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Strohschein FJ, Qi S, Davidson S, Link C, Watson L. A Retrospective Age Analysis of the Ambulatory Oncology Patient Satisfaction Survey: Differences in Satisfaction across Dimensions of Person-Centred Care and Unmet Needs among Older Adults Receiving Cancer Treatment. Curr Oncol 2024; 31:1483-1503. [PMID: 38534946 PMCID: PMC10969488 DOI: 10.3390/curroncol31030113] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Revised: 03/02/2024] [Accepted: 03/05/2024] [Indexed: 05/26/2024] Open
Abstract
Over half of all new cancer cases in Alberta are diagnosed among people aged 65+ years, a group that encompasses vast variation. Patient-reported experience measures are routinely collected within Cancer Care Alberta; however, the specific consideration of the needs and concerns of older Albertans with cancer is lacking. In 2021, 2204 adults who had received treatment at a cancer centre in Alberta completed the Ambulatory Oncology Patient Satisfaction Survey (AOPSS). In this study, we explored the age differences in satisfaction across six dimensions of person-centred care and in the proportions of unmet needs across eight types of issues, with specific attention to older adults. Using three age groups (18-39, 40-64, 65+), only the physical comfort dimension showed significantly lower satisfaction among those aged 65+ years. Using five age groups (18-39, 40-64, 65-74, 75-84, 85+), significantly lower levels of satisfaction were found related to 'physical comfort' for those aged 65-74 and 75-84, 'coordination and continuity of care' for those aged 75-84 and 85+, and 'information, communication, and education' for those aged 85+. Therefore, grouping together all older adults aged 65+ years obscured lower levels of satisfaction with some dimensions of person-centred care among those aged 75-84 and 85+ years. Unmet needs generally increased with age for all types of issues, with significant differences across age groups for emotional, financial, social/family, and sexual health issues. The lower levels of satisfaction and higher proportions of unmet needs call for tailored interventions to promote optimal care experiences and outcomes among older adults receiving cancer care in Alberta and their families.
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Affiliation(s)
- Fay J. Strohschein
- Faculty of Nursing, University of Calgary, Calgary, AB T2N 1N4, Canada
- Cancer Strategic Clinical Network, Alberta Health Services, Edmonton, AB T5J 3E4, Canada
| | - Siwei Qi
- Applied Research & Patient Experience, Cancer Care Alberta, Alberta Health Services, Calgary, AB T2S 3C3, Canada
| | - Sandra Davidson
- Faculty of Nursing, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Claire Link
- Applied Research & Patient Experience, Cancer Care Alberta, Alberta Health Services, Calgary, AB T2S 3C3, Canada
| | - Linda Watson
- Faculty of Nursing, University of Calgary, Calgary, AB T2N 1N4, Canada
- Applied Research & Patient Experience, Cancer Care Alberta, Alberta Health Services, Calgary, AB T2S 3C3, Canada
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Fitch MI, Nicoll I, Lockwood G, Strohschein FJ, Newton L. Cancer survivors 75 years and older: physical, emotional and practical needs. BMJ Support Palliat Care 2023; 13:e352-e360. [PMID: 33883172 DOI: 10.1136/bmjspcare-2020-002855] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 12/14/2020] [Revised: 03/19/2021] [Accepted: 04/04/2021] [Indexed: 12/30/2022]
Abstract
OBJECTIVES To describe physical, emotional and practical concerns and access to help of Canadian cancer survivors aged 75+ years following treatment. METHODS A survey was designed to identify concerns and access to help across three supportive care domains for cancer survivors 1-3 years post-treatment. Random samples were drawn from 10 provincial cancer registries. Survey packages were mailed to 40 790 survivors with option to reply by mail or online in French or English. Descriptive analysis was conducted. RESULTS In total, 3274 (25%) survivors aged 75+ years responded to the survey. Fifty-five per cent were men, 72% had not experienced metastatic spread and 75% reported comorbid conditions. Eighty-one per cent reported experiencing at least one physical concern, 63% experienced at least one emotional concern and 30% experienced at least one practical concern. The most commonly reported concerns were for two physical changes (fatigue 62% and bladder/urinary problems 39%) and one emotional change (anxiety/fear of recurrence 53%). More than 50% did not receive assistance for 15 concerns across the three domains. The most frequently cited reason for not seeking help for a concern was that they were told it was normal and they did not think anything could be done. Unmet needs existed for all physical, emotional and practical changes ranging from 41% to 88% of respondents. CONCLUSIONS Many older adults are at risk for experiencing physical, emotional and practical concerns following cancer treatment yet are not obtaining help. Action is needed for early identification of these individuals to mitigate the impact of unmet needs for older cancer survivors.
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Affiliation(s)
- Margaret I Fitch
- Bloomberg Faculty of nursing, University of Toronto, Toronto, Ontario, Canada
| | | | | | - Fay J Strohschein
- Department of Nursing, University of Calgary, Calgary, Alberta, Canada
| | - Lorelei Newton
- School of Nursing, University of Victoria, Victoria, British Columbia, Canada
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3
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Nicoll I, Lockwood G, Strohschein FJ, Fitch L, Longo CJ, Newton L, Fitch MI. Relationship between income and concerns about physical changes and help-seeking by older adult cancer survivors: a secondary analysis. BMC Geriatr 2023; 23:184. [PMID: 36991354 PMCID: PMC10061760 DOI: 10.1186/s12877-023-03887-1] [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] [Received: 03/16/2022] [Accepted: 03/13/2023] [Indexed: 03/31/2023] Open
Abstract
OBJECTIVE Globally, the number of older adults surviving cancer is anticipated to grow rapidly over the next decades. Cancer and its treatment can leave survivors with a myriad of challenges including physical changes which impact independence and quality of life. This project explored the relationship of income level with concerns and help-seeking for physical changes following treatment in older Canadian survivors of cancer. METHODS A Canada-wide survey of community-dwelling survivors of cancer explored their experiences with survivorship care one to three years following completion of treatment. A secondary trend analysis examined the relationship of income with older adults' level of concern and help-seeking experiences regarding physical consequences they attributed to their cancer treatment. RESULTS In total, 7,975 people aged 65 years and older who survived cancer responded to the survey, of whom 5,891 (73.9%) indicated annual household income. Prostate (31.3%), colorectal (22.7%) and breast (21.8%) cancer accounted for the majority of respondents. Of those who reported household income data, over 90% wrote about the impact of physical changes following treatment, their concerns about the changes, and whether they sought help for their concerns. The most frequently identified physical challenge was fatigue (63.7%). Older survivors with low annual household incomes of less than $CA25,000 reported the highest levels of concern about multiple physical symptoms. 25% or more of the survey respondents across all income levels reported difficulty finding assistance for their concerns about the physical challenges, especially in their local communities. CONCLUSION Older survivors of cancer can experience a range of physical changes, amenable to intervention by physical therapy, yet experience challenges obtaining relevant help. Those with low income are more severely affected, even within a universal healthcare system. Financial assessment and tailored follow-up are recommended.
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Affiliation(s)
| | | | | | - Lauren Fitch
- Physiotherapist, Riverview, New Brunswick, Canada
| | - Christopher J Longo
- Health Policy and Management, DeGroote School of Business, McMaster University, Hamilton, ON, Canada
| | - Lorelei Newton
- School of Nursing, University of Victoria, Victoria, BC, Canada
| | - Margaret I Fitch
- Bloomberg Faculty of Nursing, University of Toronto, 207 Chisholm Ave, M4C 4V9, Toronto, ON, Canada.
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Pilleron S, Alqurini N, Ferlay J, Haase KR, Hannan M, Janssen-Heijnen M, Kantilal K, Katanoda K, Kenis C, Lu-Yao G, Matsuda T, Navarrete E, Nikita N, Puts M, Strohschein FJ, Morris EJA. International trends in cancer incidence in middle-aged and older adults in 44 countries. J Geriatr Oncol 2022; 13:346-355. [PMID: 34866023 DOI: 10.1016/j.jgo.2021.11.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 08/24/2021] [Accepted: 11/22/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVE We examine international incidence trends of lung, colorectal, prostate, and breast cancers, as well as all cancers combined excluding non-melanoma skin cancer (NMSC) in adults aged 50 and older, over a fifteen-year period using data from 113 high quality population-based cancer registries included in the Cancer in Five Continents (CI5) series and NORDCAN. MATERIALS AND METHODS We calculated annual incidence rates between 1998 and 2012 for ages 50-64, 65-74, and 75+, by sex and both sexes combined. We estimated average annual percentage change (AAPC) in rates using quasi-Poisson regression models. RESULTS From 1998 to 2012, incidence trends for all cancers (excluding NMSC) have increased in most countries across all age groups, with the greatest increase observed in adults aged 75+ in Ecuador (AAPC = +3%). Colorectal cancer incidence rates increased in the majority of countries, across all age groups. Lung cancer rates among females have increased but decreased for males. Prostate cancer rates have sharply increased in men aged 50-64 with AAPC between 5% and 15% in 24 countries, while decreasing in the 75+ age group in 21 countries, by up to -7% in Bahrain. Female breast cancer rates have increased across all age groups in most countries, especially in the 65-74 age group and in Asia with AAPC increasing to 7% in the Republic of Korea. CONCLUSIONS These findings assist with anticipating changing patterns and needs internationally. Due to the specific needs of older patients, it is urgent that cancer systems adapt to address their growing number.
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Affiliation(s)
- Sophie Pilleron
- Nuffield Department of Population Health, Big Data Institute, University of Oxford, Oxford, UK.
| | - Naser Alqurini
- Central Department of Primary Health Care, Geriatric Unit- Amiri Hospital, Ministry of Health, Kuwait City, Kuwait
| | - Jacques Ferlay
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Kristen R Haase
- Faculty of Applied Science, School of Nursing, University of British Columbia, Vancouver, BC, Canada.
| | - Michelle Hannan
- Department of Medical Oncology, University Hospital Waterford, Ireland.
| | - Maryska Janssen-Heijnen
- Department of Clinical Epidemiology, VieCuri Medical Centre, Venlo, the Netherlands; Department of Epidemiology, Maastricht University Medical Centre+, GROW School for Oncology and Developmental Biology, Maastricht, the Netherlands.
| | - Kumud Kantilal
- School of Pharmacy, University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ, UK.
| | - Kota Katanoda
- Division of Cancer Statistics Integration, Center for Cancer Control and Information Services, National Cancer Center, Japan.
| | - Cindy Kenis
- Department of General Medical Oncology and Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium; Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven - University of Leuven, Leuven, Belgium.
| | - Grace Lu-Yao
- Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, USA; Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA 19107, USA; Division of International Collaborative Research, Center for Public Health Sciences, National Cancer Center, Japan.
| | - Tomohiro Matsuda
- Division of International Collaborative Research, Center for Public Health Sciences, National Cancer Center, Japan.
| | - Erna Navarrete
- Departamento de Terapia Ocupacional y Ciencia de la Ocupación, Facultad de Medicina, Universidad de Chile, Chile.
| | - Nikita Nikita
- Sidney Kimmel Cancer Center at Jefferson Health, Philadelphia, PA, USA
| | - Martine Puts
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto. Canada.
| | | | - Eva J A Morris
- Nuffield Department of Population Health, Big Data Institute, University of Oxford, Oxford, UK
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Fitch MI, Nicoll I, Newton L, Strohschein FJ. Challenges of Survivorship for Older Adults Diagnosed with Cancer. Curr Oncol Rep 2022; 24:763-773. [PMID: 35286555 PMCID: PMC8918886 DOI: 10.1007/s11912-022-01255-7] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2022] [Indexed: 11/26/2022]
Abstract
Purpose of Review The purpose of this brief review is to highlight significant recent developments in survivorship research and care of older adults following cancer treatment. The aim is to provide insight into care and support needs of older adults during cancer survivorship as well as directions for future research. Recent Findings The numbers of older adult cancer survivors are increasing globally. Increased attention to the interaction between age-related and cancer-related concerns before, during, and after cancer treatment is needed to optimize outcomes and quality of life among older adult survivors. Issues of concern to older survivors, and ones associated with quality of life, include physical and cognitive functioning and emotional well-being. Maintaining activities of daily living, given limitations imposed by cancer treatment and other comorbidities, is of primary importance to older survivors. Evidence concerning the influence of income and rurality, experiences in care coordination and accessing services, and effectiveness of interventions remains scant for older adults during survivorship. Summary There is a clear need for further research relating to tailored intervention and health care provider knowledge and education. Emerging issues, such as the use of medical assistance in dying, must be considered in this population.
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Affiliation(s)
- Margaret I. Fitch
- Bloomberg Faculty of Nursing, University of Toronto, 207 Chisholm Ave, Toronto, ON M4C 4V9 Canada
| | | | - Lorelei Newton
- School of Nursing, STN CSC, University of Victoria, PO Box 1700, Victoria, BC V8W 2Y2 Canada
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Strohschein FJ, Newton L, Puts M, Jin R, Haase K, Plante A, Loucks A, Kenis C, Fitch M. Optimiser les soins des adultes âgés atteints de cancer et l'accompagnement de leurs proches: énoncé de position et contribution des infirmières canadiennes en oncologie. Can Oncol Nurs J 2021; 31:357-362. [PMID: 34395844 PMCID: PMC8320801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023] Open
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7
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Strohschein FJ, Newton L, Puts M, Jin R, Haase K, Plante A, Loucks A, Kenis C, Fitch M. Optimizing the Care of Older Canadians with Cancer and their Families: A Statement Articulating the Position and Contribution of Canadian Oncology Nurses. Can Oncol Nurs J 2021; 31:352-356. [PMID: 34395843 PMCID: PMC8320798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023] Open
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Haase KR, Strohschein FJ, Horill TC, Lambert LK, Powell TL. A survey of nurses' experience integrating oncology clinical and academic worlds. Nurs Open 2021; 8:2840-2849. [PMID: 33836124 PMCID: PMC8363415 DOI: 10.1002/nop2.868] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 01/31/2021] [Accepted: 02/19/2021] [Indexed: 11/25/2022] Open
Abstract
Aim To better understand how oncology nurses (a) navigate graduate studies; (b) perceive the impact of their academic work on their clinical practice, and vice versa; and (c) engage with clinical settings following graduate work. Design Interpretive descriptive cross‐sectional survey. Methods A qualitative exploratory web‐based survey exploring integration of graduate studies and clinical nursing practice. Results About 87 participants from seven countries responded. 71% were employed in clinical settings, 53% were enrolled in/graduated from Master's programs; 47% were enrolled in/graduated from doctoral programs. Participants had diverse motivations for pursuing graduate studies and improving clinical care. Participants reported graduate preparation increased their ability to provide quality care and conduct research. Lack of time and institutional structures were challenges to integrating clinical work and academic pursuits. Conclusions Given the many constraints and numerous benefits of nurses engaging in graduate work, structures and strategies to support hybrid roles should be explored.
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Affiliation(s)
- Kristen R Haase
- School of Nursing, The University of British Columbia, Vancouver, BC, Canada
| | | | - Tara C Horill
- College of Nursing, University of Manitoba, Winnipeg, MB, Canada
| | - Leah K Lambert
- School of Nursing, The University of British Columbia, Vancouver, BC, Canada.,BC Cancer, Vancouver, BC, Canada
| | - Tracy L Powell
- School of Nursing and Midwifery, Mount Royal University, Calgary, AB, Canada
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Abstract
PURPOSE OF REVIEW The number of individuals aged 65+ with cancer will double in the next decade. Attention to quality of life (QOL) is imperative to identify relevant endpoints/outcomes in research and provide care that matches individual needs. This review summarizes recent publications regarding QOL measurement in older adults with cancer, considering implications for research and practice. RECENT FINDINGS QOL is a complex concept and its measurement can be challenging. A variety of measurement tools exist, but only one specific to older adults with cancer. QOL is frequently measured as functional health, adverse symptoms, and global QOL, thus only capturing a portion of this concept. Yet successful QOL intervention for older adults requires drawing from behavioral and social dimensions.Growing interest in comprehensive geriatric assessment (CGA) and patient-reported outcomes (PROs) provides important opportunities for measuring QOL. Recommendations for use of CGAs and PROs in clinical practice have been made but widespread uptake has not occurred. SUMMARY QOL is important to older adults and must be central in planning and discussing their care. It is modifiable but presents measurement challenges in this population. Various domains are associated with decline, survival, satisfaction with life, coping, and different interventions. Measurement approaches must fit with intention and capacity to act within given contexts.
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Affiliation(s)
- Margaret I Fitch
- Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Fay J Strohschein
- Oncology and Aging Program, Jewish General Hospital, Montreal, Canada, Nursing Research Consultant, Wainwright, Alberta
| | - Kirsten Nyrop
- Division of Oncology, School of Medicine, Lineberger Comprehensive Cancer Center, Deputy Director/Research - Geriatric Oncology Program, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Puts M, Oldenmenger WH, Haase KR, Sattar S, Strohschein FJ, Stolz Baskett P, Nightingale G, Newton L, Jin R, Loucks A, Fitch MI, Kenis C. Optimizing care for older adults with cancer: International Society of Geriatric Oncology Nursing and Allied Health Interest Group and European Oncology Nursing Society survey results from nurses regarding challenges and opportunities caring for older adults with cancer. J Geriatr Oncol 2021; 12:971-979. [PMID: 33632642 DOI: 10.1016/j.jgo.2021.02.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 02/10/2021] [Accepted: 02/12/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Martine Puts
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
| | - Wendy H Oldenmenger
- Erasmus MC Cancer Institute, University Medical Center Rotterdam, Department of Medical Oncology, Rotterdam, the Netherlands
| | - Kristen R Haase
- School of Nursing, Faculty of Applied Science, University of British Columbia, Vancouver, BC, Canada
| | - Schroder Sattar
- College of Nursing, University of Saskatchewan, Regina, Saskatchewan, Canada
| | | | | | - Ginah Nightingale
- Department of Pharmacy Practice, Jefferson College of Pharmacy, Thomas Jefferson University, Philadelphia, PA, USA
| | - Lorelei Newton
- School of Nursing, University of Victoria, Victoria, BC, Canada
| | - Rana Jin
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Allison Loucks
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Margaret I Fitch
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Cindy Kenis
- Department of General Medical Oncology and Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium
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Fitch MI, Nicoll I, Lockwood G, Newton L, Strohschein FJ. Improving survivorship care: Perspectives of cancer survivors 75 years and older. J Geriatr Oncol 2020; 12:453-460. [PMID: 32962951 DOI: 10.1016/j.jgo.2020.09.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 09/08/2020] [Accepted: 09/10/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE This work describes perspectives of older adult cancer survivors about improvements that should be considered during the early period of survivorship. Findings will be useful in program development of age-appropriate services following completion of cancer treatment for older adults. METHODS A national survey was conducted across ten Canadian provinces to understand follow-up experiences of cancer survivors one to three years post-treatment. The survey included open-ended questions enabling respondents to offer insight into their experiences. This publication presents analysis of responses from older adults (75+ years) about suggestions for improving survivorship care. RESULTS In total, 3274 older adults (75+ years) responded to the survey and 1424 responded to the question about improvements. Fifty-five percent of the older adults were male, 28% had experienced metastatic disease and 75% reported comorbid conditions. A total of 640 respondents offered 932 suggestions in the areas of service delivery (n = 763, 81.9%), support (n = 108, 11.6%), and practical assistance (n = 61, 6.5%). Improvements in information/communication (n = 291) and follow-up care (n = 180) accounted for the highest number of suggestions regarding service delivery. Thematic analysis revealed three key messages about improvement: 'offer me needed support', 'make access easy for me', and 'show me you care'. CONCLUSION Suggestions for improvement in survivorship care by older adults treated for cancer emphasize need for changes in the approaches taken by health care providers in interactions and organization of care delivery. Proactive provision of information, detailed schedules for follow-up care, and ease of access to post-treatment care are needed.
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Affiliation(s)
- Margaret I Fitch
- Bloomberg Faculty of Nursing, University of Toronto, 207 Chisholm Ave, Toronto, Ontario M4C 4V9, Canada.
| | | | | | - Lorelei Newton
- School of Nursing, University of Victoria, PO Box 1700 STN CSC, Victoria, BC V8W 2Y2, Canada.
| | - Fay J Strohschein
- Oncology and Aging Program, Jewish General Hospital, Wainwright, Montreal, Alberta, Canada.
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Watson L, Fitch M, Mushani T, Savage P, Strohschein FJ, Puts MTE, Kenis C, Newton L, McQuestion M. CANO/ACIO International Symposium: Working in partnership within and beyond our Canadian borders to enhance oncology care. Can Oncol Nurs J 2019; 29:210-215. [PMID: 31966009 PMCID: PMC6970470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023] Open
Affiliation(s)
- Linda Watson
- President, Canadian Association of Nurses in Oncology. Scientific Director, Applied Research and Patient Experience, Cancer Control Alberta, Alberta Health Services. Assistant Professor (Adjunct), Faculty of Nursing, University of Calgary
| | - Margaret Fitch
- Professor (Adjunct), Bloomberg Faculty of Nursing, University of Toronto, Editor in Chief, CONJ
| | - Tayreez Mushani
- Advance Practice Nurse Educator, Princess Margaret Cancer Centre, University Health Network, Adjunct Faculty, Aga Khan University
| | - Pamela Savage
- Director of Professional Practice, Princess Margaret Cancer Centre, University Health Network
| | - Fay J Strohschein
- Doctoral Candidate, Ingram School of Nursing, McGill University, Montreal, QC. Co-Chair, Oncology and Aging Special Interest Group, CANO/ACIO
| | - Martine T E Puts
- Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON. Co-chair, Nursing and Allied Health Interest Group, SIOG
| | - Cindy Kenis
- Clinical Nurse Specialist, Departments of General Medical Oncology and Geriatric Medicine, University Hospitals Leuven, Belgium. Co-chair, Nursing and Allied Health Interest Group, SIOG
| | - Lorelei Newton
- Assistant Professor, School of Nursing, University of Victoria, Victoria, BC. Co-Chair, Oncology and Aging Special Interest Group, CANO/ACIO
| | - Maurene McQuestion
- Clinical Nurse Specialist, H&N Site Group, Radiation Medicine Program. Co-Lead H&N Survivorship Programme, Princess Margaret Cancer Centre. Adjunct Lecturer, Bloomberg Faculty of Nursing, University of Toronto
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Strohschein FJ, Newton LJ. Sens et motivation dans les soins infirmiers en oncologie auprès des personnes âgées : de la conférence au groupe d’intérêt. Can Oncol Nurs J 2018; 28:95-101. [DOI: 10.5737/2368807628295101] [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] [Indexed: 11/05/2022] Open
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Strohschein FJ, Newton LJ. Mobilizing purpose and passion in oncology nursing care of older adults: From conference workshop to special interest group. Can Oncol Nurs J 2018; 28:89-94. [PMID: 31148803 DOI: 10.5737/236880762828994] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
In Canada, 45% of new cancer cases and 63% of cancer deaths occur amongst Canadians 70 years and older. These older people with cancer and their families present particular needs and concerns that often remain under-recognized and unmet. As the number of older Canadians is expected to more than double in the next 25 years, we must integrate understanding of aging into oncology nursing practice, education, policy, and research, developing models of care that optimize appropriate outcomes for older adults. We present the Canadian Association of Nurses in Oncology (CANO) Oncology and Aging Special Interest Group (SIG), as an initiative to mobilize oncology nurses in addressing these concerns. In an overview of the 2015 CANO conference workshop that launched this group, we highlight practice concerns and priorities identified through interactive discussion with participants. We also describe development of the SIG since 2015, including objectives that will define next steps.
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Affiliation(s)
- Fay J Strohschein
- Doctoral Candidate, Ingram School of Nursing, McGill University/Nursing Counsellor, Oncology & Aging Program, Segal Cancer Centre, Jewish General Hospital, 3755 Côte-Sainte-Catherine Rd, Montreal, QC H3T 1E2,
| | - Lorelei J Newton
- Faculty, Nursing, Health & Human Services, Camosun College, 3100 Foul Bay Road, Victoria, BC V8P 5J2,
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Duthie K, Strohschein FJ, Loiselle CG. Living with cancer and other chronic conditions: Patients' perceptions of their healthcare experience. Can Oncol Nurs J 2017; 27:43-48. [PMID: 31148776 DOI: 10.5737/236880762714348] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Multimorbidity is known to contribute to the complexity of care for patients with cancer. This qualitative study begins to explore cancer patients' experience with multimodal treatments, that is, treatments for multiple chronic conditions, as well as issues related to navigating the healthcare system. Participants (n=10) were recruited from an ambulatory cancer centre in a large, university-affiliated hospital in Montreal, Quebec. Important challenges were reported in terms of striking a fine balance between acute health needs and underlying ongoing chronic condition(s), experiencing unforeseen treatment complications, and negotiating silos across medical specialties. Participants also wished to be better known by the healthcare team. When reporting a positive care coordination experience, participants often attributed it to the intervention by a nurse navigator. Lastly, participants expected a more personalized care approach and would have liked to be included in multidisciplinary board meetings. Study results underscore the impetus to better integrate care across diseases, enhance person-centred care, and support patients who strive to balance competing needs when facing multimorbidity.
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Affiliation(s)
- Kia Duthie
- Staff Nurse, BC Cancer Agency, 401 - 122, Walter Hardwick Ave, Vancouver, BC V5Y 0C9, 514-726-3902;
| | - Fay J Strohschein
- Ingram School of Nursing, McGill University, Nursing Counsellor, Segal Cancer Centre, Jewish General Hospital, 3755 Côte-Sainte-Catherine, Rd, Pav. H-304.4, Montreal, QC H3T 1E2, 514-340-8222 ext. 3864;
| | - Carmen G Loiselle
- Associate Professor, Department of Oncology and Ingram School of Nursing, McGill University, Co-Director (Academic) and Senior Investigator, Segal Cancer Centre, Jewish General Hospital, 3755 Côte-Sainte-Catherine Rd, Pav. E-748, Montreal, QC H3T 1E2, 514-340-8222 ext. 3940;
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Chaturvedi SK, Strohschein FJ, Saraf G, Loiselle CG. Communication in cancer care: psycho-social, interactional, and cultural issues. A general overview and the example of India. Front Psychol 2014; 5:1332. [PMID: 25452741 PMCID: PMC4233911 DOI: 10.3389/fpsyg.2014.01332] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 11/03/2014] [Indexed: 12/02/2022] Open
Abstract
Communication is a core aspect of psycho-oncology care. This article examines key psychosocial, cultural, and technological factors that affect this communication. Drawing from advances in clinical work and accumulating bodies of empirical evidence, the authors identify determining factors for high quality, efficient, and sensitive communication and support for those affected by cancer. Cancer care in India is highlighted as a salient example. Cultural factors affecting cancer communication in India include beliefs about health and illness, societal values, integration of spiritual care, family roles, and expectations concerning disclosure of cancer information, and rituals around death and dying. The rapidly emerging area of e-health significantly impacts cancer communication and support globally. In view of current globalization, understanding these multidimensional psychosocial, and cultural factors that shape communication are essential for providing comprehensive, appropriate, and sensitive cancer care.
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Affiliation(s)
- Santosh K Chaturvedi
- Department of Psychiatry, National Institute of Mental Health and Neurosciences Bangalore, India
| | - Fay J Strohschein
- Ingram School of Nursing, McGill University Montreal, QC, Canada ; Segal Cancer Center, Jewish General Hospital Montreal, QC, Canada
| | - Gayatri Saraf
- Psychiatry, National Institute of Mental Health and Neurosciences Bangalore, India
| | - Carmen G Loiselle
- Ingram School of Nursing, McGill University Montreal, QC, Canada ; Segal Cancer Center, Jewish General Hospital Montreal, QC, Canada
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Abstract
Patient decision making is an area of increasing inquiry. For older individuals experiencing cancer, variations in health and functional status, physiologic aspects of aging, and tension between quality and quantity of life present unique challenges to treatment-related decision making. We used the pragmatic utility method to analyze the concept of patient decision making in the context of older individuals with cancer. We first evaluated its maturity in existing literature and then posed analytical questions to clarify aspects found to be only partially mature. In this context, we found patient decision making to be an ongoing process, changing with time, reflecting individual and relational components, as well as analytical and emotional ones. Assumptions frequently associated with patient decision making were not consistent with the empirical literature. Careful attention to the multifaceted components of patient decision making among older individuals with cancer provides guidance for research, supportive interventions, and targeted follow-up care.
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Strohschein FJ, Merry L, Thomas J, Gagnon AJ. Strengthening data quality in studies of migrants not fluent in host languages: a Canadian example with reproductive health questionnaires. Res Nurs Health 2010; 33:369-79. [PMID: 20572094 DOI: 10.1002/nur.20390] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The need to collect health data from refugees and asylum seekers often requires that questionnaires be translated. Verifying the clarity, meaning, and acceptability of translated questionnaires with monolingual persons, individuals from the target population who primarily speak and understand only the test language, is one important step in the translation process. Reproductive health questionnaires were tested with persons monolingual in Hindi, Tamil, Urdu, Spanish, and French. Testing revealed problematic questions and how culture, education, and migration experience can affect perceptions of questions. Bilingual liaisons from the communities of interest facilitated recruitment of participants, but liaisons' vulnerable status and lack of familiarity with research posed challenges to the testing process. When conducting monolingual testing it is important to: carefully select liaisons (consider their gender, host-language fluency, knowledge of research processes, and comfort with the subject matter of the research); recruit monolingual persons with characteristics representative of the research population; ensure adequate researcher involvement in all aspects of the testing process to triangulate data collection from various sources.
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Affiliation(s)
- Fay J Strohschein
- School of Nursing, McGill University, 3506 University Street, Montreal, Quebec, H3A 2A7, Canada
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Chan KM, Strohschein FJ, Rydz D, Allidina A, Shuaib A, Westbury CF. Randomized controlled trial of modafinil for the treatment of fatigue in postpolio patients. Muscle Nerve 2005; 33:138-41. [PMID: 16175627 DOI: 10.1002/mus.20437] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The purpose of this study was to test whether modafinil is effective in alleviating the symptoms of fatigue in postpolio patients, because it has been helpful for such symptoms in other neurologic disorders. Using a double-blind, randomized, placebo-controlled cross-over design, 14 postpolio patients with moderate to severe fatigue were assigned to receive modafinil or placebo first. Piper Fatigue Scale, Epworth Sleepiness Scale, digit span, and reaction time tests were done at baseline and then at weekly intervals. The Piper Fatigue Scale scores improved by 27 +/- 40% (mean +/- SD) following modafinil and by 43 +/- 36% following placebo. Scores for most of the other tests did not change during the study. Therefore, we conclude that modafinil was not effective in alleviating the symptoms of fatigue in postpolio patients.
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Affiliation(s)
- K Ming Chan
- Division of Physical Medicine and Rehabilitation, 513 Heritage Medical Research Centre, University of Alberta, Edmonton, Alberta T6G 2S2, Canada.
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Abstract
A rare cause of ulnar nerve compression at the elbow is presented in this report. A 42 year old right-handed mechanic developed subacute, progressive numbness, tingling and weakness in his right hand. Electrophysiologic studies demonstrated a severe conduction block affecting the ulnar nerve in the retrotrochlear groove but without any sign of major axonal loss. His hand functions were carefully studied prior to surgery. While fine motor tasks were not affected, the hand strength was markedly diminished. At surgery, a 1-cm diameter intraneural ganglion at the site of the conduction block was found and excised. The patient made a dramatic recovery within 6 weeks post-surgery. The conduction block completely resolved and the hand functions also returned to normal. This and other reported cases point to the importance of early diagnosis and intervention.
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Affiliation(s)
- K Ming Chan
- Division of Physical Medicine and Rehabilitation, University of Alberta, 513 Heritage Medical, Research Center, Alta., T6G 2S2, Edmonton, Canada.
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Abstract
Many post-polio patients develop new muscle weakness decades after the initial illness. However, its mechanism and treatment are controversial. The purpose of this study was to test the hypotheses that: (1) after strength training, post-polio patients show strength improvement comparable to that seen in the healthy elderly; (2) such training does not have a deleterious effect on motor unit (MU) survival; and (3) part of the strength improvement is due to an increase in voluntary motor drive. After baseline measures including maximum voluntary contraction force, voluntary activation index, motor unit number estimate, and the tetanic tension of the thumb muscles had been determined, 10 post-polio patients with hand involvement were randomized to either the training or control group. The progressive resistance training program consisted of three sets of eight isometric contractions, three times weekly for 12 weeks. Seven healthy elderly were also randomized and trained in a similar manner. Changes in the baseline parameters were monitored once every 4 weeks throughout the training period. The trained post-polio patients showed a significant improvement in their strength (P < 0.05). The magnitude of gain was greater than that seen in the healthy elderly (mean +/- SE, 41 +/- 16% vs. 29 +/- 8%). The training did not adversely affect MU survival and the improvement was largely attributable to an increase in voluntary motor drive. We therefore conclude that moderate intensity strength training is safe and effective in post-polio patients.
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Affiliation(s)
- K Ming Chan
- Division of Physical Medicine and Rehabilitation, Faculty of Medicine, 513 Heritage Medical Research Center, University of Alberta, Edmonton, Alberta T6G 2S2, Canada.
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Strohschein FJ, Kelly CG, Clarke AG, Westbury CF, Shuaib A, Chan KM. Applicability, validity, and reliability of the Piper Fatigue Scale in postpolio patients. Am J Phys Med Rehabil 2003; 82:122-9. [PMID: 12544758 DOI: 10.1097/00002060-200302000-00007] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To identify a scale that is potentially applicable for measuring the fatigue in postpolio patients and to evaluate its validity and reliability in this population. DESIGN Interview survey of 64 individuals with postpolio syndrome and 25 healthy controls of similar age range, with retest in a subset of postpolio patients. The sample was recruited from a postpolio support group, a postpolio clinic, and the general community. Subjects completed the Piper Fatigue Scale, the Beck Depression Inventory, and the Chalder Fatigue Questionnaire during the interview. RESULTS Face and content validity of the Piper Fatigue Scale was established by a team of experts and by a group of postpolio patients. The postpolio subjects had significantly higher Piper Fatigue Scale scores than the healthy control subjects (P < 0.001), demonstrating extreme groups validity. Convergent validity was shown with a strong positive correlation between Piper Fatigue Scale scores and Chalder Fatigue Questionnaire scores (r = 0.80). Reliability was also demonstrated with the Piper Fatigue Scale's high internal consistency (alpha = 0.98) and strong test-retest agreement (intraclass correlation coefficient = 0.98). CONCLUSIONS The Piper Fatigue Scale is a valid and reliable tool for measuring postpolio fatigue. This scale may be useful in other studies of postpolio fatigue, including those gauging the effectiveness of various treatments for this fatigue.
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Abstract
OBJECTIVE The goal of this study was to compare the relative contributions from the muscle and the central nervous system to muscle fatigue resistance in aging. METHODS Each subject carried out 90 s of sustained maximal voluntary isometric contraction (MVC) of the thumb using the thenar and forearm thumb muscles. Contractile capacity of the thenar muscles was assessed through tetanic stimulation of the median nerve. Interpolated doublets delivered during an MVC represented the overall voluntary activation level while transcranial cortical stimulation with an electromagnetic stimulator was used to assess motor output upstream from the corticomotoneuronal pathway. RESULTS Nine elderly subjects [four females and five males, 70+/-9 years old (mean+/-SD)] and 10 younger subjects (five females and five males, 30+/-6 years old) were tested. After the fatiguing exercise, the elderly group's MVC declined by 29% as opposed to 47% in the younger group (p<0.01). The elderly group's greater fatigue resistance was accounted for by increased fatigue resistance at the muscle level as well as in the central nervous system. At least some of the decline in the central motor drive was upstream from the corticomotoneuronal pathway. CONCLUSION The higher muscle fatigue resistance in the elderly group was attributable to differences in both the peripheral and central nervous systems.
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Affiliation(s)
- K M Chan
- Division of Physical Medicine and Rehabilitation, Faculty of Medicine, University of Alberta, Edmonton, Canada
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Abstract
OBJECTIVE To evaluate the risk of stimulating the same motor axon at different points along the median nerve when using the multiple point stimulation (MPS) technique and how this affects the accuracy of the motor unit number estimate (MUNE). METHODS Using the MPS technique, MUNE in the median innervated intrinsic hand muscles was done on two normal subjects, a patient with carpal tunnel syndrome and one with prior poliomyelitis. The collision technique was then used to confirm whether two motor unit action potentials (MUAPs) with similar configurations and sizes were generated by the same motor unit. A new MUNE was recalculated after the repeated inclusion of the same motor unit had been excluded. RESULTS While the risk of stimulating the same motor axon at widely separate locations of the median nerve was negligible in normal subjects, this risk was much higher in patients with a depleted motor neuron pool. This resulted in marked distortion of the calculated size of the average single MUAP and, consequently, inaccuracy of the MUNE. CONCLUSIONS The inadvertent inclusion of the same motor units, if not recognized, can markedly affect the accuracy of the MUNE. The collision technique can be useful in minimizing this risk.
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Affiliation(s)
- Y Aoyagi
- Division of Neuroscience, 513 Heritage Medical Research Center, University of Alberta, Edmonton, T6G 2S2, Alberta, Canada
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