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1.
Support Care Cancer ; 32(8): 501, 2024 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-38985345

RESUMO

OBJECTIVE: This study aims to use structural equation modeling to explore the pathways and effect sizes of factors influencing the adherence of postoperative patients with digestive tract tumor to oral nutritional supplements, providing a theoretical basis for future nursing intervention measures. METHODS: A total of 300 postoperative patients with digestive tract tumor within 30 days after surgery were conveniently sampled. Surveys were conducted using a General Information Questionnaire, Morisky Medication Adherence Scale, Digestive System Tumor Patient Nutrition Knowledge-Attitude-Behavior Questionnaire, Multidimensional Social Perception Scale, Beliefs about Medical Questionnaire, and General Self-Efficacy Scale. Structural equation modeling was employed to analyze the factors and pathways affecting adherence with oral nutritional supplements. RESULTS: The adherence score of postoperative patients with digestive tract tumor to oral nutritional supplements was 1.61 ± 1.38. The structural equation model had a good fit (χ2/df = 2.685, GFI = 0.930, CFI = 0.913, AGFI = 0.887, IFI = 0.915, and RMSEA = 0.075). Nutrition knowledge, social support, medication beliefs, and self-efficacy were found to be factors influencing adherence with oral nutritional supplements in postoperative patients with digestive tract tumor, with total effects of 0.539, 0.264, 0.215, and 0.180, respectively. Nutrition knowledge indirectly affected adherence through self-efficacy and medication beliefs, while social support indirectly affected adherence through self-efficacy. CONCLUSION: Adherence with oral nutritional supplements in postoperative patients with digestive tract tumor is at a low level. Improving social support, enhancing patients nutrition knowledge, increasing self-efficacy, and strengthening medication beliefs are effective ways to improve patient adherence.


Assuntos
Suplementos Nutricionais , Conhecimentos, Atitudes e Prática em Saúde , Adesão à Medicação , Autoeficácia , Humanos , Estudos Transversais , Feminino , Masculino , Pessoa de Meia-Idade , Adesão à Medicação/estatística & dados numéricos , Inquéritos e Questionários , Idoso , Adulto , Neoplasias do Sistema Digestório/cirurgia , Neoplasias do Sistema Digestório/psicologia , Apoio Social , Neoplasias Gastrointestinais/cirurgia , Neoplasias Gastrointestinais/psicologia , Período Pós-Operatório
2.
J Surg Oncol ; 120(3): 389-396, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31209894

RESUMO

BACKGROUND AND OBJECTIVES: Etiologies, levels, and associated factors of psychological distress in cancer patients facing surgery are poorly defined. We conducted a prospective comparative study of perioperative anxiety and depression in patients undergoing abdominal surgery for either malignant or benign disease. METHODS: With Institutional Review Board approval, patients consenting for surgery at our institution were enrolled. Surveys were completed at a preoperative visit and within 2 weeks of a postoperative appointment. Participants listed their top three sources of anxiety, and completed the Patient Health Questionnaire-9 and the General Anxiety Disorder-7. RESULTS: A total of 79 patients completed the preoperative assessment and 44 (58.7%) finished the postoperative survey. Forty-one were male (51.9%), 12 (15.2%) had a psychiatric comorbidity (PSYHx), and 47 (59.5%) had cancer. Perioperative anxiety and depression did not differ by malignancy status. Patients were most concerned about surgery (22.5%) preoperatively and finances (27.9%) postoperatively. PSYHx, frailty, insurance status, and opioid use were all associated with perioperative psychological distress. CONCLUSIONS: Cancer patients did not have significantly higher levels of perioperative psychological distress compared with benign controls. Socioeconomic worries are prevalent throughout the perioperative period, and efforts to alleviate distress should focus on providing adequate counseling.


Assuntos
Ansiedade/etiologia , Depressão/etiologia , Doenças do Sistema Digestório/psicologia , Doenças do Sistema Digestório/cirurgia , Neoplasias do Sistema Digestório/psicologia , Neoplasias do Sistema Digestório/cirurgia , Abdome/cirurgia , Ansiedade/diagnóstico , Carcinoma Neuroendócrino/patologia , Carcinoma Neuroendócrino/psicologia , Carcinoma Neuroendócrino/cirurgia , Depressão/diagnóstico , Doenças do Sistema Digestório/patologia , Neoplasias do Sistema Digestório/patologia , Procedimentos Cirúrgicos do Sistema Digestório/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
3.
Support Care Cancer ; 27(7): 2715-2724, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30498993

RESUMO

PURPOSE: Systematic assessment of QOL and care needs was applied in two gastroenterology departments to support "Cancer Care for the Whole Patient." METHODS: Patients with digestive cancer were asked to complete the Cancer Rehabilitation Evaluation System-Short Form (CARES-SF) at the start of treatment and 3 months later. Both times CARES data were processed, and summary reports on the retained insights were sent to the reference nurse for use in further follow-up of the patient. Patients' and reference nurse's experiences with the systematic CARES-assessment were explored with several survey questions and semi-structured interviews, respectively. RESULTS: The mean age of the 51 participants was 63 years (SD11.17), 52.9% was male. With the CARES-SF, a large variety of problems and care needs was detected. Problems most frequently experienced, and most burdensome for QOL are a mix of physical complaints, side effects from treatment, practical, relational, and psychosocial difficulties. Only for a limited number of experienced problems a desire for extra help was expressed. All patients positively evaluate the timing and frequency of the CARES-assessment. The majority believes that this assessment could contribute to the discussion of problems and needs with healthcare professionals, to get more tailored care. Reference nurses experienced the intervention as an opportunity to systematically explore patients' well-being in a comprehensive way, leading to detection and discussion of specific problems or needs in greater depth, and more efficient involvement of different disciplines in care. CONCLUSIONS: Systematic QOL and needs assessment with the CARES-SF in oncology can contribute to more patient-centeredness and efficiency of care.


Assuntos
Neoplasias do Sistema Digestório/terapia , Adulto , Idoso , Neoplasias do Sistema Digestório/psicologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação das Necessidades , Qualidade de Vida/psicologia , Inquéritos e Questionários
4.
Psychooncology ; 27(9): 2274-2280, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29956393

RESUMO

OBJECTIVE: Previous studies have suggested that suicide rates are elevated among cancer patients relative to the general population. In this analysis, we comprehensively evaluated characteristics associated with higher suicide rates among patients with cancers of the digestive system. METHODS: Using the United States Surveillance, Epidemiology, and End Results database, we identified all patients diagnosed with digestive system cancers during 2000 to 2014. Patients were classified as having died of suicide if their cause of death in Surveillance, Epidemiology, and End Results was listed as "suicide and self-inflicted injury." Suicide rates were compared to age-, sex-, and race-adjusted rates in the general population. RESULTS: A total of 881 suicides were identified among 856 293 patients diagnosed with digestive system cancers. The suicide rate in this population was 32.8 per 100 000 person-years and was nearly twice that in the general population (standardized mortality ratio [SMR] = 1.91; 95% CI, 1.79-2.04). Suicide rates were significantly elevated for all cancer sites but were highest for esophageal (SMR = 5.03), pancreatic (SMR = 5.28), stomach (SMR = 2.84), and liver (SMR = 2.14) cancers. Standardized mortality ratios for suicide were highest within the first 5 years of diagnosis and increased with age at diagnosis for all sites except colon and stomach. CONCLUSIONS: Patients with cancers of the digestive system have a higher incidence of suicide than the general population. Suicide rates among esophageal and pancreatic cancer patients are more than 5 times general population rates. The involvement of psychiatrists and other mental health professionals may be a critical component of cancer care for these high-risk patient subgroups.


Assuntos
Neoplasias do Sistema Digestório/mortalidade , Suicídio/estatística & dados numéricos , Adulto , Distribuição por Idade , Idoso , Causas de Morte , Neoplasias do Sistema Digestório/psicologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Programa de SEER , Estados Unidos/epidemiologia
5.
Psychol Health Med ; 20(6): 685-96, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25308122

RESUMO

The study aims were twofold: (1) To investigate the associations of posttraumatic stress symptoms (PTSS) and posttraumatic growth (PTG) with adjustment and affective reactions of digestive system cancer patients and (2) To assess the moderating effects of PTG on the associations of PTSS with adjustment and affective reactions. The sample consisted of 200 respondents 1-4 years following diagnosis and treatment for digestive system cancer. Participants completed questionnaires assessing PTSS, PTG, adjustment, positive affect (PA), and negative affect (NA). The results showed that PTG was positively associated with adjustment and PA, while PTSS was negatively associated with these outcomes and positively associated with NA. Moderation effects of PTG were also observed: The negative associations between PTSS and adjustment or PA were weaker under high levels than under low levels of PTG. It was concluded that PTG is important both as a contributor to better adjustment and PA, as well as a moderator of the detrimental effects of PTSS on adjustment and PA following recovery from cancer. Thus, when developing post-cancer intervention programs, PTG should be viewed as a factor to be encouraged and nurtured for the benefit of cancer patients' adjustment and their long-term well-being.


Assuntos
Adaptação Psicológica , Afeto , Neoplasias do Sistema Digestório/psicologia , Ajustamento Emocional , Transtornos de Estresse Pós-Traumáticos/psicologia , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise de Regressão , Desejabilidade Social
6.
J Clin Psychol Med Settings ; 22(1): 1-13, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25605269

RESUMO

The study aims to investigate the contributions of resilience, affective reactions and post traumatic growth (PTG) to psychosocial adjustment and behavioral changes among digestive system cancer patients in Israel. A sample of 200 participants, 57.5 % men (from the 46 to 70-year age range), 1-4 years following diagnosis, completed an inventory assessing demographic and medical information, resilience, current positive affect (PA) and negative affect (NA), PTG, psychosocial adjustment and retrospective report of behavioral changes following cancer treatment. Resilience, PA and NA, and PTG were related to adjustment and/or reported behavioral changes, and PA, NA and PTG mediated some of the effects of resilience on adjustment and/or reported behavioral changes. The data underline the importance of resilience, affect, and PTG in the adjustment of digestive system cancer patients. Future studies are needed to better understand the associations of resilience with psychosocial adjustment and behavioral changes. This knowledge may help improve cancer survivors' adjustment.


Assuntos
Adaptação Psicológica , Atitude Frente a Saúde , Neoplasias do Sistema Digestório/psicologia , Resiliência Psicológica , Ajustamento Social , Estresse Psicológico/psicologia , Afeto , Idoso , Neoplasias do Sistema Digestório/complicações , Feminino , Humanos , Israel , Masculino , Pessoa de Meia-Idade , Estresse Psicológico/complicações , Inquéritos e Questionários , Sobreviventes/psicologia
7.
Medsurg Nurs ; 24(5): 325-30, 362, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26665868

RESUMO

Spouses' experiences with their partners' hospitalization and the spouses' relationship with nurses and physicians were examined. Health professionals, should reflect more on the importance. of an ongoing dialogue with the spouses of patients, ensuring they receive correct information to become more involved in supporting patients.


Assuntos
Comunicação , Neoplasias do Sistema Digestório/psicologia , Papel do Profissional de Enfermagem , Papel do Médico , Apoio Social , Cônjuges/psicologia , Estresse Psicológico , Adulto , Idoso , Dinamarca , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Relações Profissional-Família
8.
Eur J Oncol Nurs ; 70: 102586, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38657348

RESUMO

PURPOSE: While Fear of progression (FoP) is a natural reaction in cancer, elevated FoP can impact life quality and social function. Our study aims to explore how illness perception, social support, and posttraumatic growth influence patients' FoP. METHODS: This study enrolled 243 young and middle-aged adults with digestive system cancer at a hospital in Guangzhou from November 2022 to November 2023. In this study, the measurement instruments utilized included The Fear of Progression Questionnaire-Short Form, The Brief Illness Perception Questionnaire, The 12-item Perceived Social Support Scale, and The 21-item Posttraumatic Growth Inventory. Data was analyzed employing polynomial regression and response surface analyses. RESULTS: The mean score of FoP was 35.45 ± 10.05, and 59.3% of the cancers (scores≥34) had clinically dysfunctional levels of FoP. Regarding congruence, patients' FoP was higher when the levels of illness perception and social support were both low or high than when the levels were both intermediate. Regarding incongruence, patients' FoP was lower when the level of illness perception was low and social support was high compared with when the level of illness perception was high and social support was low. Additionally, posttraumatic growth moderated the (in)congruence effect of illness perception-social support on the FoP of patients. CONCLUSIONS: Low or high illness perception-social support congruence was detrimental to the FoP of patients. Low illness perception-high social support incongruence was beneficial to patients' FoP. Posttraumatic growth can be a positive factor for enhancing the impact of low illness perception-high social support incongruence on patients' FoP.


Assuntos
Neoplasias do Sistema Digestório , Progressão da Doença , Medo , Apoio Social , Humanos , Masculino , Estudos Transversais , Feminino , Adulto , Pessoa de Meia-Idade , Inquéritos e Questionários , Neoplasias do Sistema Digestório/psicologia , China , Qualidade de Vida , Percepção , Adulto Jovem
9.
Front Immunol ; 15: 1393404, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39206183

RESUMO

Objective: To systematically evaluate the efficacy and safety of anlotinib targeted therapy for the treatment of patients with advanced digestive system neoplasms (DSNs). Methods: Clinical trials were extracted from PubMed, the Cochrane Library, Web of Science, Embase, China National Knowledge Infrastructure (CNKI) and the Wanfang database up to October 2023. Outcome measures, including therapeutic efficacy, quality of life (QOL) and adverse events, were extracted and evaluated. Results: Twenty trials, including 1,613 advanced DSNs patients, were included. The results indicated that, compared with conventional treatment alone, the combination of anlotinib targeted therapy with conventional treatment significantly improved the patients' 6-months overall survival (OS, OR=1.76, CI=1.53 to 2.02, P<0.00001), overall response (ORR, OR=1.76, CI=1.53 to 2.02, P<0.00001) and disease control rate (DCR, OR=1.51, 95% CI=1.25 to 1.84, P<0.0001). Moreover, the group that received the combined therapy had higher rates of hypertension (P<0.00001), proteinuria (P<0.00001), fatigue (P<0.00001), diarrhea (P<0.00001), hypertriglyceridemia (P=0.02), alanine aminotransfease (ALT)increased (P=0.004), aspartate transaminase (AST) increased (P=0.006), anorexia (P<0.00001), weight loss (P=0.002), abdominal pain (P=0.0006), hypothyroidism (P=0.02), prolonged QT interval (P=0.04). Analyses of other adverse events, such as gastrointestinal reaction, leukopenia, and neutropenia, did not reveal significant differences (P>0.05). Conclusion: The combination of anlotinib targeted therapy and conventional treatment is more effective for DSNs treatment than conventional treatment alone. However, this combined treatment could lead to greater rates of hypertension, albuminuria and hand-foot syndrome. Therefore, the benefits and risks should be considered before treatment.


Assuntos
Neoplasias do Sistema Digestório , Indóis , Quinolinas , Humanos , Antineoplásicos/administração & dosagem , Antineoplásicos/efeitos adversos , Neoplasias do Sistema Digestório/tratamento farmacológico , Neoplasias do Sistema Digestório/psicologia , Indóis/administração & dosagem , Indóis/efeitos adversos , Qualidade de Vida , Quinolinas/administração & dosagem , Quinolinas/efeitos adversos , Resultado do Tratamento , /efeitos adversos
10.
Medicine (Baltimore) ; 100(22): e25681, 2021 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-34087821

RESUMO

BACKGROUND: Digestive tumor is one of the most common cancers, its symptoms and treatment will bring patients with anxiety, depression and other negative emotions, and cause cancer-related fatigue. As a new complementary replacement therapy, music therapy can greatly reduce cancer-related fatigue, anxiety and depression, and achieve good clinical results, but there is a lack of evidence-based medicine. The purpose of this study is to evaluate the effect of music therapy on cancer-related fatigue, anxiety, and depression in patients with digestive tumors by meta-analysis. METHOD: Computer search of Chinese and English databases: Wanfang, VP Information Chinese Journal Service Platform, China National Knowledge Infrastructure, Chinese BioMedicine Literature Database and pubmed, embase, cochrane, web of science. A comprehensive collection of relevant studies on the effects of music therapy on digestive tract cancer-related fatigue, anxiety and depression, the retrieval time is from the date of establishment to March 2021. According to the inclusion and exclusion criteria, the literature is selected, the quality of the literature is evaluated and the data are extracted. The data are analyzed by meta-analysis. RESULT: The purpose of this study is to evaluate the effect of music therapy on digestive tract cancer-related fatigue, anxiety, and depression by European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire, Hamilton Depression Scale, and Hamilton Anxiety Scale . CONCLUSION: This study will provide reliable evidence-based evidence for the clinical application of music therapy in the treatment of digestive tract cancer-related fatigue and anxiety and depression. OSF REGISTRATION NUMBER: DOI 10.17605/OSF.IO/UR4GV.


Assuntos
Neoplasias do Sistema Digestório/psicologia , Neoplasias do Sistema Digestório/terapia , Saúde Mental , Musicoterapia/métodos , Ansiedade/etiologia , Ansiedade/terapia , Depressão/etiologia , Depressão/terapia , Neoplasias do Sistema Digestório/complicações , Neoplasias do Sistema Digestório/patologia , Fadiga/etiologia , Fadiga/terapia , Humanos , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Metanálise como Assunto
11.
J Surg Res ; 163(1): 40-6, 2010 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-20638690

RESUMO

BACKGROUND: By current estimates there are more than 10.8 million cancer survivors in the United States. Increasingly, oncologists are realizing that despite the "success" of cancer therapies, cancer survivors are facing previously unrecognized psychosocial issues related to cancer survivorship. In GI cancers, the medical and surgical oncologists charged with the care of the patient are not well-equipped to deal with these issues. At our institution's GI Cancer Survivorship Clinic, we utilize a multi-disciplinary model, led by surgical oncologists, that includes psychologic and pastoral support as a priority. The goal of this study was to assess our patients' quality of life (QOL) in order to better understand their survivorship needs and to optimize survivor care. MATERIALS AND METHODS: Patients with upper GI malignancies undergoing post-treatment evaluation completed the Functional Assessment of Chronic Illness Therapy-Spirituality Scale (FACIT-Sp) questionnaire that includes five domains of QOL: physical well being; social/family well being; emotional well being; functional well being; and spiritual well being. RESULTS: The results of our evaluation of health related QOL in a sample of 99 patients revealed higher self-reported QOL than those seen in a normative sample of cancer patients. Social/family well being was strongly associated with total QOL scores, and married patients reported higher social/family well being, as well as higher overall QOL. CONCLUSIONS: Cross-sectional evaluation of health related QOL in our patients revealed higher self-reported QOL than those seen in a normative sample of general cancer patients. Despite aggressive surgical and medical treatment for malignancies with a generally poor prognosis, the results of our pilot study suggest that cancer survivors treated and followed in a multidisciplinary setting can experience acceptable health-related QOL.


Assuntos
Neoplasias do Sistema Digestório/psicologia , Qualidade de Vida , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Neoplasias do Sistema Digestório/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação das Necessidades , Estudos Prospectivos , Sobreviventes , Adulto Jovem
12.
Digestion ; 82(1): 4-9, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20145402

RESUMO

AIM: To investigate the incidence of pancreatic cancer-related depression and the relationship between symptoms of depression and the quality of life (QoL) of patients. METHODS: 262 inpatients with cancer of the digestive system (pancreatic cancer, liver cancer, esophageal cancer, gastric cancer, and colorectal cancer) from four Guangzhou hospitals were enrolled into the study between June 2007 and June 2009. The Hamilton Rating Scale for Depression-24 questionnaire was used to assess the degree of depression. QoL of all patients was evaluated by EORTC QLQ-C30. Additionally, EORTC QLQ-PAN-26 was used for patients with pancreatic cancer. RESULTS: The incidence of depression among pancreatic cancer patients was significantly higher than among other digestive cancers. More pancreatic cancer patients suffered severe depression than those with liver cancer and gastric cancer. Compared with other groups with depression, QoL of pancreatic cancer patients in each functioning scale was significantly worse, while the symptoms of fatigue and pain were significantly severe. QoL of pancreatic cancer patients with depression in role, emotional, and social functioning were sharply poorer than those without depression. The symptoms of fatigue, pain and appetite loss in cancer patients with depression were significantly more frequent than those without depression. CONCLUSION: Compared with other cancers of the digestive system, depressive symptoms are common psychological disturbances in pancreatic cancer patients. Moreover, depression significantly lowers QoL in pancreatic cancer patients.


Assuntos
Depressão/psicologia , Neoplasias Pancreáticas/psicologia , Qualidade de Vida , Adaptação Psicológica , Adulto , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Distribuição de Qui-Quadrado , China/epidemiologia , Depressão/epidemiologia , Depressão/etiologia , Neoplasias do Sistema Digestório/psicologia , Feminino , Humanos , Incidência , Pacientes Internados , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Fatores de Risco
14.
J Health Psychol ; 25(6): 810-818, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-29076403

RESUMO

Mindfulness has been garnering increased attention within the area of clinical psychology due to its theorized and empirical associations with psychological well-being. Using a sample of patients diagnosed with digestive tract cancer (N = 292), we examined the relationship between perceived stress and psychological symptoms at varying levels of dispositional mindfulness. Results showed significant associations between perceived stress and psychological symptoms. More importantly, the relationship between perceived stress and psychological symptoms was only significant for patients with low, but not high, levels of dispositional mindfulness. Implications and future research directions were discussed.


Assuntos
Neoplasias do Sistema Digestório/psicologia , Atenção Plena , Estresse Psicológico/psicologia , Adulto , China , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
15.
J Health Psychol ; 25(9): 1222-1235, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-29355048

RESUMO

This qualitative study aimed to confirm and extend research on meaning making after cancer. In all, 119 adults aged 41 to 88 years (M = 65.50 years and standard deviation = 9.16 years) were interviewed 12 months after diagnosis of oral-digestive cancers. About half tried to understand why they got cancer (43%) and said that cancer changed their view of life (53%). Most (75%) reported that previous life experiences helped them cope with cancer. Cancer survivors made meanings in the areas of existential, social, and personal domains with both positive and negative content. Practitioners may wish to examine meaning making in these areas for those in distress after cancer.


Assuntos
Adaptação Psicológica , Sobreviventes de Câncer/psicologia , Neoplasias do Sistema Digestório/psicologia , Neoplasias Bucais/psicologia , Pesquisa Qualitativa , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
16.
Rev Esp Salud Publica ; 932019 Jul 29.
Artigo em Espanhol | MEDLINE | ID: mdl-31346155

RESUMO

OBJECTIVE: Non-scheduled consultation is very frequent among patients with cancer, creating alterations and delays in programmed visits. We describe the incidence of non-scheduled consultations in patients with digestive cancer in our hospital. METHODS: Descriptive, prospective, non-interventional study. In a six-month period (May-December 2017), non-scheduled visits were chronologically recorded in the medical oncology consultation of digestive tumours of Hospital Juan Ramón Jiménez de Huelva. We performed a descriptive analysis of the variables collected through the statistical program G-STAT v.2.0. RESULTS: Patients with colon or rectal cancer generated most consultations (68.63%). followed by pancreatic (9.15%) and gastric (5.23%). Most patients had metastatic or advanced stage cancer (59.87%) and were under palliative or symptomatic treatment (58.82%). The most frequent reason for consultation was clinical symptoms (47.05%). followed by information demand (18.30 %). CONCLUSIONS: Non-scheduled consultations in cancer patients are frequent; they cause interference in scheduled consultations and not always resolved satisfactorily. We propose several measures to reduce the number of non-scheduled consultation in oncology.


OBJETIVO: La demanda de asistencia no programada por parte de los pacientes oncológicos es muy frecuente (1,2) y conllevan alteraciones y retrasos en la actividad ya programada. Describimos la incidencia de consultas no programadas en pacientes con cáncer digestivo de nuestro centro. METODOS: Estudio descriptivo, prospectivo y sin intervención. Se recogieron cronológicamente en un periodo de 6 meses (15 de mayo al 14 de diciembre de 2017) y utilizando como fuente la historia clínica de los pacientes, las visitas no programadas atendidas en la consulta de oncología médica de tumores digestivos del Hospital Juan Ramón Jiménez de Huelva. Realizamos un análisis descriptivo de las variables recogidas mediante el programa estadístico G-STAT v.2.0. RESULTADOS: El mayor número de consultas fue realizado por pacientes con cáncer de colon o recto (68,63%), seguidas por los de páncreas (9,15%) y los gástricos (5,23%). La mayoría de los pacientes tenían un cáncer en situación metastásica o avanzada (59,87%) y estaban recibiendo tratamiento paliativo (58,82%) con quimioterapia o sintomático. El motivo de consulta más frecuente fueron los síntomas clínicos (47,05%), seguido por la demanda de información (18,30 %). CONCLUSIONES: Se constata una alta demanda de asistencia no programada por parte de los pacientes con cáncer digestivo, que interfiere con la asistencia programada y no siempre se resuelve satisfactoriamente. Se proponen varias medidas para reducir el número de estas consultas.


Assuntos
Agendamento de Consultas , Neoplasias do Sistema Digestório/terapia , Utilização de Instalações e Serviços/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Adulto , Idoso , Neoplasias do Sistema Digestório/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Espanha
17.
Surgery ; 166(2): 177-183, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31160060

RESUMO

BACKGROUND: Certain behavioral traits and inadequate social support are known risk factors for complications after cancer surgery. Despite their importance, it is unclear whether conventional patient preoperative evaluation captures them. This study was conducted to assess concordance between documentation and patient survey of selected risk factors and to determine whether failure to document affected postoperative outcomes. METHODS: Adult patients at a tertiary academic medical center were surveyed before abdominal cancer surgery to assess 6 psychosocial risk factors. Risk factors were also assessed by retrospective chart review and compared with survey results through concordance measures. Thirty-day postoperative complications were abstracted by chart review. Rates of major complications for those with and without clinically missed risk factors were compared. RESULTS: Comparisons between chart review and screening survey revealed poor-to-moderate positive agreement (0%-47%) for 5 risk factors and strong negative agreement (82%-99%) among all risk factors. Kappa analysis demonstrated poor-to-fair agreement among 5 risk factors (κ = 0.112-0.423). The overall complication rate was 36%. The complication rate for patients with at least 1 clinically missed risk factor was 49% vs 24% in those without (P = .021), with a similar effect replicated for each individual risk factor. CONCLUSION: This study shows a high level of discordance between formal screening and routine clinician documentation in a preoperative setting for psychosocial risk factors. There is a significant association between missing these risk factors and worse postoperative outcomes. Future work should examine whether structured screening of psychosocial risk factors may improve preoperative risk stratification through proactive interventions.


Assuntos
Neoplasias do Sistema Digestório/cirurgia , Procedimentos Cirúrgicos Eletivos/efeitos adversos , Complicações Pós-Operatórias/mortalidade , Cuidados Pré-Operatórios/métodos , Psicologia , Centros Médicos Acadêmicos , Idoso , Estudos de Coortes , Bases de Dados Factuais , Neoplasias do Sistema Digestório/diagnóstico , Neoplasias do Sistema Digestório/mortalidade , Neoplasias do Sistema Digestório/psicologia , Intervalo Livre de Doença , Procedimentos Cirúrgicos Eletivos/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Estadiamento de Neoplasias , Complicações Pós-Operatórias/psicologia , Prognóstico , Estudos Retrospectivos , Análise de Sobrevida
18.
Bull Cancer ; 106(11): 959-968, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31623835

RESUMO

INTRODUCTION: Totally implanted venous access (TIVA) improves the safety and welfare of patients treated with cancer chemotherapy (CCT). We aimed to evaluate patients' perception of TIVA placement, TIVA use, and information on TIVA, and to assess the association between patients' perception and their attitude regarding a potential TIVA re-implantation. METHODS: We conducted a single center cross-sectional survey in a university hospital in Northern France. Patients included were consecutive urologic or digestive cancer inpatients admitted for a CCT cycle via TIVA between April 9th and May 9th 2014. We analyzed patients' satisfaction, experience, and attitude, especially when requiring potential TIVA re-implantation under local anesthesia (LA), using a standardized questionnaire and medical records. We analyzed risk factors for refusing potential TIVA re-implantation under LA using multivariate logistic regression. RESULTS: Eighty-one patients were interviewed (no refusals), including 57 with a TIVA device placed under LA in our university hospital. Among them, 52/57 (91%) reported satisfactory TIVA placement, but respectively 21/57 (37%) and 18/57 (32%) complained of painful or uncomfortable TIVA placement; 51/57 (89%) were satisfied with care provided during CCT cycles. Risk factors for refusing potential re-implantation under LA were: TIVA placement considered painful (P=0.012) or uncomfortable (P=0.038) and dissatisfaction with care provided during CCT cycles (P=0.028). DISCUSSION: We show that despite good overall satisfaction regarding TIVA, some aspects were less positive and warrant improvement actions. It suggests that these actions could not only improve patients' experience of TIVA use but could also facilitate continuation of treatment in the long term.


Assuntos
Atitude , Neoplasias do Sistema Digestório/psicologia , Satisfação do Paciente , Neoplasias Urológicas/psicologia , Dispositivos de Acesso Vascular , Adulto , Idoso , Idoso de 80 Anos ou mais , Anestesia Local , Estudos Transversais , Neoplasias do Sistema Digestório/tratamento farmacológico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor Processual/etiologia , Análise de Regressão , Retratamento/psicologia , Fatores de Risco , Inquéritos e Questionários , Recusa do Paciente ao Tratamento/psicologia , Recusa do Paciente ao Tratamento/estatística & dados numéricos , Neoplasias Urológicas/tratamento farmacológico , Dispositivos de Acesso Vascular/efeitos adversos
19.
Bull Cancer ; 105(3): 228-233, 2018 Mar.
Artigo em Francês | MEDLINE | ID: mdl-29426740

RESUMO

INTRODUCTION: Adapted physical activity (APA) is recognized as an effective supportive care for asthenia and quality of life in oncology. Before an APA program was organized, the feasibility of such a program was evaluated among the patients. METHODS: Descriptive, prospective, semi-qualitative, single-center study over a 3-month period in patients treated with ambulatory chemotherapy for digestive cancer. A self-questionnaire was offered to all patients to evaluate their practice and knowledge about APA. In ten patients, fatigue, anxiety and depression were assessed, before and after 9 weeks of hospital-based APA. The scores were compared by matched Student test. RESULTS: Of the 123 patients treated, 80 questionnaires (65%) were exploitable. Before the diagnosis of cancer, 40 patients (50%) were physically active, 20% after (n=16). The reasons for not practicing were: lack of interest/not the idea (42%), lack of time (34%), do not believe in profit (9%), too expensive (8%). Fifty-three patients (66%) were interested in the program. In 10 patients, the APA program significantly reduced the depression score (P=0.024) and a non-significant improvement in anxiety and fatigue. DISCUSSION: This study shows that patients treated with chemotherapy are unaware of the usefulness of APA and that medical information can improve adherence to such a program. The establishment of an intra-hospital APA program proved to be possible and relevant.


Assuntos
Assistência Ambulatorial/métodos , Neoplasias do Sistema Digestório/tratamento farmacológico , Exercício Físico , Desenvolvimento de Programas , Adulto , Idoso , Idoso de 80 Anos ou mais , Ansiedade/diagnóstico , Depressão/diagnóstico , Neoplasias do Sistema Digestório/psicologia , Fadiga/diagnóstico , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Inquéritos e Questionários
20.
Arq Gastroenterol ; 54(2): 156-162, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28198915

RESUMO

BACKGROUND: The presence of psychiatric symptoms, anger, and personality characteristics are factors that affect the quality of life of newly diagnosed digestive system cancer patients. OBJECTIVE: This study aims to identify which stable characteristics of the individual's personality interfere with quality of life, even when reactive emotional characteristics of falling ill are controlled. METHODS: A cross-sectional study was performed at the Oncology Clinic ( Hospital das Clínicas ), Marília/SP, Brazil, in which 50 adult patients with digestive system cancer and diagnosed less than 6 months answered the State-Trait Anger Expression Inventory, Temperament and Character Inventory, Hospital Anxiety and Depression Scale and WHOQOL-BREF. Multiple regression was performed to verify if quality of life was related to stable characteristics of the subject's personality (anger trait, temperament and character) after controlling to the transient emotional aspects (anger state, psychiatric symptoms). RESULTS: The quality of life psychological health score was higher in presence of self-directedness character and reward dependence temperament and quality of life environment score was higher in presence of self-directedness character and lower in presence of harm avoidance temperament. CONCLUSION: The psychological well-being and the adaptive needs to the environment that favoring a better quality of life were reinforced mainly by the self-directedness character; which means that patients more autonomous cope better with the disease. On the other hand, the harm avoidance temperament (meaning the patient has fear of aversive situations) impaired the adaptive capacity to deal with the changes of the day-to-day imposed by the disease. Understanding these personality traits is important to the health professionals drive the patient to more successful treatment.


Assuntos
Ira , Transtornos de Ansiedade/psicologia , Depressão/psicologia , Neoplasias do Sistema Digestório/psicologia , Personalidade , Qualidade de Vida/psicologia , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Determinação da Personalidade , Análise de Regressão
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