Activism among exceptional patients with cancer

Background  

The “exceptional patients” with cancer are survivors who had advanced cancer considered incurable by medical report and who subsequently became disease-free or experienced unexplained survival time given the nature of their disease or treatment. This experience is a puzzling phenomenon that has not been formally investigated in a cancer population. The purpose of this study was to understand exceptional patients’ accounts of their experience.     

Causal attributions to epidemiological risk factors and their associations to later psychological adjustment among Japanese breast cancer patients

Goals  The objective of this study was to evaluate the causal attributions for breast cancer and their association with the subsequent psychological adjustment. Materials and methods  Sixty-three Japanese patients newly diagnosed with breast cancer were asked by an interviewer about risk factors and explanations for the etiology of breast cancer using a four-point scale. The General Health Questionnaire (GHQ-28) and the Center for Epidemiologic Studies Depression Scale (CES-D) were administered about 2 months later to measure psychological adjustment to the illness. The relationship between each causal attribution and measure of psychological adjustment was assessed with the Spearman rank correlation after adjusting for potential confounders (age, marital status, cancer stage at diagnosis, time between the day of diagnosis and follow-up, and physical symptoms at the follow-up). Main results  Attributions to several explanations, including “stress” and “personal characteristics,” were positively associated with the GHQ-28 measures. Of the attributions to risk factors, “body size” was significantly inversely (r = −0.29) associated and “never having children” was insignificantly and highly inversely (r = −0.77) associated with the GHQ-28 measures, indicating better adjustment to the illness. On the other hand, the attribution to “tobacco” was significantly and positively associated with the GHQ-28 measures (r = 0.34), indicating that the attributions antagonized adjustment to the illness. Conclusion  The current study indicates that forming causal attributions influences the adjustment to the illness in Japanese breast cancer patients and attributions to certain risk factors for breast cancer may contribute to better adjustment.     

Psychometric properties of cancer survivors’ unmet needs survey

Purpose  

This study aims to develop a psychometrically rigorous instrument to measure the unmet needs of adult cancer survivors who are 1 to 5 years post-cancer diagnosis. “Unmet needs” distinguishes between problems which survivors experience and problems which they desire help in managing.     

Benefits of nifedipine GITS in stable coronary artery disease: Further analysis of the “ACTION” database

Introduction  

Retrospective analyses of specific subgroups of patients from the database of the ACTION study have evaluated the effectiveness of a nifedipine gastrointestinal therapeutic system (GITS) on clinical outcomes. These subgroups included those patients receiving: 1) full “optimal” therapy at baseline; 2) full “optimal” therapy at baseline but excluding renin angiotensin system (RAS)-blocking drugs; 3) treatment with nifedipine GITS who were not treated with RAS blockers versus those treated with RAS blockers but not nifedipine GITS.     

Life review interviews on the spiritual well-being of terminally ill cancer patients

Goals  The aims of this study were (1) to evaluate the treatment efficacy of life review interviews on the spiritual well-being of terminally ill cancer patients, and (2) to explore any differences in the responses of patients who obtained clinical benefits and those who did not. Materials and methods  Structured life review interviews were conducted with 12 patients in a palliative care unit in Japan. They completed the SELT-M (Skalen zur Erfassung von Lebens qualitat bei Tumorkranken–Modified Version) questionnaire before and after the interviews. The patients were classified into two groups: effective (patients who showed an increase in the SELT-M scores after the intervention) and noneffective groups. Meaningful spoken sentences from the patients’ life reviews were transcribed and correspondence analysis was conducted on the sentences using text mining software. Results  The mean overall QOL score and spirituality subscale score of the SELT-M significantly increased after the life reviews from 2.57±0.61 to 3.58±1.0 (P=0.013) and 2.57±0.61 to 3.14±2.25 (P=0.023), respectively. Three dimensions were extracted from the effective group based on the scores “Positive view of life,” “Pleasure in daily activities and good human relationships,” and “Balanced evaluation of life.” Similarly, three dimensions were extracted from the noneffective group: “Worries about future caused by disease,” “Conflicts in family relationship problems,” and “Confrontation of practical problems.” Conclusion  Life review interviews may be effective in improving the spiritual well-being of terminally ill cancer patients. The potential predictors of treatment success are “positive view of life,” “pleasure in daily activities and good human relationships,” and a “balanced evaluation of life,” while those of treatment failure are “worries about future caused by disease,” “conflicts in family relationships,” and “confrontation of practical problems.” Further intervention trials on patients with predictors of treatment success are promising.     

Longitudinal changes in sexual problems related to cancer treatment in Korean breast cancer survivors: a prospective cohort study

Purpose  

The aims of the study were to investigate longitudinal changes in multiple domains of problems with sexual functioning in Korean breast cancer survivors in the first year after surgery for breast cancer and to determine which factor(s), including upper limb dysfunction, may influence sexual problems.     

Understanding the cultural health belief model influencing health behaviors and health-related quality of life between Latina and Asian-American breast cancer survivors

Purpose  The purpose of this study was to (1) describe health behaviors and health-related quality of life (HRQOL) of Latina and Asian-American breast cancer survivors (BCS), (2) estimate possible culturally driven predictors of health behaviors and HRQOL, and (3) compare pathways for predicting health behaviors and HRQOL between the two groups. Materials and methods  Secondary data were used to investigate health behaviors and HRQOL among 183 Latina and 206 Asian Americans diagnosed with breast cancer. The study methodology was guided by the health belief model and the contextual model of HRQOL. Structural equation modeling was used to test cultural predictors on health behaviors of BCS. Results  Asian Americans reported higher emotional and physical well-being scores than Latina-Americans. Confirmatory factor analyses demonstrated the adequacy of the two-factor model (“powerful others” and “sociocultural factors”) in the cultural health belief construct for Latina and Asian-American BCS. In the structural model, Latinas and Asian Americans showed different pathways in the predicted relationships among the variables. For Latina-Americans, doctor–patient relationship was positively related to exercise, and in turn, influenced physical and emotional well-being. For Asian Americans, treatment decisions and the “sociocultural factor” were significantly related to stress management. Conclusion  This study adds to the existing literature in that no study has focused on cultural health beliefs and health behaviors between Latina and Asian-American BCS. Evidence that Latinas and Asian Americans varied in the patterns of cultural factors influencing health behaviors and HRQOL might lead to the development of culturally sensitive breast cancer interventions for promoting positive health behavior and ultimately increasing HRQOL.     

Sexual dysfunction in young women with breast cancer

Objectives

The objective of this study was to determine the prevalence of sexual dysfunction in young women with breast cancer in the Netherlands, and to assess the relationship between sexual dysfunction, treatment methods and treatment-related complaints. Also, the interest among women with breast cancer in receiving care for sexual dysfunction was determined.

Methods

Data on sexual functioning were collected through an internet questionnaire. Respondents were included if they had been diagnosed with breast cancer within the past 6?years and were currently 45?years of age or younger. Results were compared with a representative sample of the general Dutch population

Results

Of the women who were still undergoing treatment, 64?% had a sexual dysfunction. In women who had completed treatment, this was 45?%. All assessed dysfunctions were more common among these young women with breast cancer in comparison with women in the Dutch population. Particularly, early menopause and hormone therapy caused long-term occurence of genital arousal disorder. Radical mastectomy caused long-term occurrence of female orgasmic disorder, and early menopause dyspareunia. Half of the women reported that the topic ??changes in sexual functioning?? had been brought up during treatment, mostly on the initiative of the health professional. Six out of 10 women with a sexual dysfunction who felt a need for care did not consult a health professional.

Conclusion

Sexual dysfunctions are highly prevalent among young women with breast cancer. This appears to improve after treatment has been completed, but women are far from recovered. The initiative to discuss sexuality should lie with the health professional. Including sexuality within treatment guidelines will prevent women with breast cancer from being deprived of care.     

Yoga of Awareness program for menopausal symptoms in breast cancer survivors: results from a randomized trial

Goal of work  

Breast cancer survivors have limited options for the treatment of hot flashes and related symptoms. Further, therapies widely used to prevent recurrence in survivors, such as tamoxifen, tend to induce or exacerbate menopausal symptoms. The aim of this preliminary, randomized controlled trial was to evaluate the effects of a yoga intervention on menopausal symptoms in a sample of survivors of early-stage breast cancer (stages IA–IIB).     

Needs of women with breast cancer as communicated to physicians on the Internet

Purpose  

With improved access to health information via the Internet, an increasing number of women with breast cancer are using this venue to obtain information about their illness and treatment from physicians. This study aims to identify the needs of women with breast cancer who communicate with physicians on the Internet.     

Resident preparedness in discussing prognosis in patients with advanced lung cancer

Goals  

Teaching delivery of bad news is part of the standard medical school curriculum. Lung cancer is a common disease with poor outcomes; therefore, “poor prognosis” discussions occur frequently. Trainee preparedness to conduct these has not been studied well to date. We surveyed residents treating lung cancer in Ontario, assessing preparedness to discuss a poor prognosis.     

Needs assessment for next generation computer-aided mammography reference image databases and evaluation studies

Introduction  

Breast cancer is globally a major threat for women’s health. Screening and adequate follow-up can significantly reduce the mortality from breast cancer. Human second reading of screening mammograms can increase breast cancer detection rates, whereas this has not been proven for current computer-aided detection systems as “second reader”. Critical factors include the detection accuracy of the systems and the screening experience and training of the radiologist with the system. When assessing the performance of systems and system components, the choice of evaluation methods is particularly critical. Core assets herein are reference image databases and statistical methods.     

压力衣治疗对乳腺癌术后上肢淋巴水肿的影响

目的:观察压力衣佩戴治疗对乳腺癌术后并发上肢淋巴水肿患者的长期疗效和对上肢功能的影响。方法:60例乳腺癌术后并发上肢淋巴水肿的患者随机分为2组各30例。观察组患者穿戴治疗师为其量身订制的压力衣进行治疗,每天佩戴时间不少于23h,同时在治疗师或护士指导下在家中进行上肢的向心性按摩及功能锻练;对照组患者只在治疗师或护士指导下在家中进行上肢的向心性按摩及功能锻练。分别在治疗前和治疗6个月后采用上肢淋巴水肿程度分级和上肢功能指数(UEFI)评分进行评估。结果:治疗6个月后,观察组水肿程度较治疗前及对照组均有下降(P0.01,0.05),对照组治疗前后差异无统计学意义。治疗后,2组UEFI评分均较治疗前明显提高(P0.01),且观察组优于对照组(P0.01)。结论:长期佩戴压力衣可明显减轻乳腺癌术后上肢淋巴水肿程度,并更有利于上肢功能的恢复。     

Problems in transition and quality of care: perspectives of breast cancer survivors

Purpose  

We conducted a qualitative study to explore breast cancer survivors’ perceptions and attitudes about their current healthcare utilization, screening, and information needs.     

Role of the general practitioner during the active breast cancer treatment phase: an analysis of health care use

Purpose  

Little is known about the actual involvement of the general practitioner (GP) during the active breast cancer treatment phase. Therefore, this study explored (disease-specific) primary health care use among women undergoing active treatment for breast cancer compared with women without breast cancer.     

Evaluation of “Loss” and “End stage renal disease” after acute kidney injury defined by the Risk,Injury, Failure,Loss and ESRD classification in critically ill patients

Purpose  

The Risk, Injury, Failure, Loss and ESRD (RIFLE) classification has been widely accepted for the definition of acute kidney injury (AKI); however, no study has described in detail the last two stages of the classification: “Loss” and “ESRD”. We aim to describe and evaluate the development of “Loss” and “ESRD” in a group of critically ill patients.     

Unexpected changes in clinical diagnosis: early abdomino-pelvic computed tomography compared with clinical evaluation

Background  

To evaluate the value of early computed tomography (CT) on identifying clinically “unexpected” diagnosis in patients presenting with “non specific” acute abdominal pain.     

Ischemic compression and kinesiotherapy on chronic myofascial pain in breast cancer survivors

Objective

assess the effects of ischemic compression and kinesiotherapy on the rehabilitation of breast cancer survivors with chronic myofascial pain.

Predictors of adherence to a behavioral therapy sleep intervention during breast cancer chemotherapy

Background  

This study’s purpose was twofold: (1) to establish adherence rates to a behavioral therapy (BT) sleep intervention and (2) to identify psychological and physical symptom predictors of adherence to the intervention in women undergoing breast cancer chemotherapy.     

Music��s relevance for pediatric cancer patients: a constructivist and mosaic research approach

Purpose  

Music is important in most children’s lives. To advance efficacious pediatric supportive care, it is necessary to understand young cancer patients’ thoughts about music. Concern about inviting unwell children to express opinions has resulted in scant research examining their views. “Mosaic” research examines children’s experiences through investigating multiple perspectives which inform a “co-constructed meaning.” This study examines pediatric cancer patients’ and their parents’ perspectives about music and music therapy’s role in the children’s lives.