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Kane K, Kennedy F, Absolom KL, Harley C, Velikova G. Quality of life support in advanced cancer-web and technological interventions: systematic review and narrative synthesis. BMJ Support Palliat Care 2023; 13:e221-e234. [PMID: 33903259 DOI: 10.1136/bmjspcare-2020-002820] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 04/01/2021] [Accepted: 04/04/2021] [Indexed: 01/27/2023]
Abstract
BACKGROUND As treatments continue to progress, patients with advanced cancer are living longer. However, ongoing physical side-effects and psychosocial concerns can compromise quality of life (QoL). Patients and physicians increasingly look to the internet and other technologies to address diverse supportive needs encountered across this evolving cancer trajectory. OBJECTIVES 1. To examine the features and delivery of web and technological interventions supporting patients with advanced cancer. 2. To explore their efficacy relating to QoL and psychosocial well-being. METHODS Relevant studies were identified through electronic database searches (MEDLINE, PsychINFO, Embase, CINAHL, CENTRAL, Web of Science and ProQuest) and handsearching. Findings were collated and explored through narrative synthesis. RESULTS Of 5274 identified records, 37 articles were included. Interventions were evaluated within studies targeting advanced cancer (13) or encompassing all stages (24). Five subtypes emerged: Interactive Health Communication Applications (n=12), virtual programmes of support (n=11), symptom monitoring tools (n=8), communication conduits (n=3) and information websites (n=3). Modes of delivery ranged from self-management to clinically integrated. Support largely targeted psychosocial well-being, alongside symptom management and healthy living. Most studies (78%) evidenced varying degrees of efficacy through QoL and psychosocial measures. Intervention complexity made it challenging to distinguish the most effective components. Incomplete reporting limited risk of bias assessment. CONCLUSION While complex and varied in their content, features and delivery, most interventions led to improvements in QoL or psychosocial well-being across the cancer trajectory. Ongoing development and evaluation of such innovations should specifically target patients requiring longer-term support for later-stage cancer. PROSPERO REGISTRATION NUMBER CRD42018089153.
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Affiliation(s)
- Kathleen Kane
- Patient Centred Outcomes Research Group, Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
| | - Fiona Kennedy
- Patient Centred Outcomes Research Group, Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
| | - Kate L Absolom
- Patient Centred Outcomes Research Group, Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Clare Harley
- School of Healthcare, University of Leeds, Leeds, UK
| | - Galina Velikova
- Patient Centred Outcomes Research Group, Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
- Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, St James's University Hospital, Leeds, UK
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2
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Siew LED, Teo NR, Ang WHD, Lau Y. Social media-based interventions for patients with cancer: a meta-analysis and meta-regression of randomised controlled trials. J Cancer Surviv 2023; 17:1606-1627. [PMID: 35960428 PMCID: PMC9372974 DOI: 10.1007/s11764-022-01244-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 08/02/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE This review aimed to (1) evaluate the effectiveness of social media-based interventions for improving the quality of life, anxiety and depressive symptoms of patients with cancer at post-intervention and follow-up; (2) identify the essential features of social media-based interventions and (3) explore the covariates of the treatment effect. METHODS All types of randomised controlled trials (RCTs) were included. Ten electronic databases, clinical trial registries and grey literature sources were searched from inception to 15 December 2021. Stata software was used to perform meta-analysis, subgroup analyses and meta-regression analyses. Individual quality assessment and certainty of evidence were assessed using Cochrane risk of bias tool version 1 and Grading of Recommendations Assessments, Development and Evaluation criteria, respectively. RESULTS This review included 43 RCTs, which comprised 6239 patients with a total mean age of 49.71 years old from across 11 countries. Social media-based interventions significantly improved the quality of life (g = 0.25, 95% CI = 0.05-0.45) and anxiety symptoms (g = - 0.41, 95% CI = - 0.76-0.07) but not depressive symptoms. The essential features based on the subgroup analysis concluded that using a mobile device with a flexible frequency had a remarkably greater effect on the quality of life and anxiety symptoms than their counterparts. The meta-regression showed the covariate features, where having more social media features in interventions significantly improved the quality of life (β = 0.21, p = 0.01). The certainty of evidence was very low for all outcomes. CONCLUSIONS Participants who received social media-based interventions may experience an increase in quality of life and reduction in anxiety symptoms. IMPLICATIONS FOR CANCER SURVIVORS Social media-based interventions may complement usual care in improving quality of life and anxiety symptoms. Registration in PROSPERO CRD42022297956.
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Affiliation(s)
- Li En Dana Siew
- Nursing Department, Singapore General Hospital, Singapore, Singapore
| | - Neil Russell Teo
- Nursing Department, Singapore General Hospital, Singapore, Singapore
| | - Wei How Darryl Ang
- Alice Lee Centre for Nursing Studies, Clinical Research Centre, National University of Singapore, Level 2Block MD11, 10 Medical Drive, Singapore, 117597 Singapore
| | - Ying Lau
- Alice Lee Centre for Nursing Studies, Clinical Research Centre, National University of Singapore, Level 2Block MD11, 10 Medical Drive, Singapore, 117597 Singapore
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Kukafka R, Kim S, Kim SH, Yoo SH, Sung JH, Oh EG, Kim N, Lee J. Digital Health Interventions for Adult Patients With Cancer Evaluated in Randomized Controlled Trials: Scoping Review. J Med Internet Res 2023; 25:e38333. [PMID: 36607712 PMCID: PMC9862347 DOI: 10.2196/38333] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 09/15/2022] [Accepted: 10/25/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Digital care has become an essential component of health care. Interventions for patients with cancer need to be effective and safe, and digital health interventions must adhere to the same requirements. OBJECTIVE The purpose of this study was to identify currently available digital health interventions developed and evaluated in randomized controlled trials (RCTs) targeting adult patients with cancer. METHODS A scoping review using the JBI methodology was conducted. The participants were adult patients with cancer, and the concept was digital health interventions. The context was open, and sources were limited to RCT effectiveness studies. The PubMed, CINAHL, Embase, Cochrane Library, Research Information Sharing Service, and KoreaMed databases were searched. Data were extracted and analyzed to achieve summarized results about the participants, types, functions, and outcomes of digital health interventions. RESULTS A total of 231 studies were reviewed. Digital health interventions were used mostly at home (187/231, 81%), and the web-based intervention was the most frequently used intervention modality (116/231, 50.2%). Interventions consisting of multiple functional components were most frequently identified (69/231, 29.9%), followed by those with the self-manage function (67/231, 29%). Web-based interventions targeting symptoms with the self-manage and multiple functions and web-based interventions to treat cognitive function and fear of cancer recurrence consistently achieved positive outcomes. More studies supported the positive effects of web-based interventions to inform decision-making and knowledge. The effectiveness of digital health interventions targeting anxiety, depression, distress, fatigue, health-related quality of life or quality of life, pain, physical activity, and sleep was subject to their type and function. A relatively small number of digital health interventions specifically targeted older adults (6/231, 2.6%) or patients with advanced or metastatic cancer (22/231, 9.5%). CONCLUSIONS This scoping review summarized digital health interventions developed and evaluated in RCTs involving adult patients with cancer. Systematic reviews of the identified digital interventions are strongly recommended to integrate digital health interventions into clinical practice. The identified gaps in digital health interventions for cancer care need to be reflected in future digital health research.
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Affiliation(s)
| | - Sanghee Kim
- College of Nursing and Mo-im Kim Nursing Research Institute, Yonsei Evidence Based Nursing Center of Korea: Affiliation of the Joanna Briggs Institution, Yonsei University, Seoul, Republic of Korea
| | - Soo Hyun Kim
- Department of Nursing, Inha University, Inchon, Republic of Korea
| | - Sung-Hee Yoo
- College of Nursing, Chonnam National University, Gwangju, Republic of Korea
| | - Ji Hyun Sung
- College of Nursing, Kosin University, Busan, Republic of Korea
| | - Eui Geum Oh
- College of Nursing and Mo-im Kim Nursing Research Institute, Yonsei Evidence Based Nursing Center of Korea: Affiliation of the Joanna Briggs Institution, Yonsei University, Seoul, Republic of Korea
| | - Nawon Kim
- Yonsei Medical Library, Yonsei University, Seoul, Republic of Korea
| | - Jiyeon Lee
- College of Nursing and Mo-im Kim Nursing Research Institute, Yonsei Evidence Based Nursing Center of Korea: Affiliation of the Joanna Briggs Institution, Yonsei University, Seoul, Republic of Korea
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Bamgboje-Ayodele A, Smith A'B, Short CE, Fardell JE, Shaw J, Beatty L, Higgins K, Tutelman PR, Chambers CT, Girgis A. Barriers and facilitators to the availability of efficacious self-directed digital health tools for adults living with cancer and their caregivers: A systematic literature review and author survey study. Patient Educ Couns 2021; 104:2480-2489. [PMID: 33741232 DOI: 10.1016/j.pec.2021.03.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 02/15/2021] [Accepted: 03/08/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE This study aimed to examine barriers and facilitators to the dissemination of efficacious self-directed digital health tools for adults affected by cancer, and quantify funding used to develop and evaluate these digital health tools. METHODS We conducted: (1) a systematic literature review to identify efficacious self-directed digital health tools for adults affected by cancer, published between 2009 and 2019 and (2) an author survey to identify barriers and facilitators to dissemination of those tools, grant funding and the user centredness of their design (UCD) process. RESULTS Of 1314 screened articles, 29 articles describing 26 tools met the inclusion criteria. From 26 surveys sent, 12 were completed, 6 of which described disseminated tools. Whilst researchers' motivation and infrastructure support facilitate tool dissemination, limited funds, lack of infrastructure and limited research timelines are the most common barriers. A median of AUD$250,000 was spent on tools not disseminated to end-users. CONCLUSION Although incorporating UCD processes in the development of digital health tools is important, it is imperative to integrate implementation processes into the planning stages of tool development to ensure dissemination. PRACTICE IMPLICATIONS Researchers, academic institutions, funding agencies and government and non-government organisations all have roles to play to support long-term implementation.
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Affiliation(s)
- Adeola Bamgboje-Ayodele
- Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Sydney, Australia.
| | - Allan 'Ben' Smith
- Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Sydney, Australia
| | - Camille E Short
- Melbourne School of Psychological Sciences and Melbourne School of Health Sciences (jointly appointed), The University of Melbourne, Australia
| | - Joanna E Fardell
- School of Women's and Children's Health, UNSW Medicine, University of New South Wales; Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Australia
| | - Joanne Shaw
- Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
| | - Lisa Beatty
- Flinders Health & Medical Research Institute, College of Medicine & Public Health, Flinders University, Australia
| | - Kristen Higgins
- Department of Psychology and Neuroscience, Dalhousie University and Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, Canada
| | - Perri R Tutelman
- Department of Psychology and Neuroscience, Dalhousie University and Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, Canada
| | - Christine T Chambers
- Department of Psychology and Neuroscience, Dalhousie University and Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, Canada
| | - Afaf Girgis
- Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Sydney, Australia
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5
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Nesterova D, Zhu J, Kramer C, Vasekar M, Truica C, Joshi A, Hayes M, Kessler J, Saunders EFH, Drabick JJ, Joshi M. Group-led creative writing and behavioural health in cancer: a randomised clinical trial. BMJ Support Palliat Care 2021; 12:91-98. [PMID: 33423021 DOI: 10.1136/bmjspcare-2020-002463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 11/26/2020] [Accepted: 12/09/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND Cancer diagnosis can adversely affect mental well-being and overall clinical outcome. We evaluated the efficacy of a group-led creative writing workshop (CWW) on mood in patients with cancer prospectively. METHODS We conducted a single-institution phase II study. Sixty adult patients with cancer (any type or stage) were randomised 2:1 to CWW (4×CWW sessions, bimonthly over 8 weeks) versus active control (AC) (independent writing at home with the help of a book, four sessions, bimonthly over 8 weeks). The total study duration was 6 months with a follow-up of up to 3 months. PRIMARY OBJECTIVE changes in overall mood, depression and anxiety symptoms before and after intervention in both arms. Emotional Thermometer Scale (ETS) was used to assess changes in patients' mood. Additionally, the Patient Health Questionnaire (PHQ)-9 and General Anxiety Disorder Scale (GAD)-7 were used to evaluate depression and anxiety symptoms. RESULTS Of 50 evaluable patients (CWW 34, AC 17), 26 patients in the CWW arm attended at least one class and 19 attended at least four classes. Patients in CWW had significant immediate improvement in the overall ETS (post vs preclass scores; p<0.0001, 95% CI -4.31 to -2.47). Four of the five subscale ETS scores were significantly lower for the CWW arm: distress (p=0.0346, 95% CI -2.6 to -0.1), anxiety (p=0.0366, 95% CI -4.1 to -0.2), depression (p=0.0441, 95% CI -3.9 to -0.1) and anger (p=0.0494, 95% CI -3.3 to 0). No significant differences were seen in the AC arm. No significant differences were observed in the PHQ-9 or the GAD-7 scores. CONCLUSION CWW had a positive effect on mood based on ETS scores, suggesting a potential therapeutic benefit among patients with cancer.
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Affiliation(s)
- Darya Nesterova
- Neurosurgery, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Junjia Zhu
- Public Health Sciences, Penn State Cancer Institute, Hershey, Pennsylvania, USA
| | | | - Monali Vasekar
- Medicine, Division of Hematology-Oncology, Penn State Cancer Institute, Hershey, Pennsylvania, USA
| | - Cristina Truica
- Medicine, Division of Hematology-Oncology, Penn State Cancer Institute, Hershey, Pennsylvania, USA
| | - Aditya Joshi
- Department of Psychiatry and Behavioral Health, Division of Adult Psychiatry, Pennsylvania Psychiatry Institute, Hershey, Pennsylvania, USA
| | - Michael Hayes
- Medicine, Division of Hematology-Oncology, Penn State Cancer Institute, Hershey, Pennsylvania, USA.,Department of Psychiatry and Behavioral Health, Division of Adult Psychiatry, Pennsylvania Psychiatry Institute, Hershey, Pennsylvania, USA
| | - Jolene Kessler
- Medicine, Division of Hematology-Oncology, Penn State Cancer Institute, Hershey, Pennsylvania, USA
| | - Erika F H Saunders
- Department of Psychiatry and Behavioral Health, Division of Adult Psychiatry, Pennsylvania Psychiatry Institute, Hershey, Pennsylvania, USA
| | - Joseph J Drabick
- Medicine, Division of Hematology-Oncology, Penn State Cancer Institute, Hershey, Pennsylvania, USA
| | - Monika Joshi
- Medicine, Division of Hematology-Oncology, Penn State Cancer Institute, Hershey, Pennsylvania, USA
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Tolby LT, Hofmeister EN, Fisher S, Chao S, Benedict C, Kurian AW, Berek JS, Schapira L, Palesh OG. Patterns of social media use and associations with psychosocial outcomes among breast and gynecologic cancer survivors. J Cancer Surviv 2021; 15:677-84. [PMID: 33161562 DOI: 10.1007/s11764-020-00959-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 10/10/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE We sought to characterize the use of social media (SM) among breast and gynecologic cancer survivors, as well as associations between patterns of SM use and psychosocial outcomes. METHODS Two hundred seventy-three breast and gynecologic cancer survivors recruited at the Stanford Women's Cancer Center completed the study. Participants completed questionnaires to measure quality of life (FACT-G), functional social support (Duke-UNC FSSQ), distress (PHQ-4), decision regret (DRS), and SM use. RESULTS In total, 75.8% of the sample reported using SM. There was no difference in quality of life (QOL), functional social support (FSS), distress, or decision regret between SM users and non-users. SM users indicated using SM for social support (34.3%) and loneliness (24.6%) more than for information-seeking (15.9%), coping (18.8%), or self-disclosure (14%). SM use for coping was associated with lower QOL (p < .001), lower FSS (p < .001), and higher decision regret (p = .029). Use for social support was associated with lower FSS (p = .029). Use for information seeking was associated with lower QOL (p = .012). Use of SM when lonely was associated with lower QOL (p < .001), higher distress (p = .007), lower FSS (p < .001), and higher decision regret (p = .020). CONCLUSIONS Associations between SM use and psychosocial outcomes are nuanced and dependent on motivation for use. Further research is needed to better characterize SM use and associations with psychosocial outcomes among cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS SM is an important potential avenue for understanding and addressing the psychosocial effects associated with cancer survivorship.
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7
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Li Y, Ye S, Zhou Y, Mao F, Guo H, Lin Y, Zhang X, Shen S, Shi N, Wang X, Sun Q. Web-Based Medical Information Searching by Chinese Patients With Breast Cancer and its Influence on Survival: Observational Study. J Med Internet Res 2020; 22:e16768. [PMID: 32301740 PMCID: PMC7316180 DOI: 10.2196/16768] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 01/26/2020] [Accepted: 02/29/2020] [Indexed: 12/30/2022] Open
Abstract
Background The internet allows patients to easily look for health information. However, how Chinese patients with breast cancer use the internet has rarely been investigated, and there is a scarcity of information about the influence of internet use on survival. Objective This observational study aimed to investigate the details of online medical information searching by Chinese patients with breast cancer and to determine whether internet use has any survival benefits. Methods Patients who were diagnosed with invasive breast cancer at Peking Union Medical College Hospital between January 2014 and December 2015 were enrolled. We obtained information on their internet-searching behavior and gathered data from the patients’ medical and follow-up records. The associations between internet use and other clinic-pathological factors were analyzed. A Cox proportional-hazards model and the Kaplan-Meier method were used for disease-free survival (DFS) analyses. Results A total of 973 patients with invasive breast cancer who underwent definitive surgery took part in the study. Among them, 477 cases (49.0%) performed web-based breast cancer information searching before the initial treatment. A multivariate logistic regression analysis suggested that web-based breast cancer information searching was significantly associated with younger age (odds ratio [OR] 0.95, 95% CI 0.94-0.97, P<.001), higher education level (OR 1.37, 95% CI 1.01–1.86, P=.04), and breast conserving surgery (OR 1.35, 95% CI 1.04-1.77, P=.03). Baidu (73.4%, 350/477) and WeChat (66.7%, 318/477) were the two most popular online information sources for breast cancer; however, only 44.9% (214/477) felt satisfied with the online information. In contrast to the nonweb searching group, the web-using patients who were satisfied with online information showed significantly improved DFS (hazard ratio 0.26; 95% CI 0.08-0.88, P=.03). Conclusions The patients who were most likely to search the internet for breast cancer information were younger and well-educated, and they were more likely to have breast conserving therapy. Web-using patients who were satisfied with the internet information showed significantly improved DFS. Patients should browse credible websites offering accurate and updated information, and website developers should provide high-quality and easy-to-understand information to better meet the needs of patients with breast cancer.
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Affiliation(s)
- Yan Li
- Department of Breast Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Shan Ye
- Department of Breast Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yidong Zhou
- Department of Breast Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Feng Mao
- Department of Breast Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Hailing Guo
- Department of Breast Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yan Lin
- Department of Breast Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiaohui Zhang
- Department of Breast Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Songjie Shen
- Department of Breast Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Na Shi
- Department of Breast Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiaojie Wang
- Department of Breast Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Qiang Sun
- Department of Breast Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
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Lleras de Frutos M, Casellas-Grau A, Sumalla EC, de Gracia M, Borràs JM, Ochoa Arnedo C. A systematic and comprehensive review of internet use in cancer patients: Psychological factors. Psychooncology 2019; 29:6-16. [PMID: 31385400 DOI: 10.1002/pon.5194] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 07/19/2019] [Accepted: 07/31/2019] [Indexed: 12/13/2022]
Affiliation(s)
- María Lleras de Frutos
- Psycho-Oncology Department, Institut Català d' Oncologia, Barcelona, Spain.,Clinical Psychology and Psychobiology Department, Universitat de Barcelona, Barcelona, Spain
| | - Anna Casellas-Grau
- Psycho-Oncology Department, Institut Català d' Oncologia, Barcelona, Spain.,Observatorio de Atención Psicosocial en Cáncer, Insitut Català d'Oncologia, Barcelona, Spain
| | - Enric C Sumalla
- Psycho-Oncology Department, Institut Català d' Oncologia, Barcelona, Spain
| | - Marta de Gracia
- Psycho-Oncology Department, Institut Català d' Oncologia, Barcelona, Spain
| | - Josep M Borràs
- Clinical Psychology and Psychobiology Department, Universitat de Barcelona, Barcelona, Spain.,Psycho-Oncology Department, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Hospital Duran i Reynals, Barcelona, Spain
| | - Cristian Ochoa Arnedo
- Psycho-Oncology Department, Institut Català d' Oncologia, Barcelona, Spain.,Clinical Psychology and Psychobiology Department, Universitat de Barcelona, Barcelona, Spain.,Psycho-Oncology Department, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Hospital Duran i Reynals, Barcelona, Spain
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Lally RM, Eisenhauer C, Buckland S, Kupzyk K. Feasibility of Synchronous Online Focus Groups of Rural Breast Cancer Survivors on Web-Based Distress Self-Management. Oncol Nurs Forum 2019; 45:E111-E124. [PMID: 30339151 DOI: 10.1188/18.onf.e111-e124] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
PURPOSE To obtain rural breast cancer survivors' perceptions of CaringGuidance™ After Breast Cancer Diagnosis, a web-based, psychoeducational, distress self-management program, and explore the feasibility of gathering survivors' perceptions about CaringGuidance using online focus groups (OFGs). PARTICIPANTS & SETTING 23 survivors of early-stage breast cancer, a mean of 2.5 years postdiagnosis, living in rural Nebraska. METHODOLOGIC APPROACH Participants reviewed the CaringGuidance program independently for an average of 12 days prior to their designated OFG. The extent of participants' pre-OFG review was verified electronically. Four synchronous, moderated OFGs were conducted. Demographic and OFG participation data were used to assess feasibility. Transcripts of OFGs were analyzed using directed content analysis. FINDINGS All enrolled women participated in their designated OFG. Five themes of the quality and usability of CaringGuidance were identified. Recommendations were used to modify CaringGuidance prior to the pilot efficacy trial. IMPLICATIONS FOR NURSING The findings contribute to nurses' knowledge and guide assessment and interventions pertaining to psychosocial needs of rural women with breast cancer, OFGs, and qualities rural women seek in web-based psychological interventions.
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Antoni MH, Dhabhar FS. The impact of psychosocial stress and stress management on immune responses in patients with cancer. Cancer 2019; 125:1417-1431. [PMID: 30768779 DOI: 10.1002/cncr.31943] [Citation(s) in RCA: 142] [Impact Index Per Article: 28.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 07/22/2018] [Accepted: 08/16/2018] [Indexed: 12/20/2022]
Abstract
The range of psychosocial stress factors/processes (eg, chronic stress, distress states, coping, social adversity) were reviewed as they relate to immune variables in cancer along with studies of psychosocial interventions on these stress processes and immune measures in cancer populations. The review includes molecular, cellular, and clinical research specifically examining the effects of stress processes and stress-management interventions on immune variables (eg, cellular immune function, inflammation), which may or may not be changing directly in response to the cancer or its treatment. Basic psychoneuroimmunologic research on stress processes (using animal or cellular/tumor models) provides leads for investigating biobehavioral processes that may underlie the associations reported to date. The development of theoretically driven and empirically supported stress-management interventions may provide important adjuncts to clinical cancer care going forward.
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Affiliation(s)
- Michael H Antoni
- Department of Psychology, University of Miami and Sylvester Comprehensive Cancer Center, University of Miami School of Medicine, Miami, Florida
| | - Firdaus S Dhabhar
- Department of Psychiatry and Behavioral Sciences and Sylvester Comprehensive Cancer Center, University of Miami School of Medicine, Miami, Florida
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11
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Huang IC, Jones CM, Brinkman TM, Hudson MM, Srivastava DK, Li Y, Robison LL, Krull KR. Development of the functional social network index for adolescent and young adult cancer survivors. Cancer 2018. [PMID: 29517807 DOI: 10.1002/cncr.31278] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND To the authors' knowledge, social network status in adolescent and young adult (AYA) cancer survivors has not been adequately studied to date. The authors developed and validated a functional social network index (FSNI) for AYA survivors, and compared its performance with that of 2 traditional indices (density and betweenness centrality). METHODS A total of 102 AYA survivors and 102 noncancer controls who were matched for age, sex, and race were recruited from an Internet panel. Each participant reported relationships with up to 25 close friends and/or relatives. The authors developed a FSNI with reported marital status, contact frequency with friends/relatives, available resources for emotional and tangible support, and available resources for physical activity and weight management advice. Linear regression was used to analyze associations between the FSNI and cancer diagnoses, treatments, and coping skills. RESULTS Based on the FSNI, survivors were found to have more available resources for emotional support (beta [b] = 3.02; P = .003), tangible support (b = 4.17; P<.001), physical activity advice (b = 3.94; P<.001), and weight management advice (b = 4.10; P<.001) compared with noncancer controls. Survivors of lymphoma had the largest FSNI, whereas survivors of central nervous system malignancies had the smallest (b = 2.77; P = .02). A higher FSNI was associated with better coping skills: less denial (b = 0.10; P = .01), using emotional support (b = 0.08; P = .04), using instrumental support (b = 0.12; P<.001), less behavioral disengagement (b = 0.08; P = .04), venting of emotions (b = 0.10; P = .004), positive reframing (b = 0.12; P = .003), planning for the future (b = 0.08; P = .03), and religious engagement (b = 0.16; P<.001). Density and betweenness centrality indices demonstrated neither significant differences in social networks between cancer survivors and controls (all P values >.05) nor significant associations with coping skills (all P values >.05). CONCLUSIONS The FSNI appears to provide a better social network assessment for AYA cancer survivors than traditional indices. Cancer 2018;124:2220-7. © 2018 American Cancer Society.
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Affiliation(s)
- I-Chan Huang
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Conor M Jones
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Tara M Brinkman
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.,Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Melissa M Hudson
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.,Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - D Kumar Srivastava
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Yuelin Li
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Leslie L Robison
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Kevin R Krull
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.,Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee
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12
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Syrjala KL, Crouch ML, Leisenring WM, Flowers MED, Artherholt SB, Fiscalini AS, Romano E, Romano JM, Martin PJ, Yi JC. Engagement with INSPIRE, an Online Program for Hematopoietic Cell Transplantation Survivors. Biol Blood Marrow Transplant 2018; 24:1692-1698. [PMID: 29753161 DOI: 10.1016/j.bbmt.2018.05.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 05/02/2018] [Indexed: 10/16/2022]
Abstract
In a secondary analysis of a randomized controlled trial (RCT), we examined participants' engagement with INSPIRE, a personalized online program for hematopoietic cell transplantation (HCT) survivors that focuses on cancer-related distress, depression, fatigue, and health care needs. We approached all adult, 3- to 18-year HCT survivors treated for hematologic malignancy without relapse or second cancer in the previous 2 years for participation in an RCT with either immediate or delayed access to INSPIRE. Participants with immediate access could view the online material at any time. Data included page view tracking, medical records, and patient-reported outcomes, including the Short Form 36 and Cancer and Treatment Distress (CTXD) measures. Of 1322 eligible HCT survivors, 771 (58%) completed the baseline assessment, and 451 received immediate INSPIRE access and were included in analyses. The cohort was 56% male, with a mean age of 52 ± 12.2 years, and 26% received an autologous transplant. Most (77%) logged into the INSPIRE site at least once, and 48% viewed ≥8 pages. Survivors who viewed ≥2 pages were more likely to be age ≥40 years (relative risk [RR], 1.41; 95% confidence interval [CI], 1.10 to 1.80), to be female (RR, 1.22; 95% CI, 1.07 to 1.40), to have chronic graft-versus-host disease (RR, 1.28; 95% CI, 1.08 to 1.51), to be less than 10 years post-HCT (RR, 1.19; 95% CI, 1.01 to 1.39), and to have moderate CTXD distress (RR, 1.34; 95% CI, 1.14 to 1.57). Engagement did not differ by race, education, income, rural/urban residence, computer experience, donor type, or depression (all P ≥ .50). The INSPIRE online program was widely used, including by those who often have reduced access to care after treatment.
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Affiliation(s)
- Karen L Syrjala
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; Biobehavioral Sciences Department, University of Washington School of Medicine, Seattle, Washington.
| | - Marie-Laure Crouch
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Wendy M Leisenring
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Mary E D Flowers
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; Biobehavioral Sciences Department, University of Washington School of Medicine, Seattle, Washington
| | - Samantha B Artherholt
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; Biobehavioral Sciences Department, University of Washington School of Medicine, Seattle, Washington
| | | | - Eleni Romano
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Joan M Romano
- Biobehavioral Sciences Department, University of Washington School of Medicine, Seattle, Washington
| | - Paul J Martin
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; Biobehavioral Sciences Department, University of Washington School of Medicine, Seattle, Washington
| | - Jean C Yi
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
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13
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Syrjala KL, Yi JC, Artherholt SB, Romano JM, Crouch ML, Fiscalini AS, Hegel MT, Flowers MED, Martin PJ, Leisenring WM. An online randomized controlled trial, with or without problem-solving treatment, for long-term cancer survivors after hematopoietic cell transplantation. J Cancer Surviv 2018; 12:560-570. [PMID: 29730827 DOI: 10.1007/s11764-018-0693-9] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 04/23/2018] [Indexed: 01/09/2023]
Abstract
PURPOSE This randomized controlled trial examines the efficacy of INSPIRE, an INternet-based Survivorship Program with Information and REsources, with or without problem-solving treatment (PST) telehealth calls, for survivors after hematopoietic cell transplantation (HCT). METHODS All adult survivors who met eligibility criteria were approached for consent. Participants completed patient-reported outcomes at baseline and 6 months. Those with baseline impaired scores on one or more of the outcomes were randomized to INSPIRE, INSPIRE + PST, or control with delayed INSPIRE access. Outcomes included Cancer and Treatment Distress, Symptom Checklist-90-R Depression, and Fatigue Symptom Inventory. Planned analyses compared arms for mean change in aggregated impaired outcomes and for proportion of participants improved on each outcome. RESULTS Of 1306 eligible HCT recipients, 755 (58%) participated, and 344 (45%) had one or more impaired scores at baseline. We found no reduction in aggregated outcomes for either intervention (P > 0.3). In analyses of individual outcomes, participants randomized to INSPIRE + PST were more likely to improve in distress than controls (45 vs. 20%, RR 2.3, CI 1.0, 5.1); those randomized to INSPIRE alone were marginally more likely to improve in distress (40 vs. 20%, RR 2.0, CI 0.9, 4.5). CONCLUSIONS The INSPIRE online intervention demonstrated a marginal benefit for distress that improved with the addition of telehealth PST, particularly for those who viewed the website or were age 40 or older. IMPLICATIONS FOR CANCER SURVIVORS Online and telehealth programs such as INSPIRE offer opportunities to enhance HCT survivorship outcomes, particularly for mood, though methods would benefit from strategies to improve efficacy.
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Affiliation(s)
- Karen L Syrjala
- Clinical Research Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, D5-220, Seattle, WA, 98109, USA. .,University of Washington School of Medicine, Seattle, WA, USA.
| | - Jean C Yi
- Clinical Research Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, D5-220, Seattle, WA, 98109, USA
| | - Samantha B Artherholt
- Clinical Research Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, D5-220, Seattle, WA, 98109, USA
| | - Joan M Romano
- University of Washington School of Medicine, Seattle, WA, USA
| | - Marie-Laure Crouch
- Clinical Research Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, D5-220, Seattle, WA, 98109, USA
| | | | - Mark T Hegel
- Dartmouth Geisel School of Medicine, Hanover, NH, USA
| | - Mary E D Flowers
- Clinical Research Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, D5-220, Seattle, WA, 98109, USA.,University of Washington School of Medicine, Seattle, WA, USA
| | - Paul J Martin
- Clinical Research Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, D5-220, Seattle, WA, 98109, USA.,University of Washington School of Medicine, Seattle, WA, USA
| | - Wendy M Leisenring
- Clinical Research Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, D5-220, Seattle, WA, 98109, USA
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14
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LeRoy AS, Shields A, Chen MA, Brown RL, Fagundes CP. Improving Breast Cancer Survivors' Psychological Outcomes and Quality of Life: Alternatives to Traditional Psychotherapy. Curr Breast Cancer Rep 2018; 10:28-34. [PMID: 32153724 DOI: 10.1007/s12609-018-0266-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Purpose of Review Breast cancer survivors (BCS) often experience psychological problems and lowered quality of life (QOL). While helpful, psychotherapy is often costly and inaccessible. This review aims to provide practitioners with the latest information on empirically tested interventions among BCS that may be used in lieu of, or in addition to, traditional psychotherapy. Recent Findings Recent developments in cancer-related psychological interventions include a focus on facilitating emotional disclosure (e.g., expressive writing), enhancing close relationships (e.g., couples-based interventions), and increasing feasibility and accessibility via online and computer-based intervention programs. These alternatives to psychotherapy offer a number of benefits including cost-effectiveness, personalized adaptability, and ease of implementation. Summary Utilizing these interventions as alternatives or supplements to traditional psychotherapy may offer BCS an opportunity to increase their QOL, improve psychosocial outcomes, and find meaning in their cancer experience. Choosing the appropriate intervention requires understanding the unique circumstances for each survivor and their family.
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Affiliation(s)
- Angie S LeRoy
- Department of Psychology, The University of Houston, 3695 Cullen Blvd. Rm 126, Houston, TX 77204, USA
- Department of Psychology, Rice University, Bioscience Research Collaborative, Houston, TX, USA
| | - Allison Shields
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Michelle A Chen
- Department of Psychology, Rice University, Bioscience Research Collaborative, Houston, TX, USA
| | - Ryan L Brown
- Department of Psychology, Rice University, Bioscience Research Collaborative, Houston, TX, USA
| | - Christopher P Fagundes
- Department of Psychology, Rice University, Bioscience Research Collaborative, Houston, TX, USA
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Department of Psychiatry, Baylor College of Medicine, Houston, TX, USA
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15
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Zhang S, Bantum EO, Owen J, Bakken S, Elhadad N. Online cancer communities as informatics intervention for social support: conceptualization, characterization, and impact. J Am Med Inform Assoc 2017; 24:451-459. [PMID: 27402140 PMCID: PMC5565989 DOI: 10.1093/jamia/ocw093] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 05/11/2016] [Indexed: 11/13/2022] Open
Abstract
Objectives: The Internet and social media are revolutionizing how social support is exchanged and perceived, making online health communities (OHCs) one of the most exciting research areas in health informatics. This paper aims to provide a framework for organizing research of OHCs and help identify questions to explore for future informatics research. Based on the framework, we conceptualize OHCs from a social support standpoint and identify variables of interest in characterizing community members. For the sake of this tutorial, we focus our review on online cancer communities. Target audience: The primary target audience is informaticists interested in understanding ways to characterize OHCs, their members, and the impact of participation, and in creating tools to facilitate outcome research of OHCs. OHC designers and moderators are also among the target audience for this tutorial. Scope: The tutorial provides an informatics point of view of online cancer communities, with social support as their leading element. We conceptualize OHCs according to 3 major variables: type of support, source of support, and setting in which the support is exchanged. We summarize current research and synthesize the findings for 2 primary research questions on online cancer communities: (1) the impact of using online social support on an individual's health, and (2) the characteristics of the community, its members, and their interactions. We discuss ways in which future research in informatics in social support and OHCs can ultimately benefit patients.
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Affiliation(s)
- Shaodian Zhang
- Department of Biomedical Informatics, Columbia University, New York, USA
| | - Erin O'Carroll Bantum
- Cancer Prevention and Control Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Jason Owen
- Veterans Administration Palo Alto Health Care System, Menlo Park, California, USA
| | - Suzanne Bakken
- Department of Biomedical Informatics, Columbia University, New York, USA
| | - Noémie Elhadad
- Department of Biomedical Informatics, Columbia University, New York, USA
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16
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Gast KC, Allen SV, Ruddy KJ, Haddad TC. Novel approaches to support breast cancer survivorship care models. Breast 2017; 36:1-13. [DOI: 10.1016/j.breast.2017.08.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 08/04/2017] [Accepted: 08/11/2017] [Indexed: 12/21/2022] Open
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Abstract
BACKGROUND Web and mobile technologies appear to hold promise for delivering evidence-informed and evidence-based intervention to cancer survivors and others living with trauma and other psychological concerns. Health-space.net was developed as a comprehensive online social networking and coping skills training program for cancer survivors living with distress. PURPOSE The purpose of this study was to evaluate the effects of a 12-week social networking intervention on distress, depression, anxiety, vigor, and fatigue in cancer survivors reporting high levels of cancer-related distress. METHODS We recruited 347 participants from a local cancer registry and internet, and all were randomized to either a 12-week waiting list control group or to immediate access to the intervention. Intervention participants received secure access to the study website, which provided extensive social networking capabilities and coping skills training exercises facilitated by a professional facilitator. RESULTS Across time, the prevalence of clinically significant depression symptoms declined from 67 to 34 % in both conditions. The health-space.net intervention had greater declines in fatigue than the waitlist control group, but the intervention did not improve outcomes for depression, trauma-related anxiety symptoms, or overall mood disturbance. For those with more severe levels of anxiety at baseline, greater engagement with the intervention was associated with higher levels of symptom reduction over time. CONCLUSIONS The intervention resulted in small but significant effects on fatigue but not other primary or secondary outcomes. Results suggest that this social networking intervention may be most effective for those who have distress that is not associated with high levels of anxiety symptoms or very poor overall psychological functioning. TRIAL REGISTRATION NUMBER The trial was registered with the ClinicalTrials.gov database ( ClinicalTrials.gov #NCT01976949).
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Affiliation(s)
- Jason E Owen
- National Center for PTSD, VA Palo Alto Health Care System, Menlo Park, CA, USA.
| | - Erin O'Carroll Bantum
- Cancer Prevention & Control Program, University of Hawai'i Cancer Center, Honolulu, HI, USA
| | - Ian S Pagano
- Cancer Prevention & Control Program, University of Hawai'i Cancer Center, Honolulu, HI, USA
| | - Annette Stanton
- Departments of Psychology and Psychiatry/Biobehavioral Sciences, Jonsson Comprehensive Cancer Center, University of California Los Angeles, Los Angeles, CA, USA
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18
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Huber J, Muck T, Maatz P, Keck B, Enders P, Maatouk I, Ihrig A. Face-to-face vs. online peer support groups for prostate cancer: A cross-sectional comparison study. J Cancer Surviv 2017; 12:1-9. [PMID: 28861845 DOI: 10.1007/s11764-017-0633-0] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 07/25/2017] [Indexed: 12/23/2022]
Abstract
BACKGROUND As social media are evolving rapidly online support groups (OSG) are becoming increasingly important for patients. Therefore, the aim of our study was to compare the users of traditional face-to-face support groups and OSG. PATIENTS AND METHODS We performed a cross-sectional comparison study of all regional face-to-face support groups and the largest OSG in Germany. By applying validated instruments, the survey covered sociodemographic and disease-related information, decision-making habits, psychological aspects, and quality of life. RESULTS We analyzed the complete data of 955 patients visiting face-to-face support groups and 686 patients using OSG. Patients using OSG were 6 years younger (65.3 vs. 71.5 years; p < 0.001), had higher education levels (47 vs. 21%; p < 0.001), and had higher income. Patients using OSG reported a higher share of metastatic disease (17 vs. 12%; p < 0.001). Patients using OSG reported greater distress. There were no significant differences in anxiety, depression, and global quality of life. In the face-to-face support groups, patient ratings were better for exchanging information, gaining recognition, and caring for others. Patients using OSG demanded a more active role in the treatment decision-making process (58 vs. 33%; p < 0.001) and changed their initial treatment decision more frequently (29 vs. 25%; p < 0.001). CONCLUSIONS Both modalities of peer support received very positive ratings by their users and have significant impact on treatment decision-making. IMPLICATIONS FOR CANCER SURVIVORS Older patients might benefit more from the continuous social support in face-to-face support groups. OSG offer low-threshold advice for acute problems to younger and better educated patients with high distress. TRIAL REGISTRATION www.germanctr.de , number DRKS00005086.
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Affiliation(s)
- Johannes Huber
- Department of Urology, Medical Faculty Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - Tanja Muck
- Department of Urology, Medical Faculty Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - Philipp Maatz
- Department of Urology, Medical Faculty Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - Bastian Keck
- Department of Urology, University Hospital Erlangen, Erlangen, Germany
| | - Paul Enders
- Prostate Cancer Patient Support Organization of Germany (BPS), Bonn, Germany
| | - Imad Maatouk
- Division of Psychooncology, Department of General Internal Medicine and Psychosomatic, Heidelberg University Hospital, Heidelberg, Germany
| | - Andreas Ihrig
- Division of Psychooncology, Department of General Internal Medicine and Psychosomatic, Heidelberg University Hospital, Heidelberg, Germany.
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19
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Falisi AL, Wiseman KP, Gaysynsky A, Scheideler JK, Ramin DA, Chou WYS. Social media for breast cancer survivors: a literature review. J Cancer Surviv 2017; 11:808-821. [PMID: 28601981 DOI: 10.1007/s11764-017-0620-5] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 05/19/2017] [Indexed: 12/13/2022]
Abstract
PURPOSE Social media may offer support to individuals who are navigating the complex and challenging experience of cancer. A growing body of literature has been published over the last decade exploring the ways cancer survivors utilize social media. This study aims to provide a systematic synthesis of the current literature in order to inform cancer health communication practice and cancer survivorship research. METHODS Using PRISMA guidelines, four electronic databases were searched to retrieve publications on breast cancer and social media published between 2005 and 2015. The final sample included 98 publications (13 commentaries and reviews, 47 descriptive studies, and 38 intervention studies). Intervention studies were assessed for key features and outcome measures. Studies utilizing content analysis were further evaluated qualitatively. RESULTS Online support groups were the most commonly studied platform, followed by interactive message boards and web forums. Limited research focuses on non-Caucasian populations. Psychosocial well-being was the most commonly measured outcome of interest. While social media engagement was assessed, few standardized measures were identified. Content analyses of social media interactions were prevalent, though few articles linked content to health outcomes. CONCLUSIONS The current literature highlights the impact and potential utility of social media for breast cancer survivors. Future studies should consider connecting social media engagement and content to psychosocial, behavioral, and physical health outcomes. IMPLICATIONS FOR CANCER SURVIVORS Online groups and communities may improve the well-being of breast cancer survivors by providing opportunities to engage with wider social networks, connect with others navigating similar cancer experiences, and obtain cancer-related information. Researchers should consider the potential role of social media in addressing the unmet needs of breast cancer survivors, and particularly the implications for clinical and public health practice.
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Affiliation(s)
- Angela L Falisi
- Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA.
| | - Kara P Wiseman
- Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA
| | | | - Jennifer K Scheideler
- Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA
| | - Daniel A Ramin
- Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA
| | - Wen-Ying Sylvia Chou
- Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA
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20
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Manne SL, Topham N, D’Agostino TA, Virtue SM, Kirstein L, Brill K, Manning C, Grana G, Schwartz MD, Ohman-Strickland P. Acceptability and pilot efficacy trial of a web-based breast reconstruction decision support aid for women considering mastectomy. Psychooncology 2016; 25:1424-1433. [PMID: 26383833 PMCID: PMC9890719 DOI: 10.1002/pon.3984] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 07/10/2015] [Accepted: 08/21/2015] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The study aim was to test the acceptability and preliminary efficacy of a novel interactive web-based breast reconstruction decision support aid (BRAID) for newly diagnosed breast cancer patients considering mastectomy. METHODS Fifty-five women considering mastectomy were randomly assigned to receive the BRAID versus the Cancer Support Community's Frankly Speaking About Cancer: Breast Reconstruction pamphlet. Participants completed measures of breast reconstruction (BR) knowledge, preparation to make a decision, decisional conflict, anxiety, and BR intentions before randomization and 2 weeks later. RESULTS In terms of acceptability, enrollment into the study was satisfactory, but the rate of return for follow-up surveys was lower among BRAID participants than pamphlet participants. Both interventions were evaluated favorably in terms of their value in facilitating the BR decision, and the majority of participants completing the follow-up reported viewing the materials. In terms of preliminary efficacy, both interventions resulted in significant increases in BR knowledge and completeness and satisfaction with preparation to make a BR decision, and both interventions resulted in a significant reduction in decision conflict. However, there were no differences between interventions. CONCLUSION A widely available free pamphlet and a web-based customized decision aid were highly utilized. The pamphlet was as effective in educating women about BR and prepared women equally as well to make the BR decision as compared with a more costly, customized web-based decision support aid. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Sharon L. Manne
- Department of Medicine, Robert Wood Johnson Medical School, Section of Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA,Correspondence to: Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick NJ 08903, USA.
| | - Neal Topham
- Department of Surgery, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Thomas A. D’Agostino
- Department of Medicine, Robert Wood Johnson Medical School, Section of Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Shannon Myers Virtue
- Department of Medicine, Robert Wood Johnson Medical School, Section of Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Laurie Kirstein
- Department of Medicine, Robert Wood Johnson Medical School, Section of Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Kristin Brill
- MD Anderson Cancer Center at Cooper Health Systems, Camden, NJ, USA
| | | | - Generosa Grana
- MD Anderson Cancer Center at Cooper Health Systems, Camden, NJ, USA
| | | | - Pamela Ohman-Strickland
- Department of Medicine, Robert Wood Johnson Medical School, Section of Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
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21
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Fann JR, Hong F, Halpenny B, Blonquist TM, Berry DL. Psychosocial outcomes of an electronic self-report assessment and self-care intervention for patients with cancer: a randomized controlled trial. Psychooncology 2016; 26:1866-1871. [PMID: 27530529 DOI: 10.1002/pon.4250] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 07/11/2016] [Accepted: 08/12/2016] [Indexed: 01/30/2023]
Abstract
BACKGROUND The use of Web-based technology to facilitate self-care and communication with health care providers has the potential to improve psychosocial outcomes for patients undergoing cancer treatment. This study reports an analysis of psychosocial outcomes of the electronic self-report assessment for cancer study. METHODS Adult patients starting cancer therapy were randomized to receive usual education about symptoms and quality of life topics (control) or usual education plus self-care instruction for symptoms and quality of life issues, communication coaching, and the opportunity to track symptoms and quality of life between clinic visits (intervention). Depression (Patient Health Questionnaire-9) and social, emotional, and role functioning (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 subscales) were measured before treatment (T1), 3 to 6 weeks after starting treatment (T2), 2 weeks later (T3), and 2 to 4 weeks after treatment ended or at the next restaging visit for participants who continued to receive treatment (T4). Clinicians received summaries of participant reports at each time point in both groups. RESULTS In multivariable analysis, the depression scores were significantly lower (P = .04) and there was a trend to higher social and role functioning (P = .07) in the intervention group compared with the control. Working status was significantly associated with lower depression and better social and role functioning. CONCLUSIONS A patient-centered, Web-based intervention that facilitates self-care and communication can improve psychosocial outcomes in the cancer setting.
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Affiliation(s)
- Jesse R Fann
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA, USA.,Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, WA, USA.,Fred Hutchinson Cancer Research Center, Seattle Cancer Care Alliance, Seattle, WA, USA
| | - Fangxin Hong
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Harvard Chan School of Public Health, Boston, MA, USA
| | - Barbara Halpenny
- Phyllis F. Cantor Center, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Traci M Blonquist
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Donna L Berry
- Phyllis F. Cantor Center, Dana-Farber Cancer Institute, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA
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Singer AE, Goebel JR, Kim YS, Dy SM, Ahluwalia SC, Clifford M, Dzeng E, O'Hanlon CE, Motala A, Walling AM, Goldberg J, Meeker D, Ochotorena C, Shanman R, Cui M, Lorenz KA. Populations and Interventions for Palliative and End-of-Life Care: A Systematic Review. J Palliat Med 2016; 19:995-1008. [PMID: 27533892 DOI: 10.1089/jpm.2015.0367] [Citation(s) in RCA: 100] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
IMPORTANCE Evidence supports palliative care effectiveness. Given workforce constraints and the costs of new services, payers and providers need help to prioritize their investments. They need to know which patients to target, which personnel to hire, and which services best improve outcomes. OBJECTIVE To inform how payers and providers should identify patients with "advanced illness" and the specific interventions they should implement, we reviewed the evidence to identify (1) individuals appropriate for palliative care and (2) elements of health service interventions (personnel involved, use of multidisciplinary teams, and settings of care) effective in achieving better outcomes for patients, caregivers, and the healthcare system. EVIDENCE REVIEW Systematic searches of MEDLINE, EMBASE, PsycINFO, Web of Science, and Cochrane Database of Systematic Reviews databases (1/1/2001-1/8/2015). RESULTS Randomized controlled trials (124) met inclusion criteria. The majority of studies in cancer (49%, 38 of 77 studies) demonstrated statistically significant patient or caregiver outcomes (e.g., p < 0.05), as did those in congestive heart failure (CHF) (62%, 13 of 21), chronic obstructive pulmonary disease (COPD; 58%, 11 of 19), and dementia (60%, 15 of 25). Most prognostic criteria used clinicians' judgment (73%, 22 of 30). Most interventions included a nurse (70%, 69 of 98), and many were nurse-only (39%, 27 of 69). Social workers were well represented, and home-based approaches were common (56%, 70 of 124). Home interventions with visits were more effective than those without (64%, 28 of 44; vs. 46%, 12 of 26). Interventions improved communication and care planning (70%, 12 of 18), psychosocial health (36%, 12 of 33, for depressive symptoms; 41%, 9 of 22, for anxiety), and patient (40%, 8 of 20) and caregiver experiences (63%, 5 of 8). Many interventions reduced hospital use (65%, 11 of 17), but most other economic outcomes, including costs, were poorly characterized. Palliative care teams did not reliably lower healthcare costs (20%, 2 of 10). CONCLUSIONS Palliative care improves cancer, CHF, COPD, and dementia outcomes. Effective models include nurses, social workers, and home-based components, and a focus on communication, psychosocial support, and the patient or caregiver experience. High-quality research on intervention costs and cost outcomes in palliative care is limited.
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Affiliation(s)
- Adam E Singer
- 1 David Geffen School of Medicine, University of California at Los Angeles , Los Angeles, California
- 2 RAND Corporation , Santa Monica, California
| | - Joy R Goebel
- 3 School of Nursing, California State University , Long Beach, Long Beach, California
| | - Yan S Kim
- 4 Division of Research, Kaiser Permanente Northern California , Oakland, California
| | - Sydney M Dy
- 5 Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland
| | | | | | - Elizabeth Dzeng
- 6 Division of Hospital Medicine, University of California at San Francisco , San Francisco, California
| | - Claire E O'Hanlon
- 2 RAND Corporation , Santa Monica, California
- 7 Pardee RAND Graduate School , RAND Corporation, Santa Monica, California
| | | | - Anne M Walling
- 1 David Geffen School of Medicine, University of California at Los Angeles , Los Angeles, California
- 2 RAND Corporation , Santa Monica, California
- 8 Veterans Affairs Greater Los Angeles Healthcare System , Los Angeles, California
| | - Jaime Goldberg
- 9 Supportive Care Medicine, Cedars-Sinai Medical Center , Los Angeles, California
| | - Daniella Meeker
- 10 Department of Preventive Medicine, University of Southern California , Los Angeles, California
| | | | | | - Mike Cui
- 12 RAND Corporation , Pittsburgh, Pennsylvania
| | - Karl A Lorenz
- 2 RAND Corporation , Santa Monica, California
- 13 Stanford University School of Medicine , Stanford, California
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Chakrabarty J, Vidyasagar MS, Fernandes D, Mayya S. Emotional Aspects and Pranayama in Breast Cancer Patients Undergoing Radiation Therapy: A Randomized Controlled Trial. Asia Pac J Oncol Nurs 2016; 3:199-204. [PMID: 27981159 PMCID: PMC5123491 DOI: 10.4103/2347-5625.177390] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE Emotional disturbances are commonly experienced by cancer patients. The aim of this study was to determine the effectiveness of certain Pranayama techniques on the emotional aspects such as impatience, worry, anxiety, and frustration among breast cancer patients undergoing radiation therapy in India. METHODS The study was conducted as a randomized controlled trial. Patients were recruited when they were seeking radiation therapy for breast cancer. They were allocated into two groups using block randomization technique. The experimental group performed Pranayama along with radiation therapy, whereas the control group received only routine care. RESULTS Emotional aspects of the two groups were compared at the end of the treatment. Mann-Whitney U-test was used for comparison as the data were not following normality. It showed a significant difference between the two groups with the group who performed Pranayama showing a lesser mean score for these negative emotions. CONCLUSIONS Pranayama might help in controlling the negative emotions likely to be faced by breast cancer patients, and it can be used as a supportive therapy for breast cancer patients receiving radiation therapy.
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Affiliation(s)
- Jyothi Chakrabarty
- Department of Medical Surgical Nursing, Manipal College of Nursing, Manipal, India
| | - M S Vidyasagar
- Department of Radiotherapy and Oncology, Kasturba Hospital, Manipal, India
| | - Donald Fernandes
- Department of Radiotherapy and Oncology, Kasturba Hospital, Manipal, India
| | - Sreemathi Mayya
- Department of Statistics, Manipal University, Manipal, Karnataka, India
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Piil K, Jakobsen J, Juhler M, Jarden M. The feasibility of a brain tumour website. Eur J Oncol Nurs 2015; 19:686-93. [DOI: 10.1016/j.ejon.2015.05.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Revised: 04/29/2015] [Accepted: 05/02/2015] [Indexed: 10/23/2022]
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Abstract
Although prevalence estimates are imprecise, growing numbers of women in the United States are living longer with metastatic breast cancer, attributable at least in part to the availability of effective targeted therapies. Women living with metastatic disease are understudied, however, and substantial heterogeneity exists in both the clinical characteristics of metastatic tumors and the physical and psychological experience of patients living with the disease. Survivorship issues are complex for patients who are living with metastatic disease over extended periods of time, from years to decades. Newly diagnosed patients with stage IV disease are confronting cancer for the first time, while others have metastatic disease as a result of breast cancer recurrence. Many patients are able to live for years on stable medical regimens, and yet others live with a moving target of aggressive disease with arduous treatments and uneven response. The psychological common denominator is the experience of profound life threat and the accompanying uncertainty, for both the affected woman and her loved ones. Maintaining life balance in the face of metastatic disease, as well as managing pain, fatigue, and other physical and psychological symptoms are major challenges. Increasingly, the clinical approach to metastatic disease reflects the consensus that palliative and supportive care are essential from the point of diagnosis. To remedy the paucity of systematic research on women living with metastatic breast cancer for extended periods, we offer directions for research to understand the experience of metastatic breast cancer and to provide evidence-based inter-professional care.
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Affiliation(s)
- Patricia A Ganz
- UCLA Schools of Medicine and Public Health, Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA,
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26
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van den Berg SW, Gielissen MFM, Custers JAE, van der Graaf WTA, Ottevanger PB, Prins JB. BREATH: Web-Based Self-Management for Psychological Adjustment After Primary Breast Cancer--Results of a Multicenter Randomized Controlled Trial. J Clin Oncol 2015; 33:2763-71. [PMID: 26169621 DOI: 10.1200/jco.2013.54.9386] [Citation(s) in RCA: 137] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
PURPOSE Early breast cancer survivors (BCSs) report high unmet care needs, and easily accessible care is not routinely available for this growing population. The Breast Cancer E-Health (BREATH) trial is a Web-based self-management intervention to support the psychological adjustment of women after primary treatment, by reducing distress and improving empowerment. PATIENTS AND METHODS This multicenter, randomized, controlled, parallel-group trial evaluated whether care as usual (CAU) plus BREATH is superior to CAU alone. BREATH is delivered in sixteen fully automated weekly modules covering early survivorship issues. Two to 4 months post-treatment, BCSs were randomly assigned to receive CAU + BREATH (n = 70) or CAU alone (n = 80) using a stratified block design (ratio 1:1). Primary outcomes were distress (Symptom Checklist-90) and empowerment (Cancer Empowerment Questionnaire), assessed before random assignment (baseline, T0) and after 4 (T1), 6 (T2), and 10 months (T3) of follow-up. Statistical (analysis of covariance) and clinical effects (reliable change index) were tested in an intention-to-treat analysis (T0 to T1). Follow-up effects (T0 to T3) were assessed in assessment completers. RESULTS CAU + BREATH participants reported significantly less distress than CAU-alone participants (-7.79; 95% CI, -14.31 to -1.27; P = .02) with a small-to-medium effect size (d = 0.33), but empowerment was not affected (-1.71; 95% CI, 5.20 to -1.79; P = .34). More CAU + BREATH participants (39 of 70 [56%]; 95% CI, 44.1 to 66.8) than CAU-alone participants (32 of 80 [40%]; 95% CI, 30.0 to 51.0) showed clinically significant improvement (P = .03). This clinical effect was most prominent in low-distress BCSs. Secondary outcomes confirmed primary outcomes. There were no between-group differences in primary outcomes during follow-up. CONCLUSION Access to BREATH reduced distress among BCSs, but this effect was not sustained during follow-up.
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Affiliation(s)
| | | | - José A E Custers
- All authors: Radboud university medical center, Nijmegen, the Netherlands
| | | | | | - Judith B Prins
- All authors: Radboud university medical center, Nijmegen, the Netherlands
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27
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Agboola SO, Ju W, Elfiky A, Kvedar JC, Jethwani K. The effect of technology-based interventions on pain, depression, and quality of life in patients with cancer: a systematic review of randomized controlled trials. J Med Internet Res 2015; 17:e65. [PMID: 25793945 PMCID: PMC4381812 DOI: 10.2196/jmir.4009] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Revised: 02/18/2015] [Accepted: 02/18/2015] [Indexed: 02/06/2023] Open
Abstract
Background The burden of cancer is increasing; projections over the next 2 decades suggest that the annual cases of cancer will rise from 14 million in 2012 to 22 million. However, cancer patients in the 21st century are living longer due to the availability of novel therapeutic regimens, which has prompted a growing focus on maintaining patients’ health-related quality of life. Telehealth is increasingly being used to connect with patients outside of traditional clinical settings, and early work has shown its importance in improving quality of life and other clinical outcomes in cancer care. Objective The aim of this study was to systematically assess the literature for the effect of supportive telehealth interventions on pain, depression, and quality of life in cancer patients via a systematic review of clinical trials. Methods We searched PubMed, EMBASE, Google Scholar, CINAHL, and PsycINFO in July 2013 and updated the literature search again in January 2015 for prospective randomized trials evaluating the effect of telehealth interventions in cancer care with pain, depression, and quality of life as main outcomes. Two of the authors independently reviewed and extracted data from eligible randomized controlled trials, based on pre-determined selection criteria. Methodological quality of studies was assessed by the Cochrane Collaboration risk of bias tool. Results Of the 4929 articles retrieved from databases and relevant bibliographies, a total of 20 RCTs were included in the final review. The studies were largely heterogeneous in the type and duration of the intervention as well as in outcome assessments. A majority of the studies were telephone-based interventions that remotely connected patients with their health care provider or health coach. The intervention times ranged from 1 week to 12 months. In general, most of the studies had low risk of bias across the domains of the Cochrane Collaboration risk of bias tool, but most of the studies had insufficient information about the allocation concealment domain. Two of the three studies focused on pain control reported significant effects of the intervention; four of the nine studies focus on depression reported significant effects, while only the studies that were focused on quality of life reported significant effects. Conclusions This systematic review demonstrates the potential of telehealth interventions in improving outcomes in cancer care. However, more high-quality large-sized trials are needed to demonstrate cogent evidence of its effectiveness.
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Affiliation(s)
- Stephen O Agboola
- Partners Healthcare Center for Connected Health, Boston, MA, United States.
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Wenzel L, Osann K, Hsieh S, Tucker JA, Monk BJ, Nelson EL. Psychosocial telephone counseling for survivors of cervical cancer: results of a randomized biobehavioral trial. J Clin Oncol 2015; 33:1171-9. [PMID: 25713429 DOI: 10.1200/jco.2014.57.4079] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
PURPOSE Survivors of cervical cancer experience quality-of-life (QOL) disruptions that persist years after treatment. This study examines the effect of a psychosocial telephone counseling (PTC) intervention on QOL domains and associations with biomarkers. PATIENTS AND METHODS We conducted a randomized clinical trial in survivors of cervical cancer, who were ≥ 9 and less than 30 months from diagnosis (n = 204), to compare PTC to usual care (UC). PTC included five weekly sessions and a 1-month booster. Patient-reported outcomes (PROs) and biospecimens were collected at baseline and 4 and 9 months after enrollment. Changes in PROs over time and associations with longitudinal change in cytokines as categorical variables were analyzed using multivariable analysis of variance for repeated measures. RESULTS Participant mean age was 43 years; 40% of women were Hispanic, and 51% were non-Hispanic white. Adjusting for age and baseline scores, participants receiving PTC had significantly improved depression and improved gynecologic and cancer-specific concerns at 4 months compared with UC participants (all P < .05); significant differences in gynecologic and cancer-specific concerns (P < .05) were sustained at 9 months. Longitudinal change in overall QOL and anxiety did not reach statistical significance. Participants with decreasing interleukin (IL) -4, IL-5, IL-10, and IL-13 had significantly greater improvement in QOL than those with increasing cytokine levels. CONCLUSION This trial confirms that PTC benefits mood and QOL cancer-specific and gynecologic concerns for a multiethnic underserved population of survivors of cancer. The improvement in PROs with decreases in T-helper type 2 and counter-regulatory cytokines supports a potential biobehavioral pathway relevant to cancer survivorship.
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Affiliation(s)
- Lari Wenzel
- Lari Wenzel, Kathryn Osann, Susie Hsieh, Jo A. Tucker, and Edward L. Nelson, University of California Irvine, Irvine, CA; and Bradley J. Monk, Creighton University School of Medicine at St Joseph's Hospital and Medical Center, Phoenix, AZ.
| | - Kathryn Osann
- Lari Wenzel, Kathryn Osann, Susie Hsieh, Jo A. Tucker, and Edward L. Nelson, University of California Irvine, Irvine, CA; and Bradley J. Monk, Creighton University School of Medicine at St Joseph's Hospital and Medical Center, Phoenix, AZ
| | - Susie Hsieh
- Lari Wenzel, Kathryn Osann, Susie Hsieh, Jo A. Tucker, and Edward L. Nelson, University of California Irvine, Irvine, CA; and Bradley J. Monk, Creighton University School of Medicine at St Joseph's Hospital and Medical Center, Phoenix, AZ
| | - Jo A Tucker
- Lari Wenzel, Kathryn Osann, Susie Hsieh, Jo A. Tucker, and Edward L. Nelson, University of California Irvine, Irvine, CA; and Bradley J. Monk, Creighton University School of Medicine at St Joseph's Hospital and Medical Center, Phoenix, AZ
| | - Bradley J Monk
- Lari Wenzel, Kathryn Osann, Susie Hsieh, Jo A. Tucker, and Edward L. Nelson, University of California Irvine, Irvine, CA; and Bradley J. Monk, Creighton University School of Medicine at St Joseph's Hospital and Medical Center, Phoenix, AZ
| | - Edward L Nelson
- Lari Wenzel, Kathryn Osann, Susie Hsieh, Jo A. Tucker, and Edward L. Nelson, University of California Irvine, Irvine, CA; and Bradley J. Monk, Creighton University School of Medicine at St Joseph's Hospital and Medical Center, Phoenix, AZ
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29
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Harris LN, Cleary EH, Stanton AL. Project connect online: user and visitor experiences of an Internet-based intervention for women with breast cancer. Psychooncology 2014; 24:1145-51. [PMID: 25521661 DOI: 10.1002/pon.3734] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Revised: 10/24/2014] [Accepted: 11/13/2014] [Indexed: 11/09/2022]
Abstract
OBJECTIVE This study's purpose was to characterize the experience of patients with breast cancer randomly assigned to the intervention arm of Project Connect Online (PCO), a randomized controlled trial of an Internet-based intervention, and to examine relationships between website use variables and psychosocial outcomes. METHODS In the larger PCO trial, patients with breast cancer (n = 88) were randomly assigned to an intervention or a waiting-list control. This report pertains to the 46 women in the intervention arm, a 3-h workshop for creation of personal websites with a blog function to communicate with their interpersonal network and chronicle their breast cancer experience. Participants completed assessments at 1 and 6 months. Visitors to the websites (n = 66) completed an online questionnaire. RESULTS Reactions to website use were positive, although lack of time was a barrier for some. Women with advanced cancer were more likely to use their websites. Women found the websites useful for telling the story of their experience and expressing emotions. Positive word use was associated with heightened positive mood at 6 months; negative word use was associated with improved depressive symptoms. Visitors were most commonly female friends of participants who valued the websites as a way to connect emotionally with participants and receive information about their health. CONCLUSIONS Specific aspects of patients' blogs predicted improvements in psychosocial functioning. Personal websites can help women with breast cancer construct a narrative of their experience, express emotions, and receive the social support they need, particularly from friends and extended family.
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Affiliation(s)
- Lauren N Harris
- Department of Psychology, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | - Elizabeth H Cleary
- Department of Psychology, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | - Annette L Stanton
- Departments of Psychology and Psychiatry/Biobehavioral Sciences; Division of Cancer Prevention and Control Research, Jonsson Comprehensive Cancer Center, UCLA, Los Angeles, CA, USA
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Keim-malpass J, Steeves RH, Kennedy C. Internet ethnography: A review of methodological considerations for studying online illness blogs. Int J Nurs Stud 2014; 51:1686-92. [DOI: 10.1016/j.ijnurstu.2014.06.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2013] [Revised: 06/06/2014] [Accepted: 06/11/2014] [Indexed: 11/20/2022]
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