European Journal of Cancer Care最新文献

Introduction: Cancer is a major global health concern with modifiable risk factors such as tobacco use, alcohol consumption, unhealthy diet, and physical inactivity. Low public awareness of evidence-based risk factors and common cancer myths hamper prevention efforts. This study evaluated the awareness of evidence-based risk factors and the prevalence of cancer myths among patients in Denizli, Türkiye.

Methods: This cross-sectional study was conducted at Pamukkale University Hospital between 1 February 2024 and 15 February 2024. A total of 747 participants were recruited. Data were collected using a structured questionnaire that assessed awareness of both evidence-based cancer risk factors and cancer myths. The questionnaire included the Cancer Awareness Measure Mythical Causes Scale (CAM-MYCS) and a scale assessing evidence-based cancer risk factors. Statistical analyses included Pearson correlation and backward linear regression.

Results: The mean CAM-MYCS score was 20.9 ± 26.4, reflecting substantial variability in beliefs about cancer myths. The mean score for the evidence-based cancer risk factor scale was 57.3 ± 23.1, suggesting a moderate awareness of evidence-based cancer risk factors. The mean total cancer awareness score was 44.1 ± 16.6, reflecting an overall moderate level of cancer awareness. Linear regression analysis identified higher education, seeking information from healthcare professionals and scientific books/articles, and self-perceived knowledge of cancer prevention as significant predictors of total cancer awareness.

Conclusion: This study highlights that despite a moderate level of awareness of evidence-based cancer risk factors, the high prevalence of cancer myths contributes to inadequate awareness of evidence-based cancer risk factors among the Turkish population. Targeted educational interventions are necessary to correct misconceptions and promote evidence-based knowledge to reduce the risk of cancer.

Background: This study aims to specifically review the efficacy of mindfulness-based interventions (MBIs) for breast cancer patients undergoing chemotherapy.

Methods: Five databases (PubMed, Embase, Cochrane, Web of Science, and CINAHL) were searched to collect relevant randomized controlled trials (RCTs). A total of 1869 articles were initially retrieved, of which 8 met the inclusion criteria. The search cutoff date was May 1, 2024. Included studies met prespecified inclusion and exclusion criteria. Data analysis was performed using RevMan 5.4 and STATA/SE 15.0 software.

Results: This study included 8 studies. The findings revealed statistically significant improvements in anxiety, depression levels, and quality of life among patients undergoing MBIs compared to those receiving standard care, with a statistically significant difference [SMD = −0.72, 95% CI (−1.07, −0.37), p = 0.040], [SMD = −0.72, 95% CI (−1.07, −0.38), p = 0.026], and [SMD = 0.51, 95% CI (0.22, 0.81), p = 0.037], respectively.

Conclusions: MBIs have been shown to significantly enhance the psychological well-being and quality of life in breast cancer patients undergoing chemotherapy. Despite certain limitations, MBIs hold substantial promise for clinical use as a complementary therapy and warrant further investigation through larger-scale RCTs. Moreover, future studies should examine the reactions of breast cancer patients from various cultural backgrounds to MBIs, with the goal of refining intervention strategies to better serve a diverse population.

Background: Palliative care focuses on end-of-life patients and their family members (caregivers) to control pain and discomfort symptoms in end-of-life patients and provides comprehensive physical, psychological, and spiritual care to improve quality of life and help patients die comfortably, peacefully, and with dignity. This study aims to develop a scientific and comprehensive palliative care service framework based on expert consensus to provide a reference and basis for palliative care practices for end-of-life adult patients in medical institutions.

Methods: This study designed three rounds of expert inquiry via the Delphi method, involving a total of 21 experts from diverse fields, including geriatrics, geriatric nursing, palliative care, hospice care, traditional Chinese medicine, death education, anesthesia, ethics, and psychology.

Results: The final framework comprises five first-level categories, namely, service process and requirements, symptom management, comfort care, psychological and social support, and complementary therapy, which are supported by 16 second-level and 37 third-level items. The expert authority coefficients (0.900–0.910) and Kendall’s W (0.330–0.489, p < 0.001) indicated high reliability and consensus.

Conclusions: This study, which is based on the Delphi method, has formulated a framework for palliative care services tailored to the needs of end-of-life adult patients in medical institutions. The content of the developed service framework is clear and relatively comprehensive. The results of this study are conducive to promoting the development and practice of Palliative Care and Hospice in China, thereby enhancing the quality of death for end-of-life adult patients.

Purpose: The aim of the study is to adapt the “Cancer Care Evaluation Scale” to Turkish and to test its validity and reliability.

Methods: The research was conducted methodologically. The data of the study were obtained from patients in a university hospital in eastern Türkiye between January and April 2023. The research was carried out with 350 people who met the inclusion criteria. The data were collected by the researchers using the “Patient Information Form” and the “Cancer Care Evaluation Scale.” Content validity index (CVI), Bartlett’s test of sphericity, Kaiser–Meyer–Olkin (KMO) index, and confirmatory factor analysis (CFA) were used to find out the content and construct validity. Cronbach’s alpha coefficient, split-half reliability analysis, and correlation analysis were used to test reliability.

Results: As a result of the evaluations and analyses, the CVI of the scale was found to be as 0.94. The Cronbach’s alpha value of the subdimensions of the scale ranged from 0.843 to 0.975 and the total Cronbach’s alpha value was found to be 0.948. In the split-half reliability analysis, Spearman–Brown’s coefficient was found to be 0.989. The fit index values were found to be as follows: X²/SD = 2.57, RMSEA = 0.067, GFI = 0.83, CFI = 0.955, and SRMR = 0.062. CFA results showed good fit index values.

Conclusion: As a result of the research, the factor structure of 35 items and 12 subdimensional scales was confirmed by CFA. It was determined that the Turkish version of the Cancer Care Evaluation Scale is a valid and reliable measurement tool to evaluate the care of cancer patients. The scale allows the care offered to cancer patients to be evaluated from the patient’s perspective. For this reason, it is thought that the scale will contribute to the identification of deficiencies in care and the improvement of the quality of care.

Introduction: The increasing survival rates among patients with advanced cancer have brought attention to the issue of work participation for working-age individuals, while current studies predominantly focus on early-stage cancer patients. The objective of this scoping review was to summarize the current knowledge regarding the work participation of patients diagnosed with advanced-stage cancer.

Methods: A scoping review was conducted following Mak and Thomas’s guidelines and adhering to PRISMA-ScR standards. Three databases (PubMed, Web of Science, and PsycINFO) were systematically searched for articles published up to December 2023. An update was performed in September 2024. We included English and French studies on patients with advanced cancer, aged 18 years and over, with a focus on their work participation. The results are presented according to the arena model, which provides a framework for understanding different dimensions of work participation.

Results: Ten studies, primarily focusing on breast cancer, were included after screening 239 records. Key findings revealed that older women and certain ethnic groups face greater challenges in maintaining employment, with treatment side effects such as pain, fatigue, and cognitive impairment having a significant impact on work participation. The research emphasized the need for improved support and information from the healthcare system regarding employment issues.

Conclusion: This scoping review addresses the challenges of work participation for patients with advanced cancer, identifying personal, psychological, and workplace barriers. It emphasizes the need for tailored interventions and highlights a significant gap in healthcare professionals’ guidance on employment issues. Expanding research beyond breast cancer is essential to improve work participation for this population. The predominance of breast cancer in the current literature underscores the urgent need for broader research that includes a wider range of tumor types and male patients, in order to ensure that work participation strategies are inclusive and equitable.

Background: Disruptions in activity-rest rhythms are common in terminal cancer patients, yet continuous monitoring of these changes is challenging. The effects of opioids and psychotropic drugs on sleep quality remain inadequately understood.

Objectives: (i) To objectively evaluate temporal changes in diurnal (8:00 a.m.–8:00 p.m.) and nocturnal (8:00 p.m.–8:00 a.m.) activity-rest rhythms over the final 2 weeks of life in terminal cancer patients using a nonwearable actigraph and (ii) to assess the adjusted impact of opioid and psychotropic drug use on these rhythms.

Design: A longitudinal study.

Settings/Participants: Twenty-six terminal cancer patients in a Japanese palliative care unit.

Measurements: A nonwearable actigraph was placed under the mattress to continuously monitor activity-rest rhythms. Measured parameters included time in bed (TIB: minutes), total sleep time (TST), wake after sleep onset (WASO), sleep efficiency (SE: 0%–100%), activity score (0–960 counts/min; higher values indicate greater activity), and movement index (MI: percentage of time moving in bed; higher values suggest restlessness).

Results: As death approached, diurnal TIB and SE increased, indicating reduced daytime activity. Nocturnal sleep metrics fluctuated irregularly, with an increase in MI, suggesting deteriorating sleep quality. Opioid users exhibited a higher MI and lower SE both day and night compared to nonusers. Psychotropic drug users showed a decreased nocturnal MI and improved SE.

Conclusion: Terminal cancer patients experience decreased daytime activity and unstable nocturnal sleep as death nears. Opioid use correlates with inadequate rest, while psychotropic drugs may enhance nocturnal sleep quality. Continuous nonwearable monitoring offers valuable insights for optimizing end-of-life care.

Background: The growing number of breast cancer survivors underscores the need for tailored follow-up care, particularly focussing on person-centred outcomes in surgical follow-ups. Electronic patient-reported outcome measures (ePROMs) have the potential to enhance person-centred care (PCC) by systematically integrating patient perspectives into clinical practice. However, the barriers and facilitators for the utilization of ePROMs in surgical breast cancer follow-ups remain unclear.

Methods: This study utilized a sequential explanatory mixed-methods design. Quantitative data were collected via a survey among healthcare professionals (HCPs) to assess their familiarity with and perspectives on ePROMs. These findings informed focussed ethnographic qualitative research, including participant observations and interviews, to explore the practical application of ePROMs in clinical practice. Data integration involved a joint display analysis to develop comprehensive insights.

Results: While most HCPs (88%) expressed interest in learning more about ePROMs, only 20% agreed that ePROMs improved treatment and care. Time constraints (reported by 56%) and limited system integration (68% were unfamiliar with access via EMR) were reported as key barriers. Nurses prioritized experiential and patient-specific approaches, often relying on intuition rather than systematic use of ePROMs, whereas surgeons viewed ePROMs as tools for improving resource allocation and surgical outcomes. Knowledge gaps and a lack of organizational support were prevalent, hindering the consistent application of ePROMs in routine care.

Conclusions: ePROMs have untapped potential to transform surgical follow-ups in breast cancer care by aligning clinical practices with person-centred outcomes. Effective integration requires addressing technical and organizational barriers, enhancing HCPs’ competencies and fostering a supportive culture for systematic ePROM utilization. Tailored implementation strategies are a key to fully realizing the benefits of ePROMs in achieving PCC.

Cancer is a major health priority in Europe and the risk of mortality is greater than for any other disease. Cancer care is complex, and interprofessional care has been identified as a key aspect in providing best-practice treatment and care for patients with cancer. Proximity of providers and fruitful interactions within the cancer care network are relevant to collaborative care models to tackle the complexity of cancer care. Pharmacists have been increasingly recognized as being well positioned to promote health and educate patients about their diseases and the appropriate use of prescribed medicines including anticancer agents. Although hospital pharmacists are acknowledged members of cancer care teams, community pharmacists are an untapped health resource, not fully integrated into the cancer care network, and often perceived as mere drug sellers rather than potential cancer patient allies. In this work, a panel of European experts explored the role of pharmacists and their integration into the cancer care network and developed actionable suggestions to take advantage of pharmacists’ role as medication experts with the final aim of optimizing cancer care.

Background: Electrochemotherapy (ECT) has emerged as a promising targeted therapy to enhance drug delivery and minimize systemic side effects in cancer patients. However, concerns about tumor lysis syndrome (TLS) and other complications persist, particularly in patients with large solid tumors.

Methods: This study evaluated the clinical outcomes, adverse effects including TLS occurrence and survival rates of ECT in 15 patients with advanced or metastatic solid tumors at Emam Khomeini Hospital from November 2023 to November 2024.

Results: The study included 15 patients (60% female, 40% male) with a median age of 55 years. Tumor types included sarcoma (20%), squamous cell carcinoma (40%), invasive ductal carcinoma (33%), and angiosarcoma (7%). Eleven patients achieved complete remission, while four showed partial response. No cases of stable disease or progression were observed. The mean tumor area reduction was 90%, with an 84% overall survival rate for 3 months. No patients developed TLS, and adverse effects were minimal, with only four patients experiencing transient acidosis post-ECT. There was no significant difference between disease-free survival (DFS) of various tumor types, while recurrent tumors had better DFS in comparison with nonrecurrent ones.

Conclusion: This study confirms ECT as an effective and safe treatment for large solid tumors, with significant tumor regression and no serious complications such as TLS. These findings support ECT as a viable alternative method for patients with primary tumors, inoperable or treatment-resistant ones.

Objectives: This study aimed to identify factors that influence appointment adherence in postradiotherapy surveillance (PRS) and to evaluate the impact of a telephone reminder system on improving patient adherence among breast and prostate cancer patients.

Methods: A retrospective cross-sectional study was conducted to analyze data from patients scheduled for PRS within a period of 6 months. A total of 468 consecutive patients who were treated with breast or prostate irradiation were divided into two groups: those who attended their appointments and those who did not. Telephone reminders were used as interventions for nonattendees, with a first reminder (I1) followed by a second reminder (I2) in case of nonresponse. Data analysis included univariate and multivariable models to assess factors that affect adherence.

Results: Out of 468 patients, 363 patients (77.6%) initially attended their scheduled appointments. The first telephone reminder increased adherence to 92.7% (434/468 patients). A second reminder further increased the attendance rate to 94.7% (443/468 patients). Marital status was a significant factor, with single individuals having more than three times the odds of nonattendance compared to married individuals. A trend toward significance was found for cigarette smoking as a possible further factor for nonattendance. No significant difference was found between the two groups in any of the other patient-, tumor- or treatment-related characteristics.

Conclusions: Telephone reminders significantly increase appointment adherence in PRS practice, with the first reminder showing the most substantial effect. Single patients have a particularly high risk of nonparticipation, highlighting the need for targeted interventions.

Advances in Knowledge: This study demonstrates the effectiveness of telephone reminders as a cost-effective strategy to improve adherence in PRS surveillance practice, particularly among the high-risk groups, such as single patients.