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1.
Amanda M. Rach Valerie McLaughlin Crabtree Tara M. Brinkman Lonnie Zeltzer Jordan Gilleland Marchak Deokumar Srivastava Brooklee Tynes Jin-Shei Lai Leslie L. Robison Gregory T. Armstrong Kevin R. Krull 《Journal of cancer survivorship》2017,11(2):256-263
Purpose
Survivors of pediatric Hodgkin’s lymphoma (HL) are at risk for a number of debilitating late effects. Excessive fatigue and poor sleep quality are primary complaints of HL survivors. Understanding the emotional and physical factors that influence fatigue and sleep quality may provide opportunities for intervention to improve health-related quality of life for HL survivors.Methods
Data from 751 adult survivors of childhood HL who participated in the Childhood Cancer Survivor Study (CCSS) from 2000–2002 were analyzed. Multivariable logistic regression analyses investigated the demographic, psychological, and physical variables that predicted clinically significant levels of poor sleep quality, fatigue, and excessive daytime sleepiness.Results
Survivors’ self-reported level of emotional distress, pain, and physical functioning limitations did not differ from population norms. Clinically elevated levels of emotional distress (OR 8.38, 95% CI 4.28–16.42) and pain (OR 3.73, 95% CI 2.09–6.67) increased the risk for endorsing elevated levels of fatigue. Survivors with elevated levels of emotional distress (OR 6.83, 95% CI 2.71–15.90) and pain (OR 5.27, 95% CI 1.78–15.61) were more likely to report poor sleep quality. Pain (OR 2.11, 95% CI 1.39–3.34) was related to excessive daytime sleepiness.Conclusions
Emotional and physical factors are associated with elevated levels of fatigue, excessive daytime sleepiness, and poor sleep quality in survivors of pediatric HL. This is consistent with findings from research conducted with non-cancer survivors.Implications for cancer survivors
These results suggest that interventions designed to target sleep and fatigue difficulties in the general population may be well suited for pediatric HL survivors as well.2.
3.
Eric S. Zhou Ann H. Partridge Karen L. Syrjala Alexis L. Michaud Christopher J. Recklitis 《Journal of cancer survivorship》2017,11(1):74-79
Purpose
Insomnia is commonly experienced by cancer survivors. Chronic insomnia is associated with significant physical and psychosocial consequences if not properly treated. Both the National Cancer Institute (NCI) and the National Comprehensive Cancer Network (NCCN) recommend the evaluation of sleep disturbances and evidence-based treatment of insomnia during routine survivorship care. To better understand current clinical practices, we conducted a survey of major cancer centers across the United States (US).Methods
Adult survivorship programs at the 25 US cancer centers that are both NCI-designated comprehensive cancer centers and NCCN member institutions were surveyed about the evaluation and treatment of insomnia in their hospital.Results
All institutions responded to the survey. Thirteen centers (56 %) reported screening <25 % of survivors for sleep disorders, and few clinicians providing survivorship care were well-prepared to conduct a proper sleep evaluation. Insomnia was most commonly treated with sleep hygiene, or pharmacotherapy, rather than cognitive-behavioral therapy. No program reported that >50 % of their survivors were receiving optimal insomnia-related care. A variety of methods to improve insomnia care were endorsed by respondents.Conclusions
There is a clear need to improve the evaluation and treatment of insomnia for cancer survivors at institutions across the country. Cancer centers deemed a number of modalities relevant for improving provider confidence in addressing sleep challenges.Implications for cancer survivors
To improve the quality of insomnia care for survivors, systematic interventions to increase standardized screening for sleep disorders, providing additional sleep medicine training for survivorship clinicians, and optimizing the role of sleep medicine specialists in the oncology setting should be considered.4.
Hermine Poghosyan Sabreen A. Darwish Sun S. Kim Mary E. Cooley 《Journal of cancer survivorship》2016,10(6):1078-1088
Purpose
This study examined the association between social support and smoking status among adult cancer survivors, with special emphasis on mental health differences using data from 10 US states.Methods
Cross-sectional data from the 2010 Behavioral Risk Factor Surveillance System, Cancer Survivorship module on 8055 cancer survivors were analyzed. Sample weights were applied for the generalization of results to 2.6 million cancer survivors.Results
In 2010, 15.6 % (418,700) were current, 38.4 % (1.03 million) former, and 46.0 % (1.2 million) never smokers. About 18.0 % of cancer survivors reported receiving the lowest level of social support and 12.1 % reported experiencing frequent mental distress in the past 30 days. Participants’ mean age at the time of the first cancer diagnosis was 51.0 (standard error (SE)?=?0.33) and mean time since their diagnosis was 11.3 years (SE?=?0.18). Compared to those with infrequent mental distress, cancer survivors with frequent mental distress were diagnosed at a younger age (45.0 vs. 51.8), more likely to be current smokers (36.8 vs. 12.7 %), and less likely to always receive social support they needed (33.4 vs. 56.3 %). Cancer survivors who received higher levels of social support were less likely to be current smokers than those who received the lowest level of social support they needed. Among cancer survivors who reported frequent mental distress, non-Hispanic blacks were more likely to be current smokers than non-Hispanic whites.Conclusions
Rates of current smokers were lower among cancer survivors who received social support and reported infrequent mental distress.Implications for Cancer Survivors
Psychosocial screening may help health care professional identify smokers with frequent mental distress who require more intensive smoking cessation interventions.5.
Purpose
Short stature has been reported in pediatric cancer survivors. Data on retinoblastoma survivors are limited. We conducted a cross-sectional study to assess the height in retinoblastoma survivors.Method
The recorded height was compared with median height for age and sex as per the Indian Academy of Pediatrics. Z-score less than ?2 was considered short statured.Result
Thirty percent of the survivors were short statured. The mean height was shorter than the mean 50th percentile height (119.7 ± 14.8 vs 128.7 ± 15 cm, p < 0.001). Previous chemotherapy showed a trend toward association (p = 0.09).Conclusion
Short stature affects a significant number of retinoblastoma survivors.6.
Shannon N. Westin Charlotte C. Sun Celestine S. Tung Robin A. Lacour Larissa A. Meyer Diana L. Urbauer Michael M. Frumovitz Karen H. Lu Diane C. Bodurka 《Journal of cancer survivorship》2016,10(2):261-270
Purpose
While overall survival from gynecologic malignancies has greatly improved over the last three decades, required treatments can lead to multiple health issues for survivors. Our objective was to identify health concerns that gynecologic cancer survivors face.Methods
A systematic, stratified sample of women with gynecologic malignancies was surveyed for 18 health issues occurring before, during, or after treatment. The impact of clinical features and treatment modality on health issues was assessed through multivariate logistic regression models.Results
Of 2,546 surveys mailed, 622 were not received by eligible subjects secondary to invalid address, incorrect diagnosis, or death. Thus, 1924 survivors potentially received surveys. Of the 1,029 surveys (53.5 %) completed, median age was 59 years; diagnoses included 29 % cervical, 26 % endometrial, 26 % ovarian/primary peritoneal/fallopian tube, 12.1 % vulvar, and 5.4 % vaginal cancers. The most frequently reported health issues included fatigue (60.6 %), sleep disturbance (54.9 %), urinary difficulties (50.9 %), sexual dysfunction (48.4 %), neurologic issues (45.4 %), bowel complaints (42.0 %), depression (41.3 %), and memory problems (41.2 %). These rankings were consistent with patients’ self-reported rankings of “highest impact” personal issues. After controlling for demographic and clinical variables, multivariate analyses revealed that treatment modality impacted the odds of experiencing a given health issue.Conclusions
Our study demonstrates that gynecologic cancer survivors experience a high frequency of health conditions and highlights the association between treatment modality and specific health concerns.Implications for Cancer Survivors
The study findings highlight the multiple health concerns experienced by gynecologic cancer survivors and suggest the potential for developing interventions to mitigate these concerns in survivorship.7.
Allan “Ben” Smith Phyllis Butow Ian Olver Tim Luckett Peter Grimison Guy C. Toner Martin R Stockler Elizabeth Hovey John Stubbs Sandra Turner George Hruby Howard Gurney Mahmood Alam Keith Cox Madeleine T. King 《Journal of cancer survivorship》2016,10(2):223-233
Purpose
This study aimed to establish the prevalence, severity, and correlates of psychological distress and impaired generic health-related quality of life (HRQOL) in testicular cancer (TC) survivors.Methods
Men who had completed active anti-cancer treatment for TC between 6 months and 5 years previously showing no evidence of recurrence were recruited from 14 Australian cancer centers from September 2009 to February 2011. Participants completed a self-report questionnaire measuring demographic, disease, and treatment information, psychological distress (i.e., depression, anxiety, and stress; DASS21), generic health-related quality of life (HRQOL; SF-36v2), TC-specific HRQOL (EORTC QLQ-TC26), coping (MAC), social support (DUFSS), and unmet needs (CaSUN).Results
Of 486 eligible TC survivors, 244 (50.2 %) completed the questionnaire. Compared with normative data, TC survivors reported: small but statistically significant increases in mean levels of anxiety and depression; a greater prevalence of moderate to extremely severe anxiety (19 %) and depression (20 %); and significant deficits to mostly mental aspects of generic HRQOL. The most problematic TC-specific HRQOL issues (e.g., fear of recurrence) were also more mental than physical. In multiple regression analyses, the strongest correlates of psychological distress and impaired generic HRQOL were psychosocial (e.g., helpless/hopeless coping and lower social support) rather than disease or treatment factors.Conclusions
Generally, TC survivors appear to experience mild psychological distress and HRQOL impairments, while a vulnerable subgroup experience more severe morbidity.Implications for Cancer Survivors
There is a need to identify TC survivors at risk of poorer outcomes and for interventions to target the areas of greatest impairment (i.e., psychological distress and mental HRQOL).8.
Deborah K. Mayer Gina Landucci Lola Awoyinka Amy K. Atwood Cindy L. Carmack Wendy Demark-Wahnefried Fiona McTavish David H. Gustafson 《Journal of cancer survivorship》2018,12(1):82-94
Purpose
This randomized controlled trial evaluated the impact of SurvivorCHESS, an eHealth intervention, on physical activity in colon cancer survivors and to explore the impact of SurvivorCHESS on quality of life and distress.Methods
This was a two-arm single-blinded multi-site randomized controlled trial comparing a control group to an intervention group receiving a smartphone with the SurvivorCHESS program.Results
Participants using SurvivorCHESS (n = 144) increased their moderate to vigorous physical activities from 19.4 min at baseline to 50 min compared to the control group (n = 140) increasing from 15.5 to 40.3 min at 6 months (p = .083) but was not sustained 3 months after the study ended. No significant differences were found between groups over time for quality of life or distress items. Reports of physical symptoms were greater than other categories for distress items. Patients who had a higher body mass index and number of comorbid conditions were less likely to increase their physical activity. Self-determination theory including autonomous motivation and relatedness was not associated with the outcomes.Conclusions
Physical activity did increase over time in both groups and was not significantly different with the use of the eHealth intervention, SurvivorCHESS, compared to the control group. The amount of SurvivorCHESS use was not associated with physical activity.Implications for cancer survivors
Increasing physical activity in colon cancer survivors has the potential to improve quality of life and reduce recurrences. Using smartphone-tracking devices may be useful in helping to change this health behavior.9.
Jennifer Allen Victoria W. Willard James L. Klosky Chenghong Li D. Kumar Srivastava Leslie L. Robison Melissa M. Hudson Sean Phipps 《Journal of cancer survivorship》2018,12(2):216-223
Purpose
The majority of research examining posttraumatic stress symptoms/disorder (PTSS/PTSD) among adult survivors of childhood cancer has been oriented to cancer, assuming that cancer has been the most traumatic experience in their lives. Whether that assumption is valid, and how it might impact assessment of PTSS, is unknown.Methods
Survivors in the St. Jude Lifetime Cohort study completed an assessment of PTSS without cancer orientation, global psychological functioning, perceived stress, and cancer-related anxiety.Results
Participants (n = 2969; Mage = 32.5 ± 8.5 years, 24.1 years since diagnosis, 49.1% female) obtained a mean score on the PTSD Checklist of 27.7, which is comparable to a normative population. Using established cutoffs, 11.8% obtained scores in the at-risk range. Multivariable modeling indicated that psychological factors [global distress (p < 0.0001), perceived stress (p = 0.001), cancer-related anxiety (p < 0.0001)] and demographic variables [female gender (p < 0.0001), survivors with less than a college education (p = 0.002)] were risk factors for increased PTSS. Only 14.5% identified a cancer-related traumatic event, and there was no difference in PTSS scores between those who identified cancer vs. non-cancer events as most stressful (28.4 ± 12.6 vs. 28.5 ± 12.7, p = 0.93).Conclusion
One in eight adult long-term survivors of childhood cancer had PTSS above the cutoff, though subgroups (e.g., females and those with lower education) report more distress symptoms. Most adult survivors do not identify cancer as their most stressful event.Implications for cancer survivors
Screening for distress in survivorship clinics should not assume that distress is directly related to the survivor’s cancer experience.10.
Anna L. Roberts Abigail Fisher Lee Smith Malgorzata Heinrich Henry W. W. Potts 《Journal of cancer survivorship》2017,11(6):704-719
Purpose
The number of cancer survivors has risen substantially due to improvements in early diagnosis and treatment. Health behaviours such as physical activity (PA) and diet can reduce recurrence and mortality, and alleviate negative consequences of cancer and treatments. Digital behaviour change interventions (DBCIs) have the potential to reach large numbers of cancer survivors.Methods
We conducted a systematic review and meta-analyses of relevant studies identified by a search of Medline, EMBASE, PubMed and CINAHL. Studies which assessed a DBCI with measures of PA, diet and/or sedentary behaviour were included.Results
Fifteen studies were identified. Random effects meta-analyses showed significant improvements in moderate-vigorous PA (seven studies; mean difference (MD) = 41 min per week; 95% CI 12, 71) and body mass index (BMI)/weight (standardised mean difference (SMD) = ?0.23; 95% CI ?0.41, ?0.05). There was a trend towards significance for reduced fatigue and no significant change in cancer-specific measures of quality of life (QoL). Narrative synthesis revealed mixed evidence for effects on diet, generic QoL measures and self-efficacy and no evidence of an effect on mental health. Two studies suggested improved sleep quality.Conclusions
DBCIs may improve PA and BMI among cancer survivors, and there is mixed evidence for diet. The number of included studies is small, and risk of bias and heterogeneity was high. Future research should address these limitations with large, high-quality RCTs, with objective measures of PA and sedentary time.Implications for cancer survivors
Digital technologies offer a promising approach to encourage health behaviour change among cancer survivors.11.
Lidewij D. Van Gessel Harriët J. G. Abrahams Hetty Prinsen Gijs Bleijenberg Marianne Heins Jos Twisk Hanneke W. M. Van Laarhoven Stans C. A. H. H. V. M. Verhagen Marieke F. M. Gielissen Hans Knoop 《Journal of cancer survivorship》2018,12(4):519-527
Purpose
Cognitive behavior therapy (CBT) reduces cancer-related fatigue (CRF) in cancer survivors in the short term. We examined fatigue levels up to 14 years after CBT.Methods
Eligible participants of two randomized controlled trials who had completed CBT for CRF and a post-treatment assessment were contacted (n?=?81). Fatigue was assessed with the subscale “fatigue severity” of the Checklist Individual Strength (CIS-fatigue). The course of fatigue over time was examined with linear mixed model analyses. Fatigue levels of participants were compared to matched population controls at long-term follow-up. We tested with multiple regression analysis if fatigue at follow-up was predicted by the patients’ fatigue level and fatigue-perpetuating factors directly after CBT (post-CBT).Results
Seventy-eight persons completed a follow-up assessment (response rate?=?96%, mean time after CBT?=?10 years). The mean level of fatigue increased from 23.7 (SD?=?11.1) at post-CBT to 34.4 (SD?=?12.4) at follow-up (p?<?0.001). Population controls (M?=?23,9, SD?=?11.4) reported lower fatigue levels than participants. Half of the patients (52%) who were recovered from severe fatigue at post-CBT (CIS-fatigue <?35) were still recovered at long-term follow-up. Patients with lower fatigue levels at post-CBT were less likely to show relapse.Conclusion
Despite initial improvement after CBT, levels of fatigue deteriorated over time. Half of the patients who were recovered from severe fatigue after CBT still scored within normal ranges of fatigue at long-term follow-up.Implications for Cancer Survivors
It should be explored how to help patients with a relapse of severe fatigue following an initially successful CBT. They may profit from CBT again, or another evidence-based intervention for fatigue (like mindfulness or exercise therapy). Future research to gain insight into reasons for relapse is warranted.12.
Gail D. Lewis Phillips Merry C. Nishimura Jennifer Arca Lacap Samir Kharbanda Elaine Mai Janet Tien Kimberly Malesky Simon P. Williams Jan Marik Heidi S. Phillips 《Breast cancer research and treatment》2017,162(3):581-589
Purpose
To examine whether baseline sleep duration or changes in sleep duration are associated with breast cancer prognosis among early-stage breast cancer survivors in the multi-center Women’s Healthy Eating and Living Study.Methods
Data were collected from 1995 to 2010. Analysis included 3047 women. Sleep duration was self-reported at baseline and follow-up intervals. Cox proportional hazard models were used to investigate whether baseline sleep duration was associated with breast cancer recurrence, breast cancer-specific mortality, and all-cause mortality. Time-varying models investigated whether changes in sleep duration were associated with breast cancer prognosis.Results
Compared to women who slept 7–8 h/night at baseline, sleeping ≥9 h/night was associated with a 48% increased risk of breast cancer recurrence (Hazard ratio [HR] 1.48, 95% Confidence interval [CI] 1.01, 2.00), a 52% increased risk of breast cancer-specific mortality (HR 1.52, 95% CI 1.09, 2.13), and a 43% greater risk of all-cause mortality (HR 1.43, 95% CI 1.07, 1.92). Time-varying models showed analogous increased risk in those who inconsistently slept ≥9 h/night (all P < 0.05), but not in those who consistently slept ≥9 h/night.Conclusions
Consistent long or short sleep, which may reflect inter-individual variability in the need for sleep, does not appear to influence prognosis among early-stage breast cancer survivors.13.
Po-Ju Lin Luke J. Peppone Michelle C. Janelsins Supriya G. Mohile Charles S. Kamen Ian R. Kleckner Chunkit Fung Matthew Asare Calvin L. Cole Eva Culakova Karen M. Mustian 《Current oncology reports》2018,20(1):5
Purpose of Review
To (1) explain what yoga is, (2) summarize published literature on the efficacy of yoga for managing cancer treatment-related toxicities, (3) provide clinical recommendations on the use of yoga for oncology professionals, and (4) suggest promising areas for future research.Recent Findings
Based on a total of 24 phase II and one phase III clinical trials, low-intensity forms of yoga, specifically gentle hatha and restorative, are feasible, safe, and effective for treating sleep disruption, cancer-related fatigue, cognitive impairment, psychosocial distress, and musculoskeletal symptoms in cancer patients receiving chemotherapy and radiation and cancer survivors.Summary
Clinicians should consider prescribing yoga for their patients suffering with these toxicities by referring them to qualified yoga professionals. More definitive phase III clinical trials are needed to confirm these findings and to investigate other types, doses, and delivery modes of yoga for treating cancer-related toxicities in patients and survivors.14.
Devesh Oberoi Victoria White John Seymour H. Miles Prince Simon Harrison Michael Jefford Ingrid Winship David Hill Damien Bolton Anne Kay Jeremy Millar Nicole Wong Doo Graham Giles 《Journal of cancer survivorship》2017,11(3):329-338
Purpose
The purpose of the study is to examine the course of anxiety, depression and unmet needs in diffuse large B cell lymphoma (DLBCL) and multiple myeloma (MM) survivors in the first 2 years post diagnosis.Methods
DLBCL and MM survivors, recruited through the Victorian Cancer Registry, completed two interviews approximately 7 and 15 months post diagnosis. Hospital Anxiety and Depression Scale (HADS) and Supportive Care Needs Survey (SCNS-SF34) were completed at both interviews. Primary outcomes were prevalence of anxiety, depression and unmet needs (any or moderate–high). Generalized estimating equation examined whether course of anxiety, depression and unmet needs differed between the two cancers.Results
Overall, 236 DLBCL and 178 MM survivors completed both telephone interviews. Course of anxiety differed (p < 0.01) with rate increasing in DLBCL (14 to 22%) while remaining stable for MM (15 to 12%). Course of depression also differed (p < 0.01), decreasing for MM (22 to 12%) and remaining stable for DLBCL (15 to 16%) survivors. Change in unmet needs was generally similar for the two cancer groups, except for moderate to high psychological needs (p < 0.05).Conclusions
Patterns of change in anxiety and depression in first 2 years post diagnosis differ for DLBCL and MM survivors.Implications for cancer survivors
Studying psychological outcomes in mixed haematological cancer samples may be inappropriate, at least in the early survivorship phase. Separate studies of the experiences of people with the different haematological cancer subtypes are needed to ensure psychosocial and supportive care interventions are appropriate to the needs of individuals with different haematological cancers.15.
Valentin H. Meissner Kathleen Herkommer Birgitt Marten-Mittag Jürgen E. Gschwend Andreas Dinkel 《Journal of cancer survivorship》2017,11(6):800-807
Purpose
Knowledge of the psychological distress of long- and very long-term (>10 years) prostate cancer (PC) survivors is limited. This study intended to examine the parameters influencing anxiety related to prostate-specific antigen (PSA) and PC in long-term survivors after radical prostatectomy.Methods
We surveyed 4719 PC survivors from the German multicenter prospective database “Familial Prostate Cancer.” We evaluated the association of PC-related anxiety (MAX-PC) with sociodemographic characteristics, family history of PC, global health status/quality of life (EORTC QLQ-C30), depression and anxiety (PHQ-2; GAD-2), latest PSA level, time since radical prostatectomy, and current therapy.Results
The survey participants’ mean age was 75.2 years (SD = 6.5). Median follow-up was 11.5 years, and 19.5% of participants had survived more than 15 years since the initial treatment. The final regression analysis found that younger age, lower global health status/quality of life, higher depression and anxiety scores, higher latest PSA level, and shorter time since radical prostatectomy predicted increased PSA-related anxiety and PC anxiety. Familial PC was predictive only of PSA anxiety (all p < 0.05). The final model explained 12% of the variance for PSA anxiety and 24% for PC anxiety.Conclusions
PC-related anxiety remained relevant many years after prostatectomy and was influenced by younger age, psychological status, rising PSA level, and shorter time since initial treatment.Implications for Cancer Survivors
Survivors with these characteristics are at increased risk of PC-related anxieties, which should be considered by the treating physician during follow-up.16.
M. D. J. Wolvers M. C. J. Leensen I. F. Groeneveld M. H. W. Frings-Dresen A. G. E. M. De Boer 《Journal of cancer survivorship》2018,12(2):169-177
Purpose
This study aims to investigate how perceived work ability, job self-efficacy, value of work, and fatigue predict return to work (RTW) in cancer patients who received chemotherapy.Methods
Data of a before-after study on a multidisciplinary intervention that aimed to enhance RTW was used, consisting of four assessments up to 18 months. Time to partial and full RTW of 76 and 81 participants, respectively, was analyzed in Cox proportional hazard analysis with time-dependent variables. Univariate analyses of work ability, job self-efficacy, value of work, or fatigue as covariates were succeeded by multivariate analyses of work ability and either job self-efficacy, value of work, or fatigue as covariates.Results
Participants were mostly female (93%), and diagnosed with breast cancer (87%). Most participants were permanently employed (84%) and 48% was sole breadwinner. When adjusted for timing variables and prognostic factors, all hypothesized factors were predictive for earlier RTW (p < .05). In models that also included work ability, only job self-efficacy significantly predicted earlier full RTW: hazard ratio = 1.681; p = .025.Conclusions
Lower fatigue and higher value of work, work ability, and job self-efficacy of cancer survivors are associated with earlier RTW. Work ability and job self-efficacy seem to be key predictors.Implications for cancer survivors
Limiting fatigue, increasing value of work, job self-efficacy, and perceived work ability are promising goals for enhancing earlier RTW. Occupational rehabilitation should empower patients to organize appropriate conditions for work and to educate them on rights and obligations during sick leave.17.
Mette Linnet Olesen Anne-Katrine Duun-Henriksen Helena Hansson Bent Ottesen Klaus Kaae Andersen Vibeke Zoffmann 《Journal of cancer survivorship》2016,10(5):832-841
Purpose
We investigated the effect of a person-centered intervention consisting of two to four nurse-led conversations using guided self-determination tailored to gynecologic cancer (GSD-GYN-C) on gynecological cancer survivors’ quality of life (QOL), impact of cancer, distress, anxiety, depression, self-esteem, and self-reported ability to monitor and respond to symptoms of recurrence.Methods
We randomly assigned 165 gynecological cancer survivors to usual care (UC) plus GSD-GYN-C or UC alone. Self-reported QOL-cancer survivor (QOL-CS) total score and subscale scores on physical, psychological, social, and spiritual well-being were assessed before randomization and at 3 and 9 months after randomization using t tests. Bonferroni and Pipper corrections were applied for multiple testing adjustments.Results
At 9 months, the GSD-GYN-C plus UC group scored significantly higher on the QOL-CS total scale (P?=?0.02) and on the QOL-CS physical well-being subscale (P?=?0.01), compared to women receiving UC alone. After adjusting for baseline scores, only the difference in the physical well-being subscale was statistically significant. No other measured outcomes differed between the intervention and control groups after baseline adjustment.Conclusion
We observed higher physical well-being 9 months after randomization in the GSD-GYN-C group, as compared to women receiving usual care.Implications for Cancer Survivors
The results suggest that the person-centered intervention GSD-GYN-C may improve physical well-being in gynecological cancer survivors. However, further testing is needed.18.
Terri L. Woodard Aubri S. Hoffman Laura A. Covarrubias Deborah Holman Leslie Schover Andrea Bradford Derek B. Hoffman Aakrati Mathur Jerah Thomas Robert J. Volk 《Journal of cancer survivorship》2018,12(1):101-114
Purpose
To improve survivors’ awareness and knowledge of fertility preservation counseling and treatment options, this study engaged survivors and providers to design, develop, and field-test Pathways: a fertility preservation patient decision aid website for young women with cancer©.Methods
Using an adapted user-centered design process, our stakeholder advisory group and research team designed and optimized the Pathways patient decision aid website through four iterative cycles of review and revision with clinicians (n = 21) and survivors (n = 14). Field-testing (n = 20 survivors) assessed post-decision aid scores on the Fertility Preservation Knowledge Scale, feasibility of assessing women’s decision-making values while using the website, and website usability/acceptability ratings.Results
Iterative stakeholder engagement optimized the Pathways decision aid website to meet survivors’ and providers’ needs, including providing patient-friendly information and novel features such as interactive value clarification exercises, testimonials that model shared decision making, financial/referral resources, and a printable personal summary. Survivors scored an average of 8.2 out of 13 (SD 1.6) on the Fertility Preservation Knowledge Scale. They rated genetic screening and having a biological child as strong factors in their decision-making, and 71% indicated a preference for egg freezing. Most women (> 85%) rated Pathways favorably, and all women (100%) said they would recommend it to other women.Conclusions
The Pathways decision aid is a usable and acceptable tool to help women learn about fertility preservation.Implications for Cancer Survivors
The Pathways decision aid may help women make well-informed values-based decisions and prevent future infertility-related distress.19.
Julie Berbis Céline Reggio Gérard Michel Pascal Chastagner Yves Bertrand Justyna Kanold Nicolas Sirvent Dominique Plantaz André Baruchel Marie-Dominique Tabone Floriane Garnier Marie-Pascale Lehucher-Michel Pascal Auquier 《Journal of cancer survivorship》2016,10(6):1058-1066
Purpose
Our principal aim was to assess the occupational outcomes of French survivors of childhood leukemia, compared to national population. The secondary objective was to identify determinants linked with employment stability after childhood leukemia.Methods
All survivors aged 15 and over enrolled in the French LEA Cohort (Childhood and Adolescent Leukemia) were included. Occupational data were self-reported. The occupational distributions expected in the cohort for each age range were established based on the distribution in France as reference, and comparisons between observed and expected distributions were performed. Logistic regression model was used to explore determinants of stability of survivors’ employment.Results
The questionnaire was completed by 845 eligible survivors (response rate 87.8 %), with a mean age of 22.3?±?5.4 years and a mean follow-up duration of 14.3?±?6.3 years. Among the 361 survivors currently in the labor market, 36 (10.0 %) were seeking a job, which is significantly lower than expected (19.3 %) compared to French population. Conversely, among those currently employed, the number of survivors in unstable employment (43.9 %) was significantly higher than expected (33.5 %). Younger age and higher number of late effects were risk factors for unstable employment.Conclusions
While the employment rate of the young French adult population of childhood leukemia survivors seems rather positive, access to a steady job appears to be compromised for some survivors.Implications for Cancer Survivors
A strategy to better identify particular subgroups of survivors at greatest risk for difficulties in their professional achievement will help ensure the development of specific intervention strategies and support procedures.20.