Pub Date : 2024-07-01DOI: 10.1097/cr9.0000000000000060
Donruedee Kamkhoad, Autchareeya Patoomwan, S. Santacroce
Most children undergoing chemotherapy for cancer experience gastrointestinal (GI) tract symptoms that affect their eating habits, nutritional status, and quality of life (QOL). Previous research on the connections between these factors has primarily focused on Western countries. As a result, there is limited understanding of these issues among Thai children. To describe GI symptoms, eating, nutritional status, and QOL for Thai children with cancer. This descriptive study used multiple methods. Quantitative data were collected through (1) standardized measures of GI symptoms and QOL and (2) extraction of medical history and clinical data from the child’s medical records, then analyzed using descriptive statistics. Qualitative data were collected with semistructured interviews with each child, then their parent, and analyzed using a directed content analysis. Sixteen child-parent dyads participated in this study. Most children exhibited reduced food intake and weight loss, primarily attributed to GI symptoms and environmental factors. Underreporting of symptoms was identified, contributing to suboptimal symptom management. Clinician-recommended low-bacterial diets posed challenges to maintaining children’s food intake. Additionally, hospital food with repetitive menus and plain flavors was generally undesirable for children during hospitalization. Multifaceted factors influencing the nutritional status and QOL of children with cancer within the unique care context of Thailand were identified. The study findings inform the development of multi-level interventions targeting to optimize eating, nutritional status, and QOL for children with cancer. The model, informed by cultural considerations, could be adapted for research in other countries with distinctive cultures.
大多数接受癌症化疗的儿童都会出现胃肠道（GI）症状，这些症状会影响他们的饮食习惯、营养状况和生活质量（QOL）。以往有关这些因素之间联系的研究主要集中在西方国家。因此，泰国儿童对这些问题的了解十分有限。 本研究旨在描述泰国癌症儿童的消化道症状、饮食、营养状况和生活质量。 这项描述性研究采用了多种方法。定量数据通过以下方法收集：（1）消化道症状和 QOL 的标准化测量；（2）从患儿病历中提取病史和临床数据，然后使用描述性统计进行分析。定性数据是通过对每个儿童及其家长进行半结构式访谈收集的，并采用定向内容分析法进行分析。 共有 16 个儿童-家长二人组参与了本研究。大多数儿童表现出食物摄入量减少和体重下降，这主要归因于消化道症状和环境因素。研究发现，症状报告不足是导致症状管理不理想的原因之一。临床医生推荐的低菌饮食对维持儿童的食物摄入量构成了挑战。此外，儿童在住院期间普遍不喜欢菜单重复、口味单一的医院食物。 在泰国独特的医疗环境中，影响癌症患儿营养状况和 QOL 的因素是多方面的。 研究结果为制定旨在优化癌症患儿饮食、营养状况和 QOL 的多层次干预措施提供了参考。 该模型考虑了文化因素，可用于其他具有独特文化的国家的研究。
{"title":"Nutritional Status, Eating Behaviors, and Gastrointestinal Symptom Cluster Among Children Receiving Cancer Chemotherapy in Thailand: A Descriptive Study","authors":"Donruedee Kamkhoad, Autchareeya Patoomwan, S. Santacroce","doi":"10.1097/cr9.0000000000000060","DOIUrl":"https://doi.org/10.1097/cr9.0000000000000060","url":null,"abstract":"\u0000 \u0000 Most children undergoing chemotherapy for cancer experience gastrointestinal (GI) tract symptoms that affect their eating habits, nutritional status, and quality of life (QOL). Previous research on the connections between these factors has primarily focused on Western countries. As a result, there is limited understanding of these issues among Thai children.\u0000 \u0000 \u0000 \u0000 To describe GI symptoms, eating, nutritional status, and QOL for Thai children with cancer.\u0000 \u0000 \u0000 \u0000 This descriptive study used multiple methods. Quantitative data were collected through (1) standardized measures of GI symptoms and QOL and (2) extraction of medical history and clinical data from the child’s medical records, then analyzed using descriptive statistics. Qualitative data were collected with semistructured interviews with each child, then their parent, and analyzed using a directed content analysis.\u0000 \u0000 \u0000 \u0000 Sixteen child-parent dyads participated in this study. Most children exhibited reduced food intake and weight loss, primarily attributed to GI symptoms and environmental factors. Underreporting of symptoms was identified, contributing to suboptimal symptom management. Clinician-recommended low-bacterial diets posed challenges to maintaining children’s food intake. Additionally, hospital food with repetitive menus and plain flavors was generally undesirable for children during hospitalization.\u0000 \u0000 \u0000 \u0000 Multifaceted factors influencing the nutritional status and QOL of children with cancer within the unique care context of Thailand were identified.\u0000 \u0000 \u0000 \u0000 The study findings inform the development of multi-level interventions targeting to optimize eating, nutritional status, and QOL for children with cancer.\u0000 \u0000 \u0000 \u0000 The model, informed by cultural considerations, could be adapted for research in other countries with distinctive cultures.\u0000","PeriodicalId":72506,"journal":{"name":"Cancer care research online","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141850974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-07DOI: 10.1097/cr9.0000000000000059
J. Challinor
{"title":"Electricity Availability and Relevance for Oncology Nursing","authors":"J. Challinor","doi":"10.1097/cr9.0000000000000059","DOIUrl":"https://doi.org/10.1097/cr9.0000000000000059","url":null,"abstract":"","PeriodicalId":72506,"journal":{"name":"Cancer care research online","volume":" 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141375775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-23DOI: 10.1097/cr9.0000000000000058
Sarah Fortunato, Matteo Danielis, Renzo Zanotti
Breast cancer affects a woman’s body and mind in complex ways and is more than just a physical condition that requires medical treatment. To investigate how women with breast cancer undergoing surgical treatment cope with and adjust to the disease. A cross-sectional study between April 12 and July 22, 2022. This study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. A total of 125 women participated (median age 52). Most (64.8%) responded rationally, 25.4% emotionally, and 9.8% nonprevailing. About 76.2% used problem-focused coping. Women living with others had better adaptation than those alone. Emotional appraisal increased the likelihood of poor adaptation compared to rational appraisal. Nonprevailing coping was linked to a 6-fold increase in psychosocial maladjustment (OR, 5.88; 95% CI,1.14-30.30). The study indicates that women with breast cancer tend to adopt problem-focused coping strategies, with rational responses correlating with better psychological adaptation outcomes, while emotional or nonprevailing responses may lead to poorer adjustment. Coping strategies should be shared by oncology nurses with targeted women, especially if their potential for postdiagnosis positive psychological change is considered. Women diagnosed with breast cancer eligible for surgical treatment may undergo a positive psychological transformation, as the majority exhibit a problem-focused, rational approach to the disease.
{"title":"Coping in Women With Breast Cancer Awaiting a Surgical Intervention: A Cross-Sectional Study","authors":"Sarah Fortunato, Matteo Danielis, Renzo Zanotti","doi":"10.1097/cr9.0000000000000058","DOIUrl":"https://doi.org/10.1097/cr9.0000000000000058","url":null,"abstract":"\u0000 \u0000 Breast cancer affects a woman’s body and mind in complex ways and is more than just a physical condition that requires medical treatment.\u0000 \u0000 \u0000 \u0000 To investigate how women with breast cancer undergoing surgical treatment cope with and adjust to the disease.\u0000 \u0000 \u0000 \u0000 A cross-sectional study between April 12 and July 22, 2022. This study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.\u0000 \u0000 \u0000 \u0000 A total of 125 women participated (median age 52). Most (64.8%) responded rationally, 25.4% emotionally, and 9.8% nonprevailing. About 76.2% used problem-focused coping. Women living with others had better adaptation than those alone. Emotional appraisal increased the likelihood of poor adaptation compared to rational appraisal. Nonprevailing coping was linked to a 6-fold increase in psychosocial maladjustment (OR, 5.88; 95% CI,1.14-30.30).\u0000 \u0000 \u0000 \u0000 The study indicates that women with breast cancer tend to adopt problem-focused coping strategies, with rational responses correlating with better psychological adaptation outcomes, while emotional or nonprevailing responses may lead to poorer adjustment.\u0000 \u0000 \u0000 \u0000 Coping strategies should be shared by oncology nurses with targeted women, especially if their potential for postdiagnosis positive psychological change is considered.\u0000 \u0000 \u0000 \u0000 Women diagnosed with breast cancer eligible for surgical treatment may undergo a positive psychological transformation, as the majority exhibit a problem-focused, rational approach to the disease.\u0000","PeriodicalId":72506,"journal":{"name":"Cancer care research online","volume":"30 25","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140672077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.1097/cr9.0000000000000057
S. Morjaria, Claire Carmody, Saket Navlakha, Wei Zhou, Donna Braccia, Jennifer Aquino, Adam Roumm, Steve Martin, G. Syrkin
Despite decades of evidence demonstrating the effectiveness of multidisciplinary mobility initiatives in improving patient clinical outcomes, the impact of mobility programs in oncology-specific settings has been ignored. The objective of this initiative is to test evidence-based mobility interventions in a cancer care center to create a culture among clinicians that prioritizes patient mobilization. We compared postintervention and preintervention outcomes using logistic regression analysis and time-to-event modeling to assess hospital length of stay. Basic statistical methods assessed whether improving mobility influenced clinical outcomes and clinician culture. Outcome data from 493 in the postintervention arm were compared to 498 patients in the preintervention arm. Patients in the postintervention group had 39% decreased odds of having the rapid response team called (confidence interval [CI] =0.39–0.97; P = .03) and 46% decreased odds of being admitted to the intensive care unit (CI = 0.29–1.02; P = .05) compared to the preintervention group. No safety issues were associated with these interventions. Hospitalized patients with cancer are especially prone to considerable debility due to their disease and treatment effects. Our initiative to create a mobility protocol in 1 medical unit resulted in positive clinical outcomes. Findings from this study can be used to increase recognition of the benefits of mobility programs for hospitalized cancer patients. Promoting mobility in the hospital often involves collaboration among various healthcare professionals, including nurses, physical therapists, occupational therapists, and physicians. This interdisciplinary approach ensures that patients receive holistic care tailored to their specific needs.
{"title":"Mobility Is Medicine, Too: Creating a Culture of Mobility Amongst Hospitalized Patients With Cancer to Improve Patient Outcomes","authors":"S. Morjaria, Claire Carmody, Saket Navlakha, Wei Zhou, Donna Braccia, Jennifer Aquino, Adam Roumm, Steve Martin, G. Syrkin","doi":"10.1097/cr9.0000000000000057","DOIUrl":"https://doi.org/10.1097/cr9.0000000000000057","url":null,"abstract":"\u0000 \u0000 Despite decades of evidence demonstrating the effectiveness of multidisciplinary mobility initiatives in improving patient clinical outcomes, the impact of mobility programs in oncology-specific settings has been ignored.\u0000 \u0000 \u0000 \u0000 The objective of this initiative is to test evidence-based mobility interventions in a cancer care center to create a culture among clinicians that prioritizes patient mobilization.\u0000 \u0000 \u0000 \u0000 We compared postintervention and preintervention outcomes using logistic regression analysis and time-to-event modeling to assess hospital length of stay. Basic statistical methods assessed whether improving mobility influenced clinical outcomes and clinician culture.\u0000 \u0000 \u0000 \u0000 Outcome data from 493 in the postintervention arm were compared to 498 patients in the preintervention arm. Patients in the postintervention group had 39% decreased odds of having the rapid response team called (confidence interval [CI] =0.39–0.97; P = .03) and 46% decreased odds of being admitted to the intensive care unit (CI = 0.29–1.02; P = .05) compared to the preintervention group. No safety issues were associated with these interventions.\u0000 \u0000 \u0000 \u0000 Hospitalized patients with cancer are especially prone to considerable debility due to their disease and treatment effects. Our initiative to create a mobility protocol in 1 medical unit resulted in positive clinical outcomes.\u0000 \u0000 \u0000 \u0000 Findings from this study can be used to increase recognition of the benefits of mobility programs for hospitalized cancer patients.\u0000 \u0000 \u0000 \u0000 Promoting mobility in the hospital often involves collaboration among various healthcare professionals, including nurses, physical therapists, occupational therapists, and physicians. This interdisciplinary approach ensures that patients receive holistic care tailored to their specific needs.\u0000","PeriodicalId":72506,"journal":{"name":"Cancer care research online","volume":"196 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140759808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-15DOI: 10.1097/cr9.0000000000000056
C. García-Vivar, Irati Rodríguez-Matesanz
{"title":"Long-term Cancer Survivorship: A Family Affair","authors":"C. García-Vivar, Irati Rodríguez-Matesanz","doi":"10.1097/cr9.0000000000000056","DOIUrl":"https://doi.org/10.1097/cr9.0000000000000056","url":null,"abstract":"","PeriodicalId":72506,"journal":{"name":"Cancer care research online","volume":"60 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140239897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-29DOI: 10.1097/cr9.0000000000000054
M. G. Christiansen, Mary Jarden, S. Colomer-Lahiguera, M. Eicher, Denise Bryant-Lukosius, M. Mirza, Helle Pappot, Karin Piil
Women with ovarian or endometrial cancer experience multiple symptoms during chemotherapy. Specialized cancer nurses possess specific knowledge and competencies to effectively monitor and manage treatment-related toxicities and provide self-management support. To describe the conception and development of a comprehensive cancer symptom model of care in an oncological setting for women diagnosed with ovarian or endometrial cancer. The participatory evidence-based, patient-focused process for guiding the development, implementation, and evaluation of advanced practice nursing roles—the participatory, evidence-based, patient-centered process for advanced practice (PEPPA) framework directed the process. The first 6 steps of this 9-step framework were utilized to incorporate research evidence, engage, and obtain the input of key stakeholders. Stakeholders (n = 27) contributed with specific knowledge, perspectives, and feedback to the entire development process, and several needs were identified. Following structured discussions, a new model of cancer symptom care with elements such as symptom management, electronic patient-reported outcomes, and an expanded nursing role in the form of nurse-led consultations was developed. We effectively utilized the PEPPA framework to design a new cancer symptom model of care, that was agreed upon by key stakeholders. This stakeholder-engaged, and evidence-driven process could be used as a template for others wanting to develop a population-specific model of care to improve cancer symptom management. With the expansion of the cancer nursing role, the new model has the potential to improve the quality of cancer care and health outcomes related to symptom management.
{"title":"Development of a Comprehensive Model for Cancer Symptom Care for Women With Ovarian or Endometrial Cancer","authors":"M. G. Christiansen, Mary Jarden, S. Colomer-Lahiguera, M. Eicher, Denise Bryant-Lukosius, M. Mirza, Helle Pappot, Karin Piil","doi":"10.1097/cr9.0000000000000054","DOIUrl":"https://doi.org/10.1097/cr9.0000000000000054","url":null,"abstract":"\u0000 \u0000 Women with ovarian or endometrial cancer experience multiple symptoms during chemotherapy. Specialized cancer nurses possess specific knowledge and competencies to effectively monitor and manage treatment-related toxicities and provide self-management support.\u0000 \u0000 \u0000 \u0000 To describe the conception and development of a comprehensive cancer symptom model of care in an oncological setting for women diagnosed with ovarian or endometrial cancer.\u0000 \u0000 \u0000 \u0000 The participatory evidence-based, patient-focused process for guiding the development, implementation, and evaluation of advanced practice nursing roles—the participatory, evidence-based, patient-centered process for advanced practice (PEPPA) framework directed the process. The first 6 steps of this 9-step framework were utilized to incorporate research evidence, engage, and obtain the input of key stakeholders.\u0000 \u0000 \u0000 \u0000 Stakeholders (n = 27) contributed with specific knowledge, perspectives, and feedback to the entire development process, and several needs were identified. Following structured discussions, a new model of cancer symptom care with elements such as symptom management, electronic patient-reported outcomes, and an expanded nursing role in the form of nurse-led consultations was developed.\u0000 \u0000 \u0000 \u0000 We effectively utilized the PEPPA framework to design a new cancer symptom model of care, that was agreed upon by key stakeholders.\u0000 \u0000 \u0000 \u0000 This stakeholder-engaged, and evidence-driven process could be used as a template for others wanting to develop a population-specific model of care to improve cancer symptom management.\u0000 \u0000 \u0000 \u0000 With the expansion of the cancer nursing role, the new model has the potential to improve the quality of cancer care and health outcomes related to symptom management.\u0000","PeriodicalId":72506,"journal":{"name":"Cancer care research online","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140415874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-14DOI: 10.1097/cr9.0000000000000055
M. Mullis, Easton N Wollney, Carma L. Bylund, G. Campbell-Salome, Kevin B. Wright, M. Sae-Hau, E. Weiss, M. Rajotte, Carla L. Fisher
Spouses are the most common type of cancer caregiver and a primary source of support across the cancer continuum. While studies show that cancer can impact caregivers’ health outcomes, less is known about how blood cancer impacts the spousal relationship. We sought to examine the impact of blood cancer on the relational connection of married couples from the perspective of the spousal caregiver. We thematically analyzed transcripts of in-depth interviews with caregivers of a spouse diagnosed with a blood cancer. Caregivers (n = 27) identified positive and negative relational impacts related to physical intimacy, emotional intimacy, marital roles, discordance between spouses in coping, and a disrupted relational future. Spousal caregivers must navigate ongoing relational impacts across the care continuum. These relational effects illustrate how cancer jointly impacts diagnosed individuals and their caregiving spouses, altering their relational connection, roles, and future as a couple. While marital bonds can become strengthened after cancer, it also challenges couples and how they typically relate, which may be informed by gendered norms in some marital relationships. To provide better support, educational resources and interventions are needed to help couples prepare for and address challenges with intimacy, gender roles, discordant communication and coping preferences, managing discussions about their future, and coping with uncertainty. To support individuals living with blood cancer and their caregiving spouses, their needs must be understood from a family-centered or relational perspective to better facilitate psychosocial adjustment during and after cancer treatment.
{"title":"“A Caregiver’s Marriage”: The Impact of Blood Cancer on the Spousal Connection","authors":"M. Mullis, Easton N Wollney, Carma L. Bylund, G. Campbell-Salome, Kevin B. Wright, M. Sae-Hau, E. Weiss, M. Rajotte, Carla L. Fisher","doi":"10.1097/cr9.0000000000000055","DOIUrl":"https://doi.org/10.1097/cr9.0000000000000055","url":null,"abstract":"\u0000 \u0000 Spouses are the most common type of cancer caregiver and a primary source of support across the cancer continuum. While studies show that cancer can impact caregivers’ health outcomes, less is known about how blood cancer impacts the spousal relationship.\u0000 \u0000 \u0000 \u0000 We sought to examine the impact of blood cancer on the relational connection of married couples from the perspective of the spousal caregiver.\u0000 \u0000 \u0000 \u0000 We thematically analyzed transcripts of in-depth interviews with caregivers of a spouse diagnosed with a blood cancer.\u0000 \u0000 \u0000 \u0000 Caregivers (n = 27) identified positive and negative relational impacts related to physical intimacy, emotional intimacy, marital roles, discordance between spouses in coping, and a disrupted relational future.\u0000 \u0000 \u0000 \u0000 Spousal caregivers must navigate ongoing relational impacts across the care continuum. These relational effects illustrate how cancer jointly impacts diagnosed individuals and their caregiving spouses, altering their relational connection, roles, and future as a couple. While marital bonds can become strengthened after cancer, it also challenges couples and how they typically relate, which may be informed by gendered norms in some marital relationships.\u0000 \u0000 \u0000 \u0000 To provide better support, educational resources and interventions are needed to help couples prepare for and address challenges with intimacy, gender roles, discordant communication and coping preferences, managing discussions about their future, and coping with uncertainty.\u0000 \u0000 \u0000 \u0000 To support individuals living with blood cancer and their caregiving spouses, their needs must be understood from a family-centered or relational perspective to better facilitate psychosocial adjustment during and after cancer treatment.\u0000","PeriodicalId":72506,"journal":{"name":"Cancer care research online","volume":"17 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139777266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-14DOI: 10.1097/cr9.0000000000000055
M. Mullis, Easton N Wollney, Carma L. Bylund, G. Campbell-Salome, Kevin B. Wright, M. Sae-Hau, E. Weiss, M. Rajotte, Carla L. Fisher
Spouses are the most common type of cancer caregiver and a primary source of support across the cancer continuum. While studies show that cancer can impact caregivers’ health outcomes, less is known about how blood cancer impacts the spousal relationship. We sought to examine the impact of blood cancer on the relational connection of married couples from the perspective of the spousal caregiver. We thematically analyzed transcripts of in-depth interviews with caregivers of a spouse diagnosed with a blood cancer. Caregivers (n = 27) identified positive and negative relational impacts related to physical intimacy, emotional intimacy, marital roles, discordance between spouses in coping, and a disrupted relational future. Spousal caregivers must navigate ongoing relational impacts across the care continuum. These relational effects illustrate how cancer jointly impacts diagnosed individuals and their caregiving spouses, altering their relational connection, roles, and future as a couple. While marital bonds can become strengthened after cancer, it also challenges couples and how they typically relate, which may be informed by gendered norms in some marital relationships. To provide better support, educational resources and interventions are needed to help couples prepare for and address challenges with intimacy, gender roles, discordant communication and coping preferences, managing discussions about their future, and coping with uncertainty. To support individuals living with blood cancer and their caregiving spouses, their needs must be understood from a family-centered or relational perspective to better facilitate psychosocial adjustment during and after cancer treatment.
{"title":"“A Caregiver’s Marriage”: The Impact of Blood Cancer on the Spousal Connection","authors":"M. Mullis, Easton N Wollney, Carma L. Bylund, G. Campbell-Salome, Kevin B. Wright, M. Sae-Hau, E. Weiss, M. Rajotte, Carla L. Fisher","doi":"10.1097/cr9.0000000000000055","DOIUrl":"https://doi.org/10.1097/cr9.0000000000000055","url":null,"abstract":"\u0000 \u0000 Spouses are the most common type of cancer caregiver and a primary source of support across the cancer continuum. While studies show that cancer can impact caregivers’ health outcomes, less is known about how blood cancer impacts the spousal relationship.\u0000 \u0000 \u0000 \u0000 We sought to examine the impact of blood cancer on the relational connection of married couples from the perspective of the spousal caregiver.\u0000 \u0000 \u0000 \u0000 We thematically analyzed transcripts of in-depth interviews with caregivers of a spouse diagnosed with a blood cancer.\u0000 \u0000 \u0000 \u0000 Caregivers (n = 27) identified positive and negative relational impacts related to physical intimacy, emotional intimacy, marital roles, discordance between spouses in coping, and a disrupted relational future.\u0000 \u0000 \u0000 \u0000 Spousal caregivers must navigate ongoing relational impacts across the care continuum. These relational effects illustrate how cancer jointly impacts diagnosed individuals and their caregiving spouses, altering their relational connection, roles, and future as a couple. While marital bonds can become strengthened after cancer, it also challenges couples and how they typically relate, which may be informed by gendered norms in some marital relationships.\u0000 \u0000 \u0000 \u0000 To provide better support, educational resources and interventions are needed to help couples prepare for and address challenges with intimacy, gender roles, discordant communication and coping preferences, managing discussions about their future, and coping with uncertainty.\u0000 \u0000 \u0000 \u0000 To support individuals living with blood cancer and their caregiving spouses, their needs must be understood from a family-centered or relational perspective to better facilitate psychosocial adjustment during and after cancer treatment.\u0000","PeriodicalId":72506,"journal":{"name":"Cancer care research online","volume":"58 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139836853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-06DOI: 10.1097/cr9.0000000000000053
Atinuke G. Oyinbo, Maira A. Castañeda-Avila, Mayra S. Tisminetzky, Jamie M. Faro, Mara M. Epstein, Kate Lapane
Most cancer survivors have multiple chronic conditions (MCC) that make it challenging to navigate disease management processes post cancer treatment. To examine associations between having MCC and receiving a survivorship care plan (SCP), which has potential benefits for improved follow-up care, among cancer survivors. Behavioral Risk Factor Surveillance System respondents with a self-reported history of cancer not actively receiving cancer treatment were included (N = 5449). SCP receipt was defined as being provided a written summary of cancer treatments received and instructions for follow-up care upon treatment completion. MCC was categorized as 0, 1, 2, or ≥3 based on a sum of 10 chronic conditions. Multivariable-adjusted logistic models were used to assess the association between MCC and SCP receipt. Most cancer survivors were age 65 or older (59%) and female (58%). Sixty percent reported receiving an SCP and 50% had at least 2 chronic conditions. Compared to those with no chronic conditions, cancer survivors with 2 and 3 or more conditions were less likely to have received an SCP. Professional organizations recommend that cancer survivors receive SCPs; however, having MCC was inversely associated with SCP provision. The high necessity for SCPs among cancer survivors with MCC and the potential barriers associated with their delivery should be recognized by healthcare professionals. This work highlights unmet survivorship care needs in cancer survivors with MCC. The findings emphasize the need to promote greater access to SCPs in healthcare settings that cater to cancer survivors with comorbid conditions.
{"title":"Multiple Chronic Conditions and the Receipt of Cancer Survivorship Care Plans","authors":"Atinuke G. Oyinbo, Maira A. Castañeda-Avila, Mayra S. Tisminetzky, Jamie M. Faro, Mara M. Epstein, Kate Lapane","doi":"10.1097/cr9.0000000000000053","DOIUrl":"https://doi.org/10.1097/cr9.0000000000000053","url":null,"abstract":"\u0000 \u0000 Most cancer survivors have multiple chronic conditions (MCC) that make it challenging to navigate disease management processes post cancer treatment.\u0000 \u0000 \u0000 \u0000 To examine associations between having MCC and receiving a survivorship care plan (SCP), which has potential benefits for improved follow-up care, among cancer survivors.\u0000 \u0000 \u0000 \u0000 Behavioral Risk Factor Surveillance System respondents with a self-reported history of cancer not actively receiving cancer treatment were included (N = 5449). SCP receipt was defined as being provided a written summary of cancer treatments received and instructions for follow-up care upon treatment completion. MCC was categorized as 0, 1, 2, or ≥3 based on a sum of 10 chronic conditions. Multivariable-adjusted logistic models were used to assess the association between MCC and SCP receipt.\u0000 \u0000 \u0000 \u0000 Most cancer survivors were age 65 or older (59%) and female (58%). Sixty percent reported receiving an SCP and 50% had at least 2 chronic conditions. Compared to those with no chronic conditions, cancer survivors with 2 and 3 or more conditions were less likely to have received an SCP.\u0000 \u0000 \u0000 \u0000 Professional organizations recommend that cancer survivors receive SCPs; however, having MCC was inversely associated with SCP provision.\u0000 \u0000 \u0000 \u0000 The high necessity for SCPs among cancer survivors with MCC and the potential barriers associated with their delivery should be recognized by healthcare professionals.\u0000 \u0000 \u0000 \u0000 This work highlights unmet survivorship care needs in cancer survivors with MCC. The findings emphasize the need to promote greater access to SCPs in healthcare settings that cater to cancer survivors with comorbid conditions.\u0000","PeriodicalId":72506,"journal":{"name":"Cancer care research online","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139860910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-06DOI: 10.1097/cr9.0000000000000052
James Evans, Julie Lanigan, Dan Green, G. O’Connor, Faith Gibson
Children undergoing bone marrow transplant (BMT) are at risk of developing malnutrition. A feeding tube becomes a requirement for most children to meet their nutritional and medication requirements. Two tubes are typically used: nasogastric tube (NGT) or gastrostomy. At the UK center where this study took place, parents are offered a choice between these tubes. This qualitative data collection in a mixed methods study explored why parents choose either tube and their experiences of using it. Parents participated in 2 semistructured interviews. First, on admission to explore why they chose either tube. Second, 1–2 months postdischarge to explore their experience of using the tube. Interviews took place over 18 months. Transcripts were thematically analyzed. Sixteen parents whose child had an NGT, 17 a gastrostomy, were interviewed. Choice was experienced across a continuum of difficulty and freedom. Many parents deferred to the expertise of professionals; others felt they were the experts in their child. Influential factors in decision-making included expected duration of need, the child’s age and activity, cosmetic differences, balancing gastrostomy surgery against NGT dislodgement, lay advice, healthcare professionals’ recommendations and prior tube feeding experiences. Parents valued choice appreciating 1 feeding tube might not suit every child. Choice of a gastrostomy or NGT should be offered to children prior to BMT. Parents navigate a complex decision-making process when choosing a feeding tube for their child. Healthcare professionals can facilitate informed decision-making through collaborative discussions, inclusion of peer support, and provision of balanced information.
{"title":"One Tube Does Not Fit All: Parent Experiences and Decision-Making for Choosing a Nasogastric Tube or Gastrostomy for Their Child During Allogeneic Bone Marrow Transplant","authors":"James Evans, Julie Lanigan, Dan Green, G. O’Connor, Faith Gibson","doi":"10.1097/cr9.0000000000000052","DOIUrl":"https://doi.org/10.1097/cr9.0000000000000052","url":null,"abstract":"\u0000 \u0000 Children undergoing bone marrow transplant (BMT) are at risk of developing malnutrition. A feeding tube becomes a requirement for most children to meet their nutritional and medication requirements. Two tubes are typically used: nasogastric tube (NGT) or gastrostomy. At the UK center where this study took place, parents are offered a choice between these tubes.\u0000 \u0000 \u0000 \u0000 This qualitative data collection in a mixed methods study explored why parents choose either tube and their experiences of using it.\u0000 \u0000 \u0000 \u0000 Parents participated in 2 semistructured interviews. First, on admission to explore why they chose either tube. Second, 1–2 months postdischarge to explore their experience of using the tube. Interviews took place over 18 months. Transcripts were thematically analyzed.\u0000 \u0000 \u0000 \u0000 Sixteen parents whose child had an NGT, 17 a gastrostomy, were interviewed. Choice was experienced across a continuum of difficulty and freedom. Many parents deferred to the expertise of professionals; others felt they were the experts in their child. Influential factors in decision-making included expected duration of need, the child’s age and activity, cosmetic differences, balancing gastrostomy surgery against NGT dislodgement, lay advice, healthcare professionals’ recommendations and prior tube feeding experiences.\u0000 \u0000 \u0000 \u0000 Parents valued choice appreciating 1 feeding tube might not suit every child.\u0000 \u0000 \u0000 \u0000 Choice of a gastrostomy or NGT should be offered to children prior to BMT.\u0000 \u0000 \u0000 \u0000 Parents navigate a complex decision-making process when choosing a feeding tube for their child. Healthcare professionals can facilitate informed decision-making through collaborative discussions, inclusion of peer support, and provision of balanced information.\u0000","PeriodicalId":72506,"journal":{"name":"Cancer care research online","volume":"315 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139858318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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