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1.
J Holist Nurs ; 39(2): 116-125, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32921255

RESUMEN

PURPOSE: This study aimed to compare the functioning, symptoms, and quality of life (QoL) of patients with breast or colon cancer before and after their first-cycle (FC) chemotherapy. DESIGN: One-group pretest/posttest design. METHOD: The study utilized the standardized Arabic-translated Quality of Life Questionnaire Version 3 from the European Organization for Research and Treatment of Cancer in measuring the functioning, symptoms, and QoL of 120 Saudi patients diagnosed with breast or colon cancer. Dependent t test was used in analyzing the presence of significant differences in mean scores before and after chemotherapy with periods ranging from 14 days to 21 days following the treatment protocol. RESULTS: The findings revealed significant differences in the functioning, symptoms, and QoL among patients with breast or colon cancer before and after FC chemotherapy (p < .001). Baseline scores showed higher physical, role, emotional, cognitive, and social functioning; lesser symptoms; lower financial difficulties; and better overall global health status compared to post-FC chemotherapy. CONCLUSION: Assessing the QoL of patients with breast or colon cancer undergoing FC chemotherapy is essential to establish a holistic care plan in supporting and alleviating the unfavorable effects of chemotherapy and implement patient-centered interventions that aid in the enhancement of their overall QoL.


Asunto(s)
Neoplasias de la Mama/tratamiento farmacológico , Neoplasias del Colon/tratamiento farmacológico , Quimioterapia/psicología , Calidad de Vida/psicología , Adulto , Quimioterapia/normas , Femenino , Humanos , Masculino , Persona de Mediana Edad , Psicometría/instrumentación , Psicometría/métodos , Arabia Saudita , Encuestas y Cuestionarios
2.
Holist Nurs Pract ; 34(2): 103-112, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32049696

RESUMEN

Auricular acupressure (AA) is widely used in East Asia and Europe to manage patients with sleep disturbance. This feasibility study was performed to demonstrate the potential of AA for sleep disturbance in patients with leukemia. Thirty-two patients with leukemia with poor sleep quality received AA 3 times a day for a total of 4 weeks. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality at baseline, at a 2-week intervention, and after a 4-week intervention. Compared with baseline scores, PSQI scores and the use of sleep medicine were significantly improved at week 2 and week 4 (P < .05). As a potential safety therapy, AA could be an alternative or complementary intervention to improve sleep quality for patients with leukemia with sleep disturbance.


Asunto(s)
Acupresión/normas , Cápsula Articular , Leucemia/terapia , Trastornos del Sueño-Vigilia/terapia , Acupresión/métodos , Acupresión/estadística & datos numéricos , Adulto , Quimioterapia/métodos , Quimioterapia/psicología , Estudios de Factibilidad , Femenino , Humanos , Leucemia/psicología , Masculino , Persona de Mediana Edad , Trastornos del Sueño-Vigilia/psicología , Resultado del Tratamiento
3.
J Holist Nurs ; 38(1): 68-77, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31230499

RESUMEN

Purpose: To assess the spiritual well-being (SWB) of cancer patients undergoing chemotherapy in an outpatient setting. Method: Quantitative, cross-sectional, and descriptive study. A convenience sample of 150 participants was obtained. Data collection instrument was a self-reported questionnaire that included the SWB Questionnaire (SWBQ), whose scores range from 20 to 100. SPSS software, version 21, was used in data analysis. The study was approved by the institutional ethics committee. Results: Patients' ages ranged between 35 and 83 years; most were female (64.7%), married (68.0%), Catholic (86.7%), and with breast cancer (35.3%) and colorectal cancer (25.3%). The average SWBQ total score was 65.91 (SD = 12.177). The highest score of the SWBQ was obtained in females, widows and singles, Evangelic and Catholic, and with lower educational level and professional occupation. The Cronbach α was 0.89, and the subscales αs ranged between 0.78 and 0.94. Conclusion: The SWBQ scores were reasonable. These results can guide nurses' clinical reasoning, as the assessment of SWB may precede the diagnosis of risk for spiritual distress, readiness for enhanced SWB, or spiritual distress. Thus, the use of this instrument may facilitate spirituality being effectively implemented in clinical practice, favoring holistic health care.


Asunto(s)
Atención Ambulatoria/psicología , Quimioterapia/psicología , Neoplasias/tratamiento farmacológico , Espiritualidad , Anciano , Estudios Transversales , Quimioterapia/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios
4.
J Holist Nurs ; 38(2): 193-204, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31619110

RESUMEN

Background: A large proportion of the world's population have religious beliefs, with 84.0% indicating an affiliation with a specific religious group. Few comprehensive measures to assess religious involvement currently exist in Portugal, particularly for the assessment of religiosity in cancer patients. Objective: To translate, adapt, and validate the 10-item Belief Into Action Scale (BIAC) in Portuguese cancer patients undergoing chemotherapy. Method: The methodological guidelines provided by Sousa and Rojjanasrirat were used to examine the psychometric properties of the BIAC. Results: The linguistic and conceptual equivalence of the scale was determined. The internal consistency was acceptable (Cronbach's α = .86). Varimax rotation with Kaiser normalization identified two factors made up of nine items. Conclusion: The European Portuguese version of the BIAC is a reliable and valid measure for assessing religiosity in cancer patients receiving chemotherapy to provide holistic care.


Asunto(s)
Neoplasias/psicología , Psicometría/normas , Espiritualidad , Adulto , Quimioterapia/métodos , Quimioterapia/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/complicaciones , Neoplasias/tratamiento farmacológico , Portugal , Psicometría/instrumentación , Psicometría/métodos , Reproducibilidad de los Resultados , Encuestas y Cuestionarios , Traducción
5.
Rev Bras Enferm ; 72(3): 640-645, 2019 Jun 27.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-31269127

RESUMEN

AIM: To demonstrate the relationship between religious/spiritual coping and hope in cancer patients undergoing chemotherapy. METHOD: This is a cross-sectional, descriptive study with a quantitative approach performed in a reference outpatient clinic in Caruaru, PE, between August and October 2017. A total of 82 cancer patients undergoing chemotherapy were included in the study, using the brief religious/spiritual coping scale (RCOPE-Brief) and the Herth Hope Scale (HHS). RESULTS: The sample presented mean positive RCOPE scores (3.03 ± 0.41) and the level of hope was considered high (42.7 points ± 3.67). Patients who had a high RCOPE score were found to have a higher mean of Herth's level of hope (44.12 points). CONCLUSION: This study becomes relevant to nursing professionals by encouraging care that takes into account the patient's spiritual dimension in order to stimulate positive mechanisms of religious coping and, consequently, raise the levels of hope.


Asunto(s)
Adaptación Psicológica , Esperanza , Neoplasias/complicaciones , Espiritualidad , Adulto , Estudios Transversales , Quimioterapia/métodos , Quimioterapia/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/tratamiento farmacológico , Psicometría/instrumentación , Psicometría/métodos , Encuestas y Cuestionarios
6.
BMC Med ; 17(1): 105, 2019 06 04.
Artículo en Inglés | MEDLINE | ID: mdl-31159786

RESUMEN

BACKGROUND: News stories represent an important source of information. We aimed to evaluate the impact of "spin" (i.e., misrepresentation of study results) in health news stories reporting studies of pharmacologic treatments on patients'/caregivers' interpretation of treatment benefit. METHODS: We conducted three two-arm, parallel-group, Internet-based randomized trials (RCTs) comparing the interpretation of news stories reported with or without spin. Each RCT considered news stories reporting a different type of study: (1) pre-clinical study, (2) phase I/II non-RCT, and (3) phase III/IV RCT. For each type of study, we identified news stories reported with spin that had earned mention in the press. Two versions of the news stories were used: the version with spin and a version rewritten without spin. Participants were patients/caregivers involved in Inspire, a large online community of more than one million patients/caregivers. The primary outcome was participants' interpretation assessed by one specific question "What do you think is the probability that 'treatment X' would be beneficial to patients?" (scale, 0 [very unlikely] to 10 [very likely]). RESULTS: For each RCT, 300 participants were randomly assigned to assess a news story with spin (n = 150) or without spin (n = 150), and 900 participants assessed a news story. Participants were more likely to consider that the treatment would be beneficial to patients when the news story was reported with spin. The mean (SD) score for the primary outcome for abstracts reported with and without spin for pre-clinical studies was 7.5 (2.2) versus 5.8 (2.8) (mean difference [95% CI] 1.7 [1.0-2.3], p < 0.001); for phase I/II non-randomized trials, 7.6 (2.2) versus 5.8 (2.7) (mean difference 1.8 [1.0-2.5], p < 0.001); and for phase III/IV RCTs, 7.2 (2.3) versus 4.9 (2.8) (mean difference 2.3 [1.4-3.2], p < 0.001). CONCLUSIONS: Spin in health news stories reporting studies of pharmacologic treatments affects patients'/caregivers' interpretation. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03094078 , NCT03094104 , NCT03095586.


Asunto(s)
Cuidadores/psicología , Comunicación , Exactitud de los Datos , Quimioterapia/psicología , Pacientes/psicología , Percepción , Adolescente , Adulto , Anciano , Actitud Frente a la Salud , Cuidadores/educación , Ensayos Clínicos Fase I como Asunto/psicología , Ensayos Clínicos Fase II como Asunto/psicología , Ensayos Clínicos Fase III como Asunto/psicología , Ensayos Clínicos Fase IV como Asunto/psicología , Evaluación Preclínica de Medicamentos/psicología , Femenino , Humanos , Internet/normas , Masculino , Persona de Mediana Edad , Educación del Paciente como Asunto/normas , Proyectos de Investigación/normas , Medición de Riesgo , Adulto Joven
7.
Rev. bras. enferm ; 72(3): 640-645, May.-Jun. 2019. tab
Artículo en Inglés | BDENF, LILACS | ID: biblio-1013565

RESUMEN

ABSTRACT Aim: To demonstrate the relationship between religious/spiritual coping and hope in cancer patients undergoing chemotherapy. Method: This is a cross-sectional, descriptive study with a quantitative approach performed in a reference outpatient clinic in Caruaru, PE, between August and October 2017. A total of 82 cancer patients undergoing chemotherapy were included in the study, using the brief religious/spiritual coping scale (RCOPE-Brief) and the Herth Hope Scale (HHS). Results: The sample presented mean positive RCOPE scores (3.03 ± 0.41) and the level of hope was considered high (42.7 points ± 3.67). Patients who had a high RCOPE score were found to have a higher mean of Herth's level of hope (44.12 points). Conclusion: This study becomes relevant to nursing professionals by encouraging care that takes into account the patient's spiritual dimension in order to stimulate positive mechanisms of religious coping and, consequently, raise the levels of hope.


RESUMEN Objetivo: demostrar la relación entre el coping religioso/espiritual y la esperanza en pacientes con cáncer en tratamiento quimioterápico. Método: se trata de un estudio transversal, descriptivo, con abordaje cuantitativo, realizado en un ambulatorio de referencia en tratamiento quimioterápico de Caruaru-PE, entre agosto y octubre de 2017. Participaron de la investigación 82 personas con cáncer en tratamiento quimioterápico, escala de coping religioso/espiritual breve (CRE-Breve) y la escala de esperanza de Herth (EEH). Resultado: la muestra presentó escores medios de CRE positivo (3,03 ± 0,41) y el nivel de esperanza fue considerado alto (42,7 puntos, ± 3,67). Se verificó que los pacientes que tuvieron clasificación alta del CRET presentaron mayor promedio del nivel de esperanza de Herth (44,12 puntos). Conclusión: se vuelve relevante a los profesionales de enfermería para alentar los cuidados que contemplan la dimensión espiritual del paciente a fin de estimular los mecanismos positivos del CRE y, consecuentemente, elevar los niveles de esperanza.


RESUMO Objetivo: demonstrar a relação entre o coping religioso/espiritual e a esperança em pacientes com câncer em tratamento quimioterápico. Método: trata-se de um estudo transversal, descritivo, com abordagem quantitativa, realizado em um ambulatório de referência em tratamento quimioterápico de Caruaru-PE, entre agosto e outubro de 2017. Participaram da pesquisa 82 pessoas com câncer em tratamento quimioterápico, utilizando-se a escala de coping religioso/espiritual breve (CRE-Breve) e a escala de esperança de Herth (EEH). Resultados: a amostra apresentou escores médios de CRE positivo (3,03 ± 0,41), e o nível de esperança foi considerado alto (42,7 pontos; ± 3,67). Verificou-se que os pacientes que tiveram classificação alta do CRET apresentaram maior média do nível de esperança de Herth (44,12 pontos). Conclusão: este estudo torna-se relevante aos profissionais de enfermagem ao encorajar cuidados que contemplem a dimensão espiritual do paciente a fim de estimular os mecanismos positivos do CRE e, consequentemente, elevar os níveis de esperança.


Asunto(s)
Humanos , Masculino , Adulto , Adaptación Psicológica , Espiritualidad , Esperanza , Neoplasias/complicaciones , Psicometría/instrumentación , Psicometría/métodos , Estudios Transversales , Encuestas y Cuestionarios , Quimioterapia/métodos , Quimioterapia/psicología , Persona de Mediana Edad , Neoplasias/tratamiento farmacológico
8.
J Integr Med ; 17(3): 150-154, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-30948352

RESUMEN

The human body is well organized, regulated and connected. One of the greatest scientific challenges today is to integrate mind, behaviour and health. Enormous advances in health care have been achieved. However, diseases like cancer still require treatment options beyond therapeutic drugs, namely surgery and radiation. Human being is not only made of cells, tissues and organs, but also feelings and sensations. Linking mental state with physical health is essential to include all elements of disease. For this purpose, halalopathy has been introduced as a new model to integrate mind, behaviour and health, where psychology, spirituality and rationality can be integrated together to generate a well-organized, regulated and connected health system. Halalopathic approaches are based on mind-trust-drug and mind-trust-belief. If the drug and human's belief are compatible, trust in the rationally designed drug will be synergized and placebo effects will be activated to initiate the healing process. Such an organized health system will lower the body's entropy and increase potential energy, which is an important aspect to promote the healing process, with a therapeutic drug toward complete recovery. This study enlightens laws of compatibility to initiate a domino chain effect to activate placebo effects and lower the body's entropy. The healing power of each effect will contribute to the healing process and enhance the total drug effects.


Asunto(s)
Quimioterapia/psicología , Terapias Mente-Cuerpo/psicología , Neoplasias/terapia , Terapia Combinada/psicología , Terapias Complementarias/psicología , Entropía , Humanos , Neoplasias/tratamiento farmacológico , Neoplasias/psicología , Efecto Placebo , Espiritualidad , Confianza
9.
Complement Med Res ; 25(2): 92-101, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29656290

RESUMEN

BACKGROUND: Elaborate consultations and life review (ECLR) has been regularly applied in patients of various cancer entities and stages within Anthroposophic-integrative oncology concepts. However, a lack of systematic research in this field has been detected. To close this gap of knowledge, we evaluated the impact of ECLR in patients with non-metastasized breast cancer before, during, and after primary oncological treatment. METHODS: Patient-reported outcome measures were evaluated by analyzing European Organisation for Research and Treatment of Cancer Quality of Life Questionnaires (EORTC QLQ-C30) in patients with non-metastasized breast cancer who had received either oncological standard therapy alone or in combination with ECLR. RESULTS: 95 female patients were eligible for questionnaire analysis (median age 58 years). Adjusted multivariable linear regression analysis revealed that ECLR was associated with significant improvements in medium-term global health/quality of life and emotional, social, and cognitive functioning. Furthermore, ECLR was associated with significant reductions of short-term appetite loss burden, pain, and short- and medium-term financial difficulties. Subgroup analyses revealed significant improvements in pivotal quality-of-life aspects including fatigue (p = 0.002) in chemotherapy-treated patients after ECLR. CONCLUSIONS: 12 months of surveillance of breast cancer patients reveals medium-term recovery of the global health status/quality of life and cognitive and psychosocial well-being associated with ECLR. In addition, our data indicate a possible association between ECLR and reduced short-term fatigue burden, which has to be re-confirmed prospectively in a larger study cohort. As long-term cancer survivors develop psychological symptoms similar to patients with chronic diseases, prospective studies should evaluate the impact of ECLR on the psychosocial well-being in these patients.


Asunto(s)
Neoplasias de la Mama/psicología , Neoplasias de la Mama/terapia , Anciano , Antineoplásicos/efectos adversos , Antineoplásicos/uso terapéutico , Supervivientes de Cáncer/psicología , Cognición , Quimioterapia/psicología , Fatiga/prevención & control , Trastornos de Alimentación y de la Ingestión de Alimentos/prevención & control , Femenino , Humanos , Modelos Lineales , Persona de Mediana Edad , Análisis Multivariante , Dolor/prevención & control , Sistemas de Apoyo Psicosocial , Calidad de Vida , Encuestas y Cuestionarios
11.
Cancer Nurs ; 40(6): E39-E48, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-27922921

RESUMEN

BACKGROUND: The suicide rate of cancer patients is high in Taiwan. Breast cancer has a high incidence rate and is the leading cause of cancer in women. There is a lack of research examining breast cancer-related depression, suicidal ideation, and quality of life. OBJECTIVES: This study evaluated the effects of muscle relaxation and therapeutic walking on depression, suicidal ideation, and quality of life in breast cancer patients receiving chemotherapy. METHODS: An experimental approach was adopted. A group of 87 breast cancer patients receiving chemotherapy were randomly assigned into an experimental group (n = 44) or a control group (n = 43). The subjects in the experimental group received 2 interventions for 3 months. This study used 3 instruments, including (1) the Center for Epidemiological Studies Depression Scale, (2) the Beck Scale for Suicidal Ideation, and (3) the World Health Organization Questionnaire on Quality of Life. RESULTS: The results showed no significant difference in any outcome variable in the pretest. The results of the posttest indicated that the 2 groups scored significantly differently only on the Center for Epidemiological Studies Depression Scale (U = 638.00, P < .05). The breast cancer patients who participated in the 3 month muscle relaxation and therapeutic walking interventions had a lower level of depression (RE¯ = 37.00) than those who did not (RC¯ = 51.16). CONCLUSION: The muscle relaxation and therapeutic walking program was effective in the reduction of breast cancer patients' depression. IMPLICATIONS FOR PRACTICE: Nursing staff could teach muscle relaxation and therapeutic walking to breast cancer patients to reduce their depression.


Asunto(s)
Neoplasias de la Mama/psicología , Depresión/psicología , Relajación Muscular , Calidad de Vida/psicología , Ideación Suicida , Adulto , Neoplasias de la Mama/complicaciones , Neoplasias de la Mama/tratamiento farmacológico , Depresión/etiología , Quimioterapia/psicología , Femenino , Humanos , Persona de Mediana Edad , Psicometría/instrumentación , Psicometría/métodos , Psicometría/estadística & datos numéricos , Encuestas y Cuestionarios , Taiwán , Caminata/psicología , Caminata/estadística & datos numéricos
12.
J Complement Integr Med ; 13(4): 405-412, 2016 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-27404902

RESUMEN

Background Several cognitive behavioral interventions have been reported to reduce psychological symptoms in breast cancer (BC) patients. The goal of this study was to evaluate the effects of a yoga intervention in reducing depression and anxiety symptoms in BC patients. Methods This study was a randomized, partially blinded, controlled trial comparing a standardized yoga intervention to standard care. It was conducted at three medical centers in Montreal, Canada. Eligible patients were women diagnosed with stage I-III BC receiving chemotherapy. Participants were randomly assigned to receive yoga intervention immediately (experimental group, n=58) or after a waiting period (n=43 control group). The Bali Yoga Program for Breast Cancer Patients (BYP-BC) consisted of 23 gentle Hatha asanas (poses), 2 prayanamas (breathing techniques), shavasanas (relaxation corpse poses) and psychoeducational themes. Participants attended eight weekly sessions lasting 90 min each and received a DVD for home practice with 20- and 40-min sessions. Participants in the wait list control group received standard care during the 8-week waiting period. Results A total of 101 participants took part in the final intention-to-treat analyses. The repeated measures analyses demonstrated that depression symptoms increased in the control group (p=0.007), while no change was reported in the BYP-BC group (p=0.29). Also, depression symptoms decreased in the WL control group after receiving the BYP-BC intervention (p=0.03). Finally, there was no statistical significance in terms of anxiety symptoms (p=0.10). Conclusions Results support the BYP-BC intervention as a beneficial means of reducing and preventing the worsening of depression symptoms during chemotherapy treatment.


Asunto(s)
Neoplasias de la Mama/psicología , Ejercicios Respiratorios , Depresión/terapia , Quimioterapia/psicología , Meditación , Yoga , Adulto , Ansiedad/terapia , Femenino , Humanos , Persona de Mediana Edad , Estadificación de Neoplasias , Quebec
13.
Holist Nurs Pract ; 29(3): 144-50, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25882264

RESUMEN

The purpose of this study is to describe the experiences of cancer blog users and their coping with difficulties. This qualitative study reviewed posts sent to a cancer blog. A content analysis was employed. The study findings were grouped into 2 major themes: challenges experienced and coping.


Asunto(s)
Adaptación Psicológica , Blogging , Quimioterapia/psicología , Neoplasias/psicología , Neoplasias/terapia , Apoyo Social , Humanos , Espiritualidad , Turquía
14.
J Altern Complement Med ; 20(6): 421-7, 2014 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-24766064

RESUMEN

The pharmaceutical industry has undergone a vast expansion in the 20th and 21st centuries. This article explores the central role now played by pills in clinical practice, but also in the public imagination. First, this article analyzes four properties that, together, account for many of the promises and perils associated with pills: They are ingestible, potent, reproducible, and miniaturized. This allows them to serve as ideal consumer items for widespread distribution and sale and also as model technological "devices" capable of downloading into the body healing chemicals. As such, they seem to promise a disburdening solution to many of life's ills. In our cultural fantasy, often shared by physician and patient alike, pills can be used not only to treat and prevent disease but also raise energy, lose weight, lessen pain, lift mood, cope with stress, and enhance sexual and athletic performance. This article also explores many adverse effects not only of pills themselves but of this exaggerated cultural fantasy of the pill. It tends to distract us from other, more holistic understandings of the locus of disease and healing. It even fosters misunderstandings of the ways in which pills themselves work, which is to assist bodily processes, and the mind's "meaning response." The intent here is not to demonize all pills-many have great therapeutic potential-but to learn how to better choose and use them wisely. We propose that this process be assisted through recontextualizing the pill as a multidimensional gift. Taken in such a way, with appropriate gratitude and discernment, we may ingest fewer pills, but with greater efficacy.


Asunto(s)
Quimioterapia/historia , Quimioterapia/psicología , Preparaciones Farmacéuticas/administración & dosificación , Administración Oral , Actitud Frente a la Salud , Industria Farmacéutica , Quimioterapia/métodos , Historia del Siglo XVI , Historia del Siglo XX , Historia del Siglo XXI , Historia Antigua , Humanos , Medicina , Comprimidos/administración & dosificación , Comprimidos/historia , Comprimidos/normas
15.
Eur J Cancer ; 49(8): 1825-35, 2013 May.
Artículo en Inglés | MEDLINE | ID: mdl-23490655

RESUMEN

AIM: Final 10-year analysis of the prospective randomised Chemo-N0 trial is presented. Based on the Chemo-N0 interim results and an European Organisation for Research and Treatment of Cancer (EORTC) pooled analysis (n=8377), American Society of Clinical Oncology (ASCO) and Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) guidelines recommend invasion and metastasis markers urokinase-type plasminogen activator (uPA)/plasminogen activator inhibitor-1 (PAI-1) for risk assessment and treatment decision in node-negative (N0) breast cancer (BC). METHODS: The final Chemo-N0 trial analysis (recruitment 1993-1998; n=647; 12 centres) comprises 113 (5-167) months of median follow-up. Patients with low-uPA and PAI-1 tumour tissue levels (n=283) were observed. External quality assurance guaranteed uPA/PAI-1 enzyme-linked immunosorbent assay (ELISA) standardisation. Of 364 high uPA and/or PAI-1 patients, 242 agreed to randomisation for CMF chemotherapy (n=117) versus observation (n=125). RESULTS: Actuarial 10-year recurrence rate (without any adjuvant systemic therapy) for high-uPA/PAI-1 observation group patients (randomised and non-randomised) was 23.0%, in contrast to only 12.9% for low-uPA/PAI-1 patients (plog-rank=0.011). High-risk patients randomised to cyclophosphamide-methotrexate-5-fluorouracil (CMF) therapy had a 26.0% lower estimated probability of disease recurrence than those randomised for observation (intention-to-treat (ITT)-analysis: hazard ratio (HR) 0.74 (0.44-1.27); plog-rank=0.28). Per-protocol analysis demonstrated significant treatment benefit: HR 0.48 (0.26-0.88), p=0.019, disease-free survival (DFS) Cox regression, adjusted for tumour stage and grade. CONCLUSIONS: Chemo-N0 is the first prospective biomarker-based therapy trial in early BC defining patients reaching good long-term DFS without adjuvant systemic therapy. Using a standardised uPA/PAI-1 ELISA, almost half of N0-patients could be spared chemotherapy, while high-risk patients benefit from adjuvant chemotherapy. These 10-year results validate the long-term prognostic impact of uPA/PAI-1 and the benefit from adjuvant chemotherapy in the high-uPA/PAI-1 group at highest level of evidence. They thus support the guideline-based routine use of uPA/PAI-1 for risk-adapted individualised therapy decisions in N0 breast cancer.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias de la Mama/tratamiento farmacológico , Adulto , Anciano , Biomarcadores de Tumor/metabolismo , Neoplasias de la Mama/metabolismo , Neoplasias de la Mama/patología , Quimioterapia Adyuvante , Ciclofosfamida/administración & dosificación , Toma de Decisiones , Supervivencia sin Enfermedad , Quimioterapia/métodos , Quimioterapia/psicología , Ensayo de Inmunoadsorción Enzimática , Femenino , Fluorouracilo/administración & dosificación , Humanos , Metotrexato/administración & dosificación , Persona de Mediana Edad , Estadificación de Neoplasias , Inhibidor 1 de Activador Plasminogénico/metabolismo , Pronóstico , Estudios Prospectivos , Factores de Riesgo , Factores de Tiempo , Resultado del Tratamiento , Activador de Plasminógeno de Tipo Uroquinasa/metabolismo
16.
Zhongguo Zhong Yao Za Zhi ; 37(15): 2344-8, 2012 Aug.
Artículo en Chino | MEDLINE | ID: mdl-23189745

RESUMEN

Traditional Chinese medicine (TCM) property theory is believed to be a key and difficult point of basic theory studies of TCM. Complex concepts, components and characteristics of TCM property have long puzzled researchers and urged them to develop new angles and approaches. In the view of cognitive science, TCM property theory is a cognitive process of storing, extracting, rebuilding and summarizing the sensory information about TCMs and their effects during the medical practice struggling against diseases under the guidance of traditional Chinese philosophical thinking. The cognitive process of TCM property has particular cognitive elements and strategies. Taking into account clinical application characteristics of TCMs, this study defines the particular cognitive elements. In the combination of research methods of modern chemistry, biology and mathematics, and on the basis early-stage work for five years, we have built a TCM property cognition model based on three elements and practiced with drugs with pungent and hot properties as example, in the hope of interpreting TCM properties with modern science and providing thoughts for the nature of medical properties and instruction for rational clinical prescription.


Asunto(s)
Cognición , Quimioterapia/psicología , Medicamentos Herbarios Chinos/química , Medicamentos Herbarios Chinos/farmacología , Medicina Tradicional China/psicología , Animales , Humanos , Modelos Teóricos
17.
Oncol Nurs Forum ; 39(5): 449-57, 2012 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-22940509

RESUMEN

PURPOSE/OBJECTIVES: To explore whether three factors (physical function, mental health, and social function) of health-related quality of life (HRQOL) are impacted differently in patients with cancer and diabetes when compared to those with cancer who do not have diabetes at the beginning of chemotherapy. DESIGN: Secondary analysis using baseline data from two randomized, controlled trials. SETTING: Two comprehensive cancer centers, one community cancer oncology program, and six hospital-affiliated community oncology centers. SAMPLE: 661 patients aged 21 years or older with a solid tumor cancer or lymphoma undergoing cancer treatment. METHODS: Baseline data from both randomized, controlled trials were used. The SF-36® was used to measure physical function, mental health, and social function. Analysis included descriptive statistics and a general linear model. MAIN RESEARCH VARIABLES: Presence or absence of diabetes and physical function, social function, and mental health. FINDINGS: Patients with cancer and diabetes had significantly lower levels of physical function (p < 0.001) when compared to those who had cancer without diabetes. The interaction of diabetes and age was found to be significantly predictive of mental health (p < 0.05). CONCLUSIONS: The presence of diabetes negatively impacts physical function and mental health in patients undergoing chemotherapy. IMPLICATIONS FOR NURSING: Nurses should be aware of diabetes' effect on HRQOL in patients with cancer. In addition, nurses may need to intervene earlier for patients with diabetes and cancer to maintain or improve their quality of life.


Asunto(s)
Diabetes Mellitus/psicología , Neoplasias/psicología , Calidad de Vida , Adulto , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Instituciones Oncológicas/estadística & datos numéricos , Terapia Cognitivo-Conductual , Comorbilidad , Depresión/epidemiología , Diabetes Mellitus/epidemiología , Diabetes Mellitus/enfermería , Quimioterapia/psicología , Femenino , Humanos , Renta , Masculino , Estado Civil , Salud Mental , Persona de Mediana Edad , Neoplasias/tratamiento farmacológico , Neoplasias/epidemiología , Neoplasias/enfermería , Aptitud Física , Ensayos Clínicos Controlados Aleatorios como Asunto/estadística & datos numéricos , Conducta Social
18.
Arch Intern Med ; 172(15): 1133-42, 2012 Aug 13.
Artículo en Inglés | MEDLINE | ID: mdl-22777380

RESUMEN

BACKGROUND: When curative treatments are no longer options for patients dying of cancer, the focus of care often turns from prolonging life to promoting quality of life (QOL). Few data exist on what predicts better QOL at the end of life (EOL) for advanced cancer patients. The purpose of this study was to determine the factors that most influence QOL at the EOL, thereby identifying promising targets for interventions to promote QOL at the EOL. METHODS: Coping With Cancer is a US multisite, prospective, longitudinal cohort study of 396 advanced cancer patients and their informal caregivers who were enrolled from September 1, 2002, through February 28, 2008. Patients were followed up from enrollment to death a median of 4.1 months later. Patient QOL in the last week of life was a primary outcome of Coping With Cancer and the present report. RESULTS: The following set of 9 factors, preceded by a sign indicating the direction of the effect and presented in rank order of importance, explained the most variance in patients' QOL at the EOL: 1 = (-) intensive care unit stays in the final week (explained 4.4% of the variance in QOL at the EOL), 2 = (-) hospital deaths (2.7%), 3 = (-) patient worry at baseline (2.7%), 4 = (+) religious prayer or meditation at baseline (2.5%), 5 = site of cancer care (1.8%), 6 = (-) feeding-tube use in the final week (1.1%), 7 = (+) pastoral care within the hospital or clinic (1.0%), 8 = (-) chemotherapy in the final week (0.8%), and 9 = (+) patient-physician therapeutic alliance at baseline (0.7%). The vast majority of the variance in QOL at the EOL, however, remained unexplained. CONCLUSION: Advanced cancer patients who avoid hospitalizations and the intensive care unit, who are less worried, who pray or meditate, who are visited by a pastor in the hospital/clinic, and who feel a therapeutic alliance with their physicians have the highest QOL at the EOL.


Asunto(s)
Modelos Estadísticos , Neoplasias , Calidad de Vida/psicología , Cuidado Terminal , Enfermo Terminal , Adulto , Anciano , Actitud Frente a la Muerte , Cuidadores/psicología , Quimioterapia/psicología , Femenino , Estudios de Seguimiento , Humanos , Masculino , Meditación/psicología , Persona de Mediana Edad , Neoplasias/epidemiología , Neoplasias/psicología , Neoplasias/terapia , Cuidado Pastoral , Relaciones Médico-Paciente , Estudios Prospectivos , Cuidado Terminal/psicología , Cuidado Terminal/estadística & datos numéricos , Enfermo Terminal/psicología , Enfermo Terminal/estadística & datos numéricos , Estados Unidos/epidemiología
19.
Holist Nurs Pract ; 23(4): 238-42, 2009.
Artículo en Inglés | MEDLINE | ID: mdl-19574761

RESUMEN

In the last decade, the public use of complementary and alternative therapies for the solution of various health problems has increased dramatically. Listening to music can be considered a support to the traditional medical practice for the reduction of anxiety and stress related to chemotherapy.


Asunto(s)
Ansiedad/terapia , Neoplasias de la Mama/psicología , Quimioterapia/psicología , Musicoterapia/métodos , Adulto , Neoplasias de la Mama/tratamiento farmacológico , Femenino , Humanos , Persona de Mediana Edad
20.
Clin Nurs Res ; 16(2): 85-99; discussion 100-2, 2007 May.
Artículo en Inglés | MEDLINE | ID: mdl-17452429

RESUMEN

This study aimed to describe the experience of massage for breast cancer patients during chemotherapy treatment. Ten patients received massage at five occasions. They were interviewed and analysis was conducted using Giorgi's ideas of phenomenological research. The essential meaning of getting massage during chemotherapy was described as a retreat from the feeling of uneasiness toward chemotherapy. Results revealed five themes: the patients experienced distraction from the frightening experience, a turn from negative to positive, a sense of relaxation, a confirmation of caring, and finally they just felt good. In conclusion, the findings of this study show that massage offered a retreat from uneasy, unwanted, negative feelings connected with chemotherapy treatment. It is a treatment that can be added to the arsenal of treatment choices available to the oncological staff.


Asunto(s)
Neoplasias de la Mama/terapia , Quimioterapia/psicología , Masaje , Estrés Psicológico/prevención & control , Adulto , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/enfermería , Neoplasias de la Mama/psicología , Quimioterapia/enfermería , Empatía , Femenino , Humanos , Persona de Mediana Edad , Terapia por Relajación
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