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Pennington KP, Schlumbrecht M, McGregor BA, Goodheart MJ, Heron L, Zimmerman B, Telles R, Zia S, Penedo FJ, Lutgendorf SK. Living Well: Protocol for a web-based program to improve quality of life in rural and urban ovarian cancer survivors. Contemp Clin Trials 2024; 144:107612. [PMID: 38914309 PMCID: PMC11323255 DOI: 10.1016/j.cct.2024.107612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 06/18/2024] [Accepted: 06/21/2024] [Indexed: 06/26/2024]
Abstract
BACKGROUND Ovarian cancer (OC) survivors commonly experience chronic symptoms including anxiety, depression, sleep disturbances, fatigue, physical symptoms, poor health-related quality of life (HRQOL), and a generally poor prognosis. Additionally, factors such as social isolation, stress, and depression are associated with key biological processes promoting tumor progression and poorer survival. Accessible psychosocial interventions to improve HRQOL and clinical outcomes are needed. This need is particularly true in rural settings where survivors may have less access to clinic-based support systems. METHODS The Living Well Study, a cluster-randomized Phase II multi-site clinical trial, is designed to evaluate the efficacy of a group-based, web-delivered psychosocial intervention (Mindful Living) verses a Health Promotion active control (Healthy Lifestyles) in increasing HRQOL and decreasing perceived stress (primary outcomes), depressive mood, anxiety, and fatigue (secondary outcomes) for 256 OC survivors who are <5 years post-primary therapy. Mindful Living targets key concerns of OC survivors and teaches stress reduction skills and coping strategies utilizing cognitive behavioral, mindfulness, and acceptance and commitment therapies. Healthy Lifestyles provides lifestyle information including exercise, nutrition, sleep, and other survivorship topics. Interventions consist of 11 consecutive weekly group sessions lasting 1.5-2 h led by trained facilitators and two booster sessions. Participants complete psychosocial questionnaires at baseline, post-intervention, at 6-months, and at 12-months. A subset completes bloodspots for analysis of inflammatory biology. CONCLUSION Easily accessible psychosocial interventions addressing key concerns of OC survivors are an unmet need. The Mindful Living intervention has the potential to substantially enhance HRQOL and decrease distress in OC survivors. Trial registrationclinicaltrials.gov Identifier: NCT04533763.
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Affiliation(s)
| | - Matthew Schlumbrecht
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, United States
| | | | - Michael J Goodheart
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA, United States; Holden Comprehensive Center, University of Iowa, Iowa City, IA, United States
| | - Leslie Heron
- Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - Bridget Zimmerman
- Department of Biostatistics, University of Iowa, Iowa City, IA, United States
| | - Rachel Telles
- Department of Psychological & Brain Sciences, University of Iowa, Iowa City, IA, United States
| | - Sharaf Zia
- Institute of Clinical and Translation Sciences, University of Iowa Hospital & Clinics, Iowa City, IA, United States
| | - Frank J Penedo
- Departments of Psychology and Medicine, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, United States
| | - Susan K Lutgendorf
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA, United States; Holden Comprehensive Center, University of Iowa, Iowa City, IA, United States; Department of Psychological & Brain Sciences, University of Iowa, Iowa City, IA, United States.
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Maral S, Bilmez H, Satici SA. Positive Childhood Experiences and Spiritual Well-Being: Psychological Flexibility and Meaning-Based Coping as Mediators in Turkish Sample. JOURNAL OF RELIGION AND HEALTH 2024; 63:2709-2726. [PMID: 38913254 PMCID: PMC11319421 DOI: 10.1007/s10943-024-02079-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/14/2024] [Indexed: 06/25/2024]
Abstract
Spiritual well-being enhances life quality, acts as a stress reliever, and mitigates unfavorable feelings. It helps individuals find meaning and purpose, increasing inner peace and happiness while improving stress management and overall well-being. This study examined whether positive childhood experiences are linked to spiritual well-being and if psychological flexibility and meaning-based coping serve as mediators. The sample included 1061 participants (Mage = 39.38; SD = 8.82) from various Turkish cities. Structural equation modeling assessed relationships between spiritual well-being, positive childhood experiences, psychological flexibility, and meaning-based coping. Results showed that positive childhood experiences directly enhance spiritual well-being, mediated by psychological flexibility and meaning-based coping. This underscores the significance of fostering positive childhood experiences to promote spiritual well-being and coping mechanisms.
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Affiliation(s)
- Sibel Maral
- Department of Psychological Counselling, Faculty of Education, Yildiz Technical University, Istanbul, Türkiye.
| | - Huzeyfe Bilmez
- Department of Psychological Counselling, Faculty of Education, Yildiz Technical University, Istanbul, Türkiye
| | - Seydi Ahmet Satici
- Department of Psychological Counselling, Faculty of Education, Yildiz Technical University, Istanbul, Türkiye
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Glaser KM, Crabtree-Ide CR, Flores TF, Reid ME. Integrating Yoga into Comprehensive Cancer Care: Starting Somewhere. Eur J Integr Med 2024; 67:102348. [PMID: 39372426 PMCID: PMC11449015 DOI: 10.1016/j.eujim.2024.102348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/08/2024]
Abstract
Introduction The rapid increase in cancer survivors in the United States (US) highlights the importance of survivors' long-term care needs and symptom management. Given evidence that yoga supports cancer related symptoms, our aim was to develop and implement a community yoga program available for cancer survivors, family members, and staff involved in cancer care at a public comprehensive cancer center in the US. Given the wide age range and potential side effects from cancer treatment, we adapted the yoga program to meet the needs of cancer survivors. Methods Beginning in May 2017, we offered sixty-minute gentle yoga sessions for all medically cleared cancer survivors and their family members, caregivers, and friends, as well as oncology staff. We aimed to evaluate acceptability, development, and implementation of an adaptive yoga program at our comprehensive cancer center using mixed methods. Classes were initially offered once a week, then increased to twice a week. A total of five service evaluations were sent approximately every six months between April 2018-October 2019 to evaluate participant satisfaction (n=90 responses). Qualitative data were collected and analyzed using thematic analysis of participant satisfaction, allowing us to continuously monitor the yoga program and adjust to meet participants' needs. Results Between May 2017 and February 2020, 176 people attended our program. Ages ranged from 21 to 72 years, with an average age of 45 years. Based on these evaluations, 96% (n=86) of participants rated both the program and teachers excellent, and 4% (n=4) rated the program and teachers good. Qualitative themes highlighted positive aspects of the program, including accessibility, inclusivity, and adaptive yoga based on medical needs, skill level, and abilities. Conclusions Adaptive yoga programs are well-accepted by cancer survivors and caregivers and may contribute a solution to healthcare staff and physician burnout. It is essential to build a solid foundation of self-care and wellness programming for cancer survivors and to create and foster adaptive yoga classes. Next steps for our program include evaluating yoga within the clinical setting, including chemotherapy infusion center and further research on reduction in stress through yoga in cancer survivors.
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Affiliation(s)
- Kathryn M. Glaser
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | | | - Tessa F. Flores
- Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Mary E. Reid
- Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, New York
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Tomić SD, Malenković G, Šljivo A, Mujičić E, Tomić S. The Role of Resilience in the Relationship between Sociodemographic, Clinical Characteristics, and Social Support among Breast Cancer Patients in Serbia. Healthcare (Basel) 2023; 11:3184. [PMID: 38132074 PMCID: PMC10743069 DOI: 10.3390/healthcare11243184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 12/13/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND The management of breast cancer treatments within the limitations of family, social, and professional life is emotionally burdening and negatively affects physical, psychological, and social well-being, reducing the overall quality of life of patients and their families. METHODS This cross-sectional descriptive-analytical study was conducted from March to August 2023 at the "Dr. Radivoj Simonović" General Hospital in Sombor. A total of 236 breast cancer patients participated in this study. The research was conducted using the following instruments: a questionnaire on sociodemographic and clinical characteristics of patients, the Berlin Social-Support Scales-for assessing social support-and the Connor-Davidson Resilience Scale-for assessing resilience. This study aimed to determine the predictors and levels of social support and resilience of breast cancer patients. We also wanted to examine whether resilience is a mediator between patients' sociodemographic and clinical characteristics and levels of social support. RESULTS The total average value of social support was 3.51 ± 0.63, while on the resilience scale, the respondents achieved a total average score of 52.2 ± 9.63. Perceived and actually received social support of breast cancer patients were positively correlated with resilience [p < 0.01], while no statistically significant correlations were found for the need for support and satisfaction. The sets of predictors can significantly predict their effects on all types of perceived social support (emotional social support: 9%; perceived instrumental social support: 9%) and all types of received social support (actually received emotional social support: 8%; actually received instrumental social support: 7%; actually received informational social support: 8%). There is a potential mediating role of resilience in relation to sociodemographic factors, clinical characteristics, and the need for support. CONCLUSION This study confirms that a strong connection exists between social support and resilience. However, the analysis did not confirm the mediating role of resilience between the sociodemographic and clinical characteristics on the one hand and social support on the other.
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Affiliation(s)
- Sanja D Tomić
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia; (G.M.); (S.T.)
| | - Goran Malenković
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia; (G.M.); (S.T.)
| | - Armin Šljivo
- Clinical Center, University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina; (A.Š.); (E.M.)
| | - Ermina Mujičić
- Clinical Center, University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina; (A.Š.); (E.M.)
| | - Slobodan Tomić
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia; (G.M.); (S.T.)
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Spampinato S, Rancati T, Waskiewicz JM, Avuzzi B, Garibaldi E, Faiella A, Villa E, Magli A, Cante D, Girelli G, Gatti M, Noris Chiorda B, Rago L, Ferrari P, Piva C, Pavarini M, Valdagni R, Vavassori V, Munoz F, Sanguineti G, Di Muzio N, Kirchheiner K, Fiorino C, Cozzarini C. Patient-reported persistent symptoms after radiotherapy and association with quality of life for prostate cancer survivors. Acta Oncol 2023; 62:1440-1450. [PMID: 37801288 DOI: 10.1080/0284186x.2023.2259597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 09/11/2023] [Indexed: 10/07/2023]
Abstract
PURPOSE To evaluate the persistence of symptoms after radiotherapy (RT) for localised prostate cancer (PCa) and the association with quality of life (QOL). MATERIALS AND METHODS Prospective patient-reported outcome (PRO) from a multi-institutional study on PCa treated with radical RT (2010-2014) was analysed. Data was collected at baseline (BL) and follow-ups (FUPs) up to 5 years. Patients with BL and ≥3 late FUPs (≥6 months) were analysed. PRO was scored by means of the IPSS and ICIQ-SF (urinary), LENT-SOMA (gastrointestinal [GI]), and EORTC-C30 (pain, insomnia, fatigue, and QOL) questionnaires. Symptoms were defined 'persistent' if the median score over FUPs was ≥3 (urinary) or ≥2 (GI, pain, insomnia, and fatigue), and worse than BL. Different thresholds were chosen to have enough events for each symptom. QOL was linearly transformed on a continuous scale (0-100). Linear-mixed models were used to identify significant differences between groups with and without persistent symptoms including age, smoking status, previous abdominal surgery, and diabetes as confounders. Mean QOL differences between groups were evaluated longitudinally over FUPs. RESULTS The analysis included 293 patients. Persistent urinary symptoms ranged from 2% (straining) to 12% (weak stream, and nocturia). Gastrointestinal symptoms ranged from 7% (rectal pain, and incontinence) to 30% (urgency). Proportions of pain, insomnia, and fatigue were 6, 13, and 18%. Significant QOL differences of small-to-medium clinical relevance were found for urinary incontinence, frequency, urgency, and nocturia. Among GI symptoms, rectal pain and incontinence showed small-to-medium differences. Fatigue was associated with the largest differences. CONCLUSIONS The analysis showed that symptoms after RT for PCa occur with different persistence and their association with QOL varies in magnitude. A number of persistent urinary and GI symptoms showed differences in a comparable range. Urinary incontinence and frequency, rectal pain, and faecal incontinence more often had significant associations. Fatigue was also prevalent and associated with largely deteriorated QOL.
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Affiliation(s)
- Sofia Spampinato
- Danish Centre for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - Tiziana Rancati
- Data Science, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Barbara Avuzzi
- Department of Radiation Oncology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Elisabetta Garibaldi
- Department of Radiotherapy, Ospedale Regionale Parini-AUSL Valle d'Aosta, Aosta, Italy
| | - Adriana Faiella
- Department of Radiotherapy, IRCCS Istituto Tumori 'Regina Elena', Rome, Italy
| | - Elisa Villa
- Department of Radiotherapy, Humanitas Gavazzeni, Bergamo, Italy
| | - Alessandro Magli
- Department of Radiotherapy, Azienda Ospedaliero Universitaria S. Maria della Misericordia, Udine, Italy
| | - Domenico Cante
- Department of Radiotherapy, ASL TO4 Ospedale di Ivrea, Ivrea, Italy
| | - Giuseppe Girelli
- Department of Radiotherapy, Ospedale degli Infermi, Biella, Italy
| | - Marco Gatti
- Department of Radiotherapy, Istituto di Candiolo - Fondazione del Piemonte per l'Oncologia IRCCS, Candiolo, Italy
| | - Barbara Noris Chiorda
- Department of Radiation Oncology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Luciana Rago
- Department of Radiotherapy, IRCCS CROB, Rionero in Vulture, Italy
| | - Paolo Ferrari
- Department of Health Physics, Provincial Hospital of Bolzano (SABES-ASDAA), Bolzano-Bozen, Italy; Lehrkrankenhaus der Paracelsus Medizinischen Privatuniversität
| | - Cristina Piva
- Department of Radiotherapy, ASL TO4 Ospedale di Ivrea, Ivrea, Italy
| | - Maddalena Pavarini
- Department of Medical Physics, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Riccardo Valdagni
- Department of Radiation Oncology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | | | - Fernando Munoz
- Department of Radiotherapy, Ospedale Regionale Parini-AUSL Valle d'Aosta, Aosta, Italy
| | - Giuseppe Sanguineti
- Department of Radiotherapy, IRCCS Istituto Tumori 'Regina Elena', Rome, Italy
| | - Nadia Di Muzio
- Department of Radiotherapy, San Raffaele Scientific Institute and Università Vita Salute San Raffaele, Milan, Italy
| | - Kathrin Kirchheiner
- Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Claudio Fiorino
- Department of Medical Physics, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Cesare Cozzarini
- Department of Radiotherapy, IRCCS San Raffaele Scientific Institute, Milan, Italy
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Pasvanis M, Hegarty S, Russell H, Peate M, Marino JL. Exploring the experiences and priorities of women with a diagnosis of ovarian cancer. Support Care Cancer 2023; 31:432. [PMID: 37389743 DOI: 10.1007/s00520-023-07903-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 06/23/2023] [Indexed: 07/01/2023]
Abstract
PURPOSE Ovarian cancer is the third most common gynaecological cancer among women, yet remains under-researched. Past studies suggest that women who present with ovarian cancer have more supportive care needs compared to women experiencing other gynaecological cancers. This study explores the experiences and priorities of women with a diagnosis of ovarian cancer and whether age may influence these needs and experiences. METHODS Participants were recruited by a community organization, Ovarian Cancer Australia (OCA), via a social media campaign promoted on Facebook. Participants were asked to rank priorities around living with ovarian cancer, and to endorse which supports and resources they had used to address those priorities. Distributions of priority rankings and resource use were compared by age (19-49 vs. 50+ years). RESULTS Two hundred and eighty-eight people completed the consumer survey and most respondents were 60-69 years (33.7%). Priorities did not vary by age. Fear of cancer recurrence was identified by 51% respondents as the most challenging aspect of having ovarian cancer. Compared with older respondents, a higher proportion of young participants were more inclined to use a mobile app version of the OCA resilience kit (25.8% vs 45.1%, p=0.002) and expressed interest in using a fertility preservation decision aid (2.4% vs 25%, p<0.001). CONCLUSION Fear of recurrence was participants' primary concern, presenting an opportunity to develop interventions. Information delivery needs to consider age-specific preferences to better reach the target audience. Fertility is more important to younger women and a fertility preservation decision aid may address this need.
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Affiliation(s)
- Maree Pasvanis
- Department of Obstetrics and Gynaecology, Royal Women's Hospital, University of Melbourne, Parkville, VIC, Australia
| | - Sue Hegarty
- Ovarian Cancer Australia, Melbourne, VIC, Australia
| | | | - Michelle Peate
- Department of Obstetrics and Gynaecology, Royal Women's Hospital, University of Melbourne, Parkville, VIC, Australia
| | - Jennifer L Marino
- Department of Obstetrics and Gynaecology, Royal Women's Hospital, University of Melbourne, Parkville, VIC, Australia.
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia.
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia.
- Centre for Epidemiology and Biostatistics, University of Melbourne, Parkville, VIC, Australia.
- Discipline of Child and Adolescent Health, University of Sydney, Westmead, NSW, Australia.
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Osann K, Wenzel L, McKinney C, Wagner L, Cella D, Fulci G, Scroggins MJ, Lankes HA, Wang V, Nephew KP, Maxwell GL, Mok SC, Conrads TP, Miller A, Birrer M. Fear of recurrence, emotional well-being and quality of life among long-term advanced ovarian cancer survivors. Gynecol Oncol 2023; 171:151-158. [PMID: 36905875 PMCID: PMC10681156 DOI: 10.1016/j.ygyno.2023.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 02/17/2023] [Accepted: 02/24/2023] [Indexed: 03/11/2023]
Abstract
OBJECTIVE Although advanced stage epithelial ovarian cancer is widely considered life-threatening, 17% of women with advanced disease will survive long-term. Little is known about the health-related quality of life (QOL) of long-term ovarian cancer survivors, or how fear of recurrence might affect QOL. METHODS 58 long-term survivors with advanced disease participated in the study. Participants completed standardized questionnaires to capture cancer history, QOL, and fear of recurrent disease (FOR). Statistical analyses included multivariable linear models. RESULTS Participants averaged 52.8 years at diagnosis and had survived >8 years (mean:13.5); 64% had recurrent disease. Mean FACT-G, FACT-O, and FACT-O-TOI (TOI) scores were 90.7 (SD:11.6), 128.6 (SD:14.8), and 85.9 (SD:10.2) respectively. Compared to the U.S. population using T-scores, QOL for participants exceeded that of healthy adults (T-score (FACT-G) = 55.9). Overall QOL was lower in women with recurrent vs. non-recurrent disease though differences did not reach statistical significance (FACT-O = 126.1 vs. 133.3, p = 0.082). Despite good QOL, high FOR was reported in 27%. FOR was inversely associated with emotional well-being (EWB) (p < 0.001), but not associated with other QOL subdomains. In multivariable analysis, FOR was a significant predictor of EWB after adjusting for QOL (TOI). A significant interaction was observed between recurrence and FOR (p = 0.034), supporting a larger impact of FOR in recurrent disease. CONCLUSION QOL in long-term ovarian cancer survivors was better than the average for healthy U.S. women. Despite good QOL, high FOR contributed significantly to increased emotional distress, most notably for those with recurrence. Attention to FOR may be warranted in this survivor population.
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Affiliation(s)
- Kathryn Osann
- Department of Medicine and Program in Public Health, University of California, 839 Health Sciences Rd, Irvine, CA 92697, USA.
| | - Lari Wenzel
- Department of Medicine and Program in Public Health, University of California, 839 Health Sciences Rd, Irvine, CA 92697, USA.
| | - Chelsea McKinney
- Department of Medicine and Program in Public Health, University of California, 839 Health Sciences Rd, Irvine, CA 92697, USA.
| | - Lynne Wagner
- Department of Social Sciences and Health Policy, Wake Forest University, 475 Vine Street, Winston-Salem, NC 27101, USA.
| | - David Cella
- Department of Medical Social Sciences, Northwestern University Health System, 633 N St Clair St, Chicago, IL 60611, USA.
| | - Giulia Fulci
- GlaxoSmithKline, 1000 Winter St, Waltham, MA 02451, USA
| | - Mary J Scroggins
- International Gynecology Cancer Society, PO Box 170645, Austin, TX 78717, USA
| | - Heather A Lankes
- The GOG Foundation, Inc., Edgewater, MD 21037, USA; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA.
| | - Victoria Wang
- Dana-Farber Cancer Institute, Department of Data Science, 450 Brookline Ave LC1052 or LC9310, Boston, MA 02215, USA.
| | - Kenneth P Nephew
- Medical Sciences Program, Indiana University School of Medicine-Bloomington, 1001 E 3rd St, Bloomington, IN, 47405, USA.
| | - George L Maxwell
- Women's Health Integrated Research Center at Inova Health System, Women's Service Line, Inova Health System, 8110 Gatehouse Rd, Falls Church, VA 22042, USA.
| | - Samuel C Mok
- Department of Gynecological Oncology & Reproductive Medicine, The University of Texas MD Anderson Cancer Center, P.O. Box 301439, Houston, TX 77230, USA.
| | - Thomas P Conrads
- Women's Health Integrated Research Center at Inova Health System, Women's Service Line, Inova Health System, 8110 Gatehouse Rd, Falls Church, VA 22042, USA.
| | - Austin Miller
- Roswell Park Comprehensive Cancer Center, 665 Elm St, Buffalo, NY 14203, USA.
| | - Michael Birrer
- Winthrop P. Rockefeller Cancer Institute University of Arkansas for Medical Sciences, 4301 W. Markham St, Little Rock, AR 72205, USA.
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Zhao J, Kong Y, Xiang Y, Yang J. The research landscape of the quality of life or psychological impact on gynecological cancer patients: A bibliometric analysis. Front Oncol 2023; 13:1115852. [PMID: 36824135 PMCID: PMC9941849 DOI: 10.3389/fonc.2023.1115852] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 01/10/2023] [Indexed: 02/09/2023] Open
Abstract
Background Gynecological cancer is one of the most common cancers in women. The quality of life (QoL) or psychological impact has emerged as an outcome indicator in many clinical trials of gynecological cancer and gained much concern in the clinical setting at the start of the 21st century. Our paper conducted a bibliometric analysis of QoL or psychological impact on gynecological cancer patients to show the status and hotspots. Methods Related publications from 2000 to 2022 were included by screening from the Web of Science Core Collection (WOSCC) on 26 June 2022. The bibliometrics was analyzed and visualized by bibliometrix R-package, VOSviewer, and CiteSpace V. Results A total of 6,479 publications were included in our study. The publications in this field were increased annually. The United States (n = 2,075) was the country with the most published papers. Sydney University (n = 167) was the most productive affiliation. Gynecologic Oncology and Journal of Clinical Oncology were the most relevant and most cited sources, respectively. The article written by Bray F et al. has the highest citation. Kim J and Aaronson NK ranked first in most productive author and most co-cited author, respectively. The keywords "mortality", "fertility preservation", and "palliative care" have bursts till 2022, which represented the frontiers of this field. Conclusion Our study provides an overall analysis of QoL or psychological impact on gynecological cancer patients, which can serve as a reference in future research.
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Affiliation(s)
- Jiayuan Zhao
- National Clinical Research Center for Obstetric & Gynecologic Diseases/Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yujia Kong
- National Clinical Research Center for Obstetric & Gynecologic Diseases/Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yang Xiang
- National Clinical Research Center for Obstetric & Gynecologic Diseases/Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Spampinato S, Tanderup K, Lindegaard JC, Schmid MP, Sturdza A, Segedin B, Jürgenliemk-Schulz IM, De Leeuw A, Bruheim K, Mahantshetty U, Chargari C, Rai B, Cooper R, van der Steen-Banasik E, Sundset M, Wiebe E, Villafranca E, Van Limbergen E, Pieters BR, Tee Tan L, Lutgens LCHW, Hoskin P, Smet S, Pötter R, Nout R, Chopra S, Kirchheiner K. Association of persistent morbidity after radiotherapy with quality of life in locally advanced cervical cancer survivors. Radiother Oncol 2023; 181:109501. [PMID: 36720348 DOI: 10.1016/j.radonc.2023.109501] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/13/2023] [Accepted: 01/22/2023] [Indexed: 01/31/2023]
Abstract
PURPOSE To quantify the association of persistent morbidity with different aspects of quality of life (QOL) in locally advanced cervical cancer (LACC) survivors. MATERIAL AND METHODS Longitudinal outcome from the EMBRACE-I study was evaluated. Patient-reported symptoms and QOL were prospectively scored (EORTC-C30/CX24) at baseline and regular follow-ups. Physician-assessed symptoms were also reported (CTCAEv.3). Persistent symptoms were defined if present in at least half of the follow-ups. QOL items were linearly transformed into a continuous scale. Linear mixed-effects models (LMM) were applied to evaluate and quantify the association of persistent symptoms with QOL. Overall QOL deterioration was evaluated by calculating the integral difference in QOL over time obtained with LMM for patients without and with persistent symptoms. RESULTS Out of 1416 patients enrolled, 741 with baseline and ≥ 3 late follow-ups were analyzed (median 59 months). Proportions of persistent EORTC symptoms ranged from 21.8 % to 64.9 % (bowel control and tiredness). For CTCAE the range was 11.3-28.6 % (limb edema and fatigue). Presence of any persistent symptom was associated with QOL, although with varying magnitude. Role functioning and Global health/QOL were the most impaired aspects. Fatigue and pain showed large differences, with reductions of around 20 % for most of the QOL aspects. Among organ-related symptoms, abdominal cramps showed the largest effect. CONCLUSION Persistent symptoms are associated with QOL reductions in LACC survivors. Organ-related symptoms showed smaller differences than general symptoms such as fatigue and pain. In addition to optimizing treatment to minimize organ-related morbidity, effort should be directed towards a more comprehensive and targeted morbidity management.
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Affiliation(s)
- Sofia Spampinato
- Danish Center for Particle Therapy, Aarhus University Hospital, 8200 Aarhus, Denmark.
| | - Kari Tanderup
- Danish Center for Particle Therapy, Aarhus University Hospital, 8200 Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, 8200 Aarhus, Denmark.
| | - Jacob C Lindegaard
- Department of Oncology, Aarhus University Hospital, 8200 Aarhus, Denmark.
| | - Maximilian P Schmid
- Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, 1090 Vienna, Austria.
| | - Alina Sturdza
- Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, 1090 Vienna, Austria.
| | - Barbara Segedin
- Department of Radiotherapy, Institute of Oncology, 1000 Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia.
| | - Ina M Jürgenliemk-Schulz
- Department of Radiation Oncology, University Medical Centre Utrecht, 3584 CX Utrecht, the Netherlands.
| | - Astrid De Leeuw
- Department of Radiation Oncology, University Medical Centre Utrecht, 3584 CX Utrecht, the Netherlands.
| | - Kjersti Bruheim
- Department of Oncology, Oslo University Hospital, 0450 Oslo, Norway.
| | - Umesh Mahantshetty
- Department of Radiation Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai and Homi Bhabha Cancer Hospital and Research Centre, Visakhapatnam, Andhra Pradesh 530053, India.
| | - Cyrus Chargari
- Department of Radiation Oncology, Gustave Roussy Cancer Campus, 94805 Villejuif, France.
| | - Bhavana Rai
- Department of Radiotherapy and Oncology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
| | - Rachel Cooper
- Leeds Cancer Centre, St James's University Hospital, Leeds LS9 7LP, United Kingdom.
| | | | - Marit Sundset
- Clinic of Oncology and Women's Clinic, St. Olavs Hospital, 7030 Trondheim, Norway.
| | - Ericka Wiebe
- Department of Oncology, Cross Cancer Institute and University of Alberta, Edmonton AB T6G 1Z2, Canada.
| | - Elena Villafranca
- Department of Radiation Oncology, Hospital of Navarra, 31008 Pamplona, Navarra, Spain.
| | - Erik Van Limbergen
- Department of Radiation Oncology, University Hospital Leuven, 3000 Leuven, Belgium.
| | - Bradley R Pieters
- Department of Radiation Oncology, Amsterdam University Medical Centers, University of Amsterdam, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Cancer Treatment and Quality of Life, 1081 HV Amsterdam, the Netherlands.
| | - Li Tee Tan
- Oncology Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, United Kingdom.
| | - Ludy C H W Lutgens
- Maastricht Radiation Oncology (MAASTRO) clinic, 6229 ET Maastricht, the Netherlands.
| | - Peter Hoskin
- Mount Vernon Cancer Centre, Mount Vernon Hospital, Northwood HA6 2RN, United Kingdom.
| | - Stéphanie Smet
- Department of Radiation Oncology, Algemeen Ziekenhuis Turnhout, 2300 Turnhout, Belgium.
| | - Richard Pötter
- Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, 1090 Vienna, Austria.
| | - Remi Nout
- Department of Clinical Oncology, Leiden University Medical Center, 2333 ZA Leiden, the Netherlands.
| | - Supriya Chopra
- Department of Radiation Oncology, Advanced Centre for Treatment Research and Education in Cancer, Tata Memorial Centre, Homi Bhabha National Institute, Navi Mumbai 410210, India.
| | - Kathrin Kirchheiner
- Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, 1090 Vienna, Austria.
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10
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Thomas TH, Bender C, Rosenzweig M, Taylor S, Sereika SM, Babichenko D, You KL, Terry MA, Sabik LM, Schenker Y. Testing the effects of the Strong Together self-advocacy serious game among women with advanced cancer: Protocol for the STRONG randomized clinical trial. Contemp Clin Trials 2023; 124:107003. [PMID: 36379436 PMCID: PMC9839496 DOI: 10.1016/j.cct.2022.107003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 10/27/2022] [Accepted: 11/09/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Women with advanced cancer experience significant barriers to achieving high-quality care and maximizing their physical and emotional health. Our novel serious game, Strong Together, aims to teach women with advanced cancer self-advocacy skills needed to improve their symptom burden, quality of life, and patient-centered care. METHODS This is a single-center, multi-site randomized clinical trial of the Strong Together intervention among 336 women within three months of an advanced breast or gynecologic cancer diagnosis. Randomization occurs to the 3-month Strong Together serious game or enhanced care as usual group. The aims are to: (1) evaluate the effects of the intervention on patient self-advocacy (primary outcome); (2) evaluate the effects of the intervention on quality of life, symptom burden, and patient-centered care (secondary outcomes); and (3) evaluate the behavioral and game mechanisms that influence the efficacy of the intervention. ELIGIBILITY CRITERIA female, age ≥ 18 years; diagnosis of advanced breast or gynecologic cancer within the past 3 months; Eastern Cooperative Oncology Group score of 0-2; English literacy; and ≥ 6-month life expectancy. Patient-reported outcome measures are collected at baseline, 3-months, and 6-months. CONCLUSION This protocol is the first large-scale intervention aimed at promoting self-advocacy in women with advanced cancer. Understanding the ability of serious games to impact patient outcomes provides critical information for researchers, clinicians, and stakeholders aiming to improve patient-centered care. TRIAL REGISTRATION NCT04813276.
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Affiliation(s)
- Teresa H Thomas
- University of Pittsburgh School of Nursing, University of Pittsburgh, 3500 Victoria Street, Pittsburgh 15261, PA, USA; Palliative Research Center (PaRC), University of Pittsburgh, 230 McKee Place, Suite 600, Pittsburgh 15213, PA, USA.
| | - Catherine Bender
- University of Pittsburgh School of Nursing, University of Pittsburgh, 3500 Victoria Street, Pittsburgh 15261, PA, USA.
| | - Margaret Rosenzweig
- University of Pittsburgh School of Nursing, University of Pittsburgh, 3500 Victoria Street, Pittsburgh 15261, PA, USA; Palliative Research Center (PaRC), University of Pittsburgh, 230 McKee Place, Suite 600, Pittsburgh 15213, PA, USA; University of Pittsburgh Medical Center Magee-Womens Hospital, 300 Halket Street, Pittsburgh 15213, PA, USA.
| | - Sarah Taylor
- University of Pittsburgh Medical Center Magee-Womens Hospital, 300 Halket Street, Pittsburgh 15213, PA, USA.
| | - Susan M Sereika
- University of Pittsburgh School of Nursing, University of Pittsburgh, 3500 Victoria Street, Pittsburgh 15261, PA, USA.
| | - Dmitriy Babichenko
- University of Pittsburgh School of Computing and Information, 135 North Bellefield Avenue, Pittsburgh 15213, PA, USA.
| | - Kai-Lin You
- University of Pittsburgh School of Nursing, University of Pittsburgh, 3500 Victoria Street, Pittsburgh 15261, PA, USA.
| | - Martha Ann Terry
- University of Pittsburgh School of Public Health, 130 De Soto Street, Pittsburgh 15261, PA, USA.
| | - Lindsay M Sabik
- University of Pittsburgh School of Public Health, 130 De Soto Street, Pittsburgh 15261, PA, USA.
| | - Yael Schenker
- Palliative Research Center (PaRC), University of Pittsburgh, 230 McKee Place, Suite 600, Pittsburgh 15213, PA, USA; University of Pittsburgh School of Medicine, Division of General Internal Medicine, 200 Lothrop Street, Pittsburgh 15213, PA, USA.
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11
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Hlubocky FJ, Daugherty CK, Peppercorn J, Young K, Wroblewski KE, Yamada SD, Lee NK. Utilization of an Electronic Patient-Reported Outcome Platform to Evaluate the Psychosocial and Quality-of-Life Experience Among a Community Sample of Ovarian Cancer Survivors. JCO Clin Cancer Inform 2022; 6:e2200035. [PMID: 35985004 PMCID: PMC9470143 DOI: 10.1200/cci.22.00035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 05/20/2022] [Accepted: 06/28/2022] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Novel distress screening approaches using electronic patient-reported outcome (ePRO) measurements are critical for the provision of comprehensive quality community cancer care. Using an ePRO platform, the prevalence of psychosocial factors (distress, post-traumatic growth, resilience, and financial stress) affecting quality of life in ovarian cancer survivors (OCSs) was examined. METHODS A cross-sectional OCS sample from the National Ovarian Cancer Coalition-Illinois Chapter completed web-based clinical, sociodemographic, and psychosocial assessment using well-validated measures: Hospital Anxiety/Depression Scale-anxiety/depression, Post-traumatic Growth Inventory, Brief Resilience Scale, comprehensive score for financial toxicity, and Functional Assessment of Cancer Therapy-Ovarian (FACT-O/health-related quality of life [HRQOL]). Correlational analyses between variables were conducted. RESULTS Fifty-eight percent (174 of 300) of OCS completed virtual assessment: median age 59 (range 32-83) years, 94.2% White, 60.3% married/in domestic partnership, 59.6% stage III-IV, 48.8% employed full-time/part-time, 55.2% had college/postgraduate education, 71.9% completed primary treatment, and median disease duration 6 (range < 1-34) years. On average, OCS endorsed normal levels of anxiety (mean ± standard deviation = 6.9 ± 3.8), depression (4.1 ± 3.6), mild total distress (10.9 ± 8.9), high post-traumatic growth (72.6 ± 21.5), normal resilience (3.7 ± 0.72), good FACT-O-HRQOL (112.6 ± 22.8), and mild financial stress (26 ± 10). Poor FACT-O emotional well-being was associated with greater participant distress (P < .001). Partial correlational analyses revealed negative correlations between FACT-O-HRQOL and anxiety (r = -0.65, P < .001), depression (r = -0.76, P < .001), and total distress (r = -0.92, P < .001). Yet, high FACT-O-HRQOL was positively correlated with post-traumatic coping (r = 0.27; P = .006) and resilience (r = 0.63; P < .001). CONCLUSION ePRO assessment is feasible for identification of unique psychosocial factors, for example, financial toxicity and resilience, affecting HRQOL for OCS. Future investigation should explore large-scale, longitudinal ePRO assessment of the OCS psychosocial experience using innovative measures and community-based advocacy populations.
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Affiliation(s)
- Fay J. Hlubocky
- Department of Medicine, Section of Hematology/Oncology, MacLean Center for Clinical Medical Ethics, Cancer Research Center, Supportive Oncology Program, The University of Chicago Medicine, Chicago, IL
- Department of Gynecology/Obstetrics, Section of Gynecologic Oncology, The University of Chicago Medicine, Chicago, IL
| | - Christopher K. Daugherty
- Department of Medicine, Section of Hematology/Oncology, MacLean Center for Clinical Medical Ethics, Cancer Research Center, Supportive Oncology Program, The University of Chicago Medicine, Chicago, IL
| | - Jeffery Peppercorn
- Division of Medicine, Hematology and Oncology, Dana Farber Partners, Massachusetts General Hospital, Boston, MA
| | - Karen Young
- Illinois Chapter of the National Ovarian Cancer Coalition (NOCC), Chicago, IL
| | - Kristen E. Wroblewski
- Department of Public Health Sciences, The University of Chicago Medicine, Chicago, IL
| | - Seiko Diane Yamada
- Department of Gynecology/Obstetrics, Section of Gynecologic Oncology, The University of Chicago Medicine, Chicago, IL
| | - Nita K. Lee
- Department of Gynecology/Obstetrics, Section of Gynecologic Oncology, The University of Chicago Medicine, Chicago, IL
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12
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Galica J, Saunders S, Romkey-Sinasac C, Silva A, Ethier JL, Giroux J, Jull J, Maheu C, Ross-White A, Stark D, Robb K. The needs of gynecological cancer survivors at the end of primary treatment: A scoping review and proposed model to guide clinical discussions. PATIENT EDUCATION AND COUNSELING 2022; 105:1761-1782. [PMID: 34865888 DOI: 10.1016/j.pec.2021.11.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 11/19/2021] [Accepted: 11/20/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Gynecological cancer (GC) survivors have unmet needs when they complete primary cancer treatment. Despite this, no known research has summarized these needs and survivors' suggestions to address them. We conducted a scoping review to fill these gaps and develop a model useful to guide clinical discussions and/or interventions. METHODS English, full length, and accessible primary studies describing the needs of GC survivors were included. No restrictions on date nor country of publication were applied. Two reviewers screened and extracted data, which was verified by a third reviewer. RESULTS Seventy-one studies met the inclusion criteria for data extraction. Results were thematically grouped into seven dimensions: physical needs, sexuality-related concerns, altered self-image, psychological wellbeing, social support needs, supporting the return to work, and healthcare challenges and preferences. After consulting with a stakeholder group (a GC survivor, clinicians, and researchers), the dimensions were summarized into a proposed model to guide clinical assessments and/or interventions. CONCLUSION Results illuminate the diverse needs of GC survivors as they complete primary cancer treatment and their recommendations for care to meet these needs. PRACTICE IMPLICATIONS The resulting model can be used to guide assessments, discussions and/or interventions to optimally prepare GC survivors for transition out of primary cancer treatment.
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Affiliation(s)
- Jacqueline Galica
- Queen's University School of Nursing, Kingston, Ontario, Canada; Queen's Cancer Research Institute, Division of Cancer Care and Epidemiology, Kingston, Ontario, Canada.
| | | | | | - Amina Silva
- Queen's University School of Nursing, Kingston, Ontario, Canada
| | - Josée-Lyne Ethier
- Queen's Cancer Research Institute, Division of Cancer Care and Epidemiology, Kingston, Ontario, Canada; Queen's University Department of Oncology; Kingston, Ontario, Canada
| | - Janet Giroux
- Queen's University School of Nursing, Kingston, Ontario, Canada; Kingston Health Sciences Centre, Kingston General Hospital Site and the Cancer Centre of Southeastern Ontario, Kingston, Ontario, Canada; Queen's University, Department of Obstetrics and Gynecology, Kingston, Ontario, Canada
| | - Janet Jull
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
| | - Christine Maheu
- Ingram School of Nursing, McGill University, Montréal, Québec, Canada
| | | | - Debora Stark
- Kingston Health Sciences Centre, Kingston General Hospital Site and the Cancer Centre of Southeastern Ontario, Kingston, Ontario, Canada
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13
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Cohen PA, Musiello T, Jeffares S, Bennett K. Mindfulness-based cognitive therapy for Fear of Recurrence in Ovarian Cancer Survivors (FROCS): a single-arm, open-label, pilot study. Support Care Cancer 2021; 30:2317-2325. [PMID: 34727225 DOI: 10.1007/s00520-021-06659-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 10/27/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Fear of recurrence is common following treatment for cancer. Our aim was to assess the feasibility of mindfulness-based cognitive therapy (MBCT) to treat fear of cancer recurrence (FCR) in ovarian cancer survivors. METHODS Investigator initiated, single-arm, open-label, pilot study. Women were eligible after completing adjuvant treatment. The intervention was an 8-week MBCT course of weekly 2-h group sessions. The primary outcome was FCR measured by the FCR inventory. Secondary outcomes were depression and anxiety measured by the Hospital Anxiety and Depression Scale (HADS). The study is registered with the Australian and New Zealand Clinical Trials Registry ACTRN12615000213549. RESULTS Between May 8, 2015, and May 6, 2019, 33 participants were enrolled. Ten women withdrew. Data were evaluable for 19 participants. There was a significant decrease in FCR at 8 weeks (FCR inventory mean 63.00, SD 27.90) compared to pre-intervention (FCR inventory mean 71.03, SD 31.01) but not at 6 months (FCR inventory mean 63.65, SD 30.08). No differences in depression were observed at baseline (HADS mean 3.42, SD 2.41), 8 weeks (HADS mean 3.10, SD 1.79) and 6 months (HADS mean 2.73, SD 1.88). Anxiety decreased from baseline (HADS mean 8.72, SD 3.99) at both 8 weeks (HADS mean 6.89, SD 2.98) and 6 months (HADS mean 7.06, SD 3.87). CONCLUSIONS MBCT may be effective as a treatment for FCR and anxiety in women following diagnosis and treatment of ovarian cancer. A randomised controlled trial is required to assess the efficacy of MBCT for FCR but may not be feasible due to high rates of withdrawal.
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Affiliation(s)
- Paul A Cohen
- Division of Obstetrics and Gynaecology, University of Western Australia, Crawley, WA, Australia.
- Dept of Gynaecological Oncology, St John of God Hospital, 12 Salvado Road, Subiaco, WA, 6008, Australia.
| | - Toni Musiello
- Division of Surgery, University of Western Australia, Crawley, WA, Australia
| | - Stephanie Jeffares
- Dept of Gynaecological Oncology, St John of God Hospital, 12 Salvado Road, Subiaco, WA, 6008, Australia
| | - Kellie Bennett
- Division of Psychiatry, University of Western Australia, Crawley, WA, Australia
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14
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Lau J, Khoo AMG, Ho AHY, Tan KK. Psychological resilience among palliative patients with advanced cancer: A systematic review of definitions and associated factors. Psychooncology 2021; 30:1029-1040. [PMID: 33728728 DOI: 10.1002/pon.5666] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 02/16/2021] [Accepted: 02/19/2021] [Indexed: 01/18/2023]
Abstract
OBJECTIVE The palliative journey can be emotionally stressful for both patients with advanced cancer and their families. Psychological resilience is crucial in aiding with patients' adaptation and post-traumatic growth. The aim of this systematic review was to critically examine the definitions of psychological resilience and its associated factors in palliative patients with advanced cancer. METHODS Four databases were systematically searched from inception to August 2020. Both qualitative and quantitative studies that examined factors associated with psychological resilience in a sample of patients with advanced cancer undergoing palliative care were included. RESULTS A total of 15 studies met the criteria, of which 10 were qualitative and five were quantitative. Nine studies included a definition of psychological resilience, from which five common themes of buffering, adaptation, resources, recovery, and growth were derived. The quantitative studies found association between resilience and hope, independence, social support, fatigue, emotional distress, and coping strategies. The qualitative studies reported additional sources of resilience such as spirituality, social support, prior experience dealing with illness and life adversity, meaning-making, reconciling with life's finiteness, acceptance of illness, control, determination, positive attitude, dignity, engagement with palliative care and quality of life being supported by palliative care. CONCLUSIONS More research is needed for developing an overarching definition of psychological resilience in palliative advanced cancer patients that acknowledges and appreciates the contextual sensitivity of this concept among different cultural groups. Further studies are also needed to examine a holistic range of bio-psycho-socio-spiritual factors associated with psychological resilience among these patients and their families.
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Affiliation(s)
- Jerrald Lau
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | | | - Andy Hau-Yan Ho
- School of Social Sciences, Nanyang Technological University, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
- Palliative Care Centre for Excellence in Research and Education, Singapore
| | - Ker-Kan Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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15
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Paepke D, Wiedeck C, Hapfelmeier A, Kiechle M, Brambs C. Lifestyle modifications after the diagnosis of gynecological cancer. BMC WOMENS HEALTH 2021; 21:260. [PMID: 34182983 PMCID: PMC8240378 DOI: 10.1186/s12905-021-01391-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 06/07/2021] [Indexed: 12/18/2022]
Abstract
Background The influence of lifestyle factors on the quality of life, incidence and tumor recurrence has been evaluated in several studies and is gaining increasing importance in cancer research. However, the extent of the influence of such lifestyle factors on the quality of life of cancer patients remains largely unclear, as does the number of patients actually pursuing these lifestyle changes. The purpose of this study was to examine the prevalence and predictors of lifestyle changes in patients with gynecological cancer.
Methods The survey consisted of a pseudonymous questionnaire that was conducted from January to May 2014 via a telephone interview with 141 patients with a gynaecological malignancy who had undergone surgery at our Department of Gynaecology and Obstetrics. Lifestyle factors (diet, physical activity, stress level, alcohol and nicotine consumption) prior to and after the diagnosis of cancer were evaluated. Results 89% (n = 125) of the patients reported lifestyle changes after being diagnosed with cancer. There was a significant association between the implementation of lifestyle changes and age as well as the use of complementary medicine. Nutrition: 66% of the patients (n = 93) consumed more fruit and vegetables and 65% ate less meat (n = 92). Physical activity: 37% (n = 52) reported no change in their exercise routine, 36% (n = 51) described a decrease, 27% (n = 38) an increase in their physical activity. Subjective feeling of stress: 77% of the patients (n = 108) described a reduction in their perceived level of stress. Nicotine consumption: 63% (n = 12) of the 19 patients who were smokers at the time of the diagnosis quit or reduced smoking thereafter. Alcohol consumption: 47% (n = 61/129) of the patients reduced their alcohol consumption. Conclusions Most of the patients from our study group implemented lifestyle changes after being diagnosed with cancer. Prospective randomized trials are needed in order to determine the benefit of lifestyle changes (physical activity, dietary habits and stress reduction) for cancer survivors. The potential impact of lifestyle on the quality of life and the trajectory of the disease should be discussed with all oncological patients. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-021-01391-5.
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Affiliation(s)
- Daniela Paepke
- Department of Gynecology and Obstetrics, Technical University of Munich, Munich, Germany.
| | - Clea Wiedeck
- Department of Gynecology and Obstetrics, Technical University of Munich, Munich, Germany
| | - Alexander Hapfelmeier
- Institute of Medical Informatics, Statistics and Epidemiology, School of Medicine, Technical University of Munich, Munich, Germany.,Institute of General Practice and Health Services Research, School of Medicine, Technical University of Munich, Munich, Germany
| | - Marion Kiechle
- Department of Gynecology and Obstetrics, Technical University of Munich, Munich, Germany
| | - Christine Brambs
- Department of Gynecology and Obstetrics, Technical University of Munich, Munich, Germany
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16
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Sisodia RC, Dewdney SB, Fader AN, Wethington SL, Melamed A, Von Gruenigen VE, Zivanovic O, Carter J, Cohn DE, Huh W, Wenzel L, Doll K, Cella D, Dowdy SC. Patient reported outcomes measures in gynecologic oncology: A primer for clinical use, part I. Gynecol Oncol 2021; 158:194-200. [PMID: 32580886 DOI: 10.1016/j.ygyno.2020.04.696] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 04/18/2020] [Indexed: 12/11/2022]
Affiliation(s)
- Rachel C Sisodia
- Department of Obstetrics and Gynecology, Massachusetts General Hospital, United States of America.
| | - Summer B Dewdney
- Division of Gynecologic Oncology, Rush University Medical Center, Chicago, IL, United States of America
| | - Amanda N Fader
- Kelly Gynecologic Oncology Service, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD, United States of America
| | - Stephanie L Wethington
- Kelly Gynecologic Oncology Service, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD, United States of America
| | - Alexander Melamed
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States of America
| | - Vivian E Von Gruenigen
- Department of Obstetrics and Gynecology, University Hospitals of Cleveland, United States of America
| | - Oliver Zivanovic
- Memorial Sloan Kettering Cancer Center, 300 East 66th Street, 8th Floor, New York, NY, 10065, United States of America
| | - Jeanne Carter
- Memorial Sloan Kettering Cancer Center, 300 East 66th Street, 8th Floor, New York, NY, 10065, United States of America
| | - David E Cohn
- Department of Obstetrics and Gynecology, Ohio State University College of Medicine, Columbus, OH 43210, United States of America
| | - Warner Huh
- Department of Obstetrics and Gynecology, University and Alabama, Birmingham, AL, United States of America
| | - Lari Wenzel
- Universtiy of California, Irvine, United States of America
| | - Kemi Doll
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, United States of America
| | - David Cella
- Department of Medical Social Sciences and Robert H Lurie Comprehensive Cancer Center, Northwestern University, United States of America
| | - Sean C Dowdy
- Division of Gynecologic Oncology, Mayo Clinic, Rochester, MN 55905, United States of America
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17
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Tan JH, Sharpe L, Russell H. The impact of ovarian cancer on individuals and their caregivers: A qualitative analysis. Psychooncology 2021; 30:212-220. [PMID: 32940943 DOI: 10.1002/pon.5551] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 08/24/2020] [Accepted: 08/27/2020] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Ovarian cancer remains an understudied cancer with poor prognosis, few effective treatments and little understanding of the how individuals and their families face the challenges and uncertainty following diagnosis. This study synthesized the subjective experiences of individuals and their caregivers in the face of the uncertainty produced by the disease. METHODS Qualitative data were obtained from the Ovarian Cancer Australia 2017 Consumer Survey. An inductive thematic analysis was conducted on responses from 219 individuals with ovarian cancer and 78 caregivers. RESULTS Nine themes were identified from the individual's responses and seven themes from the caregivers. For both groups, the uncertainty created at diagnosis led to a cascade of complex responses. For the individuals, uncertainty gave rise to fears for the future, which were exacerbated by unmet healthcare needs or treatment-related difficulties. For some individuals, these fears led to disruption to their lives, isolation and emotional distress. For others, helpful coping styles and social support protected them from these negative consequences. For caregivers, the processes were similar, but uncertainty predominantly led to feelings of hopelessness and "survivor guilt." CONCLUSIONS Our results identified processes that may guide future interventions and research targeting unmet needs and protective factors for individuals with ovarian cancer and their caregivers. Findings also suggest the potential to facilitate effective support between individuals and their caregivers.
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Affiliation(s)
- Jit Hui Tan
- Clinical Psychology Unit, The University of Sydney, Sydney, New South Wales, Australia
| | - Louise Sharpe
- Clinical Psychology Unit, The University of Sydney, Sydney, New South Wales, Australia
| | - Hayley Russell
- Ovarian Cancer Australia, Melbourne, Victoria, Australia
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18
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Han PKJ, Gutheil C, Hutchinson RN, LaChance JA. Cause or Effect? The Role of Prognostic Uncertainty in the Fear of Cancer Recurrence. Front Psychol 2021; 11:626038. [PMID: 33519656 PMCID: PMC7843433 DOI: 10.3389/fpsyg.2020.626038] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 12/22/2020] [Indexed: 11/30/2022] Open
Abstract
Background Fear of cancer recurrence (FCR) is an important cause of suffering for cancer survivors, and both empirical evidence and theoretical models suggest that prognostic uncertainty plays a causal role in its development. However, the relationship between prognostic uncertainty and FCR is incompletely understood. Objective To explore the relationship between prognostic uncertainty and FCR among patients with ovarian cancer (OC). Design A qualitative study was conducted utilizing individual in-depth interviews with a convenience sample of patients with epithelial ovarian cancer who had completed first-line treatment with surgery and/or chemotherapy. Semi-structured interviews explored participants’ (1) understanding of their prognosis; (2) experiences, preferences, and attitudes regarding prognostic information; and (3) strategies for coping with prognostic uncertainty. Inductive qualitative analysis and line-by-line software-assisted coding of interview transcripts was conducted to identify key themes and generate theoretical insights on the relationship between prognostic uncertainty and FCR. Results The study sample consisted of 21 participants, nearly all of whom reported experiencing significant FCR, which they traced to an awareness of the possibility of a bad outcome. Some participants valued and pursued prognostic information as a means of coping with this awareness, suggesting that prognostic uncertainty causes FCR. However, most participants acknowledged fundamental limits to both the certainty and value of prognostic information, and engaged in various strategies aimed not at reducing but constructing and maintaining prognostic uncertainty as a means of sustaining hope in the possibility of a good outcome. Participants’ comments suggested that prognostic uncertainty, fear, and hope are connected by complex, bi-directional causal pathways mediated by processes that allow patients to cope with, construct, and maintain their uncertainty. A provisional dual-process theoretical model was developed to capture these pathways. Conclusion Among patients with OC, prognostic uncertainty is both a cause and an effect of FCR—a fear-inducing stimulus and a hope-sustaining response constructed and maintained through various strategies. More work is needed to elucidate the relationships between prognostic uncertainty, fear, and hope, to validate and refine our theoretical model, and to develop interventions to help patients with OC and other serious illnesses to achieve an optimal balance between these states.
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Affiliation(s)
- Paul K J Han
- Center for Outcomes Research and Evaluation, Maine Medical Center, Portland, ME, United States.,Tufts University School of Medicine, Boston, MA, United States
| | - Caitlin Gutheil
- Center for Outcomes Research and Evaluation, Maine Medical Center, Portland, ME, United States
| | - Rebecca N Hutchinson
- Center for Outcomes Research and Evaluation, Maine Medical Center, Portland, ME, United States.,Tufts University School of Medicine, Boston, MA, United States.,Palliative Medicine Program, Maine Medical Center, Portland, ME, United States
| | - Jason A LaChance
- Center for Outcomes Research and Evaluation, Maine Medical Center, Portland, ME, United States.,Tufts University School of Medicine, Boston, MA, United States.,Division of Gynecologic Oncology, Maine Medical Center, Portland, ME, United States
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19
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Morrison KS, Paterson C, Coltman CE, Toohey K. What are the Barriers and Enablers to Physical Activity Participation in Women with Ovarian Cancer? A Rapid Review of the Literature. Semin Oncol Nurs 2020; 36:151069. [PMID: 33012610 DOI: 10.1016/j.soncn.2020.151069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Engagement in regular physical activity is recommended for women diagnosed with ovarian cancer due to aggressive treatment approaches, an increased risk of disease recurrence and low survival rates. OBJECTIVES To synthesize the current available evidence identifying barriers and enablers to participation in physical activity among women diagnosed with ovarian cancer. DATA SOURCES Peer-reviewed articles in electronic databases including CINAHL, Cochrane, Medline, Psych INFO and Scopus and key studies' reference lists. CONCLUSION Although evidence pertaining to the study population was limited, the findings of this review suggest women with ovarian cancer experience similar barriers and enablers to the general population and other cancer cohorts. The primary barriers to physical activity participation reported by this population were treatment or disease related side effects, fear of injury or falling and the absence of physical activity counselling. Key enablers reported to facilitate physical activity participation were the implementation of individualized interventions with targeted goals in addition to support from health and medical professionals. Future research on ovarian cancer populations is warranted to further explore perceived barriers and enablers. IMPLICATIONS FOR NURSING PRACTICE Nurses working within the oncology field are well positioned clinically to facilitate physical activity engagement and identify and overcome barriers to participation within a population that experiences high mortality rates and disease recurrence.
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Affiliation(s)
- Kittani S Morrison
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia.
| | - Catherine Paterson
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia; Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce, Australian Capital Territory, Australia; School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, Australian Capital Territory, Australia; Canberra Health Services & ACT Health, SYNERGY Nursing & Midwifery Research Centre, Canberra Hospital, Garran, Australian Capital Territory, Australia; School of Nursing, Midwifery & Paramedic Practice, Robert Gordon University, Garthdee, Aberdeen, UK
| | - Celeste E Coltman
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia; University of Canberra Research Institute for Sport and Exercise, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - Kellie Toohey
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia; Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce, Australian Capital Territory, Australia
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20
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Er Güneri S, Şen S. Women's experiences after abnormal Pap smear results: a qualitative study. J Psychosom Obstet Gynaecol 2020; 41:22-29. [PMID: 31452433 DOI: 10.1080/0167482x.2019.1657090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Background: Abnormal Pap smear result means there have been cell changes on the cervix but are not cancer. Women with abnormal test result may be affected from this situation. What do women with abnormal Pap smear results experience from a biopsychosocial perspective?Objective: This study aimed to explore the experiences of women with abnormal Pap smear results according to the biopsychosocial model.Methods: This phenomenological study's data were collected in interviews with 12 women who had abnormal Pap smear test results. Data collection tool consists of two parts that are an "Women's Information Form (WIF)" identifying women and semi-structured "Interview Form". Interviews were done face-to-face by using in-depth interviews technique. Semi-structured interview was recorded in audio recording device. Thematic approach was used to assess the data.Results: The average age of the women was 42.5 ± 3.64, their age at first sexual intercourse was 23.0 ± 2.8 years and all of them were legally married. Five main themes were determined, which were grouped under the Biopsychosocial Model Domains. The Biological Domain themes were Perception of Health and Disease, and Cervical Cancer Risk Factors; the Psychological Domain themes were Positive Feelings and Negative Feelings; the Social Domain theme was Continuing Social Life.Conclusions: It was concluded that the cultural beliefs, perceptions, emotions and practices of women with abnormal Pap smear results should be considered in the diagnostic and treatment processes. These characteristics of women's experience are also important to consider when developing strategies to address barriers to effective cervical screening, diagnosis and treatment.
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Affiliation(s)
- Sezer Er Güneri
- Obstetrics and Gynecology Nursing Department, Nursing Faculty, Ege University, Izmir, Turkey
| | - Selma Şen
- Midwifery Department, Health Science Faculty, Manisa Celal Bayar University, Manisa, Turkey
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21
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Gu ZH, Qiu T, Yang SH, Tian FQ, Wu H. A Study on the Psychological Factors Affecting the Quality of Life Among Ovarian Cancer Patients in China. Cancer Manag Res 2020; 12:905-912. [PMID: 32104072 PMCID: PMC7012214 DOI: 10.2147/cmar.s239975] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 01/22/2020] [Indexed: 01/07/2023] Open
Abstract
PURPOSE We aim to test whether resilience mediates the association of fear of progression (FoP) with quality of life (QoL) among ovarian cancer patients in China. METHODS We collected 230 questionnaires from the First Affiliated Hospital of China Medical University in Liaoning Province, and 209 completed the questionnaire survey. The survey instrument consisted of four questionnaires: a sociodemographic and clinical characteristics questionnaire, the Functional Assessment of Cancer Therapy general instrument, the Fear of Progression Questionnaire-Short Form and the Connor-Davidson Resilience Scale. Hierarchical regression analysis was used to examine the relationship among FoP, resilience, and QoL, including physical well-being, social well-being, emotional well-being, and functional well-being. We used asymptotic and resampling strategies to examine the indirect effect of resilience. RESULTS FoP was negatively associated with resilience (r=-0.543, P<0.01) and QoL (physical well-being: r=-0.537, P<0.01; social well-being: r=-0.426, P<0.01; emotional well-being: r=-0.487, P<0.01; functional well-being: r=-0.529, P<0.01). Resilience was positively related with QoL (physical well-being: r=0.449, P<0.01; social well-being: r=0.548, P<0.01; emotional well-being: r=0.430, P<0.01; functional well-being: r=0.655, P<0.01). Resilience partly mediated the association between FoP and physical well-being (a×b=-0.05, BCa 95% CI: -0.09, -0.02), social well-being (a×b=-0.21, BCa 95% CI: -0.29, -0.14), emotional well-being (a×b=-0.05, BCa 95% CI: -0.08, -0.02), and functional well-being (a×b=-0.24, BCa 95% CI: -0.32, -0.17). The proportion of the mediating effect accounted for by resilience were 22.57%, 57.22%, 26.02%, 53.42% for physical well-being, social well-being, emotional well-being and functional well-being, respectively. CONCLUSION The study showed that resilience could mediate the association between fear of progression and quality of life. It suggests that resilience might provide a potential target for intervention in quality of life with ovarian cancer.
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Affiliation(s)
- Zhi-Hui Gu
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, People’s Republic of China
| | - Tian Qiu
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, People’s Republic of China
| | - Shi-Han Yang
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, People’s Republic of China
| | - Fang-Qiong Tian
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, People’s Republic of China
| | - Hui Wu
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, People’s Republic of China
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22
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Fischer OJ, Marguerie M, Brotto LA. Sexual Function, Quality of Life, and Experiences of Women with Ovarian Cancer: A Mixed-Methods Study. Sex Med 2019; 7:530-539. [PMID: 31501030 PMCID: PMC6963110 DOI: 10.1016/j.esxm.2019.07.005] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 07/21/2019] [Accepted: 07/29/2019] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Ovarian cancer impacts approximately 1 in 75 women. Sexual health is receiving increasing attention as a critical aspect of gynecologic cancer treatment and a component of quality of life. Therefore, investigating how women with ovarian cancer experience and express sexuality is an important area of inquiry. AIMS To evaluate how women with ovarian cancer experience and express sexuality, a major determinant of quality of life, in the context of their illness. METHODS In a mixed-methods approach, 6 validated self-report questionnaires (n = 64) and an in-depth focus group (n = 3) were used to gather data. RESULTS The quantitative phase of the study showed that women with ovarian cancer have a poorer quality of life and higher rates of sexual dysfunction and sexual distress compared with published norms from the general population. They also have lower levels of relationship satisfaction and increased rates of depression. The qualitative phase of the study revealed 6 themes: (i) changes to relationship satisfaction; (ii) sexual difficulties; (iii) challenges with body image; (iv) gaps in communication with healthcare providers; (v) feelings of guilt, grief, resentment, anxiety, and fear; and (vi) strategies used for coping. CONCLUSIONS Ovarian cancer impacts women's lives beyond mere survival, including their sexual function and quality of life. Healthcare providers are urged to prepare women with ovarian cancer for these challenges and offer information and resources to help improve their quality of life and sexuality. Fischer OJ, Marguerie M, Brotto LA. Sexual Function, Quality of Life, and Experiences of Women with Ovarian Cancer: A Mixed-Methods Study. Sex Med 2019;7:530-539.
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Affiliation(s)
- Olivia J Fischer
- Department of Counselling Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Monique Marguerie
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Lori A Brotto
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
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Galica J, Giroux J, Francis JA, Maheu C. Coping with fear of cancer recurrence among ovarian cancer survivors living in small urban and rural settings: A qualitative descriptive study. Eur J Oncol Nurs 2019; 44:101705. [PMID: 32006720 DOI: 10.1016/j.ejon.2019.101705] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 11/15/2019] [Accepted: 11/26/2019] [Indexed: 11/18/2022]
Abstract
PURPOSE Fear of cancer recurrence (FCR) is a paramount concern among ovarian cancer survivors. Evidence shows that cancer survivors living in regional or rural areas have higher psychological morbidity; however, no known studies have explored how ovarian cancer survivors living in small urban and rural areas cope with FCR. METHODS In this qualitative descriptive study, a semi-structured questioning process was developed in accordance with Carver et al.'s conceptualization of coping. Focus groups or 1:1 telephone interviews were used to collect data from a convenience sample of ovarian cancer survivors. Participants completed a demographic form and the Fear of Cancer Recurrence Inventory, and clinical information was extracted from hospital charts. RESULTS The average age of participants (n = 15) was 62.8 years (Range 51-76 years) and the average time since diagnosis was 2.7 years (Range 1-19 years). Most women had elevated levels of FCR. Five themes for coping were expressed by all women: 1) health care provider support; 2) knowing, trusting, and prioritizing self; 3) finding what works; 4) uniqueness and belonging; and 5) redirecting thoughts and actions. One additional theme was expressed by most women (n = 11): 6) preparing for the future. CONCLUSION Fear of cancer recurrence was a concern for most ovarian cancer survivors who used a variety of ways to cope. Results can be used to guide nurses' discussions with post-treatment ovarian cancer survivors or be used to inform refinement and development of resources to assist ovarian cancer survivors living in small urban and rural settings to cope with FCR.
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Affiliation(s)
- Jacqueline Galica
- School of Nursing, Queen's University, 92 Barrie Street, Kingston, Ontario, K7L 3N6, Canada; Queen's Cancer Research Institute, Division of Cancer Care and Epidemiology, 10 Stuart Street, Kingston, Ontario, K7L 3N6, Canada.
| | - Janet Giroux
- School of Nursing, Queen's University, 92 Barrie Street, Kingston, Ontario, K7L 3N6, Canada; Kingston Health Sciences Centres, Department of Obstetrics and Gynecology, 76 Stuart Street, Kingston, Ontario, K7L 2V7, Canada
| | - Julie-Ann Francis
- Lakeridge Health Oshawa, Division of Gynecologic Oncology, 1 Hospital Court, Oshawa, Ontario, L1G 2B9, Canada
| | - Christine Maheu
- Ingram School of Nursing, McGill University, 680 Sherbrooke West #1800, Montréal, Québec, H3A 2M7, Canada
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Long-term distress in older patients with cancer: a longitudinal cohort study. BJGP Open 2019; 3:bjgpopen19X101658. [PMID: 31581109 PMCID: PMC6970590 DOI: 10.3399/bjgpopen19x101658] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 05/29/2019] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Receiving a cancer diagnosis can be a major life event which causes distress even years after primary treatment. AIM To examine the prevalence of distress in older patients with cancer (OPCs) up until 5 years post-diagnosis, and identify predictors present at time of diagnosis. Results are compared with reference groups of middle-aged patients with cancer (MPCs) and older patients without a cancer diagnosis (OPs). DESIGN & SETTING OPCs, MPCs, and OPs participated in a longitudinal cohort study in Belgium and the Netherlands by filling in questionnaires at designated time points from 2010-2019. METHOD Data from 541 patients were analysed using multivariable logistic regression analyses. RESULTS At baseline, 40% of OPCs, 37% of MPCs, and 17% of OPs reported distress. After 5 years, 35% of OPCs, 23% of MPCs, and 25% of OPs reported distress. No significant predictors for long-term distress in OPCs and OPs were found. For MPCs, it was found that baseline distress (odds ratio [OR] 2.94; 95% confidence intervals [CI] = 1.40 to 6.19) and baseline fatigue (OR 4.71; 95% CI = 1.81 to 12.31) predicted long-term distress. CONCLUSION Distress is an important problem for people with cancer, with peaks at different moments after diagnosis. Feelings of distress are present shortly after diagnosis but they decrease quickly for the majority of patients. In the long term, however, OPCs in particular appear to be most at risk for distress. This warrants extra attention from primary healthcare professionals, such as GPs who are often patients' first medical contact point. More research into risk factors occurring later in an illness trajectory might shed more light on predictors for development of long-term distress.
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25
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Craig F, Savino R, Scoditti S, Lucarelli E, Fanizza I, De Rinaldis M, Gennaro L, Simone M, Russo L, Trabacca A. Coping, stress and negative psychological outcomes in parents of children admitted to a pediatric neurorehabilitation care unit. Eur J Phys Rehabil Med 2019; 55:772-782. [PMID: 31290304 DOI: 10.23736/s1973-9087.19.05695-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Parents' attitudes and psychological adjustment during their child's hospitalization in a pediatric neurorehabilitation care unit are key aspects for the child's adherence to care and the impact of the disease. AIM The aim of this study was to examine the relationship between parenting stress, coping style, and negative psychological outcomes in families of children admitted for the first time to a pediatric neurorehabilitation care unit. DESIGN This is an observational study. SETTING Pediatric neurorehabilitation care unit. POPULATION One hundred twenty-four parents of children diagnosed with neurodevelopmental or neurological conditions. METHODS Parents completed standardized questionnaires assessing parenting stress, coping style, anxiety and depressive symptoms. RESULTS We found that parents of children with neurodevelopmental conditions showed more emotion-focused coping strategies (P=0.016) and depressive symptoms (P=0.01) compared with parents of children with neurological conditions. Hierarchical regression analyses showed that emotion- and avoidance-oriented coping style and socioeconomic status are crucial factors in the adjustment process of parents of children with neurodevelopmental conditions. By contrast, parenting stress and child difficulties were the most significant predictors of negative psychological outcomes in parents with neurological conditions. CONCLUSIONS This study sought to develop more understanding of the relationship among parenting stress, coping, and anxiety or depressive symptoms in parent of children hospitalized in a pediatric neurorehabilitation care unit. We suggest that examining parents may increase our understanding of the interplay between child and parent functioning in families with children admitted for the first time to a pediatric neurorehabilitation care unit. CLINICAL REHABILITATION IMPACT Identify these predictors might help professionals to develop screening procedures to identify parent at high risk for anxiety or depression, and to conduct early interventions to reduce uncertainty and maladaptive coping strategies that may influences rehabilitation process.
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Affiliation(s)
- Francesco Craig
- Unit for Severe Disabilities in Developmental Age and Young Adults, Scientific Institute, IRCCS E. Medea, Brindisi, Italy
| | - Rosa Savino
- Unit for Severe Disabilities in Developmental Age and Young Adults, Scientific Institute, IRCCS E. Medea, Brindisi, Italy
| | - Sara Scoditti
- Unit for Severe Disabilities in Developmental Age and Young Adults, Scientific Institute, IRCCS E. Medea, Brindisi, Italy
| | - Elisabetta Lucarelli
- Unit for Severe Disabilities in Developmental Age and Young Adults, Scientific Institute, IRCCS E. Medea, Brindisi, Italy
| | - Isabella Fanizza
- Unit for Severe Disabilities in Developmental Age and Young Adults, Scientific Institute, IRCCS E. Medea, Brindisi, Italy
| | - Marta De Rinaldis
- Unit for Severe Disabilities in Developmental Age and Young Adults, Scientific Institute, IRCCS E. Medea, Brindisi, Italy
| | - Leonarda Gennaro
- Unit for Severe Disabilities in Developmental Age and Young Adults, Scientific Institute, IRCCS E. Medea, Brindisi, Italy
| | - Marta Simone
- Unit for Severe Disabilities in Developmental Age and Young Adults, Scientific Institute, IRCCS E. Medea, Brindisi, Italy
| | - Luigi Russo
- Unit for Severe Disabilities in Developmental Age and Young Adults, Scientific Institute, IRCCS E. Medea, Brindisi, Italy
| | - Antonio Trabacca
- Unit for Severe Disabilities in Developmental Age and Young Adults, Scientific Institute, IRCCS E. Medea, Brindisi, Italy -
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Graça Pereira M, Ferreira G, Pereira M, Faria S, Bacalhau R, Monteiro S, Fernandes B, Vilaça M. Validation of the Quality of Life Multiple Myeloma Module Questionnaire (QLQ‐MY20) in Portuguese myeloma patients. Eur J Cancer Care (Engl) 2019; 28:e13128. [DOI: 10.1111/ecc.13128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 05/15/2019] [Accepted: 05/17/2019] [Indexed: 01/22/2023]
Affiliation(s)
- M. Graça Pereira
- School of Psychology University of Minho Braga Portugal
- Psychology Research Center (CIPsi) University of Minho Braga Portugal
| | - Gabriela Ferreira
- School of Psychology University of Minho Braga Portugal
- Psychology Research Center (CIPsi) University of Minho Braga Portugal
| | - Marta Pereira
- School of Psychology University of Minho Braga Portugal
- Psychology Research Center (CIPsi) University of Minho Braga Portugal
| | - Sara Faria
- School of Psychology University of Minho Braga Portugal
| | - Rosário Bacalhau
- Portuguese Institute of Oncology Francisco Gentil Lisboa Portugal
| | - Sara Monteiro
- Department of Education and Psychology University of Aveiro Aveiro Portugal
- Center for Health Technology and Services Research (CINTESIS) University of Porto Porto Portugal
| | - Bruna Fernandes
- Department of Education and Psychology University of Aveiro Aveiro Portugal
| | - Margarida Vilaça
- Psychology Research Center (CIPsi) University of Minho Braga Portugal
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Faccio F, Gandini S, Renzi C, Fioretti C, Crico C, Pravettoni G. Development and validation of the Family Resilience (FaRE) Questionnaire: an observational study in Italy. BMJ Open 2019; 9:e024670. [PMID: 31171547 PMCID: PMC6561460 DOI: 10.1136/bmjopen-2018-024670] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE Develop and validate an instrument to assess family resilience and, more specifically, the family dynamics and resources, estimating the adaptation flexibility to cancer disease. Cohesion, communication, coping style and relational style were considered as critical functional areas in the construction of the instrument. DESIGN Two cross-sectional studies. Study 1: identification of factorial structure of the questionnaire in two samples with different cancer sites. Study 2: validation of the questionnaire in patients with cancer in two different phases of their therapeutic pathway. PARTICIPANTS AND SETTING A total of 213 patients with a histologically confirmed non-metastatic breast or prostate cancer and 209 caregivers were recruited for the two studies from an oncological hospital in Italy. OUTCOME MEASURES The Resilience Scale for Adults and the Family Resilience (FaRE) Questionnaire, developed by the researchers, were administered to all patients and caregivers who gave consent. RESULTS In study 1, the 60-item version of the FaRE Questionnaire underwent discriminant and construct validity, internal consistency and factorial analysis. Comparisons between patient and caregiver populations showed that patients perceived higher levels of family resources (p=0.048) and that patients with prostate cancer perceived less social support compared with patients with breast cancer (p=0.002). Factor analysis demonstrated four domains: communication and cohesion, perceived social support, perceived family coping, and religiousness and spirituality. In study 2, the validity and factorial structure of the final scale, composed of 24 items, were confirmed. The Cronbach alpha of all subscales was above 82. Normative values for patients with breast cancer can provide indications of family resilience levels. CONCLUSIONS Preliminary findings showed acceptable psychometric properties for the FaRE Questionnaire to evaluate family resilience in oncological patients and their caregivers. Further research should test its sensibility to change to assess its use as a psychoemotional monitoring tool and its validity in other medical contexts.
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Affiliation(s)
- Flavia Faccio
- Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy
- Applied Division for Cognitive and Psychological Science, Istituto Europeo di Oncologia, Milan, Italy
| | - Sara Gandini
- Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy
| | - Chiara Renzi
- Applied Division for Cognitive and Psychological Science, Istituto Europeo di Oncologia, Milan, Italy
| | - Chiara Fioretti
- Department of Educational Sciences and Psychology, Università degli Studi di Firenze, Florence, Italy
| | - Chiara Crico
- Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy
- Applied Division for Cognitive and Psychological Science, Istituto Europeo di Oncologia, Milan, Italy
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy
- Applied Division for Cognitive and Psychological Science, Istituto Europeo di Oncologia, Milan, Italy
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Saner FAM, Herschtal A, Nelson BH, deFazio A, Goode EL, Ramus SJ, Pandey A, Beach JA, Fereday S, Berchuck A, Lheureux S, Pearce CL, Pharoah PD, Pike MC, Garsed DW, Bowtell DDL. Going to extremes: determinants of extraordinary response and survival in patients with cancer. Nat Rev Cancer 2019; 19:339-348. [PMID: 31076661 PMCID: PMC7255796 DOI: 10.1038/s41568-019-0145-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Research into factors affecting treatment response or survival in patients with cancer frequently involves cohorts that span the most common range of clinical outcomes, as such patients are most readily available for study. However, attention has turned to highly unusual patients who have exceptionally favourable or atypically poor responses to treatment and/or overall survival, with the expectation that patients at the extremes may provide insights that could ultimately improve the outcome of individuals with more typical disease trajectories. While clinicians can often recount surprising patients whose clinical journey was very unusual, given known clinical characteristics and prognostic indicators, there is a lack of consensus among researchers on how best to define exceptional patients, and little has been proposed for the optimal design of studies to identify factors that dictate unusual outcome. In this Opinion article, we review different approaches to identifying exceptional patients with cancer and possible study designs to investigate extraordinary clinical outcomes. We discuss pitfalls with finding these rare patients, including challenges associated with accrual of patients across different treatment centres and time periods. We describe recent molecular and immunological factors that have been identified as contributing to unusual patient outcome and make recommendations for future studies on these intriguing patients.
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Affiliation(s)
| | - Alan Herschtal
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Brad H Nelson
- Deeley Research Centre, British Columbia Cancer Agency, Victoria, British Columbia, Canada
| | - Anna deFazio
- Department of Gynaecological Oncology, Westmead Hospital, Westmead, New South Wales, Australia
- The University of Sydney, Sydney, New South Wales, Australia
- Centre for Cancer Research, The Westmead Institute for Medical Research, Sydney, New South Wales, Australia
| | - Ellen L Goode
- Department of Health Science Research, Division of Epidemiology, Mayo Clinic, Rochester, MN, USA
| | - Susan J Ramus
- School of Women's and Children's Health, University ofNew South Wales, Sydney, New South Wales, Australia
- Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - Ahwan Pandey
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Jessica A Beach
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Sian Fereday
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Andrew Berchuck
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA
| | - Stephanie Lheureux
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada
| | - Celeste Leigh Pearce
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Paul D Pharoah
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | - Malcolm C Pike
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Dale W Garsed
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Victoria, Australia.
| | - David D L Bowtell
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Victoria, Australia.
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Chinese Version of the Assessment of Survivor Concerns Scale for Gynecological Cancer Survivors: A Psychometric Study in Taiwan. J Nurs Res 2019; 27:e41. [PMID: 30908430 PMCID: PMC6752688 DOI: 10.1097/jnr.0000000000000323] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background: Most gynecological cancer survivors outlive the acute stage, and many reach permanent survival. However, the fear of cancer recurrence (FCR) is stressful and affects quality of life. Purpose: This study was designed to validate a Chinese version of the Assessment of Survivor Concerns (ASC) questionnaire in terms of its ability to assess FCR in gynecological cancer survivors. Methods: A two-stage study procedure was employed. The first stage involved the translation of the ASC questionnaire from English into Chinese using the methods proposed by Guillemin, which include translation, back-translation, consensus meetings, and a trial of potential users. In the second stage, a pilot study was completed with 37 gynecological cancer survivors followed by a psychometric property study with 287 gynecological cancer survivors. Construct validity was determined using confirmatory factor analysis (CFA) with structural equation modeling. Convergent validity was determined using composite reliability and the average variance extracted values of the ASC model. Discriminant validity was determined by comparing the model fitness of the ASC model against the model fitness of a one-construct model. Concurrent criterion validity was assessed using the European Organization for Research and Treatment of Cancer's Quality-of-Life Questionnaire Core 30 as the auxiliary instrument. Reliability was determined by measuring the internal consistency reliability using Cronbach's α in addition to the 3-week test–retest reliability with a 95% confidence interval of the intraclass correlation coefficient. Results: The process of translation and back-translation was performed to ensure the conceptual equivalence of the Chinese version with the original ASC questionnaire. For CFA, the fit indices of the ASC model (χ2 = 9.87, p > .05; root mean square error of approximation = .03. comparative fit index = 1, nonnormed fit index = 1) indicated appropriate model fitness. For convergent validity, the composite reliability and average variance extracted values of the ASC model were satisfactory. For discriminant validity, the model fitness of the ASC model was significantly improved over the one-construct model. For concurrent criterion validity, the ASC scores correlated negatively with the scores of the global quality of life and the five functions (physical, role, cognition, emotions, and social) of the European Organization for Research and Treatment of Cancer's Quality-of-Life Questionnaire Core 30, as hypothesized. For reliability, the Cronbach's α and the 95% confidence interval of intraclass correlation coefficient for the ASC model were .91 and [.18, .68], respectively. Conclusions/Implications for Practice: The Chinese version of the ASC questionnaire is a valid and reliable instrument that is suitable for assessing FCR in gynecological cancer survivors in clinical and research settings.
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van Walree IC, Hamaker ME, van de Poll-Franse LV, Vos MC, Boll D, van Huis-Tanja LH, Ezendam NPM. Older ovarian cancer survivors report lower long-term health-related quality of life than younger survivors: A study from the population-based profiles registry. Gynecol Oncol 2019; 153:391-398. [PMID: 30772033 DOI: 10.1016/j.ygyno.2019.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 01/24/2019] [Accepted: 02/03/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To assess long-term differences in health-related quality of life (HRQoL) of older ovarian cancer survivors compared to both an age-matched normative population and to younger survivors. In addition, the differential effect of chemotherapy on HRQoL between older and younger survivors was compared. METHODS Ovarian cancer survivors (n = 348) diagnosed between 2000 and 2010, as registered by the Dutch population-based Eindhoven Cancer Registry, were invited to complete the EORTC QLQ-C30 HRQoL questionnaire in 2012. HRQoL outcomes of survivors were compared with an age-matched normative population and older survivors (≥70 years) were compared with younger survivors. RESULTS The questionnaire was returned by 191 ovarian cancer survivors (55%), 31% were aged ≥70 years (n = 59). Compared to the normative population, survivors ≥70 years scored lower on global health status and all functioning subscales except emotional functioning, and they reported more symptoms. Survivors aged <70 years only reported worse physical and cognitive functioning in comparison with the normative population. Most differences were of medium to small clinical relevance. Age appeared to moderate the effect of chemotherapy on HRQoL. Older survivors who had received chemotherapy experienced better physical functioning and less pain and insomnia while the opposite was found in younger survivors. CONCLUSION In comparison with an age-matched normative population, older ovarian cancer survivors report lower HRQoL scores than younger survivors. As this represents a selection of long-term survivors, future research should focus on the trajectory of HRQoL from diagnosis throughout treatment and follow-up to identify which factors are related to worse HRQoL in the entire older ovarian cancer population and whether timely interventions are able to improve HRQoL.
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Affiliation(s)
- I C van Walree
- Department of Internal Medicine, Diakonessenhuis Utrecht, the Netherlands.
| | - M E Hamaker
- Department of Geriatric Medicine, Diakonessenhuis Utrecht, the Netherlands
| | - L V van de Poll-Franse
- CoRPS - Center of Research on Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, the Netherlands; Eindhoven Cancer Registry, Comprehensive Cancer Center the Netherlands, the Netherlands; Netherlands Cancer Institute (NKI), Amsterdam, the Netherlands
| | - M C Vos
- Department of Obstetrics and Gynecology, Elisabeth TweeSteden Ziekenhuis Tilburg, the Netherlands
| | - D Boll
- Department of Obstetrics and Gynecology, Catharina Hospital Eindhoven, the Netherlands
| | - L H van Huis-Tanja
- Department of Internal Medicine, Diakonessenhuis Utrecht, the Netherlands
| | - N P M Ezendam
- CoRPS - Center of Research on Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, the Netherlands; Netherlands Comprehensive Cancer Organisation, the Netherlands
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32
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Thomas TH, McLaughlin M, Hayden M, Shumaker E, Trybus J, Myers E, Zabiegalski A, Cohen SM. Teaching Patients with Advanced Cancer to Self-Advocate: Development and Acceptability of the Strong Together™ Serious Game. Games Health J 2019; 8:55-63. [DOI: 10.1089/g4h.2018.0021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Teresa Hagan Thomas
- Department of Health Promotion & Development, University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania
| | - Mary McLaughlin
- University of Pittsburgh Medical Center Passavant, Pittsburgh, Pennsylvania
| | - Margaret Hayden
- University of Pittsburgh Medical Center Passavant, Pittsburgh, Pennsylvania
| | - Elizabeth Shumaker
- University of Pittsburgh Medical Center Passavant, Pittsburgh, Pennsylvania
| | - Jessica Trybus
- Simcoach Games, Pittsburgh, Pennsylvania
- Entertainment Technology Center, Carnegie Mellon University, Pittsburgh, Pennsylvania
| | - Eben Myers
- Simcoach Games, Pittsburgh, Pennsylvania
| | | | - Susan M. Cohen
- Department of Health Promotion & Development, University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania
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Sekse RJT, Dunberger G, Olesen ML, Østerbye M, Seibaek L. Lived experiences and quality of life after gynaecological cancer-An integrative review. J Clin Nurs 2019; 28:1393-1421. [PMID: 30461101 PMCID: PMC7328793 DOI: 10.1111/jocn.14721] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 09/07/2018] [Accepted: 11/03/2018] [Indexed: 01/09/2023]
Abstract
Aim and objectives To review the literature on Nordic women's lived experiences and quality of life (QoL) after gynaecological cancer treatment. Background While incidence and survival are increasing in all groups of gynaecological cancers in the Nordic countries, inpatient hospitalisation has become shorter in relation to treatment. This has increased the need for follow‐up and rehabilitation. Design Integrative literature review using the Equator PRISMA guidelines. Methods The review was selected, allowing inclusion of both experimental and nonexperimental research. The search included peer‐reviewed articles published 1995–2017. To frame the search strategy, we applied the concept of rehabilitation, which holds a holistic perspective on health. Results Fifty‐five articles were included and were contextualised within three themes. Physicalwell-being in a changed body encompasses bodily changes comprising menopausal symptoms, a changed sexual life, complications in bowels, urinary tract, lymphoedema and pain, bodily‐based preparedness and fear of recurrence. Mental well-being as a woman deals with questioned womanliness, the experience of revitalised values in life, and challenges of how to come to terms with oneself after cancer treatment. Psychosocial well-being and interaction deals with the importance of having a partner or close person in the process of coming to terms with oneself after cancer. Furthermore, the women needed conversations with health professionals around the process of coping with changes and late effects, including intimate and sensitive issues. Conclusion Years after gynaecological cancer, women have to deal with fundamental changes and challenges concerning their physical, mental and psychosocial well‐being. Future research should focus on how follow‐up programmes can be organised to target the multidimensional aspects of women's QoL. Research collaboration across Nordic countries on rehabilitation needs and intervention is timely and welcomed. Relevance to clinical practice To ensure that all aspects of cancer rehabilitation are being addressed, we suggest that the individual woman is offered an active role in her follow‐up.
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Affiliation(s)
- Ragnhild Johanne Tveit Sekse
- Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Sciences, University of Bergen, Bergen, Norway
| | - Gail Dunberger
- Department of Health Care Science, Ersta Sköndal Bräcke University College, Stockholm, Sweden
| | - Mette Linnet Olesen
- Research Unit Womens and Childrens Health Department, Copenhagen, Denmark.,Department of Gynaecology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Maria Østerbye
- AU Library, Health Sciences Aarhus University, Aarhus C, Denmark
| | - Lene Seibaek
- Department of Gynecology and Obstetrics, Aarhus University Hospital, Aarhus N, Denmark
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Jelicic L, Brooker J, Shand L, Knight T, Ricciardelli L, Denham G, Burney S. Experiences and health care preferences of women with ovarian cancer during the diagnosis phase. Psychooncology 2019; 28:379-385. [PMID: 30485590 DOI: 10.1002/pon.4952] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 11/05/2018] [Accepted: 11/23/2018] [Indexed: 11/09/2022]
Abstract
OBJECTIVE An ovarian cancer diagnosis presents physical and psychological challenges. Usually identified at an advanced stage, the disease involves invasive treatment and has a high mortality rate. The diagnosis phase is generally a time of heightened distress. Accordingly, the aim of this qualitative study was to explore the health care experiences and preferences of women with ovarian cancer during this phase, and identify opportunities to enhance women's experiences and outcomes. METHODS Thirty-four women diagnosed with ovarian cancer were recruited from across Australia (median age = 60.5 years, range = 31-74 years). Semistructured interviews explored participants' experience of health care services and preferences during the diagnosis phase. Thematic analysis of interview transcripts followed. RESULTS Five themes were identified including "navigating uncertainty" which summarized women's general experiences throughout the diagnosis phase and provided a context for concomitant health care preferences. Four other themes highlighted significant areas where health care may be better aligned with women's preferences. These included "responsiveness in health care," "relational communication," "person-centered information," and "preparation for living beyond cancer treatment." CONCLUSIONS Responsive and prompt health care services that employ relational communication, provide patient-centered information, and prepare women for survivorship could improve the health care experiences of women diagnosed with ovarian cancer.
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Affiliation(s)
- Lebecca Jelicic
- School of Psychology and Public Health, LaTrobe University, Melbourne, Australia.,Melbourne Psycho-oncology Service, Cabrini Hospital, Melbourne, Australia
| | - Joanne Brooker
- Szalmuk Family Psycho-Oncology Research Unit, Cabrini Health, Melbourne, Australia.,Department of Psychiatry, Monash University, Melbourne, Australia.,School of Psychology, Faculty of Health, Deakin University, Melbourne, Australia
| | - Lyndel Shand
- Szalmuk Family Psycho-Oncology Research Unit, Cabrini Health, Melbourne, Australia.,School of Psychology, Faculty of Health, Deakin University, Melbourne, Australia
| | - Tess Knight
- School of Psychology, Faculty of Health, Deakin University, Melbourne, Australia
| | - Lina Ricciardelli
- School of Psychology, Faculty of Health, Deakin University, Melbourne, Australia
| | - Geoff Denham
- School of Psychology and Public Health, LaTrobe University, Melbourne, Australia
| | - Sue Burney
- Szalmuk Family Psycho-Oncology Research Unit, Cabrini Health, Melbourne, Australia.,School of Psychological Sciences, Monash University, Melbourne, Australia
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Abstract
Background: Being diagnosed with cancer and undergoing its treatment are associated with substantial distress that can cause long-lasting negative psychological outcomes. Resilience is an individual's ability to maintain or restore relatively stable psychological and physical functioning when confronted with stressful life events and adversities. Posttraumatic growth (PTG) can be defined as positive life changes that result from major life crises or stressful events. Objectives: The aims of this study were to 1) investigate which factors can strengthen or weaken resilience and PTG in cancer patients and survivors; 2) explore the relationship between resilience and PTG, and mental health outcomes; and 3) discuss the impact and clinical implications of resilience and PTG on the process of recovery from cancer. Methods: A literature search was conducted, restricted to PubMed from inception until May 2018, utilizing the following key words: cancer, cancer patients, cancer survivors, resilience, posttraumatic growth, coping, social support, and distress. Results: Biological, personal, and most importantly social factors contribute to cancer patients' resilience and, consequently, to favorable psychological and treatment-related outcomes. PTG is an important phenomenon in the adjustment to cancer. From the literature included in this review, a model of resilience and PTG in cancer patients and survivors was developed. Conclusions: The cancer experience is associated with positive and negative life changes. Resilience and PTG are quantifiable and can be modified through psychological and pharmacological interventions. Promoting resilience and PTG should be a critical component of cancer care.
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Affiliation(s)
- Annina Seiler
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Josef Jenewein
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zurich, Switzerland.,Clinic Zugersee, Center for Psychiatry and Psychotherapy, Oberwil-Zug, Switzerland
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Kim M, Jeon J, Ryu E. Text Network Analysis of Oncology Nursing Studies Published in the Journal of Asian Oncology Nursing. ASIAN ONCOLOGY NURSING 2019. [DOI: 10.5388/aon.2019.19.4.193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Miji Kim
- Department of Nursing, Kyungbok University, Namyangju, Korea
| | - Jaehee Jeon
- Department of Nursing, Gangneung-Wonju National University, Wonju, Korea
| | - Eunjung Ryu
- Department of Nursing, Chung-Ang University, Seoul, Korea
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Tomao F, Di Pinto A, Sassu CM, Bardhi E, Di Donato V, Muzii L, Petrella MC, Peccatori FA, Panici PB. Fertility preservation in ovarian tumours. Ecancermedicalscience 2018; 12:885. [PMID: 30679952 PMCID: PMC6345054 DOI: 10.3332/ecancer.2018.885] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Indexed: 12/14/2022] Open
Abstract
A considerable number of patients with a cancer diagnosis are of childbearing age and have not satisfied their desire for a family. Despite ovarian cancer (OC) usually occurring in older patients, 3%-14% are diagnosed at a fertile age with the overall 5-year survival rate being 91.2% in women ≤44 years of age when it is found at 1A-B stage. In this scenario, testing the safety and the efficacy of fertility sparing strategies in OC patients is very important overall in terms of quality of life. Unfortunately, the lack of randomised trials to validate conservative approaches does not guarantee the safety of fertility preservation strategies. However, evidence-based data from descriptive series suggest that in selected cases, the preservation of the uterus and at least one part of the ovary does not lead to a high risk of relapse. This conservative surgery helps to maintain organ function, giving patients of childbearing age the possibility to preserve their fertility. We hereby analysed the main evidence from the international literature on this topic in order to highlight the selected criteria for conservative management of OC patients, including healthy BRCA mutations carriers.
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Affiliation(s)
- Federica Tomao
- Department of Gynaecological and Obstetrical Sciences and Urological Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Anna Di Pinto
- Department of Gynaecological and Obstetrical Sciences and Urological Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Carolina Maria Sassu
- Department of Gynaecological and Obstetrical Sciences and Urological Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Erlisa Bardhi
- Department of Gynaecological and Obstetrical Sciences and Urological Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Violante Di Donato
- Department of Gynaecological and Obstetrical Sciences and Urological Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Ludovico Muzii
- Department of Gynaecological and Obstetrical Sciences and Urological Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | | | | | - Pierluigi Benedetti Panici
- Department of Gynaecological and Obstetrical Sciences and Urological Sciences, Sapienza University of Rome, 00161 Rome, Italy
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Kaya C, Chan F, Tansey T, Bezyak J, Aksoy S, Altundag K. Evaluating the World Health Organization’s International Classification of Functioning, Disability and Health Framework as a Participation Model for Cancer Survivors in Turkey. REHABILITATION COUNSELING BULLETIN 2018. [DOI: 10.1177/0034355218792900] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Improvements in diagnosis and treatment options for cancer now allow cancer survivors to live longer, and as a result, services are necessary to help individuals live an active and meaningful life in the community. The purpose of this study was to evaluate the World Health Organization’s International Classification of Functioning, Disability and Health (ICF) framework as a participation model for cancer survivors in Turkey. Results from simultaneous regression analyses indicated educational attainment, fatigue, perceived stress, role functioning, social functioning, core self-evaluations, independent self-construal, social support, and autonomy support were significantly associated with participation. Specific interventions including health education, psychological workshops, support groups, and assistive technology may improve cancer survivors’ motivation and desire to actively engage in community activities. Higher levels of participation were also found when cancer survivors were involved in the treatment decision-making process, and felt cared for and understood by their treatment providers.
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Affiliation(s)
| | - Fong Chan
- University of Wisconsin–Madison, USA
| | | | - Jill Bezyak
- University of Northern Colorado, Greeley, USA
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Martínez Arroyo O, Andreu Vaíllo Y, Martínez López P, Galdón Garrido MJ. Emotional distress and unmet supportive care needs in survivors of breast cancer beyond the end of primary treatment. Support Care Cancer 2018; 27:1049-1057. [DOI: 10.1007/s00520-018-4394-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Accepted: 07/31/2018] [Indexed: 01/16/2023]
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40
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Bazzi AR, Clark MA, Winter MR, Ozonoff A, Boehmer U. Resilience Among Breast Cancer Survivors of Different Sexual Orientations. LGBT Health 2018; 5:295-302. [PMID: 29878863 DOI: 10.1089/lgbt.2018.0019] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
PURPOSE Resilience could help protect the psychosocial wellbeing of sexual minority women (SMW) experiencing stressors from both breast cancer and sexual minority status; however, little research has assessed resilience among breast cancer survivors of different sexual orientations. METHODS From 2011 to 2012, we surveyed a national sample of breast cancer survivors matched on sexual orientation, age, and cancer status. RESULTS Among heterosexual (n = 339) and sexual minority (n = 201) breast cancer survivors (n = 540 overall), multivariable regression analyses revealed that more social support (coefficient: 0.87; 95% confidence interval [CI]: 0.56-1.19), fighting spirit combined with helplessness/hopelessness (coefficient: 0.30; 95% CI: 0.13-0.47), and fatalism (coefficient: 0.40; 95% CI: 0.14-0.65) were associated with greater resilience. Mental health counseling before breast cancer diagnosis and anxious preoccupation following cancer diagnosis were associated with reduced resilience (coefficient: -2.50; 95% CI: -3.83 to -1.18; and -0.46; 95% CI: -0.60 to -0.32). Although sexual orientation was not independently associated with resilience, among SMW, those who were unemployed had reduced resilience compared with those who were employed (coefficient: -3.52; 95% CI: -5.75 to -1.28), whereas there was no association between employment and resilience among heterosexual women. CONCLUSION These findings suggest that social support and other factors associated with resilience could be leveraged by interventions to improve the health and wellbeing of diverse cancer survivors.
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Affiliation(s)
- Angela R Bazzi
- 1 Department of Community Health Sciences, Boston University School of Public Health , Boston, Massachusetts
| | - Melissa A Clark
- 2 Department of Quantitative Health Sciences, University of Massachusetts Medical School , Shrewsbury, Massachusetts
| | - Michael R Winter
- 3 Data Coordinating Center, Boston University School of Public Health , Boston, Massachusetts
| | - Al Ozonoff
- 4 Center for Patient Safety and Quality Research, Boston Children's Hospital , Boston, Massachusetts.,5 Department of Pediatrics, Harvard Medical School , Boston, Massachusetts
| | - Ulrike Boehmer
- 1 Department of Community Health Sciences, Boston University School of Public Health , Boston, Massachusetts
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Shand LK, Brooker JE, Burney S, Fletcher J, Ricciardelli LA. Psychosocial factors associated with posttraumatic stress and growth in Australian women with ovarian cancer. J Psychosoc Oncol 2018; 36:470-483. [DOI: 10.1080/07347332.2018.1461728] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Lyndel K. Shand
- School of Psychology, Deakin University, Burwood Highway, Burwood, Victoria, Australia
- Szalmuk Family Psycho-Oncology Research Unit, Cabrini Health, Malvern, Victoria, Australia
| | - Joanne E. Brooker
- School of Psychology, Deakin University, Burwood Highway, Burwood, Victoria, Australia
- Szalmuk Family Psycho-Oncology Research Unit, Cabrini Health, Malvern, Victoria, Australia
- Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
| | - Sue Burney
- Szalmuk Family Psycho-Oncology Research Unit, Cabrini Health, Malvern, Victoria, Australia
- School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Jane Fletcher
- Szalmuk Family Psycho-Oncology Research Unit, Cabrini Health, Malvern, Victoria, Australia
| | - Lina A. Ricciardelli
- School of Psychology, Deakin University, Burwood Highway, Burwood, Victoria, Australia
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Faccio F, Renzi C, Giudice AV, Pravettoni G. Family Resilience in the Oncology Setting: Development of an Integrative Framework. Front Psychol 2018; 9:666. [PMID: 29867644 PMCID: PMC5952112 DOI: 10.3389/fpsyg.2018.00666] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 04/17/2018] [Indexed: 11/15/2022] Open
Abstract
Resilience is a concept that has received burgeoning interest in the last decades. Researchers have been fascinated by the ability of some individuals to bounce back from an adverse event and adapt to extremely challenging situations. More recently family resilience, namely the potential resources of the family’s system, has been considered due to numerous individual studies highlighting the crucial influence of relationships with significant others in mediating adaptation and recovery. In this article, a brief overview of the theoretical literature on individual and family resilience is presented. Following, current empirical literature on resilience in the context of oncology is evaluated. Although family resilience is considered a dynamic process unique to each family unit, some common resources and strengths that can help families face significant adversities, such as cancer, can be identified. This said to date there is no family resilience framework applied specifically to the cancer trajectory. Drawing from previous studies, we sought to provide a clinical resilience model for families living with cancer, with the aim of mapping those resources that can empower families to deal with prolonged adversity. This framework can serve as general guideline for health professionals in assessing family strengths, promoting specific family processes and facilitating adaptation to the cancer experience.
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Affiliation(s)
- Flavia Faccio
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.,Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Milan, Italy
| | - Chiara Renzi
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Milan, Italy
| | - Alice V Giudice
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Milan, Italy
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.,Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Milan, Italy
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Donoyama N, Satoh T, Hamano T, Ohkoshi N, Onuki M. Effects of Anma therapy (Japanese massage) on health-related quality of life in gynecologic cancer survivors: A randomized controlled trial. PLoS One 2018; 13:e0196638. [PMID: 29723235 PMCID: PMC5933696 DOI: 10.1371/journal.pone.0196638] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 04/05/2018] [Indexed: 11/18/2022] Open
Abstract
Objectives Anma therapy (Japanese massage therapy, AMT) significantly reduces the severity of physical complaints in survivors of gynecologic cancer. However, whether this reduction of severity is accompanied by improvement in health-related quality of life is unknown. Methods Forty survivors of gynecologic cancer were randomly allocated to either an AMT group that received one 40-min AMT session per week for 8 weeks or a no-AMT group. We prospectively measured quality of life by using the Japanese version of the European Organization for Research and Treatment of Cancer QLQ-C30 version 3.0 (EORTC QLQ-C30) at baseline and at 8-week follow-up. The QLQ-C30 response rate was 100%. Hospital Anxiety Depression Scale (HADS), Profile of Mood States (POMS), and Measure of Adjustment to Cancer were also prespecified and prospectively evaluated. Results The QLQ-C30 Global Health Status and Quality of Life showed significant improvement at 8 weeks (P = 0.042) in the AMT group compared with the no-AMT group, and the estimated mean difference reached a minimal clinically important difference of 10 points (10.4 points, 95% CI = 1.2 to 19.6). Scores on fatigue and insomnia showed significant improvement in the AMT group compared with the no-AMT group (P = 0.047 and 0.003, respectively). There were no significant between-group improvements in HADS anxiety and depression scales; however, POMS-assessed anger-hostility showed significant improvement in the AMT group compared with the no-AMT group (p = 0.028). Conclusions AMT improved health-related quality of life in gynecologic cancer survivors. AMT can be of potential benefit for applications in oncology.
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Affiliation(s)
- Nozomi Donoyama
- Department of Health, Faculty of Health Sciences, Tsukuba University of Technology, Tsukuba, Ibaraki, Japan
- * E-mail:
| | - Toyomi Satoh
- Department of Obstetrics and Gynecology, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | | | - Norio Ohkoshi
- Department of Health, Faculty of Health Sciences, Tsukuba University of Technology, Tsukuba, Ibaraki, Japan
| | - Mamiko Onuki
- Department of Obstetrics and Gynecology, University of Tsukuba, Tsukuba, Ibaraki, Japan
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44
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De Felice F, Marchetti C, Di Pinto A, Musella A, Palaia I, Porpora MG, Muzii L, Tombolini V, Panici PB, Tomao F. Fertility preservation in gynaecologic cancers. Ecancermedicalscience 2018; 12:798. [PMID: 29434664 PMCID: PMC5804712 DOI: 10.3332/ecancer.2018.798] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Indexed: 12/23/2022] Open
Abstract
Due to substantial improvement in the diagnosis and treatment of gynaecologic cancers, a better understanding of patient care needs to be revised. We reviewed the literature related to fertility preservation strategies in gynaecological cancer and discussed current general management approaches. New technical modalities and patients' own desire for motherhood should be integral and paramount in the clinical evaluation to significantly contribute to preserving fertility in those women diagnosed with gynaecologic cancers during the reproductive years.
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Affiliation(s)
- Francesca De Felice
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome 00161, Italy
| | - Claudia Marchetti
- Department of Gynecological and Obstetrical Sciences and Urological Sciences, Sapienza University of Rome, Rome 00161, Italy
| | - Anna Di Pinto
- Department of Gynecological and Obstetrical Sciences and Urological Sciences, Sapienza University of Rome, Rome 00161, Italy
| | - Angela Musella
- Department of Gynecological and Obstetrical Sciences and Urological Sciences, Sapienza University of Rome, Rome 00161, Italy
| | - Innocenza Palaia
- Department of Gynecological and Obstetrical Sciences and Urological Sciences, Sapienza University of Rome, Rome 00161, Italy
| | - Maria Grazia Porpora
- Department of Gynecological and Obstetrical Sciences and Urological Sciences, Sapienza University of Rome, Rome 00161, Italy
| | - Ludovico Muzii
- Department of Gynecological and Obstetrical Sciences and Urological Sciences, Sapienza University of Rome, Rome 00161, Italy
| | - Vincenzo Tombolini
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome 00161, Italy
| | - Pierluigi Benedetti Panici
- Department of Gynecological and Obstetrical Sciences and Urological Sciences, Sapienza University of Rome, Rome 00161, Italy
| | - Federica Tomao
- Department of Gynecological and Obstetrical Sciences and Urological Sciences, Sapienza University of Rome, Rome 00161, Italy
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Association between social support and health-related quality of life among Chinese rural elders in nursing homes: the mediating role of resilience. Qual Life Res 2017; 27:783-792. [PMID: 29124499 DOI: 10.1007/s11136-017-1730-2] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2017] [Indexed: 12/24/2022]
Abstract
PURPOSE This study aims to confirm the relationship between social support and health-related quality of life (HRQOL) among rural Chinese elders in nursing homes, and to examine the mediating role of resilience in the impact of social support on HRQOL. METHODS A cross-sectional survey of 205 elders aged 60 and above was conducted in five rural public nursing homes. Sociodemographic characteristics, the SF-36 questionnaire, and information about social support and resilience were collected. The researchers administered the questionnaires to the participants in a face-to-face setting. Descriptive analysis and a correlation matrix were used to indicate characteristics of the participants and bivariate correlations, respectively. The mediation analyses, composed of regression analysis and PROCESS analysis, were preformed to test both direct and indirect effects of social support on HRQOL, namely the mediating role of resilience. RESULTS Social support was positively related to HRQOL (β = 0.303, p < 0.001) among Chinese rural elders in nursing homes. The mediating role of resilience in the relationship between social support and HRQOL was confirmed (a*b bootstrapped 95% confidence interval = [0.098, 0.257]), which revealed that social support had an indirect effect on HRQOL through resilience. CONCLUSIONS Resilience partially mediates the relationship between social support and HRQOL. The mediation model provides a better understanding of how social support and resilience work together to affect HRQOL, and it could guide the interventions in health care for promoting HRQOL among Chinese rural elders in nursing homes.
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Schofield C, Newton RU, Galvão DA, Cohen PA, Peddle-McIntyre CJ. A Physiological Profile of Ovarian Cancer Survivors to Inform Tailored Exercise Interventions and the Development of Exercise Oncology Guidelines. Int J Gynecol Cancer 2017; 27:1560-1567. [PMID: 29036032 DOI: 10.1097/igc.0000000000001044] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE Physical activity has become increasingly important in supportive cancer care. However, physical activity and exercise guidelines for ovarian cancer survivors remain generic. The aim of this narrative review is to summarize existing data regarding the physiological characteristics (treatment-related adverse effects, concurrent comorbidities, body weight and composition, physical fitness and function, and physical activity behavior) of ovarian cancer survivors to further understanding of their cancer-specific physical activity and exercise needs. We also highlight gaps in the current knowledge base. METHODS We undertook a narrative review of current literature on the physiological status of ovarian cancer survivors. We defined physiological status as treatment-related adverse effects, concurrent comorbidities, body weight and composition, physical fitness and function, and physical activity behavior. RESULTS In addition to disease- and treatment-related symptoms and adverse effects, the majority of ovarian cancer survivors have comorbidities, which may adversely affect treatment effectiveness and safety, as well as survival. Despite high overweight and obesity rates, a large percentage of women are malnourished at diagnosis, with potentially compromised muscle mass and muscle density. Low muscle density at diagnosis and loss of muscle mass during treatment may be associated with worse survival outcomes. A small number of studies have observed impaired physical function and cardiorespiratory fitness in ovarian cancer survivors. The majority of ovarian cancer survivors are insufficiently active or sedentary. CONCLUSIONS Our review suggests that ovarian cancer survivors could benefit from physical activity and exercise oncology interventions aimed at addressing detrimental changes to physiological status due to disease and treatment. However, current knowledge gaps regarding the physiological characteristics of ovarian cancer survivors throughout the entire survivorship spectrum challenge the development of tailored exercise intervention studies and exercise oncology guidelines.
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Affiliation(s)
- Christelle Schofield
- *Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia; †UQ Centre for Clinical Research, University of Queensland, Herston, Queensland; and ‡St John of God Hospital Bendat Family Comprehensive Cancer Centre, Subiaco; §Department of Obstetrics and Gynaecology, School of Medicine, University of Western Australia, Perth; and ∥Institute for Health Research, University of Notre Dame Australia, Fremantle, Western Australia, Australia
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Lutgendorf SK, Shinn E, Carter J, Leighton S, Baggerly K, Guindani M, Fellman B, Matzo M, Slavich GM, Goodman MT, Tew W, Lester J, Moore KM, Karlan BY, Levine DA, Sood AK. Quality of life among long-term survivors of advanced stage ovarian cancer: A cross-sectional approach. Gynecol Oncol 2017; 146:101-108. [PMID: 28527672 DOI: 10.1016/j.ygyno.2017.05.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 05/05/2017] [Accepted: 05/07/2017] [Indexed: 11/28/2022]
Abstract
PURPOSE Long-term survival of women with advanced-stage ovarian cancer is relatively rare. Little is known about quality of life (QOL) and survivorship concerns of these women. Here, we describe QOL of women with advanced-stage ovarian cancer surviving for 8.5 years or longer and compare women with 0-1 recurrence to those with multiple recurrences. METHODS Participants (n=56) recruited from 5 academic medical centers and the Ovarian Cancer Research Fund Alliance completed surveys regarding QOL (FACT-O), mood (CESD), social support (SPS), physical activity (IPAQ-SF), diet, and clinical characteristics. Median survival was 14.0 years (range 8.8-33.3). RESULTS QOL and psychological adjustment of long-term survivors was relatively good, with mean FACT-G scores (multiple recurrences: 80.81±13.95; 0-1 recurrence: 89.05 ±10.80) above norms for healthy community samples (80.1±18.1). Survivors with multiple recurrences reported more compromised QOL in domains of physical and emotional well-being (p <.05), and endorsed a variety of physical and emotional concerns compared to survivors with 0-1 recurrence. Difficulties in sexual functioning were common in both groups. Almost half (43%) of the survivors reported low levels of physical activity. CONCLUSIONS Overall, women with advanced-stage ovarian cancer who have survived at least 8.5 years report good QOL and psychological adjustment. QOL of survivors with multiple recurrences is somewhat impaired compared to those with 0-1 recurrence. Limitations include a possible bias towards participation by healthier survivors, thus under-representing the level of compromise in long-term survivors. Health care practitioners should be alert to psychosocial issues faced by these long-term survivors to provide interventions that enhance QOL.
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Affiliation(s)
- Susan K Lutgendorf
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA; Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA, USA; Department of Urology, University of Iowa, Iowa City, IA, USA; Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA, USA.
| | - Eileen Shinn
- Department of Behavioral Science, Division of OVP, Cancer Prevention and Population Sciences, The University of Texas, M.D. Anderson Cancer Center, Houston, TX, USA
| | - Jeanne Carter
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Gynecology Service, Department of Psychiatry and Surgery Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Susan Leighton
- Ovarian Cancer Research Fund Alliance, Washington, DC, United States
| | - Keith Baggerly
- Department of Bioinformatics and Computational Biology, Division of Quantitative Sciences, University of Texas, M.D. Anderson Cancer Center, Houston, TX, USA
| | - Michele Guindani
- Department of Biostatistics, Division of Quantitative Sciences, University of Texas, M.D. Anderson Cancer Center, Houston, TX, USA
| | - Bryan Fellman
- Department of Biostatistics, Division of Quantitative Sciences, University of Texas, M.D. Anderson Cancer Center, Houston, TX, USA
| | - Marianne Matzo
- College of Family Medicine, Stephenson Oklahoma Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - George M Slavich
- Cousins Center for Psychoneuroimmunology, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Marc T Goodman
- Cancer Prevention and Genetics Program, Samuel Oschin Comprehensive Cancer Institute, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - William Tew
- Gynecologic Medical Oncology Service, Memorial Sloan Kettering Cancer Center, Weill Cornell Medicine, New York, NY, USA
| | - Jenny Lester
- Women's Cancer Program, Samuel Oschin Comprehensive Cancer Institute, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Kathleen M Moore
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Stephenson Oklahoma Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Beth Y Karlan
- Women's Cancer Program, Samuel Oschin Comprehensive Cancer Institute, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Douglas A Levine
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Anil K Sood
- Department of Gynecologic Oncology, University of Texas, M.D. Anderson Cancer Center, Houston, TX, USA; Department of Cancer Biology, University of Texas, M.D. Anderson Cancer Center, Houston, TX, USA; Center for RNA Interference and Noncoding RNA, University of Texas, M.D. Anderson Cancer Center, Houston, TX, USA
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Liu C, Zhang Y, Jiang H, Wu H. Association between social support and post-traumatic stress disorder symptoms among Chinese patients with ovarian cancer: A multiple mediation model. PLoS One 2017; 12:e0177055. [PMID: 28475593 PMCID: PMC5419605 DOI: 10.1371/journal.pone.0177055] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 04/23/2017] [Indexed: 12/28/2022] Open
Abstract
Post-traumatic stress disorder (PTSD) symptoms can develop after person experiences one or more traumatic events. Little research, however, has been done on PTSD symptoms of patients with ovarian cancer. The present study aimed to estimate the prevalence of PTSD symptoms in patients with ovarian cancer in China; the effects of demographic and clinical variables on PTSD symptoms; multiple mediation roles in the association between social support and PTSD symptoms in patients with ovarian cancer in China. We collected demographic and clinical information of patients with ovarian cancer in the first and second hospitals of China Medical University between January 1, 2014 and December 31, 2015. Qualified patients were asked to complete the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C), Duke-UNC Functional Social Support Questionnaire, Herth Hope Index (HHI), and Resilience Scale-14 (RS-14). 201 patients provided responses. We performed hierarchical linear regression to assess the correlation between social support and PTSD symptoms and bootstrapping to test the mediating role of hope and resilience as potential mediators. After controlling demographic and clinical characteristics, social support negatively correlated with PTSD symptoms (β = -0.406, P < 0.01). Social support explained 14.7% of the variance in PTSD symptoms. Hope and resilience explained 17.0% of the variance in PTSD symptoms. The proportion of the hope mediating effect was 43.37% for social support and the proportion of the resilience mediating effect was 10.64% for social support. Hope and resilience partly mediated the correlation between social support and PTSD symptoms despite accounting for different proportions of the mediating effect. Future intervention plans should pay more attention to social support as well as hope and resilience to prevent, relieve and treat PTSD symptoms.
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Affiliation(s)
- Chunli Liu
- Library of China Medical University, Shenyang, Liaoning, China
- Department of Social Medicine, College of Public Health, China Medical University, Shenyang, Liaoning, China
| | - Yi Zhang
- The First Affiliated Hospital of China Medical University, Heping District, Shenyang, Liaoning, China
| | - Hong Jiang
- School of Public Health, China Medical University, Shenyang, Liaoning, China
| | - Hui Wu
- Department of Social Medicine, College of Public Health, China Medical University, Shenyang, Liaoning, China
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Guntupalli SR, Sheeder J, Ioffe Y, Tergas A, Wright JD, Davidson SA, Behbakht K, Flink DM. Sexual and Marital Dysfunction in Women With Gynecologic Cancer. Int J Gynecol Cancer 2017; 27:603-607. [PMID: 28129243 DOI: 10.1097/igc.0000000000000906] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE Sexual dysfunction can be a long-term issue for women with gynecologic cancer. This study assesses the extent of sexual and marital dysfunction women face following treatment of a gynecologic cancer. METHODS A cross-sectional study of women with gynecologic cancer was conducted using a 181-item survey. Sexual dysfunction was measured by change in the Female Sexual Function Index score; marital dysfunction was measured by change in Intimate Bond Measure from prediagnosis to posttreatment. Paired t tests and Fisher exact test were used to compare women with dysfunction to those without dysfunction. RESULTS Three hundred twenty women were enrolled (mean age, 56.0 [SD, 12.0] years). Among all women, sexual function declined from a score of 21.3 (SD, 10.4) prior to 15.3 (SD, 10.2) (P < 0.001), and sexual activity decreased from 6.1 (SD, 6.8) to 2.6 (SD, 4.9) times per month following treatment (P < 0.001). Among the 208 women who were sexually active at the time of study, sexual dysfunction after treatment was associated with younger age (50.9 [SD, 11.7] years to 57.3 [SD, 12.3] years), ovarian (40.7% vs 30.7%) or cervical (21.0% vs 10.2%) cancer diagnosis, chemotherapy treatment (72.8% vs 50.4%), and being in a relationship (97.3% vs 82.7%). Among women in relationships, 27% experienced marital dysfunction. CONCLUSIONS Women who are younger, have an ovarian or cervical cancer diagnosis, receive chemotherapy, or are in a committed relationship are at particularly high risk of sexual dysfunction. These women should be provided information about the risks associated with their cancer treatment.
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Affiliation(s)
- Saketh R Guntupalli
- *Department of Obstetrics and Gynecology, University of Colorado Cancer Center, Aurora, CO; †Department of Obstetrics and Gynecology, Loma Linda University Cancer Center, Loma Linda, CA; ‡Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, NY; and §Department of Obstetrics and Gynecology, Denver Health Medical Center, Denver, CO
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Hill EM, Watkins K. Women with Ovarian Cancer: Examining the Role of Social Support and Rumination in Posttraumatic Growth, Psychological Distress, and Psychological Well-being. J Clin Psychol Med Settings 2017; 24:47-58. [DOI: 10.1007/s10880-016-9482-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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