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The Postoperative Recovery Course of Skeletal Muscle Mass in Older Esophageal Cancer Patients 老年食管癌患者术后骨骼肌质量的恢复过程
IF 2.1 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-04-28 DOI: 10.1155/2023/6655999
Tsuyoshi Harada, Tetsuya Tsuji, N. Tatematsu, Junya Ueno, Yu Koishihara, Nobuko Konishi, Takumi Yanagisawa, Nanako Hijikata, Aiko Ishikawa, T. Fujita
Purpose. Skeletal muscle mass (SMM) is an important biomarker for health in older cancer patients. However, there is limited information on the recovery course of SMM after esophagectomy in older patients. This study aimed to investigate the recovery course of SMM after esophagectomy and the predictors in older cancer patients. Methods. We conducted a single-center, retrospective cohort study. Esophageal cancer patients who underwent esophagectomy were included. The skeletal muscle mass index (SMI) was calculated using computed tomography images. The loss of SMI at 4 and 12 months after surgery was calculated as [(preoperative − postoperative SMI) ÷ preoperative SMI] × 100%. Nonrecovery was defined as an SMI loss of ≥2% at 12 months after surgery, considering physiological loss with aging. One-way analysis of variance and multivariate logistic regression analysis was used for statistical analysis. Results. A total of 105 older (≥70 years) and 156 nonolder (<70 years) patients were analyzed. Older patients had a significantly larger loss of SMI 4 months (mean: 5.7% vs. 3.1%; p = 0.021 ) and 12 months (mean: 1.0% vs. −1.4%; p = 0.040 ) after surgery than nonolder patients. In older patients, the number of patients with nonrecovery of SMI at 12 months after surgery was 55 (52%). In older patients, significant predictors for the nonrecovery of SMI were preoperative sarcopenia (adjusted OR: 0.297; p = 0.012 ), neoadjuvant chemotherapy (adjusted OR: 0.248; p = 0.015 ), and loss of SMI 4 months after surgery (per 1%; adjusted OR: 1.076; p = 0.018 ). Conclusions. It is suggested that older esophageal cancer patients have a larger unmet need for long-term postoperative loss of SMM than nonolder patients. Continuous outpatient rehabilitation, including exercise and nutritional therapy after discharge, which targets improvement in SMM at 4 months, may improve SMI at 12 months after surgery in older esophageal cancer patients.
目的。骨骼肌质量(SMM)是老年癌症患者健康状况的重要生物标志物。然而,关于老年患者食管切除术后SMM的恢复过程的信息有限。本研究旨在探讨老年肿瘤患者食管切除术后SMM的恢复过程及其预测因素。方法。我们进行了一项单中心、回顾性队列研究。食管癌患者接受了食管癌切除术。使用计算机断层扫描图像计算骨骼肌质量指数(SMI)。术后4个月和12个月SMI损失计算为[(术前-术后SMI) ÷术前SMI] × 100%。未恢复定义为手术后12个月SMI损失≥2%,考虑到衰老的生理损失。采用单因素方差分析和多因素logistic回归分析进行统计分析。结果。共分析了105例老年(≥70岁)和156例非老年(<70岁)患者。老年患者4个月的SMI损失明显更大(平均:5.7% vs 3.1%;P = 0.021)和12个月(平均:1.0% vs. - 1.4%;P = 0.040)。在老年患者中,术后12个月SMI未恢复的患者为55例(52%)。在老年患者中,重度精神分裂症无法恢复的重要预测因素是术前肌肉减少(校正OR: 0.297;p = 0.012),新辅助化疗(调整OR: 0.248;p = 0.015),术后4个月SMI丢失(每1%;调整OR: 1.076;P = 0.018)。结论。这表明,老年食管癌患者比非老年食管癌患者有更大的未满足的术后长期SMM丢失需求。持续的门诊康复,包括出院后的运动和营养治疗,目标是在4个月时改善SMM,可能改善老年食管癌患者术后12个月的SMI。
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引用次数: 0
Women’s Willingness to Pay for Mammography Screening under Two Medical Information Scenarios 两种医疗信息情景下女性支付乳房x光检查费用的意愿
IF 2.1 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-04-28 DOI: 10.1155/2023/3732383
Shirin Nosratnejad, Shiva Rahmani, Mahmood Yousefi, M. Moeeni
Objective. Secondary prevention of breast cancer (BC) helps diagnose the disease in the early stages and prevent disease progression. World Health Organization and the American Cancer Society consider early diagnosis as the best way to control BC. Mammography screening is the most sensitive and specific test that can be conducted along with the clinical examination for the early diagnosis of BC. However, like other tests, mammography is not a perfect test. The purpose of the present study is to measure willingness to pay (WTP) for mammography among a sample of women by providing each of them one of two scenarios describing medical information on the test. Methods. 450 women aged 35–55 years were assigned randomly into two groups of equal numbers in a quasi-experimental study conducted in Tabriz city, Iran. Each group was presented with one of the two designed scenarios. First scenario described the basic medical information on mammography as a good test of BC screening. The alternative scenario described some information on potential diagnostic errors of the mammography result alongside basic medical information about this test. The double bounded dichotomous choice method was used to extract women’s WTP for mammography under each scenario. Results. Based on the official currency exchange rate of 37000 IRR/USD, the mean WTP for BC screening with mammography was estimated as 30.5$ in the group receiving basic medical information and 26.8$ in the other group. However, the result of regression analysis revealed receiving information on potential diagnostic errors of mammography result did not lead to significant higher WTP for the test. The WTP for mammography raised significantly among older women, employed women, and those with higher level of education. Conclusion. The result of our study suggests that providing women with information about the potential diagnostic errors of mammography may not be correlated to economic value they give to this test. However, women with different individual status may reveal different economic value on mammography.
目标。乳腺癌的二级预防(BC)有助于在早期阶段诊断疾病并防止疾病进展。世界卫生组织和美国癌症协会认为早期诊断是控制BC的最好方法。乳房x线摄影筛查是早期诊断BC的最敏感、最特异的检查,可与临床检查一起进行。然而,像其他检查一样,乳房x光检查并不是一个完美的检查。本研究的目的是衡量支付意愿(WTP)乳房x光检查的妇女样本中,通过提供两种场景中的一种描述医学信息的测试。方法:在伊朗大不里士市进行的一项准实验研究中,450名年龄在35-55岁之间的女性被随机分为两组。每一组都有两种设计场景中的一种。第一个场景描述了乳房x光检查作为一种良好的BC筛查方法的基本医学信息。替代方案描述了乳房x光检查结果的潜在诊断错误的一些信息以及关于该检查的基本医学信息。采用双界二分类选择法提取各场景下女性乳腺x线摄影WTP。结果。根据官方货币汇率37000 IRR/USD计算,接受基本医疗信息组乳腺癌乳房x光检查的平均WTP为30.5美元,接受基本医疗信息组为26.8美元。然而,回归分析的结果显示,接受乳房x光检查结果的潜在诊断错误信息并没有导致该检查的WTP显著提高。乳房x光检查的WTP在老年妇女、在职妇女和受教育程度较高的妇女中显著升高。结论。我们的研究结果表明,向妇女提供有关乳房x光检查潜在诊断错误的信息可能与她们给予这项检查的经济价值无关。然而,不同个体地位的女性在乳房x光检查中可能显示出不同的经济价值。
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引用次数: 2
Quality of Life in Caregivers of Patients with Brain Tumours: A Systematic Review and Thematic Analysis 脑肿瘤患者照护者的生活质量:系统回顾和专题分析
IF 2.1 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-04-24 DOI: 10.1155/2023/2882837
J. Tallant, L. Pakzad-Shahabi, S. Lambert, M. Williams, Mary Wells
Objective. (1) Examine QoL of caregivers of patients with brain tumours compared to population norms and other cancer caregiver groups, (2) appraise the content of quantitative QoL outcome measures utilised, and (3) assess to what extent QoL measures used in research align with caregivers’ priorities. Methods. Systematic literature search of studies including caregivers of brain tumour patients using self-completed assessments of QoL. Extracted data from included studies included quantitative QoL outcome data, QoL outcome measures utilised, and the included QoL domains. The impact of brain tumour patient caregiving was assessed by summarising included data comparing brain tumour caregivers to other cancer caregivers and normative population data. QoL measures utilised by the studies and their domains were extracted, coded, and analysed by themes. The rates of investigation by theme were then compared to existing data on caregiver-own preference in relation to QoL. Results. 49 studies, including 57 outcome measures, incorporating a combined 124 QoL domains. Brain tumour caregivers reported lower QoL outcomes than population norms but similar to other cancer caregiver groups. Thematic analysis of QoL domains generated 7 themes: caregiving burden and adaptation, existential and self, family and social support, finances, information needs, physical symptoms and functioning, and psychological symptoms and wellbeing. The most investigated themes were physical and psychological symptoms, the most important for caregivers themselves were family and social support. Conclusions. Caregiving for brain tumour patients is shown to negatively affect QoL, particularly mental health, burden, and social life. Existing QoL research in caregivers of brain tumour patients predominantly utilises generic QoL measures designed for use in patients and draws a medicalised view of QoL priorities. The few studies using caregiver-specific QoL measures demonstrated closer alignment to caregiver preferences such as family and social support.
目标。(1)将脑肿瘤患者照护者的生活质量与人群标准和其他癌症照护者群体进行比较,(2)评估所使用的定量生活质量结果测量的内容,(3)评估研究中使用的生活质量测量在多大程度上符合照护者的优先事项。方法。系统文献检索包括脑肿瘤患者护理人员使用自我完成的生活质量评估的研究。从纳入的研究中提取的数据包括定量生活质量结果数据、使用的生活质量结果测量和纳入的生活质量领域。通过汇总包括比较脑肿瘤护理人员与其他癌症护理人员和规范人口数据的数据,评估脑肿瘤患者护理的影响。研究及其领域所使用的生活质量指标被按主题提取、编码和分析。然后将主题调查率与护理者自身对生活质量的偏好的现有数据进行比较。结果:49项研究,包括57项结果测量,合并124个生活质量域。脑肿瘤护理人员报告的生活质量结果低于人群标准,但与其他癌症护理人员组相似。对生活质量领域的专题分析产生了7个主题:照顾负担和适应、存在和自我、家庭和社会支持、财务、信息需求、身体症状和功能、心理症状和健康。调查最多的主题是身体和心理症状,对照顾者本身最重要的是家庭和社会支持。结论。研究表明,对脑肿瘤患者的护理会对其生活质量产生负面影响,尤其是心理健康、负担和社会生活。现有的针对脑肿瘤患者护理人员的生活质量研究主要采用了为患者设计的通用生活质量测量方法,并绘制了生活质量优先级的医学视图。少数使用照顾者特定生活质量测量的研究表明,与照顾者偏好(如家庭和社会支持)更接近。
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引用次数: 0
The Global, Regional, National Burden of Cutaneous Squamous Cell Carcinoma (1990–2019) and Predictions to 2035 皮肤鳞状细胞癌的全球、地区和国家负担(1990-2019)和预测到2035年
IF 2.1 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-04-21 DOI: 10.1155/2023/5484597
A. Guo, Xiajing Liu, Heqing Li, W. Cheng, Yexun Song
Objective. The aim of the study is to provide the burden of cutaneous squamous cell carcinoma (cSCC) in 21 regions, 204 countries, and territories from 1990 to 2019 by age, sex, and sociodemographic index (SDI) and to predict the global burden of cSCC to 2035. Methods. We use estimates from 2019 Global Burden of Disease (GBD) study to conduct the analysis and prediction. The burden of cSCC was estimated for 21 regions, 204 countries, and territories from 1990 to 2019, through a systematic analysis of incidence, death, and disability adjusted life years (DALYs) modelled data using the methods reported in the GBD 2019 study. We predicted the age-standardized incidence rates to 2035 at the global, regional, and national level. Results. There were 2,402,221 global incidence cases and 356,054 deaths in 2019. The age-standardized incidence rate was 30.3 and the age-standardized death rate was 0.7. cSCC, which caused 1.2 million DALYs with an ASR of 14.6 in 2019. Between 1990 and 2019, the age-standardized incidence rate increased by 36.1%, death rate increased by 6.1%, and DALY rate increased by 1.5% globally. At the regional level, the highest age-standardized incidence rate was found in high-income North America, the highest death and DALY rates were shown in Australasia. At the national level, Canada had the highest age-standardized incidence and DALY rates in 2019, and the highest death rate was shown in Tonga. A total of 11 GBD regions and 114 countries were predicted to increase in age-standardized incidence rates between 2019 and 2035, respectively. Conclusions. The cSCC is a major global public health challenge and the burden was often underestimated. The burden is increasing in most countries, especially in countries such as Canada, China, and regions such as Caribbean.
目标。该研究的目的是按年龄、性别和社会人口指数(SDI)提供1990年至2019年21个地区、204个国家和地区的皮肤鳞状细胞癌(cSCC)负担,并预测到2035年的全球cSCC负担。方法。我们使用2019年全球疾病负担(GBD)研究的估计值进行分析和预测。通过使用GBD 2019研究中报告的方法对发病率、死亡和残疾调整生命年(DALYs)建模数据进行系统分析,估计了1990年至2019年期间21个地区、204个国家和地区的cSCC负担。我们预测了到2035年全球、地区和国家层面的年龄标准化发病率。结果。2019年,全球共有2402221例病例和356054例死亡。年龄标准化发病率为30.3,年龄标准化死亡率为0.7。cSCC, 2019年造成120万DALYs, ASR为14.6。1990年至2019年,全球年龄标准化发病率增长36.1%,死亡率增长6.1%,DALY增长1.5%。在区域一级,北美洲高收入地区的年龄标准化发病率最高,澳大利亚的死亡率和伤残折算率最高。在国家一级,加拿大2019年的年龄标准化发病率和伤残调整年金率最高,汤加的死亡率最高。预计2019年至2035年期间,共有11个GBD地区和114个国家的年龄标准化发病率将分别上升。结论。儿童性脊髓炎是一项重大的全球公共卫生挑战,其负担往往被低估。在大多数国家,特别是在加拿大、中国等国家和加勒比等地区,这种负担正在增加。
{"title":"The Global, Regional, National Burden of Cutaneous Squamous Cell Carcinoma (1990–2019) and Predictions to 2035","authors":"A. Guo, Xiajing Liu, Heqing Li, W. Cheng, Yexun Song","doi":"10.1155/2023/5484597","DOIUrl":"https://doi.org/10.1155/2023/5484597","url":null,"abstract":"Objective. The aim of the study is to provide the burden of cutaneous squamous cell carcinoma (cSCC) in 21 regions, 204 countries, and territories from 1990 to 2019 by age, sex, and sociodemographic index (SDI) and to predict the global burden of cSCC to 2035. Methods. We use estimates from 2019 Global Burden of Disease (GBD) study to conduct the analysis and prediction. The burden of cSCC was estimated for 21 regions, 204 countries, and territories from 1990 to 2019, through a systematic analysis of incidence, death, and disability adjusted life years (DALYs) modelled data using the methods reported in the GBD 2019 study. We predicted the age-standardized incidence rates to 2035 at the global, regional, and national level. Results. There were 2,402,221 global incidence cases and 356,054 deaths in 2019. The age-standardized incidence rate was 30.3 and the age-standardized death rate was 0.7. cSCC, which caused 1.2 million DALYs with an ASR of 14.6 in 2019. Between 1990 and 2019, the age-standardized incidence rate increased by 36.1%, death rate increased by 6.1%, and DALY rate increased by 1.5% globally. At the regional level, the highest age-standardized incidence rate was found in high-income North America, the highest death and DALY rates were shown in Australasia. At the national level, Canada had the highest age-standardized incidence and DALY rates in 2019, and the highest death rate was shown in Tonga. A total of 11 GBD regions and 114 countries were predicted to increase in age-standardized incidence rates between 2019 and 2035, respectively. Conclusions. The cSCC is a major global public health challenge and the burden was often underestimated. The burden is increasing in most countries, especially in countries such as Canada, China, and regions such as Caribbean.","PeriodicalId":11953,"journal":{"name":"European Journal of Cancer Care","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2023-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44913973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Barriers and Facilitators for the Implementation of Exercise Oncology Provision in Germany: A Multilevel, Mixed-Methods Evaluation of the Network OnkoAktiv 德国实施运动肿瘤学规定的障碍和促进因素:对网络OnkoAktiv的多层次,混合方法评估
IF 2.1 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-04-19 DOI: 10.1155/2023/6270049
Annelie Voland, Annette Lohmann, L. Ansmann, J. Wiskemann
Background. Strong evidence supports the beneficial impact of exercise on cancer patients. However, the provision of exercise programs in Germany is highly heterogeneous. Therefore, the network OnkoAktiv (OA) enables patient consultations and referrals from coordinating regional OA centers (RE) into community-based exercise programs (CBEP). Objective. The aim of this study was to identify barriers and facilitators for the implementation of OA network structures from the perspective of RE and certified CBEP. Methods. This evaluation was executed in a sequential mixed methods design. We conducted 16 qualitative interviews with each leader in RE and the certified CBEP. Then, 89 certified CBEP were invited to a quantitative, cross-sectional survey. Results. We identified 11 facilitators each for RE and certified CBEP, 7 barriers for RE and 5 for certified CBEP. Barriers dealt with, for example, financing OA network structures, a lack of knowledge of exercise trainers, inadequate patient referral, and missing collaborations by healthcare professionals (HCPs). Most of the named facilitators were adequate internal organizational resources, support and reachability of OA staffs, and collaboration with HCPs. Conclusion. Our findings indicate different challenges for the implementation of OA network structures. Future implementation efforts should consider the evaluation of individual barriers and the development of specific solutions.
背景有力的证据支持运动对癌症患者的有益影响。然而,德国提供的锻炼项目具有高度的异质性。因此,OnkoAktiv(OA)网络使患者能够从协调区域OA中心(RE)转诊到社区锻炼计划(CBEP)。客观的本研究的目的是从RE和认证CBEP的角度确定OA网络结构实施的障碍和促进因素。方法。该评估是在顺序混合方法设计中执行的。我们对RE和认证CBEP的每位领导者进行了16次定性访谈。然后,89名获得认证的CBEP被邀请参加一项定量的横断面调查。后果我们为RE和认证CBEP分别确定了11个促进者,为RE确定了7个障碍,为认证CBEP确定了5个障碍。例如,解决的障碍包括资助OA网络结构、缺乏锻炼培训师的知识、患者转诊不足以及医疗保健专业人员(HCP)缺乏合作。大多数被提名的促进者都是充足的内部组织资源、OA员工的支持和可达性,以及与HCP的合作。结论我们的研究结果表明,OA网络结构的实施面临着不同的挑战。今后的执行工作应考虑评估个别障碍和制定具体的解决办法。
{"title":"Barriers and Facilitators for the Implementation of Exercise Oncology Provision in Germany: A Multilevel, Mixed-Methods Evaluation of the Network OnkoAktiv","authors":"Annelie Voland, Annette Lohmann, L. Ansmann, J. Wiskemann","doi":"10.1155/2023/6270049","DOIUrl":"https://doi.org/10.1155/2023/6270049","url":null,"abstract":"Background. Strong evidence supports the beneficial impact of exercise on cancer patients. However, the provision of exercise programs in Germany is highly heterogeneous. Therefore, the network OnkoAktiv (OA) enables patient consultations and referrals from coordinating regional OA centers (RE) into community-based exercise programs (CBEP). Objective. The aim of this study was to identify barriers and facilitators for the implementation of OA network structures from the perspective of RE and certified CBEP. Methods. This evaluation was executed in a sequential mixed methods design. We conducted 16 qualitative interviews with each leader in RE and the certified CBEP. Then, 89 certified CBEP were invited to a quantitative, cross-sectional survey. Results. We identified 11 facilitators each for RE and certified CBEP, 7 barriers for RE and 5 for certified CBEP. Barriers dealt with, for example, financing OA network structures, a lack of knowledge of exercise trainers, inadequate patient referral, and missing collaborations by healthcare professionals (HCPs). Most of the named facilitators were adequate internal organizational resources, support and reachability of OA staffs, and collaboration with HCPs. Conclusion. Our findings indicate different challenges for the implementation of OA network structures. Future implementation efforts should consider the evaluation of individual barriers and the development of specific solutions.","PeriodicalId":11953,"journal":{"name":"European Journal of Cancer Care","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2023-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45237168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Multiple Myeloma in People of Working Age: A Systematic Review and Evidence Synthesis of Experiences of Paid and Unpaid Work 工作年龄人群多发性骨髓瘤:有偿和无偿工作经验的系统回顾和证据综合
IF 2.1 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-04-13 DOI: 10.1155/2023/6292479
L. Forbat, Tim Sedgley, Laura Bellussi
Introduction. This review sought to synthesise the qualitative evidence pertaining to the experiences of myeloma patients and relatives of work, given the distinct symptom burden and illness trajectory. Methods and Designs. CINAHL, Medline, Web of Science, PsychINFO, SocIndex were searched on 22-Apr-2022. No limiters were used for language or date of publication. CASP was used for critical appraisal. An integrative synthesis was conducted to inductively construct analytic themes PROSPERO CRD42022323137. Results. 34 articles were included, published from 2004 to 2022. Nineteen were assessed as having low risk of bias, and four with moderate risk of bias. The following four themes were derived from analysis of the papers: (i) side effects, medicines, and stigma; (ii) relationships; (iii) creation and maintenance of identity; (iv) privilege and income. Conclusion. Myeloma impacts the engagement of patients and relatives in paid and unpaid work, yet very little is currently known on how the cancer impacts these important interdependent systems. Addressing workplace stigma, understanding the role of workplace relationships, the construction of self through work, interpreting data through a lens of life-course and, privilege offer helpful starting points.
介绍鉴于不同的症状负担和疾病轨迹,这篇综述试图综合与骨髓瘤患者和工作亲属的经历有关的定性证据。方法和设计。CINAHL、Medline、Web of Science、PsychINFO、SocIndex于2022年4月22日搜索。语言或出版日期未使用任何限制。CASP用于批判性评估。进行了综合综合,归纳构建了分析主题PROSPERO CRD42022323137。后果收录了34篇文章,发表于2004年至2022年。19人被评估为具有低偏倚风险,4人具有中等偏倚风险。通过对论文的分析得出以下四个主题:(一)副作用、药物和污名;(ii)关系;(iii)身份的创造和维持;(iv)特权和收入。结论骨髓瘤影响患者及其亲属从事有偿和无偿工作,但目前对癌症如何影响这些重要的相互依赖系统知之甚少。解决工作场所的污名,理解工作场所关系的作用,通过工作构建自我,通过人生历程的视角解读数据,以及特权提供了有益的起点。
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引用次数: 1
Prostate Cancer, Radical Prostatectomy, Recovery, and Survivorship: A Narrative Study of How Men Make Sense of a Cancer Diagnosis 前列腺癌,根治性前列腺切除术,恢复和生存:男性如何理解癌症诊断的叙事研究
IF 2.1 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-03-21 DOI: 10.1155/2023/1915790
M. Corbally, C. McGarvey, Barry Kestell
Prostate cancer invariably impacts men’s health and well-being and remains the most common male cancer. This study explored how men with prostate cancer who were scheduled for radical prostatectomy made sense of their cancer diagnosis. A narrative analysis was performed of 18 men’s life stories at three different time points: preoperatively (n = 13), three months postoperatively (n = 10), and six to nine months postoperatively (n = 11). In total, 34 interviews were undertaken in Ireland to examine how men talked over time. Riessman’s narrative analytic technique and structural and thematic analysis were used as the analytic framework. The following four themes emerged which reflected how men made sense of their prostate cancer diagnosis: seeking coherence, connecting through collective masculinity, rejecting a survivorship identity, and positioning prostate cancer. Seeking coherence was evident in the preoperative phase whilst the other three themes emerged in both postoperative time points. Whilst the experience of prostate cancer was an individualised one, masculine identity and narrative positioning underpinned every aspect of men’s accounts. Subscription to and expression of a masculine identity underpinned all aspects of the men’s narratives. In conclusion, it is recommended that care interventions targeted towards meeting the unmet needs of this group account for this highly masculinised experience. Appropriately sequenced information and support which is gender sensitive to individualised and collective identity expression is crucial. Acknowledgment of masculinised language is also recommended for men’s individual and collective recovery from this life-altering experience.
前列腺癌总是影响男性的健康和福祉,并且仍然是最常见的男性癌症。这项研究探讨了计划进行根治性前列腺切除术的前列腺癌患者如何理解他们的癌症诊断。对18例患者在术前(n = 13)、术后3个月(n = 10)、术后6 ~ 9个月(n = 11)三个不同时间点的生活故事进行叙事分析。在爱尔兰总共进行了34次访谈,以调查男性在一段时间内的谈话方式。本文采用Riessman的叙事分析方法和结构与主题分析作为分析框架。以下四个主题反映了男性如何理解他们的前列腺癌诊断:寻求一致性,通过集体男子气概联系,拒绝幸存者身份,以及定位前列腺癌。寻求一致性在术前阶段很明显,而其他三个主题在术后两个时间点出现。虽然前列腺癌的经历是个体化的,但男性的身份和叙事定位支撑着男性叙述的各个方面。对男性身份的认同和表达支撑着男性叙事的各个方面。总之,建议针对满足这一群体未满足需求的护理干预措施来解释这种高度男性化的经历。对个人和集体身份表达敏感的适当排序的信息和支持至关重要。对于男性个人和集体从这种改变生活的经历中恢复过来,也建议承认男性化的语言。
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引用次数: 0
Development of a Core Set of Self-Management Support Needs of Esophageal Cancer Patients: Results from a Delphi Study among Healthcare Professionals 食管癌症患者自我管理支持需求核心集的开发:来自医疗保健专业人员的德尔菲研究结果
IF 2.1 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-03-14 DOI: 10.1155/2023/3164450
D. Adriaans, F. Heesakkers, J. Teijink, A. D. Dierick-van Daele, J. Haveman, M. Sosef, J. W. van den Berg, M. van Det, H. Hartgrink, W. Jansen, C. Rosman, S. Lagarde, S. van Esser, E. van der Harst, H. V. van Laarhoven, G. Nieuwenhuijzen
Objective. We aimed to gain consensus on HCPs’ perspectives on self-management support information needs of patients with esophageal cancer during the preoperative phase. Methods. Based on the literature, observations of clinical consultations, and hospital patient information leaflets, a survey was created. HCPs were surveyed twice about their opinion on importance of information, from “not essential” to “absolutely essential,” using Delphi methods. Topics were included in the second round if predetermined criteria were met. To be included in the final list, topics had to meet criteria for consensus and stability. Results. 64 information items and 6 sources of support were identified. Survey response rates were 59% (68 out of 116, first round) and 75% thereafter. The final list included 33 topics, including logistical information, expectations for future health condition, complications, follow-up care, nutrition during treatment, and nutrition during recovery as topics with 100% agreement. Consensus on the source of support was reached for face-to-face contact, written information, information video, and a case manager. Conclusion. This study provides a list of important topics, from the perspectives of HCPs, to guide the systematic provision of education to support EC patients’ self-management during the preoperative phase. Additionally, the most preferred sources of support were face-to-face contact and a case manager.
客观的我们旨在就HCP对食管癌症患者术前阶段自我管理支持信息需求的观点达成共识。方法。根据文献、临床咨询观察和医院患者信息传单,创建了一项调查。HCP使用德尔菲方法对他们对信息重要性的看法进行了两次调查,从“不重要”到“绝对重要”。如果符合预先确定的标准,则将主题纳入第二轮。要列入最后清单,专题必须符合协商一致和稳定的标准。后果确定了64个信息项目和6个支助来源。调查回复率为59%(第一轮116次中有68次),之后为75%。最终名单包括33个主题,包括后勤信息、对未来健康状况的期望、并发症、后续护理、治疗期间的营养和康复期间的营养,这些主题100%一致。通过面对面接触、书面信息、信息视频和案件管理人员,就支持来源达成了共识。结论本研究从HCP的角度提供了一系列重要主题,以指导系统地提供教育,支持EC患者在术前阶段的自我管理。此外,最喜欢的支持来源是面对面接触和个案经理。
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引用次数: 0
Noninvasive Brain Stimulation for Cancer Pain Management in Nonbrain Malignancy: A Meta-Analysis 非创伤性脑刺激治疗非脑恶性肿瘤癌症疼痛的Meta分析
IF 2.1 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-03-03 DOI: 10.1155/2023/5612061
Yung-Jiun Chien, Chun-Yu Chang, Meng-Yu Wu, Y. Chien, Hsin-Chi Wu, Y. Horng
Purpose. Noninvasive brain stimulation (NIBS) has been reported to have analgesic effects on fibromyalgia and chronic neuropathic pain; however, its effects on cancer pain have yet to be determined. The present study aimed to evaluate the effects of NIBS on patients with pain secondary to nonbrain malignancy. Methods. Electronic databases including PubMed, Embase, Cochrane Library, and Web of Science were searched from inception through June 5th, 2022. Parallel, randomized, placebo-controlled studies were included that enrolled adult patients with cancer pain, except for that caused by brain tumors, compared NIBS with placebo stimulation, and reported sufficient data for performing meta-analysis. Results. Four parallel, randomized, sham-controlled studies were included: two of repetitive transcranial magnetic stimulation (rTMS), one of transcranial direct current stimulation (tDCS), and one of cranial electrical stimulation (CES). rTMS significantly improved pain in the subgroup analysis (standardized mean difference (SMD): −1.148, 95% confidence interval (CI): −1.660 to −0.637, ( p < 0.001 )), while NIBS was not benefited in reducing pain intensity (SMD: −0.632, 95% CI: −1.356 to 0.092, p = 0.087). Also, NIBS significantly improved depressive symptoms (SMD: −0.665, 95% CI: −1.178 to −0.153, p = 0.011), especially in the form of rTMS (SMD: −0.875, 95% CI: −1.356 to −0.395, p < 0.001 ) and tDCS (SMD: −1.082, 95% CI: −1.746 to −0.418, p = 0.001). Conclusion. rTMS significantly improved pain secondary to nonbrain malignancy apart from other forms of NIBS without major adverse events.
意图非侵入性脑刺激(NIBS)已被报道对纤维肌痛和慢性神经性疼痛具有镇痛作用;然而,它对癌症疼痛的影响尚待确定。本研究旨在评估NIBS对非恶性肿瘤继发疼痛患者的影响。方法。从成立到2022年6月5日,检索了PubMed、Embase、Cochrane Library和Web of Science等电子数据库。纳入了平行、随机、安慰剂对照研究,纳入的癌症疼痛成年患者(脑肿瘤引起的疼痛除外)将NIBS与安慰剂刺激进行了比较,并报告了足够的数据用于进行荟萃分析。后果包括四项平行、随机、假对照研究:两项重复经颅磁刺激(rTMS),一项经颅直流电刺激(tDCS)和一项颅骨电刺激(CES)。rTMS在亚组分析中显著改善了疼痛(标准化平均差(SMD):−1.148,95%置信区间(CI):−1.660至−0.637,(p<0.001)),而NIBS在降低疼痛强度方面没有益处(SMD:−0.632,95%CI:−1.356至0.092,p = 此外,NIBS显著改善了抑郁症状(SMD:−0.665,95%CI:−1.178至−0.153,p = 0.011),特别是以rTMS(SMD:−0.875,95%CI:−1.356至−0.395,p<0.001)和tDCS(SMD:−1.082,95%CI:−1.746至−0.418,p = 0.001)。结论。rTMS显著改善了非脑恶性肿瘤继发的疼痛,与其他形式的NIBS不同,没有重大不良事件。
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引用次数: 1
Symptom Experiences before Medical Help-Seeking and Psychosocial Responses of Patients with Esophageal Cancer: A Qualitative Study 癌症患者就诊前症状体验及心理社会反应的定性研究
IF 2.1 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-03-03 DOI: 10.1155/2023/6506917
Hui Ge, Liang Zhang, Xuanxuan Ma, Wen Li, Shuwen Li
Objective. The purpose of this study was to investigate patients with esophageal cancer symptom experiences before seeking medical help and psychosocial responses. Methods. Within one month of diagnosis, semistructured interviews were held with 14 adult patients with esophageal cancer. To fully comprehend the symptom experiences that patients with esophageal cancer had prior to seeking medical help and the psychosocial responses they had to these experiences, thematic analysis and interpretative phenomenological analysis were used. Results. Patients with esophageal cancer recounted their symptom experiences, and psychosocial responses were categorized into three main themes: physical, psychological, and social. Three subthemes were included in the physiological aspect: early symptoms (warning signs), specific symptoms (the catalyst for seeking medical help), and concurrent symptoms (masked side effects). Four subthemes were associated with psychological aspects: unfairness, regret, worry, and acceptance. Two subthemes were related to the social element, namely, dragging down one’s family and societal self-isolation. Conclusion. Due to the self-remitting nature of early symptoms, the normalization of their interpretation, and concealment by other illnesses, patients with esophageal cancer may delay medical help-seeking. The findings could serve as a reference for healthcare professionals to implement tailored psychosocial interventions and help patients identify symptoms early in order to seek medical help.
目标。本研究的目的是调查食管癌患者在寻求医疗帮助前的症状经历和心理社会反应。方法。在诊断的一个月内,对14名成年食管癌患者进行了半结构化访谈。为了充分了解食管癌患者在寻求医疗帮助之前的症状经历以及他们对这些经历的心理社会反应,采用了主题分析和解释性现象学分析。结果。食管癌患者叙述了他们的症状经历,社会心理反应分为三个主要主题:身体、心理和社会。生理方面包括三个子主题:早期症状(警告信号)、特异性症状(寻求医疗帮助的催化剂)和并发症状(被掩盖的副作用)。四个次要主题与心理方面有关:不公平、后悔、担心和接受。两个副主题与社会因素有关,即拖垮家庭和社会自我孤立。结论。由于早期症状的自我缓解性,其解释的正常化,以及被其他疾病掩盖,食管癌患者可能会延迟就医。研究结果可以作为医疗保健专业人员实施量身定制的社会心理干预的参考,并帮助患者早期识别症状,以便寻求医疗帮助。
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引用次数: 0
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European Journal of Cancer Care
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