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Zhang Y, Chen X, Li R, Wang Y, Sun Z, Li Q. Interventions strategies and their efficacy in illness perceptions in patients with cancer: A systematic review and meta-analysis. Eur J Oncol Nurs 2024; 70:102599. [PMID: 38810586 DOI: 10.1016/j.ejon.2024.102599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 04/20/2024] [Accepted: 04/25/2024] [Indexed: 05/31/2024]
Abstract
PURPOSES To identify intervention strategies for improving illness perception (IP) of cancer patients and/or family caregivers; and to examine the effects of IP interventions by meta-analysis. METHODS A systematic search was performed to identify literature that focused on improving the IP of cancer patients and/or family caregivers from the establishment of eight databases to August 2023. Manual screening was also applied. The IP intervention strategies for cancer populations were synthesized basing the CSM. Meta-analysis was conducted to assess the effects of IP interventions on health outcomes. Multiple subgroup analyses of the same intervention conditions were conducted to explore the optimal IP-focused intervention. RESULTS 18 studies were included. 11 studies were conducted in a meta-analysis. No studies on family caregivers' IP were identified. Compared to general care, subgroup analysis revealed that IP interventions had favorable effects on cancer patients' IP as well as quality of life and other outcomes. Six IP intervention strategies (information support, cognitive reframing, emotion adjustment, active coping, effective appraisal, and self-social identification) were generated. Meta-analysis showed that compared with theory-less studies (Z = 8.64, p < 0.01) and single delivery formats (Z = 3.66, p < 0.01), the theory-based interventions (Z = 10.86, p < 0.01) and mixed delivery formats (Z = 7.15, p < 0.01) had higher positive effects on IP outcomes. CONCLUSIONS The positive outcomes of IP intervention focusing on cancer patients were highlighted. IP traits and patients' and their caregivers' needs in coping with specific cancer types should be explored before the intervention design. More IP interventions targeting cancer dyads are warranted to develop in the future.
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Affiliation(s)
- Yi Zhang
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Xuan Chen
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Rongyu Li
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Ye Wang
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Zheng Sun
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Qiuping Li
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China; Affiliated Hospital of Jiangnan University, Wuxi, China.
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Ma H, Hu K, Wu W, Wu Q, Ye Q, Jiang X, Tang L, He Y, Yang Q. Illness perception profile among cancer patients and its influencing factors: A cross-sectional study. Eur J Oncol Nurs 2024; 69:102526. [PMID: 38401348 DOI: 10.1016/j.ejon.2024.102526] [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: 12/09/2023] [Revised: 02/01/2024] [Accepted: 02/04/2024] [Indexed: 02/26/2024]
Abstract
PURPOSE The purpose of this study was to explore latent profiles of illness perception among cancer patients and its influencing factors. METHODS This study was a cross-sectional study adopting convenience sampling to select cancer patients from two hospitals in China. A total of 286 patients completed Brief Illness Perception Questionnaire, Post-traumatic Growth Inventory, Fear of Disease Progression Questionnaire and Psychosocial Adjustment to Illness Scale. Latent profile analysis and multiple linear regression were performed to explore the subgroups and factors influencing classification. RESULTS Three subgroups were identified, which were labelled as "Moderate Illness Perception Group" (16.8%; C1), "High Illness Perception with Heightened Concerns Group" (68.5%; C2) and "High Resilience and Low Symptomatic Impact Group" (14.7%; C3). Specifically, "Normal", "Mild symptom" and "Bed time during the day <50%" of "Functional Status" were more associated with C3. "Worker", "Farmer" and "Self-employed" were more associated with C1 and C2. Patients who had more "knowledge of the disease" were more associated with C2 and C3, who had less "post-traumatic growth" were more associated with C1, and who had less "fear of disease progression" and more "psychosocial adjustment" were more associated with C3 (all P < 0.05). CONCLUSIONS There was significant variability of illness perception among three subgroups of cancer patients, which emphasized the complexity of psychological condition. The insights derived from these distinct profiles enables tailored interventions and patient-centered communication strategies. However, integrating objective measures or biomarkers is needed to complement self-reported data.
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Affiliation(s)
- Hualong Ma
- School of Nursing, Jinan University, Guangdong, China
| | - Ke Hu
- School of Nursing, Jinan University, Guangdong, China
| | - Weixin Wu
- St. Mark's School, 25 Marlboro Road Southborough, MA, USA
| | - Qinyang Wu
- School of Nursing, Jinan University, Guangdong, China
| | - Qiuyun Ye
- Tianhe Shipai Huashi Community Health Service Center, Guangdong, China
| | | | - Lu Tang
- Shanwei Second People's Hospital, Guangdong, China
| | - Yongyue He
- Shanwei Second People's Hospital, Guangdong, China.
| | - Qiaohong Yang
- School of Nursing, Jinan University, Guangdong, China.
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Chen J, Guo Z, Luo X, Zhang Y, Zhang X, Li M, Xiong C, Zhao M, Yan J. Longitudinal trajectories of illness perception regarding breast cancer-related lymphedema among women with breast cancer. J Psychosom Res 2023; 170:111344. [PMID: 37178472 DOI: 10.1016/j.jpsychores.2023.111344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 03/19/2023] [Accepted: 04/29/2023] [Indexed: 05/15/2023]
Abstract
OBJECTIVE To identify longitudinal trajectories of illness perception (IP) regarding breast cancer-related lymphedema (BCRL) in the first six months after surgery among women with breast cancer and to explore the predictive effects of demographics and clinical factors on IP trajectories. METHODS From August 2019 to August 2021, a total of 352 patients participated in this study, 328 of whom were included in the data analysis. Demographic and clinical characteristics were collected at baseline (1-3 days after surgery). The BCRL-specific revised illness perception questionnaire was used to measure IP regarding BCRL at baseline and 1 month, 3 months and 6 months post-surgery. A multilevel model was conducted to analyze the data. RESULTS Over the first six months post-surgery, the "timeline acute/chronic" and "illness coherence" dimensions showed positive growth trajectories; the "personal control" and "treatment control" dimensions presented negative growth trajectories; and the trajectories of identity, consequences, cyclicality and emotional influence perceptions regarding BCRL showed no significant changes. Age, education level, marital status, employment status, family monthly income per person, cancer stage and status of removed lymph nodes were indicated to be predictive factors of IP trajectories. CONCLUSIONS The present study determined significant changes over the first six months post-surgery in four IP dimensions and predictive effects of some demographics and clinical details on IP trajectories. These findings may help healthcare providers know more about the dynamic characteristics of IPs regarding BCRL in patients with breast cancer and assist them in identifying patients with a tendency toward improper IP regarding BCRL.
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Affiliation(s)
- Jing Chen
- School of Nursing, Sun Yat-Sen University, No. 74, Zhongshan II Road, Guangzhou, Guangdong Province, China
| | - Zijun Guo
- School of Nursing, Sun Yat-Sen University, No. 74, Zhongshan II Road, Guangzhou, Guangdong Province, China
| | - Xia Luo
- School of Nursing, Sun Yat-Sen University, No. 74, Zhongshan II Road, Guangzhou, Guangdong Province, China
| | - Yue Zhang
- School of Nursing, Sun Yat-Sen University, No. 74, Zhongshan II Road, Guangzhou, Guangdong Province, China
| | - Xiaomin Zhang
- School of Nursing, Sun Yat-Sen University, No. 74, Zhongshan II Road, Guangzhou, Guangdong Province, China
| | - Mingfang Li
- School of Nursing, Sun Yat-Sen University, No. 74, Zhongshan II Road, Guangzhou, Guangdong Province, China
| | - Chenxia Xiong
- School of Nursing, Sun Yat-Sen University, No. 74, Zhongshan II Road, Guangzhou, Guangdong Province, China
| | - Meng Zhao
- School of Nursing, Sun Yat-Sen University, No. 74, Zhongshan II Road, Guangzhou, Guangdong Province, China
| | - Jun Yan
- School of Nursing, Sun Yat-Sen University, No. 74, Zhongshan II Road, Guangzhou, Guangdong Province, China.
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Mavragani A, Müller B, Katz G, Dallas L, Aguaron A, Azoulai M, Girard N. Patient Perspectives on Value Dimensions of Lung Cancer Care: Cross-sectional Web-Based Survey. JMIR Form Res 2023; 7:e37190. [PMID: 36416499 PMCID: PMC9912155 DOI: 10.2196/37190] [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: 02/23/2022] [Revised: 10/17/2022] [Accepted: 10/31/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND While the lung cancer (LC) treatment landscape has rapidly evolved in recent years, easing symptom burden and treatment side effects remain central considerations in disease control. OBJECTIVE The aim of this study was to assess the relative importance of dimensions of LC care to patients, and to explore the disease burden, including socioeconomic aspects not commonly covered in patient-reported outcomes instruments. METHODS A questionnaire was sent to patients with LC and their caregivers to rate the value of a diverse set of quality of life dimensions in care, to evaluate communication between health care professionals (HCPs) and patients, and to explore the economic impact on respondents. The survey included questions on the dimensions of care covered by patient-reported outcomes instruments for quality-of-life evaluation (Functional Assessment of Cancer Therapy-Lung scale, EQ-5D, the European Organization for Research and Treatment of Cancer's Core Quality of Life questionnaire, and the European Organization for Research and Treatment of Cancer's Core Quality of Life in lung cancer 13-item questionnaire), as well as the International Consortium for Health Outcomes Measurement (ICHOM) standard set of patient-centered outcomes for LC. The survey respondents were participants on Carenity's patient community platform, living either in France, the United Kingdom, Germany, Italy, or Spain. RESULTS The survey included 150 respondents (115 patients and 35 caregivers). "Physical well-being" and "end-of-life care" (median scores of 9.6, IQR 7.7-10, and 9.7, IQR 8.0-10, on a 10-point scale) were rated highest among the different value dimensions assessed. "Physical well-being and functioning" was the dimension most frequently discussed with health care professionals (82/150, 55%), while only (17/100, 17%) reported discussing "end-of-life care." After diagnosis, 43% (49/112) of patients younger than 65 years stopped working. Among respondents who indicated their monthly household income before and after diagnosis, 55% (38/69) reported a loss of income. CONCLUSIONS Our results showed the relevance of a broad range of aspects of care for the quality of life of patients with LC. End-of-life care was the dimension of care rated highest by patients with LC, irrespective of stage at diagnosis; however, this aspect is least frequently discussed with HCPs. The results also highlight the considerable socioeconomic impact of the disease, despite insurance coverage of direct costs.
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Affiliation(s)
| | - Borna Müller
- Global Access, F Hoffmann-La Roche Ltd, Basel, Switzerland
| | - Grégory Katz
- Université Paris-Cité Medical School, Paris, France.,PromTime, Paris, France
| | | | | | | | - Nicolas Girard
- Institut du Thorax Montsouris, Institut Curie, Paris, France.,Paris Saclay University, Université Versailles Saint Quentin, Paris, France
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Levoy K, Wool J, Ashare RL, Rosa WE, Barg FK, Meghani SH. "It's Rougher on Me Than It Is on Him": Family Caregiver-Generated and Prioritized Illness Concerns While Patients Undergo Cancer Treatments. JCO Oncol Pract 2022; 18:e525-e536. [PMID: 34735272 PMCID: PMC9014424 DOI: 10.1200/op.21.00164] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
PURPOSE Research eliciting patients' illness concerns has typically focused later in the cancer continuum, rather than during cancer treatments. Family caregiver concerns are overlooked during this time. Less is known about how patients and caregivers prioritize concerns during cancer treatments, which holds potential for improving supportive oncology care (ie, primary palliative care). The purpose of this study was to elicit and compare which domains of supportive oncology are of highest importance to patients and caregivers during cancer treatments. METHODS Freelisting, a cognitive anthropology method, was used to elicit concerns in order of importance. Freelist data were analyzed using Smith's salience index. Qualitative interviews were conducted with a caregiver subsample to add explanatory insights. RESULTS In descending order, pain, death, fear, family, and awful were salient Freelist items for patients (n = 65), whereas sadness, time-consuming, support, anger, tired, death, and frustration were salient for caregivers (n = 24). When integrated with supportive oncology domains, patients' concerns reflected a prioritization of the physical (pain) and emotional (death, fear, and awful) domains, with less emphasis on social (family) aspects. Caregivers' prioritized the emotional (sadness, anger, death, and frustration) and social (time-consuming and support) domains, with less emphasis on the physical (tired) aspects. CONCLUSION Our findings suggest that enhancing primary palliative care delivery by oncology teams requires systems thinking to support both the patient and caregiver as the primary unit of care. Primary palliative care may be improved by prioritizing interventions that address physical concerns among patients as well as key social concerns among caregivers to support the complex caregiving role while patients undergo cancer treatments.
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Affiliation(s)
- Kristin Levoy
- Department of Community and Health Systems, Indiana University School of Nursing, Indianapolis, IN,Center for Aging Research, Regenstrief Institute, Indianapolis, IN,Kristin Levoy, PhD, MSN, RN, Department of Community and Health Systems, Indiana University School of Nursing, 600 Barnhill Dr, Indianapolis, IN 46202; e-mail:
| | - Jesse Wool
- Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, PA,NewCourtland Center for Transitions and Health, University of Pennsylvania School of Nursing, Philadelphia, PA,Nursing Operations Department, Children's Hospital of Philadelphia, Philadelphia, PA
| | | | - William E. Rosa
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Frances K. Barg
- Department of Family and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Salimah H. Meghani
- Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, PA,NewCourtland Center for Transitions and Health, University of Pennsylvania School of Nursing, Philadelphia, PA,Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
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Ośmiałowska E, Staś J, Chabowski M, Jankowska-Polańska B. Illness Perception and Quality of Life in Patients with Breast Cancer. Cancers (Basel) 2022; 14:cancers14051214. [PMID: 35267522 PMCID: PMC8909179 DOI: 10.3390/cancers14051214] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/21/2022] [Accepted: 02/24/2022] [Indexed: 12/04/2022] Open
Abstract
Simple Summary The declining average age of cancer patients may become a serious problem for health care systems and societies in general in the near future. For this reason, there is a need to fully understand the factors determining health-related quality of life in breast cancer patients, beyond clinical characteristics and sociodemographic factors. In our study, we aimed to demonstrate the relationship between illness perception and quality of life in breast cancer patients. The results of our study confirm the beneficial effect of positive illness perception on the intensity of symptoms related to cancer and treatment, as well as functional domains of EORTC QLQ-C30. Abstract Introduction. In 2020, breast cancer was the most frequently diagnosed malignancy worldwide. The QoL level plays a role in assessing the effectiveness of the diagnosis and therapy and is a significant prognostic factor. The subject that is relatively less often addressed in the literature is the impact of psycho-social factors and health-related beliefs on QoL in breast cancer patients. The aim of the study was to assess the association of illness perception, the sense of coherence, and illness acceptance with QoL in breast cancer patients. Methods. The study included 202 women (mean age 53.0 ± 10.3) treated surgically for breast cancer at the Lower Silesian Oncology Centre. The following standardized questionnaires were used: Acceptance of Illness Scale (AIS), Mental Adjustment to Cancer (Mini-MAC), Quality of Life Questionnaires (EORTC QLQ-C30 and QLQ-BR23), The Multidimensional Essence of Disease and Illness Scale (MEDIS), and Life Orientation Test (LOT-R). Results. There is a statistically significant association between illness acceptance and QoL. There is a statistically significant association between the sense of coherence (life optimism—LOT-R) and QoL among breast cancer patients. There is a statistically significant association between illness perception and QoL. There was a statistically significant correlation between the increasing importance of illness as a dysfunction, decreasing QoL, and increasing intensity of symptoms and complaints. Conclusions. Patients with a high level of illness acceptance, with an optimistic disposition, and with a positive illness perception have better QoL within all the functional domains and experience lower intensity of cancer- and treatment-related symptoms as compared to those with low level of illness acceptance, with moderate optimism or a pessimistic disposition, and with neutral or negative illness perception.
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Affiliation(s)
- Edyta Ośmiałowska
- Division of Anesthesiologic and Surgical Nursing, Department of Nursing and Obstetrics, Faculty of Health Science, Wroclaw Medical University, 5 Bartla Street, 51-618 Wroclaw, Poland;
| | - Jakub Staś
- Student Research Group No. 180, Faculty of Medicine, Wroclaw Medical University, 50-367 Wrocław, Poland;
| | - Mariusz Chabowski
- Division of Anesthesiologic and Surgical Nursing, Department of Nursing and Obstetrics, Faculty of Health Science, Wroclaw Medical University, 5 Bartla Street, 51-618 Wroclaw, Poland;
- Department of Surgery, 4th Military Teaching Hospital, 5 Weigla Street, 50-981 Wrocław, Poland
- Correspondence: ; Tel.: +48-261-660-247; Fax: +48-261-660-245
| | - Beata Jankowska-Polańska
- Innovation and Research Center, 4th Military Teaching Hospital, 5 Weigla Street, 50-981 Wrocław, Poland;
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