RESUMEN
BACKGROUND: The body image of patients with cancer can be negatively affected due to treatment toxicities. Changes in body image may cause patients to experience social appearance anxiety. This study aimed to evaluate the body image and social appearance anxiety of patients with cancer undergoing radiotherapy. METHODS: The cross-sectional study was conducted with 153 patients with cancer undergoing radiotherapy in a university hospital. The data were collected with a Patient Information Form, the Body Image Scale, and the Social Appearance Anxiety Scale and the Radiation Therapy Oncology Group Skin Toxicity Criteria. RESULTS: Patients' mean body image score was 15.18 ± 8.26 (min = 0, max = 30), mean social appearance anxiety score was 45.29 ± 14.50 (min = 16, max = 80). Patients with low education levels and low-income levels had higher body image and social appearance anxiety scores (p < 0.01). Body image and social appearance anxiety scores were found to be higher in patients with advanced cancer, grade III-IV skin toxicity, pain, fatigue, and constipation (p < 0.05). CONCLUSIONS: Radiotherapy may negatively affect body image and social appearance anxiety. Assessments of body image and social appearance anxiety regularly before, during, and after treatment are essential. Psychosocial support should be provided to patients to reduce body image and social appearance anxiety and increase their well-being. Patients with cancer especially those who have low income and education levels, advanced cancer stage and skin toxicity, and suffer from pain, fatigue, constipation, etc. should be supported by methods such as counseling and social support groups.
Asunto(s)
Ansiedad , Imagen Corporal , Neoplasias , Humanos , Estudios Transversales , Imagen Corporal/psicología , Masculino , Femenino , Persona de Mediana Edad , Neoplasias/radioterapia , Neoplasias/psicología , Neoplasias/complicaciones , Ansiedad/psicología , Ansiedad/etiología , Adulto , Anciano , Radioterapia/efectos adversos , Radioterapia/psicologíaRESUMEN
PURPOSE: Significant proportions of patients either refuse or discontinue radiotherapy, even in the curative setting, leading to poor clinical outcomes. This study explores patient perceptions that underlie decisions to refuse/discontinue radiotherapy at a cancer care facility in northern Sri Lanka. METHODS: An exploratory descriptive qualitative study was carried out among 14 purposively selected patients with cancer who refused/discontinued radiotherapy. In-depth semi-structured interviews were transcribed in Tamil, translated into English, coded, and thematically analyzed. RESULTS: All participants referred to radiotherapy as "current" with several understanding the procedure to involve electricity, heat, or hot vapour. Many pointed to gaps in information provided by healthcare providers, who were perceived to focus on side effects without explaining the procedure. In the absence of these crucial details, patients relied on family members and acquaintances for information, often based on second or third-hand accounts of experiences with radiotherapy. Many felt pressured by family to refuse radiation, feared radiation, or felt ashamed to ask questions, while for others COVID-19 was an impediment. All but three participants regretted their decision, claiming they would recommend radiation to patients with cancer, especially when it is offered with curative intent. CONCLUSION: Patients with cancer who refused/discontinued radiation therapy have significant information needs. While human resource deficits need to be addressed in low-resource settings like northern Sri Lanka, providing better supportive cancer care could improve clinical outcomes and save healthcare resources that would otherwise be wasted on patient preparation for radiotherapy.
Asunto(s)
Neoplasias , Investigación Cualitativa , Negativa del Paciente al Tratamiento , Humanos , Sri Lanka , Neoplasias/radioterapia , Neoplasias/psicología , Masculino , Femenino , Persona de Mediana Edad , Adulto , Anciano , Negativa del Paciente al Tratamiento/psicología , Radioterapia/métodos , Radioterapia/psicología , COVID-19 , Entrevistas como AsuntoRESUMEN
BACKGROUND/AIM: Many cancer patients receive radiotherapy, which may cause distress. This pilot study evaluated distress levels before and after radiotherapy to contribute to the design of a prospective trial. PATIENTS AND METHODS: Two-hundred patients completed distress thermometers before and after radiotherapy. Distress levels ranged from 0 (no distress) to 10 (maximum distress). Five characteristics were retrospectively analyzed regarding changes of distress including age, sex, performance score, tumor type, previous radiotherapy, and treatment intention. Additional analyses were performed for elderly (>65 years) and non-elderly (≤65 years) patients. RESULTS: In all patients and both age groups, median pre-radiotherapy and post-radiotherapy distress levels were 5 (0-10) vs. 4 (0-10) points. Mean changes of distress levels were -0.5 (±2.6) points in all, -0.4 (±2.5) in elderly, and -0.7 (±2.8) in non-elderly patients. Changes were significantly associated with tumor type in all (p=0.049) and elderly (p=0.025) patients. CONCLUSION: Future studies investigating distress levels in patients receiving radiotherapy should consider age and tumor type.
Asunto(s)
Neoplasias , Distrés Psicológico , Anciano , Humanos , Persona de Mediana Edad , Neoplasias/radioterapia , Proyectos Piloto , Estudios Prospectivos , Radioterapia/efectos adversos , Radioterapia/psicología , Estudios Retrospectivos , Ensayos Clínicos como AsuntoRESUMEN
OBJECTIVE: The aim of this study was to elicit the views of relevant stakeholders on the design of a device using simulated affective touch to reduce procedural anxiety surrounding radiotherapy and imaging. DESIGN: This qualitative study collected data from focus groups which were then analysed using inductive thematic analysis in line with Braun and Clarke's methods. PARTICIPANTS AND SETTING: Twenty patients and carers were recruited, as well as 10 healthcare practitioners involved in either delivering radiotherapy or imaging procedures. RESULTS: Patients, carers and healthcare practitioners agreed on some aspects of the device design, such as ensuring the device is warm and flexible in where it can be used on the body. However, patient and healthcare practitioner cohorts had at times differing viewpoints. For example, healthcare practitioners provided professional perspectives and required easy cleaning of the device. Meanwhile patients focused on anxiety-relieving factors, such as the tactile sensation of the device being either a vibration or pulsation. There was no consensus on who should control the device. CONCLUSIONS: The desired features of a simulated affective touch device have been investigated. Different priorities of patients and their carers and healthcare practitioners were evident. Any design must incorporate such features as to appease both groups. Areas where no consensus was reached could be further explored, alongside including further patient and public involvement in the form of a project advisory group.
Asunto(s)
Cuidadores , Tacto , Ansiedad/prevención & control , Diagnóstico por Imagen/psicología , Grupos Focales , Humanos , Investigación Cualitativa , Radioterapia/psicologíaRESUMEN
OBJECTIVE/HYPOTHESIS: To estimate the prevalence of baseline clinically significant distress (distress score ≥ 4) in head and neck cancer patients planned and treated with radical intent radiotherapy using the National Comprehensive Cancer Network Distress Thermometer (DT) and assess factors predictive of distress. STUDY DESIGN: Cross-sectional study. METHODS: This was a cross-sectional study evaluating distress in 600 head and neck cancer patients undergoing radiation therapy. The DT was used to screen patients for distress at baseline before radiotherapy. RESULTS: The median distress score of the entire cohort was 4 interquartile range (IQR) (IQR: 3-5), and 340 patients (56.7%) had clinically significant distress. On univariate analysis, the causal factors predictive of distress were low socioeconomic status (P = .04), presence of proliferative growth at presentation (P = .008), site of the tumor (oral cavity, P = .02), comorbidity (P = .04), and presence of Ryle's tube or tracheostomy tube at baseline (P = .01). Low socioeconomic status was significant (P = .04) on multivariate analysis for high levels of distress. CONCLUSIONS: Among head and neck cancer patients, 56% of patients had clinically significant baseline distress, and patients with low socioeconomic status had high distress. There is a need for interventions to mitigate distress. LEVEL OF EVIDENCE: 4 Laryngoscope, 131:2023-2029, 2021.
Asunto(s)
Neoplasias de Cabeza y Cuello/radioterapia , Tamizaje Masivo/normas , Radioterapia/psicología , Autoinforme/estadística & datos numéricos , Adulto , Estudios de Casos y Controles , Comorbilidad , Estudios Transversales , Quimioterapia/métodos , Femenino , Neoplasias de Cabeza y Cuello/patología , Humanos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Valor Predictivo de las Pruebas , Prevalencia , Distrés Psicológico , Radioterapia/efectos adversos , Clase Social , Escala Visual AnalógicaRESUMEN
PURPOSE: Psychological distress in primary malignant brain tumour (PMBT) patients is associated with poorer outcomes. Radiotherapy (RT) often induces side effects that significantly influence patients' quality of life (QoL), with potential impact on survival. We evaluated distress, anxiety, depression, and QoL over time to identify patients with difficulties in these areas who required more intense psychological support. METHODS: Psychological questionnaires-Distress Thermometer (DT), Hospital Anxiety and Depression Scale (HADS), and Functional Assessment of Cancer Therapy (FACT-G and FACT-Br)-were completed at the beginning (T0), in the middle (T1), directly after RT (T2), and 3 months after RT (T3). We personalised the psychological support provided for each patient with a minimum of three sessions ('typical' schedule) and a maximum of eight sessions ('intensive' schedule), depending on the patients' psychological profiles, clinical evaluations, and requests. Patients' survival was evaluated in the glioblastoma multiforme (GBM) patients, with an explorative intent. RESULTS: Fifty-nine consecutive PMBT patients receiving post-operative RT were included. For patients who were reported as 'not distressed' at T0, no statistically significant changes were noted. In contrast, patients who were 'distressed' at T0 showed statistically significant improvements in DT, HADS, FACT-G, and FACT-Br scores over time. 'Not distressed' patients required less psychological sessions over the study duration than 'distressed' patients. Interestingly, 'not distressed' GBM patients survived longer than 'distressed' GBM patients. CONCLUSIONS: Increased psychological support improved distress, mood, and QoL for patients identified as 'distressed', whereas psychological well-being was maintained with typical psychological support in patients who were identified as being 'not distressed'. These results encourage a standardisation of psychological support for all RT patients.
Asunto(s)
Neoplasias Encefálicas/psicología , Distrés Psicológico , Psicoterapia/estadística & datos numéricos , Calidad de Vida/psicología , Radioterapia/psicología , Adulto , Anciano , Ansiedad/mortalidad , Ansiedad/psicología , Ansiedad/terapia , Neoplasias Encefálicas/mortalidad , Neoplasias Encefálicas/radioterapia , Depresión/mortalidad , Depresión/psicología , Depresión/terapia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Psicooncología/métodos , Psicooncología/estadística & datos numéricos , Radioterapia/mortalidad , Estrés Psicológico/mortalidad , Estrés Psicológico/psicología , Estrés Psicológico/terapia , Encuestas y Cuestionarios , Escala Visual AnalógicaRESUMEN
This study was to explore the change in purpose in life (PIL) and symptom distress among cancer patients with radiotherapy and associated risk factors. This was a longitudinal study.160 patients were recruited from a medical center in Southern Taiwan. Surveys were conducted one week before and one week after the patients had radiotherapy by questionnaire. Multivariate regression analysis were performed to analyze the data. The patients had significant changes in PIL after radiotherapy compared to before. They had low PIL scores when they were at stage IV, were unable to receive surgery, had tumors in sites other than the abdominal cavity and pelvic, or had high scores in symptom distress scale. Our findings empirically demonstrated that the sense of meaning is integrally associated with the physical and psychosocial effects of illness. Given that cancer patients who are at an advanced stage, unable to receive surgery and have tumors at sites that are not the abdominal cavity and pelvis are at a high risk for having low PIL after RT, care services should be directed to the patients under these conditions.
Asunto(s)
Neoplasias/psicología , Neoplasias/radioterapia , Satisfacción Personal , Distrés Psicológico , Adulto , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Análisis Multivariante , Radioterapia/psicología , Factores de Riesgo , Encuestas y Cuestionarios , TaiwánRESUMEN
PURPOSE: Treatment with radiation therapy (RT) can cause anxiety and distress for pediatric patients and their families. Radiation oncology teams have developed strategies to reduce the negative psychological impact. This survey study aimed to characterize these methods. METHODS AND MATERIALS: A 37-item questionnaire was sent to all radiation oncology members of the Children's Oncology Group to explore strategies to improve the pediatric patient experience. The Wilcoxon rank-sum test was used to assess factors associated with use of anesthesia for older children. RESULTS: Surveys were completed by 106 individuals from 84/210 institutions (40%). Respondents included 89 radiation oncologists and 17 supportive staff. Sixty-one percent of centers treated ≤50 children per year. Respondents described heterogenous interventions. The median age at which most children no longer required anesthesia was 6 years (range: ≤3 years to ≥8 years). Routine anesthesia use at an older age was associated with physicians' lack of awareness of these strategies (P = .04) and <10 years of pediatric radiation oncology experience (P = .04). Fifty-two percent of respondents reported anesthesia use added >45 minutes in the radiation oncology department daily. Twenty-six percent of respondents planned to implement new strategies, with 65% focusing on video-based distraction therapy and/or augmented reality/virtual reality. CONCLUSIONS: Many strategies are used to improve children's experience during RT. Lack of awareness of these interventions is a barrier to their implementation and is associated with increased anesthesia use. This study aims to disseminate these methods with the goal of raising awareness, facilitating implementation, and, ultimately, improving the experience of pediatric cancer patients and their caregivers.
Asunto(s)
Neoplasias/radioterapia , Satisfacción del Paciente/estadística & datos numéricos , Radioterapia/psicología , Cuidadores/psicología , Niño , Preescolar , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , MasculinoRESUMEN
PURPOSE: Patient knowledge of radiation therapy (RT) before consult is typically limited, with many having misconceptions or fears. There exists a need to improve patient education in RT. Our purpose was to study the impact of patient education videos on patient-reported knowledge of RT, anxiety/fear, and satisfaction. METHODS AND MATERIALS: At our institution, we created 2 RT educational videos: a general RT video and a breast cancer-specific video. Patients presenting for breast RT who agreed to participate (n = 107) were randomly assigned to receive a link to the videos (video group; n = 58) or not (no-video group; n = 49) before consultation. Pre- and postconsult surveys were administered assessing patient-reported measures on a 5-point Likert-type scale. RESULTS: Patients in the video group reported significantly higher levels of confidence in their knowledge of radiation side effects, with 45.6.% at least somewhat confident versus 21.3% in the no-video group (P = .009; median on a 5-point Likert-type scale, 2 [interquartile range {IQR}, 2-3] versus 2 [IQR, 1-2], respectively [P = .012]). There was a trend toward higher knowledge of the radiation treatment process in the video group (median, 3 [IQR, 2-3] versus 2 [IQR, 2-3] for no-video group; P = .064). There were no significant differences in preconsult anxiety or fear between the groups, but of those who were assigned videos, 46.8% reported decreased anxiety afterward, and 66.0% felt more comfortable coming to a consult. While those in the no-video group hypothesized that a video would be helpful (median, 3; IQR, 3-4), those in the video group found them to be very helpful in real life (median, 4; IQR, 45; P = .0009). After the consult, all patients in both groups were satisfied. CONCLUSIONS: Patient education videos increase patient-reported knowledge of RT and are found to be very helpful.
Asunto(s)
Neoplasias de la Mama/radioterapia , Conocimientos, Actitudes y Práctica en Salud , Educación del Paciente como Asunto/métodos , Grabación en Video , Ansiedad/epidemiología , Neoplasias de la Mama/psicología , Miedo , Femenino , Humanos , Análisis de Intención de Tratar , Masculino , Persona de Mediana Edad , Neoplasias/radioterapia , Satisfacción del Paciente , Radioterapia/efectos adversos , Radioterapia/psicología , Distribución Aleatoria , Encuestas y Cuestionarios/estadística & datos numéricosRESUMEN
BACKGROUND: Little is known about treatment expectations of patients with spinal metastases undergoing radiotherapy and/or surgery. Assuming that patients with spinal metastases share characteristics with patients who had spinal surgery for non-cancer related conditions and with advanced cancer patients, we performed a systematic review to summarize the literature on patient expectations regarding treatment outcomes of spinal surgery and advanced cancer care. METHODS: A comprehensive search was performed in MEDLINE, EMBASE and PsycINFO for studies between 2000 and sep-2019. Studies including adult patients (> 18 years), undergoing spinal surgery or receiving advanced cancer care, investigating patients' pre-treatment expectations regarding treatment outcomes were included. Two independent reviewers screened titles, abstracts and full-texts, extracted data and assessed methodological quality. RESULTS: The search identified 7343 articles, of which 92 were selected for full-text review. For this review, 31 articles were included. Patients undergoing spinal surgery had overly optimistic expectations regarding pain and symptom relief, they underestimated the probability of functional disability, and overestimated the probability of (complete) recovery and return to work. Studies highlighted that patients feel not adequately prepared for surgery in terms of post-treatment expectations. Similarly, advanced cancer patients receiving palliative treatment often had overly optimistic expectations regarding their survival probability and cure rates. CONCLUSIONS: Patients tend to have overly optimistic expectations regarding pain and symptom relief, recovery and prognosis following spinal surgery or advanced cancer care. Pretreatment consultation about the expected pain and symptom relief, recovery and prognosis may improve understanding of prognosis, and promote and manage expectations, which, in turn, may lead to better perceived outcomes. TRIAL REGISTRATION: PROSPERO registration number: CRD42020145151 .
Asunto(s)
Anticipación Psicológica , Motivación , Procedimientos Neuroquirúrgicos/psicología , Pacientes/psicología , Radioterapia/psicología , Neoplasias de la Columna Vertebral/secundario , Actividades Cotidianas , Adulto , Anciano , Consejo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dolor/etiología , Dolor/psicología , Investigación Cualitativa , Calidad de Vida , Recuperación de la Función , Factores Socioeconómicos , Neoplasias de la Columna Vertebral/psicología , Neoplasias de la Columna Vertebral/radioterapia , Neoplasias de la Columna Vertebral/cirugía , Resultado del TratamientoRESUMEN
INTRODUCCIÓN: El cáncer es una de las principales causas de morbilidad y mortalidad en el mundo, según la Organización Mundial de la Salud (OMS), en 2012 14 millones de casos nuevos y 8,2 millones de muertes. Se demostró que los pacientes en tratamiento, cirugía, quimioterapia y radioterapia tienen niveles altos de cortisol que influye en su calidad de vida. OBJETIVO: Identificar la relación entre el estrés, a nivel de cortisol y las estrategias de afrontamiento en pacientes con cáncer sometidos a tratamiento. MATERIAL Y MÉTODOS: Estudio transversal, descriptivo y correlacional realizado junio a diciembre del 2019. RESULTADOS EPIDEMIOLÓGICOS: 68.2% mujeres 31.8 % hombres, entre 17 y 76 años, con diagnósticos de: Ca mama (30.3%), de próstata (18.3), colon (15.2), pulmón (13.6), cervical (12.1% gástrico (9.1%) cáncer de piel (1.5%). Estadísticos: El 35,3% informaron cortisol a niveles normales y 64.5% niveles altos; el estrés obtuvo un promedio de 13.9 (DE = 4.64). Sobre el nivel de cortisol y el tipo de tratamiento, se observaron diferencias significativas (X2 = 1,546, p = .04), es decir, el paciente que tienen un tratamiento mixto el cortisol es más alto. CONCLUSIONES: Es importante reevaluar las estrategias centradas en el problema, analizar implicaciones y proponer estudios en el contexto en que se desenvuelven, en futuro desarrollar una intervención incluyendo actividades de enfermería en la quimioterapia y radioterapia, apoyando estrategias de afrontamiento efectivas. En este sentido y derivado de la minimización de amenazas centradas en el problema, es importante tener un enfoque integral más profundo
INTRODUCTION: Cancer is one of the leading causes of morbidity and mortality worldwide, according to the World Health Organization (WHO), in 2012 14 million new cases and 8.2 million deaths. (WHO, 2019). Patients in treatment, surgery, chemotherapy and radiation therapy have been shown to have high levels of cortisol that influence their quality of life. OBJECTIVE: to identify the relationship between stress, cortisol level and coping strategies in cancer patients undergoing treatment. MATERIAL AND METHODS: Cross-sectional, descriptive and correlational study conducted June to December 2018. In 65 male and female patients under treatment. RESULTS: 68.2% were women 31.8% men, between 17 and 76 years. With diagnoses Ca breast (30.3%), prostate cancer (18.3), colon (15.2), lung (13.6), cervical (12.1% gastric (9.1%) skin cancer (1.5%). Statistics: 35.3% reported cortisol at normal levels and 64.5% high levels; stress averaged 13.9 (DE s 4.64). On the level of cortisol and the type of treatment, significant differences were observed (X2 X 1,546, p .04), i.e. the patient who has a mixed treatment cortisol is higher. CONCLUSIONS: It is important to reevaluate the strategies focused on the problem, analyze implications and propose studies in the context in which they operate, in the future develop an intervention including nursing activities in chemotherapy and radiotherapy, supporting effective coping strategies. minimizing threats focused on the problem, it is important to have a deeper comprehensive approach
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Hidrocortisona/análisis , Estrés Psicológico/epidemiología , Adaptación Psicológica/clasificación , Neoplasias/psicología , Síndrome de Adaptación General/epidemiología , Estudios Transversales , Metástasis de la Neoplasia/fisiopatología , Radioterapia/psicología , Quimioterapia/psicología , Escalas de Valoración Psiquiátrica/estadística & datos numéricosRESUMEN
OBJECTIVE: Radiotherapy for gynaecological cancer is associated with multiple adverse effects. This randomised controlled trial evaluated the impact of a combined nurse- and peer-led psycho-educational intervention on psychological distress, preparation for treatment, quality of life, psychosexual function, unmet needs and vaginal stenosis. METHODS: Eligible women had a confirmed diagnosis of gynaecological cancer, scheduled to receive radiotherapy with curative intent, aged ≥18 years, and able to read and write English. Participants randomly assigned one-to-one to either four nurse-led consultations plus four peer-led telephone sessions, or to usual care. Participants completed study measures at baseline, immediately before first radiotherapy (FU1), and four weeks (FU2), three (FU3), six (FU4), and 12 months (FU5) post radiotherapy. The primary outcomes were psychological distress at FU1 and FU2 measured by the Hospital Anxiety and Depression Scale. RESULTS: Of 840 eligible participants, 625 were approached and 319 (51%) consented; 158 assigned to intervention, 160 to usual care with 1 withdrawing before randomisation. Between-groups differences for primary outcomes were trivial- and small-sized, (both p > 0.05). Notable effects on secondary outcomes favouring the intervention at FU2 included preparation for treatment (sensory/psychological concerns, d = 0.57; and procedural concerns, d = 0.52) and specific needs domains (sexuality needs, d = 0.38; and health system and information needs, d = 0.41). CONCLUSIONS: There was no evidence that a nurse- and peer-led intervention had a beneficial effect on psychological distress compared to usual care. However, improved treatment readiness and lower health system and sexuality needs indicate the intervention may have addressed outcomes known to be important to this population.
Asunto(s)
Neoplasias de los Genitales Femeninos/radioterapia , Educación del Paciente como Asunto/métodos , Distrés Psicológico , Derivación y Consulta/organización & administración , Sexualidad/psicología , Adulto , Anciano , Ansiedad , Supervivientes de Cáncer/psicología , Depresión , Femenino , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Enfermeras y Enfermeros/organización & administración , Educación del Paciente como Asunto/organización & administración , Estudios Prospectivos , Calidad de Vida , Radioterapia/efectos adversos , Radioterapia/psicología , Grupos de Autoayuda/organización & administración , Teléfono , Resultado del TratamientoRESUMEN
Clinical placement experience is an important component of medical radiation science (MRS) education, equipping students to safely transition into complex healthcare environments. This commentary draws on evidence from the literature that reports challenges allied health students face in clinical environments. As several factors are implicated that could result in a higher prevalence of psychological distress and mental ill-health in MRS students, there is a need to re-emphasize the importance of developing strategies to support students in clinical education. A key recommendation is to identify associated risk factors early as they can impact on the quality of education and in severe cases be detrimental to students' psychological well-being. This requires an understanding of the full extent and nature of the challenges through partnered approaches between professional organisations, clinical departments, academics and students. Developing evidence-based strategies for improving students' well-being in clinical environments is also essential.
Asunto(s)
Empleos Relacionados con Salud/educación , Técnicos Medios en Salud/educación , Técnicos Medios en Salud/psicología , Radiografía/psicología , Radioterapia/psicología , Estudiantes de Medicina/psicología , Humanos , Radiografía/métodos , Radioterapia/métodosRESUMEN
As radiation therapy is needed by approximately 50% of patients with cancer there needs to be ongoing research to ensure that radiation therapy targets the tumour effectively and minimises potential side effects. Major advances in radiation therapy, due to improvements in engineering and computing, have made it more precise, reducing side effects and improving cancer control. Patients need to be informed of its risks, both short and long term, to enable them to be active participants in their cancer treatment path.
Asunto(s)
Atención a la Salud/estadística & datos numéricos , Neoplasias/radioterapia , Medicina Nuclear/estadística & datos numéricos , Pacientes/psicología , Radioterapia/psicología , HumanosRESUMEN
PURPOSE: It is important to understand the differences between men and women when it comes to attitudes and risk perception toward disease. This study aimed to explore the fear of cancer from the standpoint of themselves and the opposite sex by cancer type. MATERIALS AND METHODS: A cross-sectional survey with a representative sample was conducted. RESULTS: The least and the most feared cancers in men were thyroid cancer and lung cancer, respectively. When men assumed the perspective of women, the least and the most feared cancer were thyroid cancer and stomach cancer, respectively. The least and the most feared cancers in women were thyroid cancer and stomach cancer, respectively. When women assumed the perspective of men, the least and the most feared cancer were prostate cancer and lung cancer, respectively. When both men and women assume the perspective of the opposite sex, the fear of sex-specific cancer was relatively low compared to the actual responses of both men and women. The top six of the most feared side effects of cancer treatment were pain, psychological problems, general weakness, digestive dysfunction, fatigue, and appearance change. These were the same between men and women. CONCLUSION: Health care providers and caregivers in the family should provide care with more attention to the differences in thoughts about cancer between men and women. Health care providers should provide care with more attention to the differences in these problems between men and women.
Asunto(s)
Miedo , Conocimientos, Actitudes y Práctica en Salud , Neoplasias/psicología , Adulto , Anciano , Estudios Transversales , Quimioterapia/psicología , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/mortalidad , Neoplasias/terapia , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/psicología , Radioterapia/efectos adversos , Radioterapia/psicología , Factores Sexuales , Procedimientos Quirúrgicos Operativos/efectos adversos , Procedimientos Quirúrgicos Operativos/psicología , Encuestas y Cuestionarios/estadística & datos numéricos , Tasa de Supervivencia , Adulto JovenRESUMEN
PURPOSE: With an increasing emphasis on patient-centered care, clinicians in subspecialties such as breast surgery and radiation oncology that offer multiple therapeutic options with equivalent outcomes are under increasing pressure to aid patients with the decision-making process. The aim of this review is to summarize existing studies that either evaluated factors in patient's decision-making regarding locoregional therapy in early-stage breast cancer or evaluated benefit thresholds required to change therapy decisions. METHODS: A PubMed search to identify prospective or retrospective studies written in English reporting factors in patient decision-making regarding locoregional therapy in early-stage breast cancer was conducted. No restriction was placed on publication date. Studies that focused on breast reconstruction decisions or on patient preferences for decision-making involvement were excluded. RESULTS: A total of 39 studies were identified; 19 examining patient preferences for breast-conserving surgery versus mastectomy, 7 on preferences for contralateral prophylactic mastectomy, 2 on non-surgical options, 2 on the extent of axillary surgery, and 9 on radiation therapy decisions. Themes such as fear of recurrence, desire to avoid additional invasive therapy, and the importance of physician preference were common, but many studies also highlighted factors important to specific subpopulations of women. CONCLUSIONS: Patient preference is difficult to define and measure, and heterogeneity across studies renders direct comparison difficult. Future work is needed to define women's risk-thresholds for certain treatments, delve into the psychological factors that direct their decisions, and understand how patients' valuations of risk interact with society's.
Asunto(s)
Neoplasias de la Mama/terapia , Mastectomía Segmentaria/psicología , Mastectomía/psicología , Recurrencia Local de Neoplasia/terapia , Prioridad del Paciente/psicología , Radioterapia/psicología , Neoplasias de la Mama/psicología , Femenino , Humanos , Mastectomía/métodos , Mastectomía Segmentaria/métodos , Recurrencia Local de Neoplasia/psicología , Estadificación de Neoplasias , Prioridad del Paciente/estadística & datos numéricos , Atención Dirigida al Paciente/normas , Radioterapia/métodosRESUMEN
OBJECTIVES: Suicide is a leading cause of death in the working-age population. We investigated suicide mortality among diagnostic medical radiation workers in relation to their demographic and occupational factors in South Korea. METHODS: The study population consisted of all diagnostic medical radiation workers enrolled in the National Dosimetry Registry from 1996 to 2011. The registry data were linked with mortality data through the end of 2017. We calculated age-standardised suicide rates, standardised mortality ratios (SMRs) and rate ratios (RRs) by demographic and occupational factors. RESULTS: A total of 207 suicides were identified among 94 367 medical radiation workers, exhibiting a suicide rate of 14.0 per 100 000 person-years. Compared with the general population, suicide rates were lower for both male and female workers (SMR 0.49, 95% confidence interval (CI) 0.42 to 0.57; SMR 0.54, 95% CI 0.41 to 0.70, respectively). Similarly, decreased SMRs were observed across job titles and other work-related factors. However, a shorter duration of employment was positively associated with RRs for suicide; risks were 2.74 (95% CI 1.56 to 4.81) and 4.66 (95% CI 1.53 to 14.20) times higher in male and female workers with less than 1 year of employment, respectively, than in those with at least 10 years of employment. CONCLUSIONS: Diagnostic medical radiation workers in South Korea showed lower suicide rates than in the general population. However, a shorter duration of employment was associated with higher risk of suicide. Suicide prevention efforts could target workers engaged in short-term employment.
Asunto(s)
Personal de Salud/psicología , Radioterapia/efectos adversos , Suicidio/estadística & datos numéricos , Adulto , Causas de Muerte/tendencias , Femenino , Personal de Salud/estadística & datos numéricos , Humanos , Masculino , Radioterapia/psicología , Radioterapia/estadística & datos numéricos , Sistema de Registros/estadística & datos numéricos , República de Corea/epidemiología , Factores de TiempoRESUMEN
PURPOSE: To identify the unmet needs of breast cancer survivors after radiation therapy. PARTICIPANTS & SETTING: Patients who received radiation therapy for unilateral breast cancer with six months or longer of follow-up and exhibited no disease progression were eligible for selection to a study conducted at an outpatient radiation therapy academic practice in the southeastern United States. METHODOLOGIC APPROACH: A qualitative descriptive study was undertaken using semistructured interviews, framed by the five domains of the Survivor Unmet Needs Survey and analyzed using an iterative inductive and deductive process. FINDINGS: Of the 24 invited patients, 17 agreed to the interview (including one male patient). Themes emerged from the emotional, relationships, and information needs domains. IMPLICATIONS FOR NURSING: Healthcare providers should perform a comprehensive needs assessment for patients with breast cancer receiving radiation therapy. Self-management assessment instruments may address patients' confidence in managing all phases of radiation therapy side effects.
Asunto(s)
Neoplasias de la Mama/psicología , Neoplasias de la Mama/radioterapia , Supervivientes de Cáncer/psicología , Evaluación de Necesidades , Satisfacción del Paciente , Calidad de Vida/psicología , Radioterapia/psicología , Adaptación Psicológica , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Investigación Cualitativa , Apoyo Social , Sudeste de Estados Unidos , Encuestas y CuestionariosRESUMEN
A cancer diagnosis can be extremely stressful and life-altering for patients. Chronically high levels of stress can increase inflammation and affect the progression of the cancer. Psychosocial interventions could reduce stress and address cancer patients' emotional, psychological, and spiritual needs. This mixed-methods pilot study compared 2 single-session arts-based approaches for patients in active radiation treatment in a large urban hospital. Participants were assigned to either the active control of independent coloring or the therapeutic intervention of open studio art therapy. Participants completed pre-session and post-session saliva samples and standardized psychosocial measures of stress, affect, anxiety, self-efficacy, and creative agency. Both conditions significantly increased participants' positive affect, self-efficacy, and creative agency, and decreased negative affect, perceived stress, and anxiety. No changes of note were seen in the salivary measures. Participants' narrative responses corroborated the quantitative findings and highlighted additional benefits such as supporting meaning-making and spiritual insights. Both arts-based interventions can support the emotional, psychological, and spiritual needs of cancer patients while each has features that may be more suited to the needs of certain patients. Further replication of these findings could support our initial findings that suggest that patients could benefit from having art studio spaces with art therapists and choices of art materials available on the oncology unit.
Asunto(s)
Arteterapia/métodos , Neoplasias/psicología , Psicooncología/métodos , Calidad de Vida , Radioterapia , Autoeficacia , Estrés Psicológico , Ansiedad/diagnóstico , Ansiedad/etiología , Ansiedad/terapia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/diagnóstico , Neoplasias/radioterapia , Técnicas Psicológicas , Intervención Psicosocial/métodos , Radioterapia/métodos , Radioterapia/psicología , Espiritualidad , Estrés Psicológico/diagnóstico , Estrés Psicológico/etiología , Estrés Psicológico/terapia , Resultado del TratamientoRESUMEN
The Breast Cancer overall survival rate has raised impressively in the last 20 years mainly due to improved screening and effectiveness of treatments. This increase in survival paralleled the awareness over the long-lasting impact of the side effects of treatments on patient quality of life, emphasizing the motto "a longer but better life for breast cancer patients". In breast cancer more strikingly than in other cancers, besides the side effects of systemic treatments, there is the visible impact of surgery and radiotherapy on patients' body image. This has sparked interest on the development of tools for the aesthetic evaluation of Breast Cancer locoregional treatments, which evolved from manual, subjective approaches to computerized, automated solutions. However, although studied for almost four decades, past solutions were not mature enough to become a standard. Recent advancements in machine learning have inspired trends toward deep-learning-based medical image analysis, also bringing new promises to the field of aesthetic assessment of locoregional treatments. In this paper, a review and discussion of the previous state-of-the-art methods in the field is conducted and the extracted knowledge is used to understand the evolution and current challenges. The aim of this paper is to delve into the current opportunities as well as motivate and guide future research in the aesthetic assessment of Breast Cancer locoregional treatments.