Ethical, legal, organizational and social issues related to the use of scalp cooling for the prevention of chemotherapy-induced alopecia: A systematic review.

INTRODUCTION: Scalp cooling (SC) aims to prevent chemotherapy-induced alopecia. The goal of this systematic review is to tackle ethical, legal, organizational and social issues related to SC. METHODS: A critical appraisal of the literature was carried out using a systematic review design. MEDLINE, Embase and Web of Science databases were searched up until 2 June 2021. Studies addressing these aspects in English or Spanish were considered. Representatives of both patient associations and professional scientific societies related to the topic participated in the design of the protocol and the review of the findings. RESULTS: A total of 17 studies were included. Articles were critically appraised using the MMAT and SANRA. Findings were organized into four categories: (1) ethical aspects focused on equal access, gender equity and doctor-patient communication supported by Patient Decision Aids (PtDAs); (2) patient perspective and acceptability; (3) professional perspective and acceptability; (4) organizational aspects focused on accessibility and feasibility. CONCLUSION: Cancer patients' expectations when using SC need to be adjusted to reduce the potential distress associated with hair loss. PtDAs could help patients clarify their values and preferences regarding SC. Equal access to technology should be guaranteed. PATIENT OR PUBLIC CONTRIBUTION: In this systematic review, the representatives of the patient associations (Ms. María Luz Amador Muñoz of the Spanish Association Against Cancer [AECC] and Ms. Catiana Martinez Cánovas of the Spanish Breast Cancer Federation [FECMA]) participated in the review of the study protocol, as well as in the results, discussion and conclusions, making their contributions. In the type of design of these studies (systematic reviews), it is not usual to have the direct participation of patients, but in this one, we have done so, as it is a systematic review that is part of a report of the Spanish Network of Health Technology Assessment Agencies (ETS).

Effectiveness of a psychoeducative intervention in a summer camp for children with type 1 diabetes mellitus.

PURPOSE: The purpose of this study was to evaluate the effectiveness of a psychoeducative intervention implemented in a summer camp for children with type 1 diabetes. METHODS: A prospective cohort study was conducted comparing 2 groups of children with type 1 diabetes. The intervention group (n = 34) received interventions that addressed knowledge, behaviors, skills, and psychological factors during a summer camp. The control group (n = 23) received the usual education and care. Evaluated measurements were glycosylated hemoglobin (A1C), diabetes knowledge, anxiety, psychological adaptation, and use of health care services. RESULTS: No significant changes in A1C annual average, body mass index (BMI), diabetes knowledge, anxiety, medical visits, or hospital admissions were observed after the intervention in comparison with before intervention. Only the adaptation to the school environment improved significantly. The control group significantly increased BMI and A1C. CONCLUSIONS: No relevant variations in diabetes knowledge, anxiety, psychological adaptation, or use of health care services were found after the psychoeducative intervention implemented in the summer camp. Future studies with random allocation of subjects are necessary to confirm the intervention's effectiveness.