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1.
Curr Oncol ; 28(1): 294-300, 2021 01 08.
Artigo em Inglês | MEDLINE | ID: mdl-33430131

RESUMO

BACKGROUND: The current Coronavirus disease 2019 (COVID-19) pandemic is a highly stressful event that may lead to significant psychological symptoms, particularly in cancer patients who are at a greater risk of contracting viruses. This study examined the frequency of stressors experienced in relation to the ongoing coronavirus pandemic and its relationship with psychological symptoms (i.e., anxiety, depression, insomnia, fear of cancer recurrence) in breast cancer patients. METHODS: Thirty-six women diagnosed with a non-metastatic breast cancer completed the Insomnia Severity Index, the Hospital Anxiety and Depression Scale, the severity subscale of the Fear of Cancer Recurrence Inventory, and the COVID-19 Stressors Questionnaire developed by our research team. Participants either completed the questionnaires during (30.6%) or after (69.4%) their chemotherapy treatment. RESULTS: Results revealed that most of the participants (63.9%) have experienced at least one stressor related to the COVID-19 pandemic (one: 27.8%, two: 22.2%, three: 11.1%). The most frequently reported stressor was increased responsibilities at home (33.3%). Higher levels of concerns related to the experienced stressors were significantly correlated with higher levels of anxiety, depressive symptoms, insomnia, and fear of cancer recurrence, rs(32) = 0.36 to 0.59, all ps < 0.05. CONCLUSIONS: Cancer patients experience a significant number of stressors related to the COVID-19 pandemic, which are associated with increased psychological symptoms. These results contribute to a better understanding of the psychological consequences of a global pandemic in the context of cancer and they highlight the need to better support patients during such a challenging time.


Assuntos
Neoplasias da Mama/complicações , Sobreviventes de Câncer/psicologia , Pandemias , Estresse Psicológico/epidemiologia , Adulto , Ansiedade/diagnóstico , Ansiedade/epidemiologia , Ansiedade/psicologia , Neoplasias da Mama/imunologia , Neoplasias da Mama/psicologia , Neoplasias da Mama/terapia , /psicologia , Sobreviventes de Câncer/estatística & dados numéricos , Estudos Transversais , Depressão/diagnóstico , Depressão/epidemiologia , Depressão/psicologia , Medo , Feminino , Humanos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/psicologia , Questionário de Saúde do Paciente/estatística & dados numéricos , Índice de Gravidade de Doença , Distúrbios do Início e da Manutenção do Sono/diagnóstico , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Distúrbios do Início e da Manutenção do Sono/psicologia , Estresse Psicológico/diagnóstico , Estresse Psicológico/etiologia , Estresse Psicológico/psicologia
2.
Psicooncología (Pozuelo de Alarcón) ; 17(2): 239-253, jul.-dic. 2020.
Artigo em Espanhol | IBECS | ID: ibc-199114

RESUMO

OBJETIVO: El objetivo de la investigación fue determinar las relaciones entre el distrés psicológico, el miedo a la recurrencia del Cáncer (MRC) y la calidad de vida relacionada con la salud (CDVRS) en pacientes sobrevivientes de cáncer de mama venezolanas. MÉTODO: El estudio fue de corte correlacional y participaron 203 pacientes sobrevivientes de Cáncer de mama, de edades entre 24 y 75 años. Se emplearon las escalas de Ansiedad y Depresión Hospitalaria (HADS), de preocupaciones relacionadas con el Cáncer y de salud global SF - 12 versión 2. RESULTADOS: Se reportaron niveles bajos de distrés psicológico, aunque con predominio de niveles medios de ansiedad y de MRC. La prevalencia de ansiedad elevada fue de 23%, de depresión elevada de 7%, de distrés psicológico de 18% y de MRC de 36%. El distres psicológico y MRC correlacionaron de forma positiva y significativa, aunque con fuerza de baja a moderada. La CDVRS estuvo en un rango normal y correlacionó de forma inversa y significativa con el distrés psicológico así como también con el MRC. CONCLUSIÓN: El distrés psicológico se encuentra asociado, aunque no en gran magnitud, con el MRC y que ambos se asocian con un deterioro de la CDVRS en las pacientes sobrevivientes de Cáncer de mama venezolanas. Además, el MRC y la CDVRS correlacionaron de forma positiva, baja y significativa con el tiempo de supervivencia de las pacientes


The objetivo of the following study was to determine the relationships between psychological distress, fear of cancer recurrence (FCR) and health - related quality of life (HQoL) in Venezuelan breast cancer survivors. The study was with a correlational cut, 203 breast cancer survivors between the age of 24 and 75 participated. METHOD: The scales of Hospital Anxiety and Depression (HADS), Cancer- related Worry and Global Health SF - 12 version 2 were used. RESULTS: Low levels of psychological distress were reported, but with a predominance of means levels of anxiety and FCR. The prevalence of high anxiety was 23%, depression 7% an FCR 36%. Psychological distrees and FCR correlated positively and significantly, although with low to moderate. HQoL was in a normal range and correlated inversely and significantly with psychological distress, as well as with FCR. CONCLUSION: The psychological distress and MRC are associated, but although not in large magnitude, and that both are associated with a deterioration of HQoL in Venezuelan breast cancer survivors. FCR nd HQoL correlated positively and significantly with time survival of patients


Assuntos
Humanos , Feminino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Recidiva Local de Neoplasia/psicologia , Neoplasias da Mama/psicologia , Qualidade de Vida/psicologia , Estresse Psicológico , Depressão/psicologia , Ansiedade/psicologia , Medo/psicologia , Fatores Socioeconômicos , Venezuela
3.
Eur J Cancer ; 133: 120-130, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32502876

RESUMO

BACKGROUND: Brentuximab vedotin was approved for adult patients with CD30-expressing cutaneous T-cell lymphoma treated with prior systemic therapy based on improved response rates and progression-free survival with brentuximab vedotin (1.8 mg/kg once every 3 weeks; ≤16 cycles) versus physician's choice (methotrexate/bexarotene; ≤48 weeks) in the phase III ALCANZA study. Quality of life (QoL) in ALCANZA patients was also examined. METHODS: QoL measures in ALCANZA were based on the Skindex-29, Functional Assessment of Cancer Therapy-General (FACT-G) and European QoL 5-dimension (EQ-5D) questionnaires. RESULTS: Mean maximum reduction from the baseline Skindex-29 symptom domain score (key secondary end-point) was greater with brentuximab vedotin than physician's choice (-27.96 versus -8.62); the difference, -18.9 (95% confidence interval -26.6, -11.2; adjusted p < 0.001), exceeded the study-defined minimally important difference (9.0-12.3). Mean changes from baseline to end-of-treatment visit total FACT-G scores were similar with brentuximab vedotin and physician's choice (0.15 versus -2.29). EQ-5D changes were also comparable between arms. Among brentuximab vedotin-treated patients with peripheral neuropathy (PN), mean maximum reduction in Skindex-29 symptom domain was -35.54 versus -11.11 in patients without PN. PN had no meaningful effect on FACT-G and EQ-5D QoL scores. CONCLUSIONS: In summary, brentuximab vedotin produced superior reductions in symptom burden compared with physician's choice, without adversely impacting QoL. QoL was unaffected by the presence of PN in brentuximab vedotin-treated patients. CLINICAL TRIAL REGISTRATION: NCT01578499.


Assuntos
Brentuximab Vedotin/uso terapêutico , Linfoma Cutâneo de Células T/tratamento farmacológico , Qualidade de Vida , Neoplasias Cutâneas/tratamento farmacológico , Adulto , Idoso , Idoso de 80 Anos ou mais , Resistencia a Medicamentos Antineoplásicos/efeitos dos fármacos , Feminino , Humanos , Linfoma Cutâneo de Células T/epidemiologia , Linfoma Cutâneo de Células T/patologia , Linfoma Cutâneo de Células T/psicologia , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/tratamento farmacológico , Recidiva Local de Neoplasia/epidemiologia , Recidiva Local de Neoplasia/psicologia , Medidas de Resultados Relatados pelo Paciente , Psicometria/métodos , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/psicologia , Inquéritos e Questionários , Resultado do Tratamento , Adulto Jovem
4.
Qual Life Res ; 29(7): 1789-1800, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32152817

RESUMO

BACKGROUND: Breast cancer-related lymphedema (BCRL) and its associated symptoms harm the quality of life (QoL) of cancer survivors and can stimulate fear of cancer recurrence (FCR). Self-management education for lymphedema has been introduced as an effective method in controlling FCR. This study investigates the effect of lymphedema group-based education compared to the social network-based and control group on QoL and FCR in breast cancer patients. METHODS: This three-arm clinical trial studied 105 patients with breast cancer-related lymphedema referred to Seyed_Khandan rehabilitation center. Sampling was done by random allocation method in blocks of 3 with 35 subjects in each group. All subjects received routine lymphedema treatments. The group-based education (GE) and social network-based education (SNE) groups received self-management education in the clinic and Telegram™ messenger channel, respectively. Impairment in QoL and mean score of FCR were assessed before, immediately after, and three months after the intervention by using the Persian version of Lymphedema Life Impact Scale (LLIS) and Fear of Progression Questionnaire-Short Form (FoPQ-SF), respectively. Mixed-model ANOVA was applied for statistical analysis. RESULTS: There was a significant time effect on total LLIS (P = 0.007), psychosocial (P = 0.038) and functional (P = 0.024) subscale changes in three groups of study. Interaction between the main effect of group and time on psychosocial subscale changes was statistically significant (P = 0.017). The multicomparison results illustrated that the main effect of time, the main effect of group, and interaction of them on the mean score of FCR were P = 0.084, P = 0.380, and P = 0.568, respectively. CONCLUSION: Despite no significant reduction in the FCR score, results showed the improvement of most QoL aspects after three months of intervention. Although the social network-based education method was effective, the group-based education method was more beneficial. Applying these educational methods in lymphedema treatment protocols needs cost-effectiveness studies. TRIAL REGISTRATION: This study was registered at the Iranian Registry of Clinical Trials (IRCT2017052834176N1).


Assuntos
Neoplasias da Mama/psicologia , Medo/psicologia , Linfedema/psicologia , Recidiva Local de Neoplasia/psicologia , Adolescente , Adulto , Idoso , Neoplasias da Mama/mortalidade , Sobreviventes de Câncer , Feminino , Humanos , Pessoa de Meia-Idade , Qualidade de Vida , Autogestão , Rede Social , Inquéritos e Questionários , Adulto Jovem
5.
BMC Cancer ; 20(1): 223, 2020 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-32178640

RESUMO

BACKGROUND: Cognitive therapy has been shown to reduce fear of cancer recurrence (FCR), mainly in breast cancer survivors. The accessibility of cognitive behavioural interventions could be further improved by Internet delivery, but self-guided interventions have shown limited efficacy. The aim of this study is to test the efficacy of a therapist guided internet-delivered intervention (TG-iConquerFear) vs. augmented treatment as usual (aTAU) in Danish colorectal cancer survivors. METHODS/DESIGN: A population-based randomized controlled trial (RCT) comparing TG-iConquerFear with aTAU (1:1) in n = 246 colorectal cancer survivors who suffer from clinically significant FCR (Fear of Cancer Recurrence Inventory Short Form (FCRI-SF) ≥ 22 and semi-structured interview). Evaluation will be conducted at 2 weeks, 3 and 6 months post-treatment and between-group differences will be evaluated. Long-term effects will be evaluated after one year. Primary outcome will be post-treatment FCR (FCRI-SF). Secondary outcomes are global overall health and global quality of life (Visual Analogue Scales 0-100), bodily distress syndrome (BDS checklist), health anxiety (Whiteley-6), anxiety (SCL4-anx), depression (SCL6-dep) and sickness absence and health expenditure (register data). Explanatory outcomes include: Uncertainty in illness (Mishels uncertainty of illness scale, short form, MUIS), metacognitions (MCQ-30 negative beliefs about worry subscale), and perceived risk of cancer recurrence (Visual analogue Scale 1-100). DISCUSSION: This RCT will provide valuable information on the clinical and cost-effectiveness of TG-iConquerFear vs. aTAU for CRC survivors with clinical FCR, as well as explanatory variables that may act as outcome moderators or mediators. TRIAL REGISTRATION: ClinicalTrials.gov; NCT04287218, registered 25.02.2020. https://clinicaltrials.gov/ct2/results?cond=&term=NCT04287218&cntry=&state=&city=&dist=.


Assuntos
Sobreviventes de Câncer/psicologia , Terapia Cognitivo-Comportamental/métodos , Neoplasias Colorretais/psicologia , Medo , Recidiva Local de Neoplasia/psicologia , Transtornos Fóbicos/terapia , Ensaios Clínicos Controlados Aleatórios como Assunto , Ansiedade , Terapia Cognitivo-Comportamental/economia , Análise Custo-Benefício , Dinamarca , Depressão , Humanos , Internet , Qualidade de Vida
6.
Support Care Cancer ; 28(11): 5147-5156, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32060704

RESUMO

PURPOSE: This study aimed to identify unobserved distinct latent classes/subgroups of breast cancer (BC) patients in China with respect to various sexual health measures and examine the association of the latent membership with individual characteristics. METHODS: In a cross-sectional study, 123 BC patients were analyzed. Their sexual health was measured using the Female Sexual Functioning Index (FSFI). Latent class analysis (LCA) was used to examine the patterns of sexual health in patients. Associations of the latent class membership with individual characteristics were examined using multinomial logistic regression. RESULTS: Three a priori unknown distinct latent classes of patients were identified with respect to the 19 FSFI sexual health measures: 50 patients (41.6%) were classified in class 1 "No Impairment Group," 49 patients (39.4%) in class 2 "Organic Sexual Dysfunction Group," and 24 patients (19.1%) in class 3 "Poor Sexual Health Group." Income and anxiety were positively, whereas disease duration was negatively associated with the likelihood of being in class 2 than in class 1, patients with recurrence of cancer were likely to be in classes 2 and 3. Patients classified in class 3 were more likely to have better prior body image and have more severe menopausal symptoms, whereas less likely to have better post body image and have better partner relationships. CONCLUSION: The findings revealed the heterogeneity of sexual health among BC patients in China and may guide to identify the high-risk patients and enable early intervention.


Assuntos
Neoplasias da Mama/fisiopatologia , Comportamento Sexual/fisiologia , Adulto , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/psicologia , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Renda , Análise de Classes Latentes , Modelos Logísticos , Menopausa/fisiologia , Menopausa/psicologia , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/fisiopatologia , Recidiva Local de Neoplasia/psicologia , Comportamento Sexual/psicologia , Comportamento Sexual/estatística & dados numéricos , Saúde Sexual/estatística & dados numéricos , Parceiros Sexuais , Inquéritos e Questionários
7.
Psychooncology ; 29(4): 788-795, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32026563

RESUMO

OBJECTIVE: Fear of cancer recurrence (FCR) is characterized by the fear, worry or concern that cancer will come back or progress. The negative effects associated with FCR are consistently identified by cancer survivors as one of their most prominent unmet needs. Current measures of FCR can be long, complex and burdensome for survivors to complete. The objective of the present study is to develop and validate a one-item measure of FCR. METHODS: The ability of the FCR-1 to detect change in FCR over time was analyzed using a repeated-measures ANOVA and paired-samples t-tests. Pearson correlations were used to measure the concurrent, convergent and discriminant validity of the FCR-1, and a ROC analysis was conducted to determine an optimal clinical cut-off score. RESULTS: The FCR-1 was found to be responsive to change in FCR over time. It demonstrated concurrent validity with the FCRI (r = .395, P = .010), and convergent validity with the Mishel Uncertainty in Illness Scale (r = .493, P = .001) and the Reassurance Questionnaire (r = .325, P = .044). Discriminant validity was confirmed when the FCR-1 did not significantly correlate with unrelated measures. A ROC analysis pinpointed an optimal clinical cut-off score of 45.0. CONCLUSIONS: The FCR-1 is a promising tool that can be incorporated in clinical and research settings. Due to its brevity, the care needs of highly distressed patients can be met quickly and efficiently. In research settings, the FCR-1 can reduce the cognitive burden experienced by survivors.


Assuntos
Sobreviventes de Câncer/psicologia , Recidiva Local de Neoplasia/psicologia , Transtornos Fóbicos/diagnóstico , Escalas de Graduação Psiquiátrica/normas , Angústia Psicológica , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes
8.
Breast Cancer Res Treat ; 180(2): 449-459, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32020433

RESUMO

PURPOSE: To prospectively investigate accelerated aging and its association with total mortality and breast cancer-specific mortality/recurrence among breast cancer survivors. METHODS: This study included 4218 female breast cancer patients enrolled into a population-based cohort study approximately 6-month post-diagnosis. Information on aging-related symptoms (i.e., self-rated overall health condition, energy level, depression, sleep difficulty, and quality) was collected at 18- and 36-month post-diagnosis surveys. Information on overall health, daily function impairments, survival status, and recurrence was collected at 10-year post-diagnosis survey. Record linkages with vital statistics were conducted to collect mortality information. Cox proportional hazards model was applied. RESULTS: Among 3041 10-year survivors with a mean age of 63.7 ± 9.7 years, respectively, 52.3%, 19.0%, and 27.6% reported poor health, limitation in daily activity, and climbing floors. Age-specific prevalence revealed that breast cancer survivors reached similar prevalence of the functional limitations 5-10 years earlier than cancer-free women. At the 18-month post-diagnosis survey, respectively, 47.0%, 72.5%, and 25.1% of survivors reported unsatisfied overall health condition, reduced energy level, and depression symptoms. After a median follow-up of 10.9 years, low self-rated overall health, low energy level, and depression were significantly associated with increased total mortality, with hazard ratios (HRs; 95% confidence intervals [CI]) of 3.14 (2.43, 4.06), 1.49 (1.20, 1.84), and 1.59 (1.21, 2.09), respectively. Low self-rated health was associated with breast cancer-specific mortality/recurrence (HR 1.85, 95% CI 1.30, 2.65). No significant association was found for sleep difficulty and quality. CONCLUSION: Aging-related physical changes/symptoms are commonly presented at 18 months after breast cancer diagnosis and are associated with worse prognosis. IMPACT: Our findings highlight the concern of accelerated aging among breast cancer survivors.


Assuntos
Envelhecimento/patologia , Neoplasias da Mama/mortalidade , Sobreviventes de Câncer/psicologia , Recidiva Local de Neoplasia/mortalidade , Qualidade de Vida , Atividades Cotidianas/psicologia , Adulto , Idoso , Neoplasias da Mama/patologia , Neoplasias da Mama/psicologia , Sobreviventes de Câncer/estatística & dados numéricos , Depressão/patologia , Fadiga/patologia , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/psicologia , Estudos Prospectivos , Fatores de Risco , Distúrbios do Início e da Manutenção do Sono/patologia , Taxa de Sobrevida , Adulto Jovem
9.
Eur J Oncol Nurs ; 44: 101706, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32007696

RESUMO

PURPOSE: Adjuvant endocrine therapy (AET) significantly reduces the risk of breast cancer recurrence and mortality in women with hormone receptor (HR+) breast cancer. Despite the documented survival benefits with AET, non-adherence and non-persistence remains a significant problem. This systematic review of qualitative research aimed to synthesise breast cancer patients' experiences of adherence and persistence to oral endocrine therapy. METHODS: The ENTREQ guidelines were followed. A systematic search strategy was performed across eleven electronic databases (Embase, Cinahl, Pubmed, Psychinfo, Proquest, Lenus, Scopus, Web of Science, Rian.ie, EThOS e-theses online, DART Europe). Thomas and Harden's three-stage approach to thematic analysis was undertaken on the findings of all included studies. Confidence in the findings were reviewed using GRADE-CERQual. RESULTS: Twenty-four qualitative studies were included in the synthesis. Three analytic themes were identified (We don't have an option; the side effects are worse than the disease; help us with information and support). Adherence was often driven by women feeling they had no option and a fear of cancer recurrence. Persistence was helped with support and information. Non-adherence and non-persistence were associated with debilitating side effects, inadequate information and lack of support. CONCLUSIONS: Adherence and persistence to AET was often suboptimal among breast cancer patients. Women commonly felt isolated and neglected as a result of insufficient information and support from healthcare professionals. If women are to persist with AET, primary care providers should be aware of the facilitators and barriers to adherence, and they should be knowledgeable in symptom management strategies.


Assuntos
Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/psicologia , Sobreviventes de Câncer/psicologia , Disruptores Endócrinos/uso terapêutico , Adesão à Medicação/psicologia , Adesão à Medicação/estatística & dados numéricos , Recidiva Local de Neoplasia/tratamento farmacológico , Recidiva Local de Neoplasia/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Sobreviventes de Câncer/estatística & dados numéricos , Quimioterapia Adjuvante/psicologia , Terapia Combinada/psicologia , Europa (Continente) , Feminino , Humanos , Pessoa de Meia-Idade , Pesquisa Qualitativa , Adulto Jovem
10.
Eur J Oncol Nurs ; 44: 101705, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32006720

RESUMO

PURPOSE: Fear of cancer recurrence (FCR) is a paramount concern among ovarian cancer survivors. Evidence shows that cancer survivors living in regional or rural areas have higher psychological morbidity; however, no known studies have explored how ovarian cancer survivors living in small urban and rural areas cope with FCR. METHODS: In this qualitative descriptive study, a semi-structured questioning process was developed in accordance with Carver et al.'s conceptualization of coping. Focus groups or 1:1 telephone interviews were used to collect data from a convenience sample of ovarian cancer survivors. Participants completed a demographic form and the Fear of Cancer Recurrence Inventory, and clinical information was extracted from hospital charts. RESULTS: The average age of participants (n = 15) was 62.8 years (Range 51-76 years) and the average time since diagnosis was 2.7 years (Range 1-19 years). Most women had elevated levels of FCR. Five themes for coping were expressed by all women: 1) health care provider support; 2) knowing, trusting, and prioritizing self; 3) finding what works; 4) uniqueness and belonging; and 5) redirecting thoughts and actions. One additional theme was expressed by most women (n = 11): 6) preparing for the future. CONCLUSION: Fear of cancer recurrence was a concern for most ovarian cancer survivors who used a variety of ways to cope. Results can be used to guide nurses' discussions with post-treatment ovarian cancer survivors or be used to inform refinement and development of resources to assist ovarian cancer survivors living in small urban and rural settings to cope with FCR.


Assuntos
Sobreviventes de Câncer/psicologia , Medo/psicologia , Recidiva Local de Neoplasia/psicologia , Neoplasias Ovarianas/psicologia , Transtornos Fóbicos/psicologia , Adaptação Psicológica , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Ontário , Pesquisa Qualitativa , População Rural/estatística & dados numéricos , Sobreviventes/psicologia , População Urbana/estatística & dados numéricos
11.
Health Qual Life Outcomes ; 18(1): 21, 2020 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-32019567

RESUMO

BACKGROUND: To determine relationship between cancer survivors' perception of care coordination and their health outcomes. METHODS: Study subjects were 1306 Korean adulthood cancer survivors who were enrolled in two academic hospital and completed a questionnaire consisting of questions asking two aspects of care coordination for cancer treatment they had received: 1) who played a main coordinator role and 2) whether care services had met their necessitated health concerns. We measured health outcomes including new comorbidity, number of clinic visits, health-related quality of life (HRQoL) and fear of cancer recurrence (FCR). Associations between the level of care coordination and health outcomes were evaluated by multiple logistic regression analysis after adjusting for covariates. RESULTS: Survivors with uncoordinated care were more likely to have more new comorbidities after cancer diagnosis, visit clinic more frequently and have worse HRQoL and higher FCR. Females and unmarried survivors were more likely to have received uncoordinated care than males and ever married survivors. Uncoordinated care group had an increased the risk of new comorbidity (odds ratio 1.73, [95% confidence interval] 1.02-2.92), multiple clinic visits (1.69, 1.00-2.88), severe FCR (2.28, 1.33-3.93), low EuroQoL Visual Analogue Scale (1.82, 1.28-2.60), low global health status (1.51, 1.04-2.21), and poor physical (2.00, 1.31-3.04), role (2.46, 1.69-3.56) and emotional function (2.62, 1.81-3.78). CONCLUSIONS: Coordinated care of Korean cancer survivors was associated with their health outcomes, including new comorbidity, clinic visits, HRQoL and FCR. Good care coordination may be reinforced to improve outcomes of survivorship care.


Assuntos
Sobreviventes de Câncer/psicologia , Continuidade da Assistência ao Paciente/normas , Qualidade de Vida , Adulto , Idoso , Sobreviventes de Câncer/estatística & dados numéricos , Estudos de Casos e Controles , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/psicologia , Neoplasias/epidemiologia , Neoplasias/psicologia , Neoplasias/terapia , Avaliação de Resultados em Cuidados de Saúde , República da Coreia/epidemiologia , Inquéritos e Questionários
12.
Cancer ; 126(8): 1784-1792, 2020 04 15.
Artigo em Inglês | MEDLINE | ID: mdl-31913499

RESUMO

BACKGROUND: Fear of cancer recurrence (FCR) has been associated with cancer screening behaviors among cancer survivors, but to the authors' knowledge, the question of whether the same is true for caregivers is unknown. The current study investigated the extent to which FCR among caregivers predicted their cancer screening behaviors years after their relatives' cancer diagnosis. METHODS: A total of 813 caregivers (67% of whom were female, mean age of 56 years, and 92% non-Hispanic white) completed surveys 2 years (T1) and 8 years (T2) after their patients' cancer diagnosis. FCR, anxiety (Profile of Mood States-Short Form [POMS-SF]), and general mental health (Medical Outcomes Study 36-Item Short-Form Health Survey [MOS SF-36]) were reported at T1; caregivers' engagement in screening for colorectal, breast, and prostate cancers because of the patients' diagnoses were reported at T2. RESULTS: Caregivers were found to engage in cancer screening at rates similar to those of the national average. Controlling for covariates, hierarchical logistic regression modeling for each type of cancer screening demonstrated that greater FCR was linearly related to a higher likelihood of undergoing colorectal cancer screening (odds ratio [OR], 1.15) and maintaining prostate cancer screening (OR, 1.34), but a lower likelihood of maintaining breast cancer screening in an age-appropriate manner (OR, 0.27). Examining curvilinear effects demonstrated that moderate levels of FCR were associated with a higher likelihood of maintaining age-appropriate colorectal cancer screening (OR, 1.48). CONCLUSIONS: The overall FCR among caregivers uniquely promotes their engagement in cancer screening behaviors. The role of caregivers' FCR in other types of cancer preventive behaviors and ways to channel FCR concerns into promoting healthy lifestyle behaviors should be investigated.


Assuntos
Sobreviventes de Câncer/psicologia , Cuidadores/psicologia , Detecção Precoce de Câncer/psicologia , Medo/psicologia , Recidiva Local de Neoplasia/psicologia , Neoplasias/diagnóstico , Neoplasias/psicologia , Ansiedade/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
13.
Gynecol Oncol ; 156(3): 561-567, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31982178

RESUMO

OBJECTIVE: To measure preferences of women with ovarian cancer regarding risks, side effects, costs and benefits afforded by maintenance therapy (MT) with a poly ADP ribose polymerase (PARP) inhibitor. METHODS: A discrete-choice experiment elicited preferences of women with ovarian cancer regarding 6 attributes (levels in parentheses) relevant to decisions for MT versus treatment break: (1) overall survival (OS; 36, 38, 42 months); (2) progression-free survival (PFS; 15, 17, 21 months); (3) nausea (none, mild, moderate); (4) fatigue (none, mild, moderate); (5) probability of death from myelodysplastic syndrome/acute myelogenous leukemia (MDS/AML; 0% to 10%); (6) monthly out-of-pocket cost ($0 to $1000). Participants chose between 2 variable MT scenarios and a static scenario representing treatment break, with multiple iterations. Random-parameters logit regression was applied to model choices as a function of attribute levels. RESULTS: 95 eligible participants completed the survey; mean age was 62, 48% had recurrence, and 17% were ever-PARP inhibitor users. Participants valued OS (average importance weight 24.5 out of 100) and monthly costs (24.6) most highly, followed by risk of death from MDS/AML (17.9), nausea (14.7), PFS (10.5) and fatigue (7.8). Participants would accept 5% risk of MDS/AML if treatment provided 2.2 months additional OS or 4.8 months PFS. Participants would require gains of 2.6 months PFS to accept mild treatment-related fatigue and 4.4 months to accept mild nausea. CONCLUSIONS: When considering MT, women with ovarian cancer are most motivated by gains in OS. Women expect at least 3-4 months of PFS benefit to bear mild side effects of treatment.


Assuntos
Neoplasias Ovarianas/tratamento farmacológico , Preferência do Paciente/psicologia , Inibidores de Poli(ADP-Ribose) Polimerases/administração & dosagem , Tomada de Decisões , Feminino , Humanos , Quimioterapia de Manutenção , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/tratamento farmacológico , Recidiva Local de Neoplasia/economia , Recidiva Local de Neoplasia/psicologia , Neoplasias Ovarianas/economia , Neoplasias Ovarianas/psicologia , Inibidores de Poli(ADP-Ribose) Polimerases/efeitos adversos , Inibidores de Poli(ADP-Ribose) Polimerases/economia , Intervalo Livre de Progressão , Taxa de Sobrevida , Estados Unidos
14.
Eur J Oncol Nurs ; 44: 101717, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31986346

RESUMO

PURPOSE: Caregivers of patients with cancer play an important role throughout the treatment trajectory. This can be challenging and might infer health and psychosocial problems. This may especially be the case in caregivers of patients with cancers that carry a high risk of recurrence such as cancers of the pancreas, duodenum and bile duct. This study therefore explored the experiences of caregivers of patients attending follow-up after completion of treatment with curative intent for cancers of the pancreas, duodenum and bile duct. METHODS: A qualitative study using semi-structured, individual interviews. Data were analysed using content analysis. RESULTS: Ten caregivers of patients attending follow-up after completed curative treatment for cancers of the pancreas, duodenum and bile duct in a specialized gastro-surgical center at a tertiary hospital in the Capital Region of Denmark participated. We identified three themes: "From bystander to enlisted carer", inferring that caregivers felt enlisted as carers during treatment and follow-up, however without sufficient instruction or assessment of their needs. "Lonesome worrying" meaning that caregivers hid their feelings of concern and foreboding, and finally, "Keeping a stiff upper lip" indicating that caregivers outwardly maintained a positive face when interacting with the patient. CONCLUSION: Caregivers described taking on a substantial burden of care without feeling competent. They experienced distress and emotional isolation which affected their relationship with the patient and their mutual coping. The results indicate a need for health care professionals to facilitate reflection on the needs and roles of both patients and caregivers throughout the treatment trajectory.


Assuntos
Neoplasias dos Ductos Biliares/enfermagem , Neoplasias dos Ductos Biliares/psicologia , Cuidadores/psicologia , Neoplasias Duodenais/enfermagem , Neoplasias Duodenais/psicologia , Neoplasias Pancreáticas/enfermagem , Neoplasias Pancreáticas/psicologia , Adaptação Psicológica , Adulto , Idoso , Idoso de 80 Anos ou mais , Dinamarca , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/enfermagem , Recidiva Local de Neoplasia/psicologia , Pesquisa Qualitativa
15.
Support Care Cancer ; 28(9): 4173-4181, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31900611

RESUMO

PURPOSE: A number of cancer patients experience fear of cancer recurrence (FCR), which affects their psychological adjustment. This study tested the hypothesized model of FCR to predict psychological adjustment in cancer patients undergoing chemotherapy. METHODS: A total of 203 patients, who had been diagnosed with either breast cancer or colorectal cancer and were undergoing chemotherapy, were recruited from two university hospitals in Seoul, Korea. Data were collected using validated questionnaires and were analyzed using SPSS 24.0 and AMOS 25.0 program for structural equation modeling procedures. RESULTS: The fit index of the hypothesized model was appropriate. Symptom distress, contextual factors, FCR, and illness representations had statistically significant direct, indirect, and total effects on psychological adjustment. These variables explained 76% of the total variance of the psychological adjustment in cancer patients undergoing chemotherapy. Fear of cancer recurrence was a mediating factor for the effects of symptom distress, contextual factors, and illness representation on psychological adjustment. CONCLUSIONS: Based on these results, interventions aimed at reducing symptom distress and FCR, and improving social support, optimism, and illness representations, may be useful for the successful psychological adjustment of cancer patients undergoing chemotherapy.


Assuntos
Neoplasias da Mama/psicologia , Neoplasias Colorretais/psicologia , Modelos Psicológicos , Recidiva Local de Neoplasia/psicologia , Adaptação Psicológica , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/tratamento farmacológico , Neoplasias Colorretais/tratamento farmacológico , Estudos Transversais , Medo/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Fóbicos/etiologia , Transtornos Fóbicos/psicologia , República da Coreia , Inquéritos e Questionários
16.
Cancer ; 126(7): 1512-1521, 2020 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-31869452

RESUMO

BACKGROUND: To the authors' knowledge, studies regarding risk perception among survivors of thyroid cancer are scarce. METHODS: The authors surveyed patients who were diagnosed with differentiated thyroid cancer from the Surveillance, Epidemiology, and End Results registries of Georgia and Los Angeles County (2632 patients; 63% response rate). The analytic cohort was defined by a ≤5% risk of disease recurrence and mortality (1597 patients). Patients estimated their recurrence and mortality risks separately (increments of 10% and endpoints of ≤5% and ≥95%). Both outcomes were dichotomized between reasonably accurate estimates (risk perception of ≤5% or 10%) versus overestimation (risk perception of ≥20%). Multivariable logistic regression was used to identify factors associated with risk overestimation, and the relationships between overestimation and both worry and quality of life were evaluated. RESULTS: In the current study sample, 24.7% of patients overestimated their recurrence risk and 12.5% overestimated their mortality risk. A lower educational level was associated with overestimating disease recurrence (≤high school diploma: odds ratio [OR], 1.64 [95% CI, 1.16-2.31]; and some college: OR, 1.36 [95% CI, 1.02-1.81]) and mortality (≤high school diploma: OR, 1.86 [95% CI, 1.18-2.93]) risk compared with those attaining at least a college degree. Hispanic ethnicity was found to be associated with overestimating recurrence risk (OR, 1.44, 95% CI 1.02-2.03) compared with their white counterparts. Worry about recurrence and death was found to be greater among patients who overestimated versus those who had a reasonably accurate estimate of their risk of disease recurrence and mortality, respectively (P < .001). Patients who overestimated mortality risk also reported a decreased physical quality of life (mean T score, 43.1; 95% CI, 41.6-44.7) compared with the general population. CONCLUSIONS: Less educated patients and Hispanic patients were more likely to report inaccurate risk perceptions, which were associated with worry and a decreased quality of life.


Assuntos
Sobreviventes de Câncer/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Recidiva Local de Neoplasia , Neoplasias da Glândula Tireoide , Adulto , Idoso , Ansiedade/epidemiologia , Ansiedade/etiologia , Feminino , Georgia , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/psicologia , Percepção , Qualidade de Vida , Programa de SEER , Neoplasias da Glândula Tireoide/psicologia
17.
Psychooncology ; 29(3): 500-506, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31733086

RESUMO

OBJECTIVE: The prevalence of smoking among cervical cancer survivors typically exceeds what is found among women in the general population and other cancer survivors. Yet, there is a dearth of literature on risk and protective factors related to smoking among cervical cancer survivors, especially when it comes to identification of variables that are amendable to intervention. To help fill this gap in the literature, this qualitative study examines the nature of smoking-related causal attributions and risk perceptions in cervical cancer survivors who smoked at cancer diagnosis. METHODS: Participants are 21 female cervical cancer survivors (M=45.7, SD=8.4 years old), all diagnosed in the past five years. Nearly three-quarters of participants reported smoking in the past month. RESULTS: Smoking was not uniformly recognized as a cause of cervical cancer (whether in general or participants' own cancer); the link between smoking and lung, head-neck, and other cancers was more readily accepted. Despite generally weak endorsements of causal attributions, many participants reported smoking significantly increases risk for poor clinical (e.g., recurrence) and quality of life (e.g., pain) outcomes after cervical cancer diagnosis. CONCLUSIONS: Findings suggest cervical cancer survivors may not fully understand or appreciate the role of smoking in cervical cancer risk whereas their beliefs about the role of smoking in cervical cancer prognosis are more well-formed. This study highlights the potential role of causal attributions and risk perceptions in understanding and addressing the smoking-related experience of cervical cancer survivors.


Assuntos
Sobreviventes de Câncer/psicologia , Qualidade de Vida/psicologia , Fumar/psicologia , Neoplasias do Colo do Útero/psicologia , Adulto , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/psicologia , Pesquisa Qualitativa , Neoplasias do Colo do Útero/fisiopatologia
18.
Surgery ; 167(1): 94-101, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31623853

RESUMO

BACKGROUND: The long-term health-related quality-of-life implications of treating low-risk differentiated thyroid cancer with total thyroidectomy or hemithyroidectomy is important to patients but remains poorly understood. METHODS: Using a cross-sectional mailed survey, we compared long-term health-related quality-of-life in low-risk differentiated thyroid cancer survivors treated with hemithyroidectomy to those treated with total thyroidectomy between 2005 and 2016 at a university hospital. European Organisation for Research and Treatment of Cancer Quality of Life core Questionnaire version 3.0, the supplementary Thyroid Cancer specific questionnaire module version 2.0, and the Assessment of Survivor Concerns (ASC) questionnaires were used. Our primary outcome was the global scale of quality of life. Exploratory outcomes included differences among other health-related quality-of-life items corrected for potential confounders in multivariable regression analyses. RESULTS: The response rate was 51.0% (270 of 529), of which 59 patients (21.9%) were treated with hemithyroidectomy. Main outcome score global quality of life did not differ between groups (76.9 hemithyroidectomy vs 77.7 total thyroidectomy, P = .450). Exploratory analyses showed hemithyroidectomy to be associated with more worry about recurrence on the Assessment of Survivor Concerns questionnaire (2.4 hemithyroidectomy vs 2.1 total thyroidectomy, P = .021). CONCLUSION: Long-term quality of life was not significantly different between low-risk differentiated thyroid cancer patients treated with total thyroidectomy compared with hemithyroidectomy. In secondary analyses, worry about recurrence appeared to be higher in individuals treated with hemithyroidectomy. These data highlight previously unreported impact of surgical regimen to the health-related quality-of-life for low-risk differentiated thyroid cancer patients.


Assuntos
Sobreviventes de Câncer/psicologia , Recidiva Local de Neoplasia/psicologia , Qualidade de Vida , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia/efeitos adversos , Adulto , Idoso , Sobreviventes de Câncer/estatística & dados numéricos , Estudos Transversais , Medo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/prevenção & controle , Estudos Retrospectivos , Inquéritos e Questionários/estatística & dados numéricos , Neoplasias da Glândula Tireoide/psicologia , Tireoidectomia/métodos
19.
Support Care Cancer ; 28(7): 3033-3040, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31576471

RESUMO

PURPOSE: The aim of the study was to evaluate an outpatient psychoeducational group program for breast cancer patients aimed to improve various psychosocial parameters, enhancing the patients' competence and reducing fear of recurrence. METHODS: The study is based on a multi-center, non-randomized control group design with three measurement time points (T1 baseline, T2 end of the intervention, T3 6-week follow-up). Breast cancer patients were assessed with various standardized questionnaires including fear of progression, self-efficacy, depression, and quality of life. RESULTS: A total of 50 breast cancer patients participated (intervention group n = 27, control group n = 23). The results show a significant reduction in the fear of progression/recurrence (FoPR) (p = 0.003) and a significant increase in self-efficacy (SE) (p = 0.007) for the intervention group with a large (FoPR, Eta2 = .178) and medium (SE, Eta2 = .113) effect size, respectively. For all other outcome criteria such as depressive symptoms, social support, or quality of life, no significant changes over time or differences between both groups were found. CONCLUSIONS: The psychoeducational program has been proven to be effective for breast cancer survivors, but further investigation based on a randomized trial is necessary. PRACTICE IMPLICATIONS: To improve participation rate assessment of patient's needs and close cooperation with rehabilitation centers, psychosocial counseling services, and medical oncologists are recommended.


Assuntos
Neoplasias da Mama/psicologia , Neoplasias da Mama/terapia , Sobreviventes de Câncer/psicologia , Educação de Pacientes como Assunto/métodos , Neoplasias da Mama/cirurgia , Depressão/etiologia , Depressão/psicologia , Medo/psicologia , Feminino , Humanos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/psicologia , Projetos Piloto , Qualidade de Vida , Autoeficácia , Apoio Social , Fatores Sociológicos
20.
Cancer ; 126(2): 416-424, 2020 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-31584705

RESUMO

BACKGROUND: Many parents of children with advanced cancer pursue curative goals when cure is no longer possible. To the authors' knowledge, no pediatric studies to date have prospectively evaluated prognosis communication or influences on decision making in poor-prognosis childhood cancer. METHODS: The authors conducted a prospective cohort study at 9 pediatric cancer centers that enrolled 95 parents of children with recurrent or refractory, high-risk neuroblastoma (63% of those who were approached), a condition for which cure rarely is achieved. Parents were surveyed regarding the child's likelihood of cure; their primary goal of care; the child's symptoms, suffering, and quality of life; and regret concerning the last treatment decision. Medical records identified care and treatment decisions. RESULTS: Only 26% of parents recognized that the chance of cure was <25%. When asked to choose a single most important goal of care, approximately 72% chose cure, 10% chose longer life, and 18% chose quality of life. Parents were more likely to prioritize quality of life when they recognized the child's poor prognosis (P = .002). Approximately 41% of parents expressed regret about the most recent treatment decision. Parents were more likely to experience regret if the child had received higher intensity medical care (odds ratio [OR], 3.14; 95% CI, 1.31-7.51), experienced suffering with limited benefit from the most recent treatment (OR, 4.78; 95% CI, 1.16-19.72), or experienced suffering from symptoms (OR, 2.91; 95% CI, 1.18-7.16). CONCLUSIONS: Parents of children with poor-prognosis cancer frequently make decisions based on unrealistic expectations. New strategies for effective prognosis communication are needed.


Assuntos
Atitude Frente a Morte , Recidiva Local de Neoplasia/mortalidade , Neuroblastoma/mortalidade , Cuidados Paliativos/psicologia , Pais/psicologia , Adulto , Criança , Pré-Escolar , Ensaios Clínicos como Assunto , Comunicação , Tomada de Decisões , Emoções , Feminino , Humanos , Masculino , Motivação , Recidiva Local de Neoplasia/psicologia , Recidiva Local de Neoplasia/terapia , Neuroblastoma/psicologia , Neuroblastoma/terapia , Relações Médico-Paciente , Prognóstico , Estudos Prospectivos , Qualidade de Vida , Inquéritos e Questionários/estatística & dados numéricos , Terapias em Estudo/psicologia
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