1
|
Phan J, Laurence V, Marec-Berard P, Cordero C, Riberon C, Flahault C. The Place of Sick Peers in Adolescents and Young Adults with Cancer: Advantage, Disadvantage, and What Makes Barriers to the Encounter. J Adolesc Young Adult Oncol 2023; 12:879-889. [PMID: 36999900 DOI: 10.1089/jayao.2022.0176] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023] Open
Abstract
Purpose: The appreciation of peer support can vary from one country to another due to the cultural and relational differences. This study explores what perceptions French adolescents and young adults (AYAs) in post-treatment for cancer have of the place of sick peers during their treatment and what can make barriers to meet them. Methods: A semistructured interview has been proposed 6 months after the end of cancer treatments. A thematic analysis has been conducted to highlight the major themes and subthemes identified through the participants' discourses. Results: Twelve AYAs (mean age 23 y.o., standard deviation = 2.8; min = 19; max = 26) from two French cancer centers were interviewed. Five major themes were identified, but only two were presented in this article: the place of peers and the impact of coronavirus disease 2019 (COVID-19) epidemic on AYA facilities. AYA peers with cancer major theme demonstrated that meeting sick peers has benefits (e.g., identification, understanding, support, feeling of normalcy) but also has disadvantages (e.g., negative emotional influence). The benefits of peer-to-peer meetings seem to outweigh the disadvantages. Nevertheless, AYAs can face social barriers to this kind of relationship (e.g., fatigue, need to focus on oneself, confrontation to cancer and negative events, feeling of unnatural meeting). Finally, patients' encounters and the normal functioning of AYA facilities have been hampered by the COVID-19 pandemic. Conclusion: Even if AYA services systematically suggest a meeting with other sick peers, it is important to reiterate this proposal since the needs can evolve over time. It can also be interesting to propose places of life outside the hospital to make the encounters more comfortable and natural for AYAs. Clinical Trial Registration number: NCT03964116.
Collapse
Affiliation(s)
- Jeff Phan
- Psychopathology and Health Processes Laboratory, Paris Cité University, Boulogne Billancourt, France
- Adolescents and Young Adults Unit, Curie Institute, Paris, France
| | - Valérie Laurence
- Psychopathology and Health Processes Laboratory, Paris Cité University, Boulogne Billancourt, France
- Adolescents and Young Adults Unit, Medical Oncology and SIREDO (Care, Innovation and Research for Children, Adolescents, and Young Adults with Cancer) Departments, Curie Institute, Paris, France
| | - Perrine Marec-Berard
- Pediatrics and Adolescents and Young Adults Oncology Department, Institute of Hematology and Pediatric Oncology, Lyon, France
| | - Camille Cordero
- Adolescents and Young Adults Unit, Medical Oncology and SIREDO (Care, Innovation and Research for Children, Adolescents, and Young Adults with Cancer) Departments, Curie Institute, Paris, France
| | - Christèle Riberon
- Pediatrics and Adolescents and Young Adults Oncology Department, Institute of Hematology and Pediatric Oncology, Lyon, France
| | - Cécile Flahault
- Psychopathology and Health Processes Laboratory, Paris Cité University, Boulogne Billancourt, France
- Psycho-Oncology Unit, Gustave Roussy Hospital, Villejuif, France
- Functional Unit of Psychology and Liaison Psychiatry and Emergency, Adult and Elderly Psychiatry Service, George Pompidou European Hospital, Paris, France
| |
Collapse
|
2
|
Phan J, Vander Haegen M, Karsenti L, Laurence V, Marec-Berard P, Cordero C, Thisse A, Riberon C, Flahault C. Psychological Adjustment, Adaptation, and Perception of Social Support in French Adolescents and Young Adults After the Diagnosis of Cancer. J Adolesc Young Adult Oncol 2022. [PMID: 36067271 DOI: 10.1089/jayao.2022.0034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: The third Cancer Plan (2014-2019) has helped with the recognition of adolescents and young adults (AYAs) with cancer's medical and psychosocial specificities and has enabled the creation of dedicated structures in France. Methods: The study involved 43 AYA patients (Nmen = 21; Nwomen = 22) between 15 and 27 years old (Mage = 19.9), diagnosed with all types of cancer, and were recruited in two French cancer centers. Online questionnaires were filled in 2 months after the beginning of treatment. AYAs completed measures of depressive and anxiety symptoms, perceived social support, and coping strategies. Results: Results demonstrated moderate depressive symptoms (M = 10.7, standard deviation [SD] = 7.0) and suggested a good satisfaction (M = 30, SD = 9.5) and a mild availability (M = 27, SD = 10.3) of the social support. Spearman's correlations demonstrated that coping strategies are related to depressive symptoms, for which acceptance (p < 0.01) of the disease played a key role in their psychological adjustment. Perceived social support subscales were positively correlated with the use of distraction as a coping strategy (p < 0.05). Kruskal-Wallis test demonstrated the preferential use of instrumental (p < 0.05) and emotional support (p < 0.01), denial (p < 0.01), and self-blame (p < 0.01) for women and the use of acceptance (p < 0.05) and humor (p < 0.05) for men; and there were no significant differences between patients hospitalized in the two cancer center facilities. Conclusion: Finally, a better understanding of the psychological adjustment and processes among French AYAs with cancer will help families and processionals to better adjust AYA-specific needs at the beginning of cancer treatment. ClinicalTrials.gov.: NCT03964116.
Collapse
Affiliation(s)
- Jeff Phan
- Psychopathology and Health Processes Laboratory, UR 4057, Paris Cité University, Boulogne Billancourt, France.,Adolescents and Young Adults Unit, Curie Institute, Paris, France
| | - Marie Vander Haegen
- Psychopathology and Health Processes Laboratory, UR 4057, Paris Cité University, Boulogne Billancourt, France.,Unit of Research: Health and Society Interfaculty, Liège University, Liège, Belgium.,Haute École Léonard de Vinci, Brussels, Belgium
| | - Lucille Karsenti
- Psychopathology and Health Processes Laboratory, UR 4057, Paris Cité University, Boulogne Billancourt, France.,Adolescents and Young Adults Unit, Curie Institute, Paris, France.,Psycho-Oncology Unit, Gustave Roussy Hospital, Villejuif, France
| | - Valérie Laurence
- Psychopathology and Health Processes Laboratory, UR 4057, Paris Cité University, Boulogne Billancourt, France.,Adolescents and Young Adults Unit, Medical Oncology and SIREDO (Care, Innovation and Research for Children, Adolescents and Young Adults with Cancer) Departments, Curie Institute, Paris, France
| | - Perrine Marec-Berard
- Pediatrics and Adolescents and Young Adults Oncology Department, Institute of Hematology and Pediatric Oncology, Lyon, France
| | - Camille Cordero
- Adolescents and Young Adults Unit, Medical Oncology and SIREDO (Care, Innovation and Research for Children, Adolescents and Young Adults with Cancer) Departments, Curie Institute, Paris, France
| | - Audrey Thisse
- Pediatrics and Adolescents and Young Adults Oncology Department, Institute of Hematology and Pediatric Oncology, Lyon, France
| | - Christèle Riberon
- Pediatrics and Adolescents and Young Adults Oncology Department, Institute of Hematology and Pediatric Oncology, Lyon, France
| | - Cécile Flahault
- Psychopathology and Health Processes Laboratory, UR 4057, Paris Cité University, Boulogne Billancourt, France.,Psycho-Oncology Unit, Gustave Roussy Hospital, Villejuif, France.,Functional Unit of Psychology and Liaison Psychiatry and Emergency, Adult and Elderly Psychiatry Service, George Pompidou European Hospital, Paris, France
| |
Collapse
|
3
|
Marec-Berard P, Lervat C, Riberon C, Laurence V. Go-AJA : dix ans au profit des adolescents et jeunes adultes atteints de cancers. Bull Cancer 2022; 109:985-987. [DOI: 10.1016/j.bulcan.2022.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 07/18/2022] [Accepted: 07/24/2022] [Indexed: 11/26/2022]
|
4
|
Phan J, Laurence V, Marec-Berard P, Cordero C, Riberon C, Flahault C. La confrontation au deuil d’un pair chez une AJA atteinte de cancer. Une analyse phénoménologique interprétative. PSYCHO-ONCOLOGIE 2022. [DOI: 10.3166/pson-2022-0197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Objectif : Les adolescents et jeunes adultes (AJA) atteints de cancer faisant face à la perte d’un autre AJA malade peuvent être confrontés à une « triple tâche » : le processus d’adolescence, l’ajustement psychologique au cancer et la mort d’un pair malade. L’objectif de l’étude a été d’explorer les processus sous-jacents à la perte d’un pair malade chez les AJA atteints de cancer.
Matériel et méthodes : Un entretien unique a été soumis à une Analyse phénoménologique interprétative (IPA), conçu pour comprendre le système de significations attaché à un phénomène subjectif et intime tel que le deuil.
Résultats : L’IPA a fait émerger six thèmes majeurs : le parcours de vie ; le parcours de soins ; les représentations du cancer, de soi et du monde ; l’ajustement psychologique au cancer ; les relations interpersonnelles ainsi que la perte d’un pair AJA malade. Le récit interprétatif montre la place centrale du processus d’identification aux pairs malades, notamment au défunt, dans la mise en sens du cancer et du deuil. Cette expérience du deuil d’un pair comporte des aspects négatifs (e.g., perspective de sa propre mort, perte de repère, peur de la rechute) et positifs (e.g., sentiment de continuité avec le défunt, changement de perception de soi et du monde).
Conclusion : L’étude montre l’importance de considérer ces processus dans l’accompagnement des AJA atteints de cancer confrontés à la mort d’un pair malade et de proposer des interventions adaptées à cette tranche d’âge.
Collapse
|
5
|
Penel-Page M, Marec-Bérard P, Morelle M, Bertrand A, Riberon C, Boyle H, Perrier L. Management of Febrile Neutropenias in Adolescents and Young Adults: A Cost-Minimization Analysis Between Adult Versus Pediatric Units. J Adolesc Young Adult Oncol 2017; 6:542-550. [PMID: 28678005 DOI: 10.1089/jayao.2017.0035] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE Management of adolescents and young adults (AYAs) differs between adult and pediatric units, especially regarding febrile neutropenia (FN). In our previous study, we found that AYAs treated in adult units were significantly less hospitalized for FN than in pediatric units, without difference in morbimortality. The objective of this work was to assess the economic impact of these practices. METHODS This study retrospectively collected data from the medical records of AYAs treated at the Comprehensive Cancer Center Léon Bérard, Lyon, France, in the Euro-E-W-I-N-G99 protocol between September 1, 2000 and May 31, 2013. We focused on FN occurring after VIDE (vincristine, ifosfamide, doxorubicin, etoposide) courses. Costs were calculated using a micro-costing technique from the hospital's perspective (in 2014-Euro); the time horizon was the induction period. Multivariate analyses were performed on the total cost and cost of FN. Uncertainty was captured by sensitivity analyses. RESULTS Forty-four AYAs (18 in the adult sector, 26 in the pediatric sector) received 260 courses of VIDE. Mean cost of care was €37,544 in the pediatric sector, including €11,948 (32%) for FN (€11,851 in hospitalization), versus €34,677 in the adult sector, including €6,143 (18%) for FN (€5,789 in hospitalization). Cost for FN was significantly higher in pediatric units (difference in mean cost of €5,830 per patient, 95% bootstrapped confidence interval [1,939.1; 10,028.9]). In multivariate analysis, the only factor significantly influencing this cost difference was the sector of care. The most sensitive parameter was the unit cost of conventional hospitalization. CONCLUSION These results support the adult sector strategy, in agreement with the results of our first work showing comparable effectiveness.
Collapse
Affiliation(s)
- Mathilde Penel-Page
- 1 Institut d'Hématologie et d'Oncologie Pédiatrique (IHOP) , Lyon, France .,2 Université Claude Bernard Lyon 1 , Lyon, France
| | - Perrine Marec-Bérard
- 1 Institut d'Hématologie et d'Oncologie Pédiatrique (IHOP) , Lyon, France .,3 Dispositif Adolescents et Jeunes Adultes, IHOP et CLB , Lyon, France
| | - Magali Morelle
- 4 Centre Léon Bérard (CLB) , Lyon, France .,5 GATE L-SE UMR 5824 , Lyon, France
| | - Amandine Bertrand
- 1 Institut d'Hématologie et d'Oncologie Pédiatrique (IHOP) , Lyon, France
| | - Christèle Riberon
- 3 Dispositif Adolescents et Jeunes Adultes, IHOP et CLB , Lyon, France
| | - Helen Boyle
- 3 Dispositif Adolescents et Jeunes Adultes, IHOP et CLB , Lyon, France .,4 Centre Léon Bérard (CLB) , Lyon, France
| | - Lionel Perrier
- 4 Centre Léon Bérard (CLB) , Lyon, France .,5 GATE L-SE UMR 5824 , Lyon, France
| |
Collapse
|
6
|
Penel-Page M, Normand C, Bertrand A, Levard A, Boyle H, Riberon C, Marec-Berard P. [Management of febrile neutropenias in adolescents and young adults: Differences of practice between adult and pediatric units]. Bull Cancer 2015; 102:915-22. [PMID: 26384690 DOI: 10.1016/j.bulcan.2015.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 01/12/2015] [Revised: 07/15/2015] [Accepted: 08/04/2015] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Adolescents and young adults (AYA, 15-25years old) with cancer are treated either in adult or pediatric units. Management of febrile neutropenia (FN) is different between these units. Monitoring rules and indications of hospitalization are often stricter in pediatrics. This study evaluates if these differences influence the occurrence of complications. METHODS The medical records of AYA patients treated in our institution in the Euro-E-W-I-N-G99 protocol between 01/09/2000 and 31/05/2013 were retrospectively analyzed. We studied febrile neutropenias occurring after VIDE courses, during the induction period. RESULTS Forty-four patients were included (18 from adult units, 26 from pediatrics). Median age at inclusion was 19.6. After 260 courses of VIDE, we observed a median of 2 FN per adult and 3 per pediatric patient (P=0.2). Hospitalization occurred in median 1.5 time per adult and 3 per pediatric patient (P=0.008). Median cumulated length of stay was 4.5days for adults versus 16 days for pediatric patients (P=0.008). There was no significant difference for survival, number of documented infections, transfusions, dose modifications, chemotherapy delay, need for intensive care, infection after post-induction surgery. CONCLUSION AYA treated in adult services are less frequently hospitalized for FN with no difference in morbi-mortality. Homogeneous recommendations could be made for these patients, whatever the units they are treated in.
Collapse
Affiliation(s)
- Mathilde Penel-Page
- Institut d'hématologie et d'oncologie pédiatrique (IHOP), 1, place Joseph-Renaut, 69008 Lyon, France; Université Claude-Bernard Lyon 1 69008 Lyon, France.
| | - Charline Normand
- Institut d'hématologie et d'oncologie pédiatrique (IHOP), 1, place Joseph-Renaut, 69008 Lyon, France
| | - Amandine Bertrand
- Institut d'hématologie et d'oncologie pédiatrique (IHOP), 1, place Joseph-Renaut, 69008 Lyon, France
| | - Alice Levard
- Centre Léon-Bérard (CLB), 28, rue Laennec, 69008 Lyon, France
| | - Helen Boyle
- Dispositif adolescents-jeunes adultes, commun au CLB et à l'IHOP (DAJAC), 28, rue Laennec, 69008 Lyon, France
| | - Christèle Riberon
- Dispositif adolescents-jeunes adultes, commun au CLB et à l'IHOP (DAJAC), 28, rue Laennec, 69008 Lyon, France
| | - Perrine Marec-Berard
- Dispositif adolescents-jeunes adultes, commun au CLB et à l'IHOP (DAJAC), 28, rue Laennec, 69008 Lyon, France; Université Claude-Bernard Lyon 1 69008 Lyon, France
| |
Collapse
|