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Wu W, Graziano T, Salner A, Chen MH, Judge MP, Cong X, Xu W. Acceptability, Effectiveness, and Roles of mHealth Applications in Supporting Cancer Pain Self-Management: Integrative Review. JMIR Mhealth Uhealth 2024; 12:e53652. [PMID: 39024567 PMCID: PMC11294773 DOI: 10.2196/53652] [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: 10/27/2023] [Revised: 02/22/2024] [Accepted: 04/23/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND Cancer pain remains highly prevalent and persistent throughout survivorship, and it is crucial to investigate the potential of leveraging the advanced features of mobile health (mHealth) apps to empower individuals to self-manage their pain. OBJECTIVE This review aims to comprehensively understand the acceptability, users' experiences, and effectiveness of mHealth apps in supporting cancer pain self-management. METHODS We conducted an integrative review following Souza and Whittemore and Knafl's 6 review processes. Literature was searched in PubMed, Scopus, CINAHL Plus with Full Text, PsycINFO, and Embase, from 2013 to 2023. Keywords including "cancer patients," "pain," "self-management," "mHealth applications," and relevant synonyms were used in the search. The Johns Hopkins research evidence appraisal tool was used to evaluate the quality of eligible studies. A narrative synthesis was conducted to analyze the extracted data. RESULTS A total of 20 studies were included, with the overall quality rated as high (n=15) to good (n=5). Using mHealth apps to monitor and manage pain was acceptable for most patients with cancer. The internal consistency of the mHealth in measuring pain was 0.96. The reported daily assessment or engagement rate ranged from 61.9% to 76.8%. All mHealth apps were designed for multimodal interventions. Participants generally had positive experiences using pain apps, rating them as enjoyable and user-friendly. In addition, 6 studies reported significant improvements in health outcomes, including enhancement in pain remission (severity and intensity), medication adherence, and a reduced frequency of breakthrough pain. The most frequently highlighted roles of mHealth apps included pain monitoring, tracking, reminders, education facilitation, and support coordination. CONCLUSIONS mHealth apps are effective and acceptable in supporting pain self-management. They offer a promising multi-model approach for patients to monitor, track, and manage their pain. These findings provide evidence-based insights for leveraging mHealth apps to support cancer pain self-management. More high-quality studies are needed to examine the effectiveness of digital technology-based interventions for cancer pain self-management and to identify the facilitators and barriers to their implementation in real-world practice.
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Affiliation(s)
- Weizi Wu
- School of Nursing, University of Connecticut, Storrs, CT, United States
| | - Teresa Graziano
- School of Nursing, University of Connecticut, Storrs, CT, United States
| | - Andrew Salner
- Hartford HealthCare Cancer Institute, Hartford, CT, United States
| | - Ming-Hui Chen
- Department of Statistics, University of Connecticut, Storrs, CT, United States
| | - Michelle P Judge
- School of Nursing, University of Connecticut, Storrs, CT, United States
| | - Xiaomei Cong
- Yale School of Nursing, Orange, CT, United States
| | - Wanli Xu
- School of Nursing, University of Connecticut, Storrs, CT, United States
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Liu Q, Gao LL, Dai YL, Wang Y, Wang HX, Luo XJ, Chai XM, Mu GX, Liang XY, Zhang X, Liu J, Yu JQ, Li YX. Breakthrough Pain: A Qualitative Study of Patients with Advanced Cancer in Northwest China. Pain Manag Nurs 2018; 19:506-515. [DOI: 10.1016/j.pmn.2017.11.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 09/25/2017] [Accepted: 11/06/2017] [Indexed: 10/17/2022]
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Liu Q, Gao LL, Dai YL, Li YX, Wang Y, Bai CF, Mu GX, Chai XM, Han WJ, Zhou LJ, Zhang YJ, Tang L, Liu J, Yu JQ. Nitrous oxide/oxygen mixture for analgesia in adult cancer patients with breakthrough pain: A randomized, double-blind controlled trial. Eur J Pain 2017; 22:492-500. [PMID: 29226545 DOI: 10.1002/ejp.1144] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND The aim of this study was to assess the efficacy of a fixed nitrous oxide/oxygen mixture for the management of breakthrough cancer pain. METHODS/DESIGN A double-blind, placebo-controlled, randomized clinical trial was undertaken in the Medical ward of Tumor Hospital of General Hospital of Ningxia Medical University. 240 cancer patients with breakthrough pain were recruited and randomly received a standard pain treatment (morphine sulphate immediate release) plus a pre-prepared nitrous oxide/oxygen mixture, or the standard pain treatment plus oxygen. The primary endpoint measure was the numerical rating scale (NRS) score measured at baseline, 5 and 15 min after the beginning of treatment, and at 5 min post treatment. RESULT In all, analysis of pain score (NRS) at 5 min after the beginning of treatment shown a significant decrease in nitrous oxide/oxygen mixture treated patients with 2.8 ± 1.3 versus 5.5 ± 1.2 in controls (p < 0.01). At 15 min during the intervention, the mean pain score for nitrous oxide/oxygen was 2.0 ± 1.1 compared with 5.6 ± 1.3 for oxygen (p < 0.01). CONCLUSION This study shows that self-administered nitrous oxide/oxygen mixture was effective in reducing moderate to severe breakthrough pain among patients with cancer. SIGNIFICANCE The management of breakthrough cancer pain is always a challenge due to its temporal characteristics of rapid onset, moderate to severe in intensity, short duration (median 30-60 min). Our study find that self-administered nitrous oxide/oxygen mixture was effective in reducing moderate to severe breakthrough cancer pain.
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Affiliation(s)
- Q Liu
- School of Nursing, Ningxia Medical University, Yinchuan, China.,School of Basic Medical Sciences, Ningxia Medical University, Yinchuan, China
| | - L-L Gao
- School of Nursing, Ningxia Medical University, Yinchuan, China
| | - Y-L Dai
- School of Nursing, Ningxia Medical University, Yinchuan, China
| | - Y-X Li
- School of Nursing, Ningxia Medical University, Yinchuan, China
| | - Y Wang
- School of Nursing, Ningxia Medical University, Yinchuan, China
| | - C-F Bai
- School of Nursing, Ningxia Medical University, Yinchuan, China
| | - G-X Mu
- School of Nursing, Ningxia Medical University, Yinchuan, China
| | - X-M Chai
- School of Nursing, Ningxia Medical University, Yinchuan, China
| | - W-J Han
- Department of Nursing, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - L-J Zhou
- Institute of Translational Medicine, Second Military Medical University, Shanghai, China
| | - Y-J Zhang
- Department of Medical Oncology, General Hospital of Ningxia Medical University, Yinchuan, China
| | - L Tang
- Department of Anesthesiology, General Hospital of Jinan Military Command, Jinan, China
| | - J Liu
- School of Nursing, Ningxia Medical University, Yinchuan, China.,School of Basic Medical Sciences, Ningxia Medical University, Yinchuan, China
| | - J-Q Yu
- Department of Pharmacology, Pharmaceutical Institute of Ningxia Medical University, Yinchuan, China
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Kotronoulas G, Papadopoulou C, Burns-Cunningham K, Simpson M, Maguire R. A systematic review of the supportive care needs of people living with and beyond cancer of the colon and/or rectum. Eur J Oncol Nurs 2017; 29:60-70. [DOI: 10.1016/j.ejon.2017.05.004] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 05/03/2017] [Accepted: 05/20/2017] [Indexed: 12/23/2022]
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Cox A, Lucas G, Marcu A, Piano M, Grosvenor W, Mold F, Maguire R, Ream E. Cancer Survivors' Experience With Telehealth: A Systematic Review and Thematic Synthesis. J Med Internet Res 2017; 19:e11. [PMID: 28069561 PMCID: PMC5259589 DOI: 10.2196/jmir.6575] [Citation(s) in RCA: 204] [Impact Index Per Article: 29.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 11/14/2016] [Accepted: 11/23/2016] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Net survival rates of cancer are increasing worldwide, placing a strain on health service provision. There is a drive to transfer the care of cancer survivors-individuals living with and beyond cancer-to the community and encourage them to play an active role in their own care. Telehealth, the use of technology in remote exchange of data and communication between patients and health care professionals (HCPs), is an important contributor to this evolving model of care. Telehealth interventions are "complex," and understanding patient experiences of them is important in evaluating their impact. However, a wider view of patient experience is lacking as qualitative studies detailing cancer survivor engagement with telehealth are yet to be synthesized. OBJECTIVE To systematically identify, appraise, and synthesize qualitative research evidence on the experiences of adult cancer survivors participating in telehealth interventions, to characterize the patient experience of telehealth interventions for this group. METHODS Medline (PubMed), PsychINFO, Cumulative Index for Nursing and Allied Health Professionals (CINAHL), Embase, and Cochrane Central Register of Controlled Trials were searched on August 14, 2015, and March 8, 2016, for English-language papers published between 2006 and 2016. Inclusion criteria were as follows: adult cancer survivors aged 18 years and over, cancer diagnosis, experience of participating in a telehealth intervention (defined as remote communication or remote monitoring with an HCP delivered by telephone, Internet, or hand-held or mobile technology), and reporting qualitative data including verbatim quotes. An adapted Critical Appraisal Skill Programme (CASP) checklist for qualitative research was used to assess paper quality. The results section of each included article was coded line by line, and all papers underwent inductive analysis, involving comparison, reexamination, and grouping of codes to develop descriptive themes. Analytical themes were developed through an iterative process of reflection on, and interpretation of, the descriptive themes within and across studies. RESULTS Across the 22 included papers, 3 analytical themes emerged, each with 3 descriptive subthemes: (1) influence of telehealth on the disrupted lives of cancer survivors (convenience, independence, and burden); (2) personalized care across physical distance (time, space, and the human factor); and (3) remote reassurance-a safety net of health care professional connection (active connection, passive connection, and slipping through the net). Telehealth interventions represent a convenient approach, which can potentially minimize treatment burden and disruption to cancer survivors' lives. Telehealth interventions can facilitate an experience of personalized care and reassurance for those living with and beyond cancer; however, it is important to consider individual factors when tailoring interventions to ensure engagement promotes benefit rather than burden. CONCLUSIONS Telehealth interventions can provide cancer survivors with independence and reassurance. Future telehealth interventions need to be developed iteratively in collaboration with a broad range of cancer survivors to maximize engagement and benefit.
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Affiliation(s)
- Anna Cox
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Grace Lucas
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Afrodita Marcu
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Marianne Piano
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Wendy Grosvenor
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Freda Mold
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Roma Maguire
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Emma Ream
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
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Thiagarajan M, Chan CMH, Fuang HG, Beng TS, Atiliyana MA, Yahaya NA. Symptom Prevalence and Related Distress in Cancer Patients Undergoing Chemotherapy. Asian Pac J Cancer Prev 2016; 17:171-6. [PMID: 26838205 DOI: 10.7314/apjcp.2016.17.1.171] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Much has been done to examine the psychological impact of cancer treatment, but it remains unclear to what extent anxiety and depression is related to symptom prevalence. The present study concerned the characteristics and frequency of distress as related to symptom prevalence in cancer patients undergoing chemotherapy in Malaysia. MATERIALS AND METHODS Participants were 303 consecutive adult cancer patients undergoing chemotherapy in an academic medical center. The short form Memorial Symptom Assessment Scale (MSAS-SF), which covers three domains of symptoms (global distress, physical- and psychological symptoms) was used to cross-sectionally measure symptom frequency and associated distress via self-reporting. One-way ANOVA and t-tests were used to test mean differences among MSAS-SF subscale scores. RESULTS Complete data were available for 303 patients. The mean number of symptoms was 14.5. The five most prevalent were fatigue, dry mouth, hair loss, drowsiness and lack of appetite. Overall, symptom burden and frequency were higher than in other published MSAS-SF studies. Higher symptom frequency was also found to be significantly related to greater distress in cancer patients undergoing chemotherapy. CONCLUSIONS Patients undergoing chemotherapy suffer from multiple physical and psychological symptoms. Better symptom control or palliative care is needed. Greater frequency of reported symptoms may also indicate a subconscious bid by patients for care and reassurance - thus tailored intervention to manage distress should be offered.
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Affiliation(s)
- Muthukkumaran Thiagarajan
- Department of Clinical Oncology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia E-mail :
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Ohlsson-Nevo E, Andershed B, Nilsson U. Psycho-educational intervention on mood in patients suffering from colorectal and anal cancer: A randomized controlled trial. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/2057158516679790] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Psycho-educational interventions can moderate the negative impact of cancer on patients’ mental wellbeing, although studies of the effect on colorectal cancer (CRC) patients are scarce. Hence, the primary aim of this study was to test whether a nurse-led psycho-educational programme (PEP) could affect the emotional wellbeing of persons being treated for CRC and anal cancer. A secondary aim was to test whether there were any differences in emotional wellbeing in the patients before undergoing a PEP compared to a subset of the Swedish population. A randomized controlled trial was used. In total, 86 patients were randomized either to a PEP comprising seven lectures followed by discussions and reflections with peers or to standard treatment. Mental wellbeing was measured with the Mood Adjective Check List. The PEP significantly ( p < 0.04) increased the patients’ overall mood one month after the end of the intervention. The PEP seemed to have a short-term effect on patients’ overall mood. Other outcomes such as self-efficacy could be useful measures when evaluating PEP.
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Affiliation(s)
- Emma Ohlsson-Nevo
- Health Care Research Center, University Hospital, Örebro, Sweden
- School of Health Sciences, Örebro University, Sweden
| | - Birgitta Andershed
- Faculty of Health, Care and Nursing, Norwegian University of Science and Technology, Gjövik, Norway
- Department of Palliative Research Centre, Ersta Sköndal University College, Stockholm, Sweden
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Røhrl K, Guren MG, Miaskowski C, Cooper BA, Diep LM, Rustøen T. No Differences in Symptom Burden Between Colorectal Cancer Patients Receiving Curative Versus Palliative Chemotherapy. J Pain Symptom Manage 2016; 52:539-547. [PMID: 27470003 DOI: 10.1016/j.jpainsymman.2016.04.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 03/08/2016] [Accepted: 04/29/2016] [Indexed: 11/23/2022]
Abstract
CONTEXT Colorectal cancer (CRC) is one of the most common cancers worldwide. Patients with CRC may have multiple cooccurring symptoms as a result of their disease or its treatment. Little is known about potential differences in symptom burden in CRC patients scheduled to receive curative versus palliative chemotherapy (CTX). OBJECTIVES The purposes of this study were to investigate the overall symptom burden of patients with CRC before their first CTX treatment or before the initiation of a new CTX regimen and to evaluate for differences in symptom occurrence, severity, and distress between patients with CRC who were scheduled to receive curative versus palliative CTX. METHODS Consecutive patients with CRC were recruited (n = 120), and symptoms were assessed using the Memorial Symptom Assessment Scale before the initiation of the CTX. The most common symptoms that occurred in ≥30% of the patients were evaluated. Differences in occurrence rates and severity and distress scores between the curative (n = 68) and palliative (n = 52) patient groups were evaluated using binary logistic regression and ordinal logistic regression analyses, respectively. RESULTS In both groups, patients reported an average of 10 cooccurring symptoms. Worrying (65%), lack of energy (59%), feeling drowsy (54%), feeling bloated (53%), pain (51%), and difficulty sleeping (50%) were the most prevalent symptoms. Problems with sexual interest had the highest severity and distress scores in both groups. For the 13 most common symptoms, no significant differences were found between the two patient groups on any of the Memorial Symptom Assessment Scale dimensions (i.e., occurrence, severity, distress). CONCLUSION Regardless of the reason for CTX, CRC patients experience a large number of cooccurring symptoms.
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Affiliation(s)
- Kari Røhrl
- Institute for Health and Society, University of Oslo, Oslo, Norway; Department of Oncology, Oslo University Hospital, Oslo, Norway.
| | - Marianne Grønlie Guren
- Department of Oncology, Oslo University Hospital, Oslo, Norway; K.G. Jebsen Colorectal Cancer Research Centre, Oslo University Hospital, Oslo, Norway
| | | | - Bruce A Cooper
- School of Nursing, University of California, San Francisco, California, USA
| | - Lien My Diep
- Department for Biostatistics, Epidemiology, and Health Economics, Oslo University, Oslo, Norway
| | - Tone Rustøen
- Institute for Health and Society, University of Oslo, Oslo, Norway; Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
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Bauer A, Vordermark D, Seufferlein T, Schmoll HJ, Dralle H, Mau W, Unverzagt S, Boese S, Fach EM, Landenberger M. Trans-sectoral care in patients with colorectal cancer: Protocol of the randomized controlled multi-center trial Supportive Cancer Care Networkers (SCAN). BMC Cancer 2015; 15:997. [PMID: 26694748 PMCID: PMC4689007 DOI: 10.1186/s12885-015-2002-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 12/11/2015] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Managing therapy-related side-effects and improving health-related quality of life in patients with colorectal cancer is still challenging. The need for an effective management of adverse events and unmet supportive care needs have been widely discussed. In the past decade, interventions by nursing staff gained more and more importance. Evidence suggests that a majority of patients even in early stages of the disease experience substantial impairments potentially resulting in diminished therapy adherence as well as impaired quality of life. However, evidence for the effectiveness of nurse-led interventions on symptom management and quality of life is still very limited. This especially applies to care transitions between different inpatient and outpatient health care providers throughout the course of treatment and aftercare. METHODS/DESIGN Supportive Cancer Care Networkers (SCAN) is a prospective randomized controlled trial conducted in eight large and middle-sized German cancer centers and municipal hospitals. The target population is adults with colorectal cancer UICC I-III after initial R-0 resection scheduled for adjuvant chemotherapy or guideline-based aftercare only. 370 patients will be randomly assigned to either intervention or control group. Patients in the intervention group will receive an additional support by specialized oncology nurses for eight weeks after discharge from hospital by telephone, consisting of symptom monitoring, counselling on self-assessment and self-management and dealing with individual resources for coping and psychosocial well-being. The primary endpoint will be health-related quality of life (HRQoL) at eight weeks after discharge from the initial treating hospital. DISCUSSION The presented SCAN trial is to provide information that will be useful to advance our understanding of complex interdependencies between symptom severity, supportive care needs, functioning and the risk for diminished HRQoL. Most importantly, these patient-reported outcomes are not fully implemented in today's clinical routine practice potentially resulting in therapy cessations and lower chemotherapy treatment rates for colorectal cancer especially in older patients. TRIAL REGISTRATION ClinicalTrials.gov Identifier NCT01651832.
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Affiliation(s)
- Alexander Bauer
- Martin-Luther-University Halle-Wittenberg, Medical Faculty, Institute for Health and Nursing Science, Magdeburger Strasse 8, D-06112, Halle, Germany.
| | - Dirk Vordermark
- Department of Radiation Oncology, University Hospital Halle, Ernst-Grube-Strasse 40, D-06120, Halle, Germany.
| | - Thomas Seufferlein
- Department of Internal Medicine I, University Hospital Ulm, Albert Einstein Allee 23, Ulm, D-89081, Germany.
| | - Hans-Joachim Schmoll
- University Hospital Halle, Clinic for Internal Medicine IV, Ernst-Grube-Strasse 40, D-06120, Halle, Germany.
| | - Henning Dralle
- Department of General, Visceral and Vascular Surgery, University Hospital, Ernst-Grube-Strasse 40, D-06120, Halle, Germany.
| | - Wilfried Mau
- Martin-Luther-University Halle-Wittenberg, Medical Faculty, Institute for Rehabilitation Medicine, Magdeburger Strasse 8, D-06112, Halle, Germany.
| | - Susanne Unverzagt
- Martin-Luther-University Halle-Wittenberg, Medical Faculty, Institute for Medical Epidemiology, Biostatistics and Informatics, Magdeburger Strasse 8, D-06112, Halle, Germany.
| | - Stephanie Boese
- Martin-Luther-University Halle-Wittenberg, Medical Faculty, Institute for Health and Nursing Science, Magdeburger Strasse 8, D-06112, Halle, Germany.
| | - Eva-Maria Fach
- Martin-Luther-University Halle-Wittenberg, Medical Faculty, Institute for Health and Nursing Science, Magdeburger Strasse 8, D-06112, Halle, Germany.
| | - Margarete Landenberger
- Martin-Luther-University Halle-Wittenberg, Medical Faculty, Institute for Health and Nursing Science, Magdeburger Strasse 8, D-06112, Halle, Germany.
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Landenberger M, Boese S, Fach EM, Bauer A. [Trans-sectoral care for patients with colorectal cancer: Design of a prospective randomized controlled multi-center trial (FKZ 01GY1143)]. ZEITSCHRIFT FUR EVIDENZ FORTBILDUNG UND QUALITAET IM GESUNDHEITSWESEN 2014; 109:171-80. [PMID: 26028456 DOI: 10.1016/j.zefq.2014.06.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Revised: 05/01/2014] [Accepted: 06/06/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND Health-related quality of life (HrQoL) is an increasingly focused aim in the care for patients with colorectal cancer that are treated with curative intent. Achieving this aim partly depends on the quality of the transsectoral management of these patients throughout the entire treatment course. However, recent population-based surveys have shown that HrQoL in patients with colorectal cancer is significantly impaired over a long time following initial diagnosis. This also applies to patients for whom adjuncant chemotherapy is not indicated according to the German medical S3 guideline. In addition, the patients' need for medical and psychosocial support has repeatedly been reported to persist at a significantly increased level - despite the extensive establishment of certified cancer centres which has apparently failed to solve this problem sufficiently. AIM The SCAN intervention aims to increase the percentage of patients reaching an enhancement of their HrQoL by at least 12 points (range: 0-100 pts.) within eight weeks after hospital discharge by 15 percent compared to standard care. DESIGN AND METHODS The SCAN intervention is carried out as a randomised controlled multicentre trial in seven large- and middle-sized hospitals all over Saxony-Anhalt. 370 patients have been enrolled, 185 of whom are offered additional nurse-led outpatient counselling. INTERVENTION Patients in the intervention group are offered transitional guidance and support consisting of routine symptom assessment and patient counselling regarding self-management, informed therapy-related decision-making and psychosocial support. ENDPOINTS The primary endpoint of the study is the patients' global health-related quality of life (HrQoL), assessed by the EORTC Quality of Life Questionnaire QLQ C-30 V3.0, item 30. Disease-free survival within eight months, the utilisation of indicated adjuvant chemotherapies as well as therapy-related side effects, e. g., anxiety and depression and the patients' symptom burden are monitored as secondary endpoints. EXPECTED RESULTS We assume that the SCAN intervention will be effective in increasing the percentage of patients reaching a clinically relevant enhancement of their HrQoL within eight weeks after hospital discharge by 15 percent compared to standard care.
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Affiliation(s)
- Margarete Landenberger
- Martin-Luther-Universität Halle-Wittenberg, Medizinische Fakultät, Institut für Gesundheits- und Pflegewissenschaft, Halle, Deutschland
| | - Stephanie Boese
- Martin-Luther-Universität Halle-Wittenberg, Medizinische Fakultät, Institut für Gesundheits- und Pflegewissenschaft, Halle, Deutschland
| | - Eva-Maria Fach
- Martin-Luther-Universität Halle-Wittenberg, Medizinische Fakultät, Institut für Gesundheits- und Pflegewissenschaft, Halle, Deutschland
| | - Alexander Bauer
- Martin-Luther-Universität Halle-Wittenberg, Medizinische Fakultät, Institut für Gesundheits- und Pflegewissenschaft, Halle, Deutschland.
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Shun SC, Yeh KH, Liang JT, Huang J, Chen SC, Lin BR, Lee PH, Lai YH. Unmet Supportive Care Needs of Patients With Colorectal Cancer: Significant Differences by Type D Personality. Oncol Nurs Forum 2013; 41:E3-11. [DOI: 10.1188/14.onf.e3-e11] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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