Pub Date : 2024-11-19DOI: 10.1016/j.ejon.2024.102740
Lynn Leppla , Klaus Kaier , Anja Schmid , Sabine Valenta , Janette Ribaut , Juliane Mielke , Alexandra Teynor , Robert Zeiser , Sabina De Geest , SMILe study team
<div><h3>Purpose</h3><div>eHealth-facilitated integrated care models (eICMs) have proved effective in improving outcomes for chronically ill patients. However, evidence on cost-effectiveness of eICMs is scarce so far. Allogeneic stem cell transplantation (alloSCT) recipients' post-discharge treatment costs and mortality are greatly influenced by complications. Within the international, multicentric SMILe implementation science project, the eHealth-facilitated SMILe integrated care model (SMILe–<span>ICM</span>) was developed to support patients minimize complications' effects within the first year post-alloSCT.</div><div>Using initial effectiveness findings from the first center that implemented the SMILe-ICM, this study provides a cost and cost-effectiveness evaluation considering one-year and long-term survival effects, post-discharge costs, and patient-related factors.</div></div><div><h3>Methods</h3><div>A single-center hybrid effectiveness implementation randomized controlled trial was conducted at a German university hospital from 2/2020 to 8/2022. Eligible alloSCT patients were randomized to the SMILe–ICM or usual care, i.e., one pre-transplant educational nursing visit followed by a physician-led follow-up. The intervention group received usual care plus the SMILe-ICM's four intervention modules (i.e., monitoring of medical/symptom-related parameters, medication adherence, infection prevention, physical activity). All modules were delivered by Advanced Practice Nurses (APNs) in face-to-face visits, combined with continuous online support. Daily, patients entered seventeen medical and symptom-related parameters to the SMILe App, so that APNs could monitor for and investigate possible pre-complication signs. Healthcare utilization costs were assessed at eight time-points (d+30 post-alloSCT–d365) on fourteen self-reported cost indicators and validated against health records. To calculate costs, we applied German standardized unit costs. Cost- and cost-effectiveness were analyzed in five steps: 1.) Calculate total costs, including for the alloSCT inpatient stay and post-discharge follow-up. 2.) Determine life-years gained (survival) as a health benefit unit. 3.) Calculate overall and rehospitalization-free survival estimates. 4.) Calculate the intervention's long-term cost-effectiveness, including extended follow-up, rate of survival until day 1000, and restricted mean survival time. 5.) Contrast these long-term estimates to current post-discharge costs with comparable patient-related factors (age ≥ or < 65, living alone, gender).</div></div><div><h3>Results</h3><div>Seventy-two patients participated (n = 36/group). Total intergroup healthcare utilization and post-discharge costs differed, but non-significantly. Survival rates improved with the SMILe–ICM (88% vs. 80%) at least until day +1000. Rehospitalization-free survival showed improvement (38% vs. 30%); however, considering this sample size, both findings were nonsignificant. Cost-eff
{"title":"Evaluating the cost, cost-effectiveness and survival of an eHealth-facilitated integrated care model for allogeneic stem cell transplantation: Results of the German SMILe randomized, controlled implementation science trial","authors":"Lynn Leppla , Klaus Kaier , Anja Schmid , Sabine Valenta , Janette Ribaut , Juliane Mielke , Alexandra Teynor , Robert Zeiser , Sabina De Geest , SMILe study team","doi":"10.1016/j.ejon.2024.102740","DOIUrl":"10.1016/j.ejon.2024.102740","url":null,"abstract":"<div><h3>Purpose</h3><div>eHealth-facilitated integrated care models (eICMs) have proved effective in improving outcomes for chronically ill patients. However, evidence on cost-effectiveness of eICMs is scarce so far. Allogeneic stem cell transplantation (alloSCT) recipients' post-discharge treatment costs and mortality are greatly influenced by complications. Within the international, multicentric SMILe implementation science project, the eHealth-facilitated SMILe integrated care model (SMILe–<span>ICM</span>) was developed to support patients minimize complications' effects within the first year post-alloSCT.</div><div>Using initial effectiveness findings from the first center that implemented the SMILe-ICM, this study provides a cost and cost-effectiveness evaluation considering one-year and long-term survival effects, post-discharge costs, and patient-related factors.</div></div><div><h3>Methods</h3><div>A single-center hybrid effectiveness implementation randomized controlled trial was conducted at a German university hospital from 2/2020 to 8/2022. Eligible alloSCT patients were randomized to the SMILe–ICM or usual care, i.e., one pre-transplant educational nursing visit followed by a physician-led follow-up. The intervention group received usual care plus the SMILe-ICM's four intervention modules (i.e., monitoring of medical/symptom-related parameters, medication adherence, infection prevention, physical activity). All modules were delivered by Advanced Practice Nurses (APNs) in face-to-face visits, combined with continuous online support. Daily, patients entered seventeen medical and symptom-related parameters to the SMILe App, so that APNs could monitor for and investigate possible pre-complication signs. Healthcare utilization costs were assessed at eight time-points (d+30 post-alloSCT–d365) on fourteen self-reported cost indicators and validated against health records. To calculate costs, we applied German standardized unit costs. Cost- and cost-effectiveness were analyzed in five steps: 1.) Calculate total costs, including for the alloSCT inpatient stay and post-discharge follow-up. 2.) Determine life-years gained (survival) as a health benefit unit. 3.) Calculate overall and rehospitalization-free survival estimates. 4.) Calculate the intervention's long-term cost-effectiveness, including extended follow-up, rate of survival until day 1000, and restricted mean survival time. 5.) Contrast these long-term estimates to current post-discharge costs with comparable patient-related factors (age ≥ or < 65, living alone, gender).</div></div><div><h3>Results</h3><div>Seventy-two patients participated (n = 36/group). Total intergroup healthcare utilization and post-discharge costs differed, but non-significantly. Survival rates improved with the SMILe–ICM (88% vs. 80%) at least until day +1000. Rehospitalization-free survival showed improvement (38% vs. 30%); however, considering this sample size, both findings were nonsignificant. Cost-eff","PeriodicalId":51048,"journal":{"name":"European Journal of Oncology Nursing","volume":"74 ","pages":"Article 102740"},"PeriodicalIF":2.7,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142697411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
the aim of the study is to evaluate the presence of fatigue syndrome, the quality of life and functional ability of patients with bone and soft tissue sarcomas during the first 6 months of chemotherapy and identify possible prognostic factors.
Methods
prospective observational study was conducted. All patients about to start chemotherapy were consecutively recruited from July 2019 to April 2021. Patient fatigue, quality of life was measured at the start of chemotherapy and after 6 months. BFI score and EORTC QLQ C-30 was used respectively.
Results
The analysis of risk factors was performed on 98 patients. According to BFI score, in 36% of patients fatigue was classified from moderate to severe. The average global quality of life and TESS score increased by 3.9 and 8.5 points respectively. The strength of the association between the BFI score and EORTC subscales and TESS score was moderate (p < 0.001). Smoking status, higher BMI and impaired functional capabilities were independent predictive factors of fatigue.
Conclusion
Fatigue syndrome is present in a significant percentage of patients both at the start of chemotherapy treatment and in the following 6 months. Being a no smoker, higher BMI and impaired functional ability could impact fatigue syndrome. Fatigue screening, patient education and adapted aerobic exercise should be encouraged from the beginning of chemotherapy treatment. The quality of life and functional ability are associated with fatigue syndrome.
{"title":"Fatigue, functional ability and quality of life in patients with bone and soft tissue sarcomas undergoing chemotherapy treatment: An observational study","authors":"Mattia Morri, Riccardo Boccomino, Eugenio Brruku, Erika Romagnoli, Rita Boschi, Giovanni Raucci, Ausilia Bellina Terra, Paola Coluccino","doi":"10.1016/j.ejon.2024.102736","DOIUrl":"10.1016/j.ejon.2024.102736","url":null,"abstract":"<div><h3>Purpose</h3><div>the aim of the study is to evaluate the presence of fatigue syndrome, the quality of life and functional ability of patients with bone and soft tissue sarcomas during the first 6 months of chemotherapy and identify possible prognostic factors.</div></div><div><h3>Methods</h3><div>prospective observational study was conducted. All patients about to start chemotherapy were consecutively recruited from July 2019 to April 2021. Patient fatigue, quality of life was measured at the start of chemotherapy and after 6 months. BFI score and EORTC QLQ C-30 was used respectively.</div></div><div><h3>Results</h3><div>The analysis of risk factors was performed on 98 patients. According to BFI score, in 36% of patients fatigue was classified from moderate to severe. The average global quality of life and TESS score increased by 3.9 and 8.5 points respectively. The strength of the association between the BFI score and EORTC subscales and TESS score was moderate (p < 0.001). Smoking status, higher BMI and impaired functional capabilities were independent predictive factors of fatigue.</div></div><div><h3>Conclusion</h3><div>Fatigue syndrome is present in a significant percentage of patients both at the start of chemotherapy treatment and in the following 6 months. Being a no smoker, higher BMI and impaired functional ability could impact fatigue syndrome. Fatigue screening, patient education and adapted aerobic exercise should be encouraged from the beginning of chemotherapy treatment. The quality of life and functional ability are associated with fatigue syndrome.</div></div><div><h3>Registration number (clinicaltrial.gov)</h3><div>NCT04104750 (26/09/2019)</div></div>","PeriodicalId":51048,"journal":{"name":"European Journal of Oncology Nursing","volume":"74 ","pages":"Article 102736"},"PeriodicalIF":2.7,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-16DOI: 10.1016/j.ejon.2024.102735
Baoyi Zhang , Ni Zhang , Ye Zhang , Jingwen Yan , Lili Chen , Haiyan He , Shihao Sun , Yiheng Zhang , Meifen Zhang
Purpose
Chemotherapy-induced taste alterations (CiTA) are significant predictors of gastrointestinal symptoms, malnutrition, and poor prognosis. However, the prevalence and risk factors of CiTA vary substantially between studies. This study aimed to synthesize the prevalence and risk factors of CiTA among cancer patients.
Methods
Eight databases (Pubmed, Web of Science, Embase, ScienceDirect, Sinomed, China National Knowledge Infrastructure, Wanfang and Weipu database) were retrieved to collect observational studies regarding the prevalence or risk factors of CiTA published before June 1, 2024. The random effects meta-analysis was conducted to estimate the pooled prevalence. Subgroup analysis was conducted to identify heterogeneity across studies. For the same risk factor, the odds ratio and 95% confidence interval were calculated.
Results
In total, 30 studies with 15,722 participants were included. The pooled prevalence of CiTA was 70.0% (95% CI: 59.1%–79.9%, I2 = 99.4%), ranging from 21.0% to 100.0%. Female (OR = 2.59, 95% CI: 1.59 to 4.22), patients with xerostomia (OR = 2.04, 95% CI: 1.48 to 2.81), oral mucositis/ulcers (OR = 3.72, 95% CI: 1.46 to 9.47), receiving not less than 2 chemotherapy cycles (OR = 3.95, 95% CI: 3.20 to 4.88) were more likely to develop CiTA.
Conclusions
The prevalence of CiTA among cancer patients was alarmingly high. Female, xerostomia, oral mucositis/ulcers, receiving not less than 2 chemotherapy cycles were significant risk factors of CiTA. Healthcare practitioners should identify high-risk patients and develop targeted interventions to manage CiTA based on identified risk factors.
目的：化疗引起的味觉改变（CiTA）是预测胃肠道症状、营养不良和预后不良的重要因素。然而，不同研究对 CiTA 的发生率和风险因素的研究差异很大。本研究旨在综合癌症患者中 CiTA 的患病率和风险因素：检索8个数据库（Pubmed、Web of Science、Embase、ScienceDirect、Sinomed、中国国家知识基础设施、万方和卫普数据库），收集2024年6月1日前发表的有关CiTA患病率或危险因素的观察性研究。采用随机效应荟萃分析法估算汇总患病率。为确定不同研究间的异质性，还进行了分组分析。对于同一风险因素，计算了几率比和 95% 的置信区间：共纳入了 30 项研究，15722 名参与者。汇总的 CiTA 患病率为 70.0%（95% CI：59.1%-79.9%，I2 = 99.4%），范围从 21.0% 到 100.0%。女性（OR = 2.59，95% CI：1.59 至 4.22）、有口腔干燥症（OR = 2.04，95% CI：1.48 至 2.81）、口腔粘膜炎/溃疡（OR = 3.72，95% CI：1.46 至 9.47）、接受不少于 2 个化疗周期（OR = 3.95，95% CI：3.20 至 4.88）的患者更有可能患上 CiTA：结论：CiTA在癌症患者中的发病率之高令人震惊。女性、口腔干燥症、口腔粘膜炎/溃疡、接受不少于 2 个化疗周期是 CiTA 的重要风险因素。医护人员应识别高危患者，并根据识别出的风险因素制定有针对性的干预措施来控制 CiTA。
{"title":"Prevalence and risk factors of chemotherapy-induced taste alterations among cancer patients: A systematic review and meta-analysis","authors":"Baoyi Zhang , Ni Zhang , Ye Zhang , Jingwen Yan , Lili Chen , Haiyan He , Shihao Sun , Yiheng Zhang , Meifen Zhang","doi":"10.1016/j.ejon.2024.102735","DOIUrl":"10.1016/j.ejon.2024.102735","url":null,"abstract":"<div><h3>Purpose</h3><div>Chemotherapy-induced taste alterations (CiTA) are significant predictors of gastrointestinal symptoms, malnutrition, and poor prognosis. However, the prevalence and risk factors of CiTA vary substantially between studies. This study aimed to synthesize the prevalence and risk factors of CiTA among cancer patients.</div></div><div><h3>Methods</h3><div>Eight databases (Pubmed, Web of Science, Embase, ScienceDirect, Sinomed, China National Knowledge Infrastructure, Wanfang and Weipu database) were retrieved to collect observational studies regarding the prevalence or risk factors of CiTA published before June 1, 2024. The random effects meta-analysis was conducted to estimate the pooled prevalence. Subgroup analysis was conducted to identify heterogeneity across studies. For the same risk factor, the odds ratio and 95% confidence interval were calculated.</div></div><div><h3>Results</h3><div>In total, 30 studies with 15,722 participants were included. The pooled prevalence of CiTA was 70.0% (95% <em>CI</em>: 59.1%–79.9%, <em>I</em><sup><em>2</em></sup> = 99.4%), ranging from 21.0% to 100.0%. Female (<em>OR</em> = 2.59, 95% <em>CI</em>: 1.59 to 4.22), patients with xerostomia (<em>OR</em> = 2.04, 95% <em>CI</em>: 1.48 to 2.81), oral mucositis/ulcers (<em>OR</em> = 3.72, 95% <em>CI</em>: 1.46 to 9.47), receiving not less than 2 chemotherapy cycles (<em>OR</em> = 3.95, 95% <em>CI</em>: 3.20 to 4.88) were more likely to develop CiTA.</div></div><div><h3>Conclusions</h3><div>The prevalence of CiTA among cancer patients was alarmingly high. Female, xerostomia, oral mucositis/ulcers, receiving not less than 2 chemotherapy cycles were significant risk factors of CiTA. Healthcare practitioners should identify high-risk patients and develop targeted interventions to manage CiTA based on identified risk factors.</div></div>","PeriodicalId":51048,"journal":{"name":"European Journal of Oncology Nursing","volume":"74 ","pages":"Article 102735"},"PeriodicalIF":2.7,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-15DOI: 10.1016/j.ejon.2024.102734
Shuhan Li , Qingxin Mai , Xiaoxiao Mei , Yingting Jiang , Ying Xiong , Yihao Zeng , M.Tish Knobf , Zengjie Ye
Purpose
To estimate the longitudinal association between resilience and sleep quality in patients with newly diagnosed breast cancer within the first 6 months.
Method
Between July 2023 and September 2023, 155 newly diagnosed BC patients were recruited to participate in the Be Resilience to Breast Cancer program (Abbreviated as BRBC). They completed the 10-item Connor-Davidson Resilience scale and Pittsburgh Sleep Quality Index Scale. The following three timepoints were set to collect the data, including 1 month after initial diagnosis (T0), 3 months (T1), and 6 months (T2). Data were analyzed using Cross-lagged Panel Model (CLPM), and Parallel Latent Growth Model (PLGM).
Results
Excluded questionnaires with a large number of missing items and finally 125 patients were included, with the response rate of 83.3%. CLPM indicated that resilience at T1 predicted PSQI at T2 (r = −0.168, P 0.001), and PSQI at T1 predicted resilience at T2 (r = −0.112, P 0.001). PLGM demonstrated that changes in resilience was significantly associated with changes in PSQI (r = −0.874, P 0.001).
Conclusion
A longitudinal association between resilience and sleep quality was confirmed in patients with newly diagnosed breast cancer. Resilience was a protective factor in the development of sleep quality.
{"title":"The longitudinal association between resilience and sleep quality in breast cancer","authors":"Shuhan Li , Qingxin Mai , Xiaoxiao Mei , Yingting Jiang , Ying Xiong , Yihao Zeng , M.Tish Knobf , Zengjie Ye","doi":"10.1016/j.ejon.2024.102734","DOIUrl":"10.1016/j.ejon.2024.102734","url":null,"abstract":"<div><h3>Purpose</h3><div>To estimate the longitudinal association between resilience and sleep quality in patients with newly diagnosed breast cancer within the first 6 months.</div></div><div><h3>Method</h3><div>Between July 2023 and September 2023, 155 newly diagnosed BC patients were recruited to participate in the Be Resilience to Breast Cancer program (Abbreviated as BRBC). They completed the 10-item Connor-Davidson Resilience scale and Pittsburgh Sleep Quality Index Scale. The following three timepoints were set to collect the data, including 1 month after initial diagnosis (T0), 3 months (T1), and 6 months (T2). Data were analyzed using Cross-lagged Panel Model (CLPM), and Parallel Latent Growth Model (PLGM).</div></div><div><h3>Results</h3><div>Excluded questionnaires with a large number of missing items and finally 125 patients were included, with the response rate of 83.3%. CLPM indicated that resilience at T1 predicted PSQI at T2 (r = −0.168, P <span><math><mrow><mo><</mo></mrow></math></span> 0.001), and PSQI at T1 predicted resilience at T2 (r = −0.112, P<span><math><mrow><mo><</mo></mrow></math></span> 0.001). PLGM demonstrated that changes in resilience was significantly associated with changes in PSQI (r = −0.874, P<span><math><mrow><mo><</mo></mrow></math></span> 0.001).</div></div><div><h3>Conclusion</h3><div>A longitudinal association between resilience and sleep quality was confirmed in patients with newly diagnosed breast cancer. Resilience was a protective factor in the development of sleep quality.</div></div>","PeriodicalId":51048,"journal":{"name":"European Journal of Oncology Nursing","volume":"74 ","pages":"Article 102734"},"PeriodicalIF":2.7,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-15DOI: 10.1016/j.ejon.2024.102731
Xing Ma , Meimei Shang , Cho Lee Wong , Yishu Qi , Dorothy Ngo Sheung Chan
Purpose
Yoga can alleviate cancer-related fatigue and psychological distress while improving health-related quality of life. However, most studies focused on breast cancer. This study aimed to evaluate the feasibility and acceptability of a yoga program for women with gynecological cancer and estimate its preliminary effects on cancer-related fatigue, psychological distress, and health-related quality of life.
Methods
This pilot study used a single-blinded randomized controlled trial design. Participants in the intervention group received the yoga program and usual care, while the control group only received usual care. Feasibility was assessed using eligibility, consent, attrition, and adherence rates. Acceptability was measured using a satisfaction questionnaire. Preliminary effects were evaluated on cancer-related fatigue, psychological distress, and health-related quality of life outcomes.
Results
The yoga program demonstrated feasibility, with satisfactory rates of eligibility (62.7%), consent (64.9%), attrition (4.2%), and adherence (75%). The participants reported high satisfaction with the program. Significant intervention effects were observed on the behavioral/severity dimension of cancer-related fatigue (Hedges's g = 0.86). The intervention group demonstrated greater reductions in overall and other cancer-related fatigue subscales than the control group. Greater improvements in distress, anxiety, depression, and health-related quality of life were noted in the intervention group than in the control group, with effect sizes of 0.29, 0.77, 0.21, and 0.12, respectively.
Conclusions
The yoga program is feasible and acceptable, showing a trend in reducing cancer-related fatigue and psychological distress and improving health-related quality of life in women with gynecological cancer. A full-scale randomized controlled trial is warranted.
目的：瑜伽可以缓解与癌症有关的疲劳和心理困扰，同时提高与健康有关的生活质量。然而，大多数研究都集中在乳腺癌上。本研究旨在评估妇科癌症女性瑜伽课程的可行性和可接受性，并估计其对癌症相关疲劳、心理困扰和健康相关生活质量的初步影响：本试验研究采用单盲随机对照试验设计。干预组的参与者接受瑜伽课程和常规护理，而对照组只接受常规护理。可行性通过资格审查、同意率、流失率和坚持率进行评估。可接受性则通过满意度问卷来衡量。对癌症相关疲劳、心理困扰和健康相关生活质量结果的初步效果进行了评估：结果：瑜伽项目证明了其可行性，合格率（62.7%）、同意率（64.9%）、减员率（4.2%）和坚持率（75%）均令人满意。参与者对该计划的满意度很高。在癌症相关疲劳的行为/严重程度维度上观察到了显著的干预效果（Hedges's g = 0.86）。与对照组相比，干预组在总体和其他癌症相关疲劳分量表上的减幅更大。与对照组相比，干预组在苦恼、焦虑、抑郁和健康相关生活质量方面的改善幅度更大，效应大小分别为 0.29、0.77、0.21 和 0.12：瑜伽项目是可行的、可接受的，在减轻癌症相关疲劳和心理困扰、改善妇科癌症妇女的健康相关生活质量方面显示出趋势。有必要进行全面的随机对照试验。
{"title":"A pilot randomized controlled trial of a yoga program for alleviating cancer-related fatigue and psychological distress in women with gynecological cancer","authors":"Xing Ma , Meimei Shang , Cho Lee Wong , Yishu Qi , Dorothy Ngo Sheung Chan","doi":"10.1016/j.ejon.2024.102731","DOIUrl":"10.1016/j.ejon.2024.102731","url":null,"abstract":"<div><h3>Purpose</h3><div>Yoga can alleviate cancer-related fatigue and psychological distress while improving health-related quality of life. However, most studies focused on breast cancer. This study aimed to evaluate the feasibility and acceptability of a yoga program for women with gynecological cancer and estimate its preliminary effects on cancer-related fatigue, psychological distress, and health-related quality of life.</div></div><div><h3>Methods</h3><div>This pilot study used a single-blinded randomized controlled trial design. Participants in the intervention group received the yoga program and usual care, while the control group only received usual care. Feasibility was assessed using eligibility, consent, attrition, and adherence rates. Acceptability was measured using a satisfaction questionnaire. Preliminary effects were evaluated on cancer-related fatigue, psychological distress, and health-related quality of life outcomes.</div></div><div><h3>Results</h3><div>The yoga program demonstrated feasibility, with satisfactory rates of eligibility (62.7%), consent (64.9%), attrition (4.2%), and adherence (75%). The participants reported high satisfaction with the program. Significant intervention effects were observed on the behavioral/severity dimension of cancer-related fatigue (Hedges's g = 0.86). The intervention group demonstrated greater reductions in overall and other cancer-related fatigue subscales than the control group. Greater improvements in distress, anxiety, depression, and health-related quality of life were noted in the intervention group than in the control group, with effect sizes of 0.29, 0.77, 0.21, and 0.12, respectively.</div></div><div><h3>Conclusions</h3><div>The yoga program is feasible and acceptable, showing a trend in reducing cancer-related fatigue and psychological distress and improving health-related quality of life in women with gynecological cancer. A full-scale randomized controlled trial is warranted.</div></div>","PeriodicalId":51048,"journal":{"name":"European Journal of Oncology Nursing","volume":"74 ","pages":"Article 102731"},"PeriodicalIF":2.7,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-15DOI: 10.1016/j.ejon.2024.102738
Gareth Hill , Cathy Bulley
Purpose
Cancer incidence is growing in the UK population and will affect half of all individuals in their lifetime, with most new diagnoses occurring over the age of 60 years old. Despite legal reforms and liberation of lesbian, gay, bisexual, transgender, queer, or questioning (LGBTQ) people's rights in recent years, many LGBTQ people affected by cancer will have faced significant societal discrimination in their lives. The aim of this research was to explore how cancer treatment impacts on the personhood of LGB people, and to increase understanding of social issues specific to this community.
Methods
Underpinned by person-centred principles and Critical Social Theory, a community-based participatory inquiry was carried out with nine LBG people who had been affected by cancer. In two subsequent sessions, participants created an identity map and then reflected on how cancer and care experiences had impacted their identity. Initially, content analysis of transcripts was informed by Mezirow's perspective transformation, followed by inductive thematic analysis within each data framework category. Participants were invited to provide feedback on the identified themes.
Results
The processes of coming out and facing a cancer diagnosis emerged as significant crises, leading to personal transformation. Factors such as past experiences of homophobia, duration of being openly out, and confidence in embracing altered identities influence interactions with healthcare providers and the level of support received.
Conclusions
This research makes a unique contribution by shedding light on the unreported support needs of LGB individuals affected by cancer, suggesting the need for additional assistance.
目的：在英国，癌症发病率在不断上升，一半的人一生中都会受到癌症的影响，而大多数新确诊的癌症患者年龄都在 60 岁以上。尽管近年来进行了法律改革并解放了女同性恋、男同性恋、双性恋、跨性别者、同性恋者或质疑者（LGBTQ）的权利，但许多受癌症影响的 LGBTQ 患者在生活中仍会面临严重的社会歧视。本研究旨在探讨癌症治疗如何影响 LGBT 群体的人格，并加深对该群体特有的社会问题的了解：在以人为本的原则和批判性社会理论的支持下，我们与九名受癌症影响的女同性恋、男同性恋、双性恋和变性者进行了社区参与式调查。在随后的两次会议中，参与者绘制了一张身份认同地图，然后反思癌症和护理经历如何影响了他们的身份认同。最初，根据 Mezirow 的视角转换法对记录誊本进行内容分析，然后在每个数据框架类别内进行归纳式主题分析。我们邀请参与者就确定的主题提供反馈意见：出柜和面对癌症诊断的过程是导致个人转变的重要危机。过去仇视同性恋的经历、公开出柜的持续时间以及接受改变身份的信心等因素影响着与医疗服务提供者的互动以及获得支持的程度：这项研究揭示了受癌症影响的女同性恋、男同性恋、双性恋和变性者未被报道的支持需求，表明他们需要额外的帮助，从而做出了独特的贡献。
{"title":"Examining the impact of cancer treatment on personhood: A participatory research investigation into the unique experiences of lesbian, gay, and bisexual individuals","authors":"Gareth Hill , Cathy Bulley","doi":"10.1016/j.ejon.2024.102738","DOIUrl":"10.1016/j.ejon.2024.102738","url":null,"abstract":"<div><h3>Purpose</h3><div>Cancer incidence is growing in the UK population and will affect half of all individuals in their lifetime, with most new diagnoses occurring over the age of 60 years old. Despite legal reforms and liberation of lesbian, gay, bisexual, transgender, queer, or questioning (LGBTQ) people's rights in recent years, many LGBTQ people affected by cancer will have faced significant societal discrimination in their lives. The aim of this research was to explore how cancer treatment impacts on the personhood of LGB people, and to increase understanding of social issues specific to this community.</div></div><div><h3>Methods</h3><div>Underpinned by person-centred principles and Critical Social Theory, a community-based participatory inquiry was carried out with nine LBG people who had been affected by cancer. In two subsequent sessions, participants created an identity map and then reflected on how cancer and care experiences had impacted their identity. Initially, content analysis of transcripts was informed by Mezirow's perspective transformation, followed by inductive thematic analysis within each data framework category. Participants were invited to provide feedback on the identified themes.</div></div><div><h3>Results</h3><div>The processes of coming out and facing a cancer diagnosis emerged as significant crises, leading to personal transformation. Factors such as past experiences of homophobia, duration of being openly out, and confidence in embracing altered identities influence interactions with healthcare providers and the level of support received.</div></div><div><h3>Conclusions</h3><div>This research makes a unique contribution by shedding light on the unreported support needs of LGB individuals affected by cancer, suggesting the need for additional assistance.</div></div>","PeriodicalId":51048,"journal":{"name":"European Journal of Oncology Nursing","volume":"74 ","pages":"Article 102738"},"PeriodicalIF":2.7,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-15DOI: 10.1016/j.ejon.2024.102732
Xuan Chen , Junrui Zhou , Zhiming Wang , Chunyan Lin , Jie Zhao , Qiuping Li
Purpose
Self-perceived burden can take a toll on the physical and psychological well-being of cancer couples and prevent them from achieving favorable outcomes. There is limited qualitative research synthesizing the cognition and coping with self-perceived burden among Chinese colorectal cancer patients and their caregivers. Therefore, this study examined perceptions of self-perceived burden and coping strategies from the perspectives of colorectal cancer patients, their spousal caregivers and nursing staff.
Methods
A qualitative study based on semi-structured interviews was implemented from May 15 to July 14, 2023. Data were analyzed using inductive thematic analysis.
Results
This study summarized the cognition and coping strategies regarding self-perceived burden through three themes. Life under self-perceived burden contained sub-themes of Uncomfortable role changing, The handling of interpersonal relationships and Communication attitudes. What need to cope with contained sub-themes of Physical changes and discomfort, Negative emotions, Inappropriate decision-making and Negative communication. Coping with different perspectives contained sub-themes of Improving self-care ability correctly, Maintaining emotional stability, Finding new meaning and Solid family support.
Conclusions
The presence of self-perceived burden hinders good outcomes for colorectal cancer couples. It is necessary to help colorectal cancer couples cope with self-perceived burden together. Nursing staff need to be a bridge of communication and exchange for colorectal cancer couples, providing them with effective and reliable information and support, thus helping colorectal cancer patients and their spousal caregivers achieve true inner peace and better outcomes.
{"title":"Perception and coping with self-perceived burden among colorectal cancer patients and their caregivers: A qualitative study","authors":"Xuan Chen , Junrui Zhou , Zhiming Wang , Chunyan Lin , Jie Zhao , Qiuping Li","doi":"10.1016/j.ejon.2024.102732","DOIUrl":"10.1016/j.ejon.2024.102732","url":null,"abstract":"<div><h3>Purpose</h3><div>Self-perceived burden can take a toll on the physical and psychological well-being of cancer couples and prevent them from achieving favorable outcomes. There is limited qualitative research synthesizing the cognition and coping with self-perceived burden among Chinese colorectal cancer patients and their caregivers. Therefore, this study examined perceptions of self-perceived burden and coping strategies from the perspectives of colorectal cancer patients, their spousal caregivers and nursing staff.</div></div><div><h3>Methods</h3><div>A qualitative study based on semi-structured interviews was implemented from May 15 to July 14, 2023. Data were analyzed using inductive thematic analysis.</div></div><div><h3>Results</h3><div>This study summarized the cognition and coping strategies regarding self-perceived burden through three themes. Life under self-perceived burden contained sub-themes of Uncomfortable role changing, The handling of interpersonal relationships and Communication attitudes. What need to cope with contained sub-themes of Physical changes and discomfort, Negative emotions, Inappropriate decision-making and Negative communication. Coping with different perspectives contained sub-themes of Improving self-care ability correctly, Maintaining emotional stability, Finding new meaning and Solid family support.</div></div><div><h3>Conclusions</h3><div>The presence of self-perceived burden hinders good outcomes for colorectal cancer couples. It is necessary to help colorectal cancer couples cope with self-perceived burden together. Nursing staff need to be a bridge of communication and exchange for colorectal cancer couples, providing them with effective and reliable information and support, thus helping colorectal cancer patients and their spousal caregivers achieve true inner peace and better outcomes.</div></div>","PeriodicalId":51048,"journal":{"name":"European Journal of Oncology Nursing","volume":"74 ","pages":"Article 102732"},"PeriodicalIF":2.7,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-14DOI: 10.1016/j.ejon.2024.102730
Bethina Thulstrup Paulsen , Mathilde Laura Kærgaard Johansen , Sarah Kjærsgaard Lund , Helle Enggaard , Lone Jørgensen
Purpose
To explore the experience of being a relative to a patient with incurable cancer and the relatives’ perceived need for support.
Method
A qualitative design with a critical hermeneutics approach was applied. In total, 15 semi-structured individual interviews with relatives of patients with incurable cancer were conducted and analysed through a Paul Ricœur-inspired analysis.
Findings
Three themes emerged: (1) being in a paradoxical waiting position, (2) the complex need for a respite during the illness and (3) the importance of person-centred information and continuity. The themes highlight how relatives are in a vulnerable position experiencing anticipatory grief while waiting for the patient's death. They have ambivalent feelings because of the tension between the need to be supportive and the need for a respite from the illness. However, they do not want to centre their needs and remove the attention from the patient. Their needs change over time and increase the longer the cancer has lasted. In addition, the relatives need person-centred information and continuity among healthcare professionals.
Conclusion
Relatives of patients with incurable cancer are in a vulnerable position, with a range of complex and varied needs for support. This underscores the importance of healthcare professionals being aware of anticipatory grief and the management of relatives’ needs to avoid complicated grief and its consequences.
{"title":"Anticipatory grief - A neglected phenomenon among relatives of patients with incurable cancer: A qualitative study","authors":"Bethina Thulstrup Paulsen , Mathilde Laura Kærgaard Johansen , Sarah Kjærsgaard Lund , Helle Enggaard , Lone Jørgensen","doi":"10.1016/j.ejon.2024.102730","DOIUrl":"10.1016/j.ejon.2024.102730","url":null,"abstract":"<div><h3>Purpose</h3><div>To explore the experience of being a relative to a patient with incurable cancer and the relatives’ perceived need for support.</div></div><div><h3>Method</h3><div>A qualitative design with a critical hermeneutics approach was applied. In total, 15 semi-structured individual interviews with relatives of patients with incurable cancer were conducted and analysed through a Paul Ricœur-inspired analysis.</div></div><div><h3>Findings</h3><div>Three themes emerged: <em>(1) being in a paradoxical waiting position, (2) the complex need for a respite during the illness</em> and <em>(3) the importance of person-centred information and continuity.</em> The themes highlight how relatives are in a vulnerable position experiencing anticipatory grief while waiting for the patient's death. They have ambivalent feelings because of the tension between the need to be supportive and the need for a respite from the illness. However, they do not want to centre their needs and remove the attention from the patient. Their needs change over time and increase the longer the cancer has lasted. In addition, the relatives need person-centred information and continuity among healthcare professionals.</div></div><div><h3>Conclusion</h3><div>Relatives of patients with incurable cancer are in a vulnerable position, with a range of complex and varied needs for support. This underscores the importance of healthcare professionals being aware of anticipatory grief and the management of relatives’ needs to avoid complicated grief and its consequences.</div></div>","PeriodicalId":51048,"journal":{"name":"European Journal of Oncology Nursing","volume":"74 ","pages":"Article 102730"},"PeriodicalIF":2.7,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-08DOI: 10.1016/j.ejon.2024.102729
Cecilia Olsson , Maria Larsson , Anna Josse Eklund , Anders Ringnér
Purpose
Sexuality and body image are closely related to health-related quality of life (HRQoL), but these factors are less investigated in patients treated for lymphoma.
Therefore, the aim of this study was to describe and explore the associations between sexuality, body image, comorbidities and HRQoL in patients treated for diffuse large B-cell lymphoma.
Methods
A cross-sectional study with 257 patients (25% response rate) was conducted in 2019 using measures for sexuality, HRQoL and body image and data from the Swedish National Quality Registry for Leukemia–Subregistry for Lymphoma.
Results
The participants had a mean HRQoL of 69.75 on a 1 to 100 scale, and the functional scales ranged from 68.50 for Role to 80.82 for Social functioning. The symptoms ranged from 5.56 for nausea and vomiting to 37.73 for fatigue. Regarding body image, the participants scored a total of 14.47 (reference values 10–40). The total score for Sexual adjustment was 3.02 (fair), and for the subscales Sexual Interest 2.63 (low), Sexual Relation 2.72 (low), Sexual Function 3.62 (high) and Sexual Satisfaction 3.50 (high). HRQoL was positively associated with Sexual Relation; however, negative body image and comorbidities showed negative associations. The model explains 39.6% of the variation in HRQoL.
Conclusion
The positive impact of sexual relationships on HRQoL was highlighted, which emphasised the unfavourable effect of negative body image and comorbidities on HRQoL for lymphoma patients. Cancer nurses should address these topics with patients to improve their long-term well-being.
{"title":"Associations between sexuality, body image and health-related quality of life in patients treated for diffuse large B-cell lymphoma: A cross-sectional study","authors":"Cecilia Olsson , Maria Larsson , Anna Josse Eklund , Anders Ringnér","doi":"10.1016/j.ejon.2024.102729","DOIUrl":"10.1016/j.ejon.2024.102729","url":null,"abstract":"<div><h3>Purpose</h3><div>Sexuality and body image are closely related to health-related quality of life (HRQoL), but these factors are less investigated in patients treated for lymphoma.</div><div>Therefore, the aim of this study was to describe and explore the associations between sexuality, body image, comorbidities and HRQoL in patients treated for diffuse large B-cell lymphoma.</div></div><div><h3>Methods</h3><div>A cross-sectional study with 257 patients (25% response rate) was conducted in 2019 using measures for sexuality, HRQoL and body image and data from the Swedish National Quality Registry for Leukemia–Subregistry for Lymphoma.</div></div><div><h3>Results</h3><div>The participants had a mean HRQoL of 69.75 on a 1 to 100 scale, and the functional scales ranged from 68.50 for Role to 80.82 for Social functioning. The symptoms ranged from 5.56 for nausea and vomiting to 37.73 for fatigue. Regarding body image, the participants scored a total of 14.47 (reference values 10–40). The total score for Sexual adjustment was 3.02 (fair), and for the subscales Sexual Interest 2.63 (low), Sexual Relation 2.72 (low), Sexual Function 3.62 (high) and Sexual Satisfaction 3.50 (high). HRQoL was positively associated with Sexual Relation; however, negative body image and comorbidities showed negative associations. The model explains 39.6% of the variation in HRQoL.</div></div><div><h3>Conclusion</h3><div>The positive impact of sexual relationships on HRQoL was highlighted, which emphasised the unfavourable effect of negative body image and comorbidities on HRQoL for lymphoma patients. Cancer nurses should address these topics with patients to improve their long-term well-being.</div></div>","PeriodicalId":51048,"journal":{"name":"European Journal of Oncology Nursing","volume":"73 ","pages":"Article 102729"},"PeriodicalIF":2.7,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-07DOI: 10.1016/j.ejon.2024.102728
Hee-Ju Kim , Kyung Mi Chae , Sun-Ok Jung , Su Wol Chung , Tenko Raykov
Purpose
This study aimed to examine (a) whether psychological stress is associated with experiencing multiple psycho-neurological symptoms (depression, cognitive impairment, fatigue, sleep disturbance, and pain) as a cluster and (b) whether stress hormones (adrenocorticotropic hormone [ACTH] and cortisol) are associated with psychological stress and symptom cluster experience.
Methods
This cross-sectional study analyzed data from 133 patients with hematologic cancer awaiting chemotherapy. Enzyme-linked immunosorbent assays analyzed the morning stress hormone levels (ACTH and cortisol). Latent profile analyses identified the group experiencing a psycho-neurological symptom cluster. Factors influencing the experience of the psycho-neurological symptom cluster were included as covariates and analyzed using multinomial logistic regression.
Results
Thirty-three percent (n = 44) experienced all five psycho-neurological symptoms as a cluster and experienced each symptom in a higher severity than those who did not experience the symptom cluster (ps < 0.05). Thereby, this group legitimately experienced the psycho-neurological symptom cluster. The major determinant of this group was the perceived psychological stress (OR = 8.05, 95% CI = 3.08; 20.99). Further, each symptom demonstrated a positive association with stress levels (correlation r ranged from 0.22 to 0. 56, all ps < 0.05). Participants with higher stress were more likely to experience the symptom cluster. Stress hormones levels (ACTH and cortisol) were neither associated with the symptom cluster experience nor with psychological stress levels.
Conclusions
Psychological stress, rather than biological stress response, is involved in experiencing the psycho-neurological symptom cluster. Managing stress levels would help alleviate this symptom cluster.
{"title":"Psychological and biological stress pathways as common mechanisms underlying a psycho-neurological symptom cluster in cancer patients: Perceived stress, cortisol, and ACTH","authors":"Hee-Ju Kim , Kyung Mi Chae , Sun-Ok Jung , Su Wol Chung , Tenko Raykov","doi":"10.1016/j.ejon.2024.102728","DOIUrl":"10.1016/j.ejon.2024.102728","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to examine (a) whether psychological stress is associated with experiencing multiple psycho-neurological symptoms (depression, cognitive impairment, fatigue, sleep disturbance, and pain) as a cluster and (b) whether stress hormones (adrenocorticotropic hormone [ACTH] and cortisol) are associated with psychological stress and symptom cluster experience.</div></div><div><h3>Methods</h3><div>This cross-sectional study analyzed data from 133 patients with hematologic cancer awaiting chemotherapy. Enzyme-linked immunosorbent assays analyzed the morning stress hormone levels (ACTH and cortisol). Latent profile analyses identified the group experiencing a psycho-neurological symptom cluster. Factors influencing the experience of the psycho-neurological symptom cluster were included as covariates and analyzed using multinomial logistic regression.</div></div><div><h3>Results</h3><div>Thirty-three percent (n = 44) experienced all five psycho-neurological symptoms as a cluster and experienced each symptom in a higher severity than those who did not experience the symptom cluster (<em>p</em>s < 0.05). Thereby, this group legitimately experienced the psycho-neurological symptom cluster. The major determinant of this group was the perceived psychological stress (OR = 8.05, 95% CI = 3.08; 20.99). Further, each symptom demonstrated a positive association with stress levels (correlation r ranged from 0.22 to 0. 56, all ps < 0.05). Participants with higher stress were more likely to experience the symptom cluster. Stress hormones levels (ACTH and cortisol) were neither associated with the symptom cluster experience nor with psychological stress levels.</div></div><div><h3>Conclusions</h3><div>Psychological stress, rather than biological stress response, is involved in experiencing the psycho-neurological symptom cluster. Managing stress levels would help alleviate this symptom cluster.</div></div>","PeriodicalId":51048,"journal":{"name":"European Journal of Oncology Nursing","volume":"74 ","pages":"Article 102728"},"PeriodicalIF":2.7,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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