapting to new modes of communication (focusing on experiences of remote communication); (2) Experience of care delivery during the pandemic (describing how all aspects of care delivery had been affected); (3) Impact of the COVID-19 pandemic on quality of life (QOL) (focus on the psychological impact and feeling of reduced support). Themes 1 and 2 are heavily interlinked and both had bearing on patients' QOL experience. CONCLUSION Lung cancer patients were impacted psychologically by changes to care delivery and changes in their personal life. The findings highlight some benefits to remote consultations but the stage of the treatment pathway and illness trajectory should be considered when determining if this is appropriate. Participants felt support from peers, family and friends was limited during the pandemic.
Collapse
Affiliation(s)
- Sally Taylor
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Wilmslow Road, Manchester, M20 4BX, UK. .,School of Nursing and Midwifery, The University of Manchester, Oxford Road, Manchester, M13 9PL, UK.
| | - Melissa Stanworth
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Wilmslow Road, Manchester, M20 4BX, UK
| | - Charlotte Eastwood
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Wilmslow Road, Manchester, M20 4BX, UK
| | - Fabio Gomes
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Wilmslow Road, Manchester, M20 4BX, UK.,Medical Oncology Department, The Christie NHS Foundation Trust, Wilmslow Road, Manchester, M20 4BX, UK
| | - Binish Khatoon
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Wilmslow Road, Manchester, M20 4BX, UK.,School of Nursing and Midwifery, The University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | - Janelle Yorke
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Wilmslow Road, Manchester, M20 4BX, UK.,School of Nursing and Midwifery, The University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| |
Collapse
|
32
|
Sun Y, Ma Y, Li Q, Ge J. Supportive care needs of women with gynaecological cancer: A systematic review and synthesis of qualitative studies. J Adv Nurs 2023. [PMID: 36811244 DOI: 10.1111/jan.15614] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 01/23/2023] [Accepted: 02/11/2023] [Indexed: 02/24/2023]
Abstract
AIMS To synthesize existing qualitative research evidence on the supportive care needs of women with gynaecological cancer. DESIGN Qualitative systematic review. DATA SOURCES A comprehensive literature search was performed using nine databases (PubMed, Web of Science, PsycINFO, CINAHL, Embase, CBM, CNKI, VIP and WanFang) without restrictions regarding publication date; qualitative studies published in English or Chinese were included. Initial search in December 2021 and updated in October 2022. REVIEW METHODS This study was conducted according to the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidelines. The Critical Appraisal Skills Programme tool for qualitative research was used to assess the quality of all included papers. Finally, we adopted a thematic synthesis method, synthesized the main findings, and constructed themes. RESULTS Eleven studies published between 2010 and 2021 were included in the review. Based on the thematic synthesis method, 10 descriptive themes were generated and five analytical themes were derived: psychological support, information support, social support, disease-specific symptom management and form of care. Women with gynaecological cancer expressed a desire for psychological support from empathetic healthcare professionals; information support included access to adequate and appropriate information, as well as communication and involvement; social support highlighted women's desire for peer support, family-related support and financial support; disease-specific symptom management described women's desire for support in coping with reproduction/sexual issues and form of care highlighted the need for continuity of care and holistic care. CONCLUSION The supportive care needs of women with gynaecological cancer are multidimensional and complex. The future care practice should take women's needs as a starting point and provide ongoing holistic and individualized support. Healthcare providers' understanding and support of these needs are critical to improving women's clinical outcomes and quality of care. IMPACT The present findings can help further develop supportive care programmes and make nursing interventions more targeted and effective. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
Collapse
Affiliation(s)
- Yue Sun
- School of Nursing, China Medical University, Shenyang, China.,Department of Gynaecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yanling Ma
- Department of Orthopedics, West China Hospital of Sichuan University, Chengdu, China
| | - Qiaoran Li
- School of Nursing, China Medical University, Shenyang, China.,Department of Gynaecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jingling Ge
- Department of Gynaecology, Shengjing Hospital of China Medical University, Shenyang, China
| |
Collapse
|
33
|
Kong YC, Danaee M, Kaur R, Thiagarajan M, Zaharah H, Sener M, Rajah HDA, Taib NA, Chinna K, Yip CH, Bhoo-Pathy N. Development and Validation of a Dual-Language (English and Malay) Needs Assessment Tool for Breast Cancer (NeAT-BC). Diagnostics (Basel) 2023; 13:diagnostics13020241. [PMID: 36673050 PMCID: PMC9858119 DOI: 10.3390/diagnostics13020241] [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: 11/03/2022] [Revised: 12/16/2022] [Accepted: 01/05/2023] [Indexed: 01/11/2023] Open
Abstract
Background: Needs assessment tools may be used to guide the optimisation of cancer survivorship services. We sought to develop and validate a dual-language needs assessment tool for women with breast cancer. Methods: The study comprised two phases; (I) co-design, and (II) psychometric testing. In Phase I, items were generated based on focus group discussions with patients and a literature review. These items were then translated into the Malay language. Content and face validation were undertaken with an expert panel. In phase II, 315 Malaysian women living with breast cancer were recruited. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted to determine construct validity and reliability. Criterion validity was assessed using the EORTC QLQ-C30 questionnaire. Results: We co-designed and validated a 48-item dual-language needs assessment tool for breast cancer (NeAT-BC). Five underlying constructs were revealed in the EFA: (1) emotional support, (2) social and intimate relationships, (3) hospital appointments, (4) personal care and health, and (5) information and services. The NeAT-BC demonstrated good reliability across all constructs (Cronbach’s alpha: 0.90 to 0.96). CFA also demonstrated acceptable convergent and divergent validity, composite reliability ≥ 0.87, and Heterotrait−Monotrait index < 0.85 for all constructs. Criterion validity was established given the significant negative correlation between overall needs and quality of life (r = −0.14; p = 0.02). The NeAT-BC took approximately 25 min to be completed and could be interviewer-administered or self-administered. Conclusion: The utilization of the NeAT-BC is expected to guide establishment of evidence-based cancer survivorship services in Malaysia, with wider potentials for adoption in other multi-ethnic and/or low-and-middle income settings.
Collapse
Affiliation(s)
- Yek-Ching Kong
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Mahmoud Danaee
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Ranjit Kaur
- Breast Cancer Welfare Association Malaysia, Petaling Jaya 46200, Malaysia
| | | | - Hafizah Zaharah
- Department of Radiotherapy and Oncology, National Cancer Institute, Putrajaya 62250, Malaysia
| | - Mustafa Sener
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia
- Erasmus University Medical Centre, 3015 GD Rotterdam, The Netherlands
| | - Harenthri Devy Alagir Rajah
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Nur Aishah Taib
- Department of Surgery, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Karuthan Chinna
- Faculty of Business and Management, UCSI University, Kuala Lumpur 56100, Malaysia
| | - Cheng-Har Yip
- Subang Jaya Medical Centre, Subang Jaya 47500, Malaysia
| | - Nirmala Bhoo-Pathy
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia
- Correspondence: or ; Tel.: +6-03-7967-7526
| |
Collapse
|
34
|
Psychosocial Care after Cancer Diagnosis: Recent Advances and Challenges. Cancers (Basel) 2022; 14:cancers14235882. [PMID: 36497363 PMCID: PMC9739074 DOI: 10.3390/cancers14235882] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 11/18/2022] [Indexed: 12/02/2022] Open
Abstract
Psychosocial oncology is coming of age [...].
Collapse
|
35
|
Hyatt A, Chung H, Aston R, Gough K, Krishnasamy M. Social return on investment economic evaluation of supportive care for lung cancer patients in acute care settings in Australia. BMC Health Serv Res 2022; 22:1399. [PMID: 36419150 PMCID: PMC9685972 DOI: 10.1186/s12913-022-08800-x] [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: 08/11/2022] [Accepted: 11/07/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Unmanaged consequences of cancer and its treatment are high among patients with lung cancer and their informal carers, resulting in avoidable healthcare use and financial burden. Provision of cancer supportive care addressing the impacts of cancer and its treatment has demonstrated efficacy in mitigating these consequences; however, globally, there is a lack of investment in these services. Paucity of robust economic evidence regarding benefit of cancer supportive care has limited policy impact and allocation of resources. This study therefore utilised a Social Return on Investment (SROI) methodology to conduct a forecast evaluation of lung cancer supportive care services, to ascertain potential social value and return on investment. METHODS An SROI economic evaluation model was developed using qualitative stakeholder consultations synthesised with published evidence to develop the inputs, outcomes and financial value associated with the delivery of a hypothetical model of quality lung cancer supportive care services over a one and five year period. SROI ratios were generated to determine the social value and cost savings associated per every $1AUD invested in cancer supportive care for both the healthcare system and patients. Deadweight, drop off and attribution were calculated, and sensitivity analysis was performed to confirm the stability of the model. RESULTS The value generated from modelled supportive care service investments in a one-year period resulted in an SROI ratio of 1:9; that is, for every dollar invested in supportive care, AUD$9.00 social return is obtained when savings to the healthcare system and benefits to the patients are combined. At five-years, these same investments resulted in greater cumulative value generated for both the patient and the healthcare system, with a SROI ratio of 1:11. CONCLUSION Our study provides strong evidence for policy makers, clinicians and consumers to advocate for further investment in cancer supportive care, as demonstrated cost savings could be achieved through implementation of the proposed supportive care service model, with these accruing over a five-year period. The SROI model provides a comprehensive framework detailing supportive care services and the health workforce necessary to achieve value-based outcomes for patients and the healthcare system.
Collapse
Affiliation(s)
- Amelia Hyatt
- Department of Health Services Research, Peter MacCallum Cancer Centre, 305 Grattan Street Parkville, Melbourne, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, VIC, 3010, Melbourne, Australia
| | - Holly Chung
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, VIC, 3010, Melbourne, Australia.,Academic Nursing Unit, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Ruth Aston
- Centre for Program Evaluation, Melbourne Graduate School of Education, The University of Melbourne, VIC, 3010, Melbourne, Australia
| | - Karla Gough
- Department of Health Services Research, Peter MacCallum Cancer Centre, 305 Grattan Street Parkville, Melbourne, Australia.,Department of Nursing, Faculty of Medicine, Dentistry, and Health Sciences, The University of Melbourne, 3052, Melbourne, Australia
| | - Meinir Krishnasamy
- Department of Health Services Research, Peter MacCallum Cancer Centre, 305 Grattan Street Parkville, Melbourne, Australia. .,Sir Peter MacCallum Department of Oncology, The University of Melbourne, VIC, 3010, Melbourne, Australia. .,Academic Nursing Unit, Peter MacCallum Cancer Centre, Melbourne, Australia. .,Department of Nursing, Faculty of Medicine, Dentistry, and Health Sciences, The University of Melbourne, 3052, Melbourne, Australia. .,Victorian Comprehensive Cancer Centre Alliance, VIC, 3010, Melbourne, Australia.
| |
Collapse
|
36
|
Chambers-Richards T, Chireh B, D'Arcy C. Unmet health care needs: factors predicting satisfaction with health care services among community-dwelling Canadians living with neurological conditions. BMC Health Serv Res 2022; 22:1256. [PMID: 36253779 PMCID: PMC9578245 DOI: 10.1186/s12913-022-08611-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 09/26/2022] [Indexed: 11/16/2022] Open
Abstract
Background Neurological conditions (NCs) can lead to long-term challenges including functional impairments and limitations to activities of daily living. People with neurological conditions often report unmet health care needs and experience barriers to care. This study aimed to (1) explore the factors predicting patient satisfaction with general health care, hospital, and physician services among Canadians with NCs, (2) examine the association between unmet health care needs and satisfaction with health care services among neurological patients in Canada, and (3) contrast patient satisfaction between physician care and hospital care among Canadians with NCs. Methods We conducted a secondary analysis on a subsample of the 2010 Canadian Community Health Survey - Annual Component data (N = 6335) of respondents with neurological conditions, who received general health care services, hospital services, and physician services within twelve months. Multivariate logistic regression fitted the models and odds ratios and 95% confidence intervals were reported using STATA version 14. Results Excellent quality care predicts higher odds of patient satisfaction with general health care services (OR, 95%CI–237.6, 70.4–801.5), hospital services (OR, 95%CI–166.9, 67.9–410.6), and physician services (OR, 95%CI–176.5, 63.89–487.3). In contrast, self-perceived unmet health care needs negatively predict patient satisfaction across all health care services: general health care services (OR, 95%CI–0.59, 0.37–0.93), hospital services (OR, 95%CI–0.41, 0.21–0.77), and physician services (OR, 95%CI–0.29, 0.13–0.69). Other negative predictors of patient satisfaction include some post-secondary education (OR, 95%CI–0.36, 0.18–0.72) for general health services and (OR, 95%CI–0.26, 0.09–0.80) for physician services. Those with secondary (OR, 95% CI–0.32, 0.13–0.76) and post-secondary graduation (OR, 95%CI– 0.28, 0.11–0.67) negatively predicted patient satisfaction among users of physician services while being an emergency room patient most recently (OR, 95%CI– 0.39, 0.20–0.77) was also negatively associated with patients satisfaction among hospital services users. Conclusion This study found self-perceived unmet health care needs as a significant negative predictor of neurological patients’ satisfaction across health care services and emphasizes the importance of ensuring coordinated efforts to provide appropriate and accessible care of the highest quality for Canadians with neurological conditions.
Collapse
Affiliation(s)
| | - Batholomew Chireh
- Saskatchewan Cancer Agency, 1804 McOrmond Drive, Saskatoon, SK, Canada.
| | - Carl D'Arcy
- School of Public Health, University of Saskatchewan, Saskatoon, SK, Canada.,Department of Psychiatry, University of Saskatchewan, Saskatoon, SK, Canada
| |
Collapse
|
37
|
Hamann HA, Gerber DE. Placing a Cancer Diagnosis in Clinical Context: Applying Functional Trajectories to Advanced NSCLC. JTO Clin Res Rep 2022; 3:100366. [PMID: 36176486 PMCID: PMC9513545 DOI: 10.1016/j.jtocrr.2022.100366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 06/14/2022] [Indexed: 11/16/2022] Open
Affiliation(s)
- Heidi A. Hamann
- Department of Psychology, University of Arizona, Tucson, Arizona
- Department of Family and Community Medicine, University of Arizona Health Sciences, Tucson, Arizona
- The University of Arizona Cancer Center, University of Arizona, Tucson, Arizona
- Corresponding author. Address for correspondence: Heidi A. Hamann, PhD, Department of Psychology, University of Arizona, 1513 East University Boulevard, Tucson, AZ 85721.
| | - David E. Gerber
- Division of Hematology-Oncology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas
| |
Collapse
|
38
|
Collet R, Major M, van Egmond M, van der Leeden M, Maccow R, Eskes A, Stuiver M. Experiences of interaction between people with cancer and their healthcare professionals: A systematic review and meta-synthesis of qualitative studies. Eur J Oncol Nurs 2022; 60:102198. [DOI: 10.1016/j.ejon.2022.102198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/16/2022] [Accepted: 08/25/2022] [Indexed: 11/29/2022]
|
39
|
Compound Taxus chinensis Capsule Combined with Chemotherapy for Non-Small-Cell Lung Cancer: A PRISMA-Compliant Systematic Review and Meta-Analysis of Randomized Controlled Trials. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:9535061. [PMID: 34956388 PMCID: PMC8702306 DOI: 10.1155/2021/9535061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 11/14/2021] [Accepted: 11/29/2021] [Indexed: 11/17/2022]
Abstract
Background Compound Taxus chinensis capsule (CTCC), an antitumor Chinese patent medicine, has been commonly prescribed as an adjunctive agent to chemotherapy for the management of non-small-cell lung cancer (NSCLC); however, the effects of CTCC added to chemotherapy for NSCLC patients have never been comprehensively evaluated or summarized. Purpose To assess the synergistic effects of CTCC and chemotherapy on NSCLC. Study Design. Evidence-based study, systematic review, and quantitative meta-analysis. Methods This systematic review and meta-analysis was implemented in accordance with the PRISMA (Preferred Reported Items for Systematic Review and Meta-Analysis) guidelines. Eight databases including China National Knowledge Infrastructure, SINOMED, China Biomedical Literature Database, Wanfang Database, VIP, PubMed, Cochrane Library, and EMBASE were searched for relevant RCTs from their inception until May 24, 2021, and hand-searching was also carried out to identify additional studies. All randomized controlled trials (RCTs) that compared CTCC combined with chemotherapy versus chemotherapy alone were included in our study. The Cochrane Risk-of-Bias tool was used to determine the risk of bias and methodological quality of the included RCTs. Review Manager 5.3 software was used for comprehensive analysis. The primary outcome measure for this study was the disease control rate (DCR), and the secondary outcomes included the objective response rate (ORR), adverse reactions, and quality of life (QOL). Results Six RCTs with a total sample size of 410 were finally included. The pooled data showed that, compared with chemotherapy alone, CTCC combined with chemotherapy significantly improved DCR (RR = 1.15, 95% CI: 1.06–1.25, P = 0.006), ORR (RR = 1.38, 95% CI: 1.18–1.63, P < 0.00001), and QOL (MD = 8.69, 95% CI: 7.26–10.13, P < 0.006) and reduced the incidence of total adverse reactions (RR = 0.48, 95% CI: 0.38–0.60, P < 0.00001). The subgroup analyses indicated that CTCC plus chemotherapy significantly improved gastrointestinal reactions (P = 0.004), leukopenia (P = 0.0009), thrombocytopenia (P = 0.01), rash (P = 0.002), and fever (P = 0.007). Conclusion Based on the available evidence, compared with chemotherapy alone, CTCC used as an adjunctive agent to chemotherapy for NSCLC can improve the clinical efficacy and quality of life and decrease the likelihood of adverse reactions, suggesting that CTCC might be an effective and safe adjunctive medicine to chemotherapy for NSCLC. However, considering the relatively small sample size and the inherent imperfections of the included randomized controlled trials, more high-quality clinical trials with longer follow-up time are needed to further assess the efficacy and safety of this combined treatment regimen.
Collapse
|