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C. Calderon P. J. Ferrando A. Carmona-Bayonas U. Lorenzo-Seva C. Jara C. Beato T. García A. Ramchandani B. Castelo M. M. Muñoz S. Garcia O. Higuera M. Mangas-Izquierdo P. Jimenez-Fonseca 《Clinical & translational oncology》2017,19(11):1312-1319
Objective
The aim of this study was to analyze the psychometric properties of the Shared Decision-Making Questionnaire–Physician version (SDM-Q-Doc) in a sample of medical oncologists who provide adjuvant treatment to patients with non-metastatic resected cancer and the correlations between the total SDM-Q-Doc score and physician satisfaction with the information provided.Methods
Prospective, observational and multicenter study in which 32 medical oncologists and 520 patients were recruited. The psychometric properties, dimensionality, and factor structure of the SDM-Q-Doc were assessed.Results
Exploratory factor analyses suggested that the most likely solution was two-dimensional, with two correlated factors: one factor regarding information and another one about treatment. Confirmatory factor analysis based on cross-validation showed that the fitted two-dimensional solution provided the best fit to the data. Reliability analyses revealed good accuracy for the derived scores, both total and sub-scale, with estimates ranging from 0.81 to 0.89. The results revealed significant correlations between the total SDM-Q-Doc score and physician satisfaction with the information provided (p < 0.01); between information sub-scale scores (factor 1) and satisfaction (p < 0.01), and between treatment sub-scale scores (factor 2) and satisfaction (p < 0.01). Medical oncologists of older age and those with more years of experience showed more interest in the patient preferences (p = 0.026 and p = 0.020, respectively). Patient age negatively correlated with SDM information (p < 0.01) and physicians appear to provide more information to young patients.Conclusion
SDM-Q-Doc showed good psychometric properties and could be a helpful tool that examines physician’s perspective of SDM and as an indicator of quality and satisfaction in patients with cancer.3.
Impact of Obesity on Quality of Life,Psychological Distress,and Coping on Patients with Colon Cancer
David Gomez Paula Jimenez-Fonseca Aránzazu Manzano Fernández Patricia Cruz Castellanos Maria Valero Arbizu Ruth Martínez Cabañes David Lorente Estellés Estrella Ferreira Jorge del Rio Teresa García García Alberto Carmona-Bayonas Caterina Calderon 《The oncologist》2021,26(5):e874-e882
BackgroundDespite the causal relationship between obesity and colon cancer being firmly established, the effect of obesity on the course of cancer calls for further elucidation. The objective of this study was to assess differences in clinical‐pathological and psychosocial variables between obese and nonobese individuals with colon cancer.Materials and MethodsThis was a prospective, multicentric, observational study conducted from 2015–2018. The sample comprised patients with stage II–III, resected colon cancer about to initiate adjuvant chemotherapy with fluoropyrimidine in monotherapy or associated with oxaliplatin and grouped into nonobese (body mass index <30 kg/m2) or obese (≥30 kg/m2). Subjects completed questionnaires appraising quality of life (European Organization for Research and Treatment of Cancer Quality of Life Core questionnaire), coping (Mini‐Mental Adjustment to Cancer), psychological distress (Brief Symptom Inventory 18), perceived social support (Multidimensional Scale of Perceived Social Support), personality (Big Five Inventory 10), and pain (Brief Pain Inventory). Toxicity, chemotherapy compliance, 12‐month recurrence, and mortality rate data were recorded.ResultsSeventy‐nine of the 402 individuals recruited (19.7%) were obese. Obese subjects exhibited more comorbidities (≥2 comorbidities, 46.8% vs. 30.3%, p = .001) and expressed feeling slightly more postoperative pain (small size‐effect). There was more depression, greater helplessness, less perceived social support from friends, and greater extraversion among the obese versus nonobese subjects (all p < .04). The nonobese group treated with fluoropyrimidine and oxaliplatin suffered more grade 3–4 hematological toxicity (p = .035), whereas the obese had higher rates of treatment withdrawal (17.7% vs. 7.7%, p = .033) and more recurrences (10.1% vs. 3.7%, p = .025). No differences in sociodemographic, quality of life, or 12‐month survival variables were detected.ConclusionObesity appears to affect how people confront cancer, as well as their tolerance to oncological treatment and relapse.Implications for PracticeObesity is a causal factor and affects prognosis in colorectal cancer. Obese patients displayed more comorbidities, more pain after cancer surgery, worse coping, and more depression and perceived less social support than nonobese patients. Severe hematological toxicity was more frequent among nonobese patients, whereas rates of withdrawal from adjuvant chemotherapy were higher in the obese cohort, and during follow‐up, obese patients presented greater 12‐month recurrence rates. With the growing and maintained increase of obesity and the cancers associated with it, including colorectal cancer, the approach to these more fragile cases that have a worse prognosis must be adapted to improve outcomes. 相似文献
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Alvarez-Manceñido Felipe Jimenez-Fonseca Paula Carmona-Bayonas Alberto Arrazubi Virginia Hernandez Raquel Cano Juana M. Custodio Ana Pericay Pijaume Carles Aguado Gema Martínez Lago Nieves Sánchez Cánovas Manuel Cacho Lavin Diego Visa Laura Martinez-Torron Alba Arias-Martinez Aranzazu López Flora Limón M. Luisa Vidal Tocino Rosario Fernández Montes Ana Alsina Maria Pimentel Paola Reguera Pablo Martín Carnicero Alfonso Ramchandani Avinash Granja Mónica Azkarate Aitor Martín Richard Marta Serra Olbia Hernández Pérez Carolina Hurtado Alicia Gil-Negrete Aitziber Sauri Tamara Morales del Burgo Patricia Gallego Javier 《Gastric cancer》2021,24(4):926-936
Gastric Cancer - Advanced esophageal adenocarcinoma (EAC) is generally treated similarly to advanced gastroesophageal junction (GEJ-AC) and gastric (GAC) adenocarcinomas, although GAC clinical... 相似文献
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P. Jimenez-Fonseca A. Carmona-Bayonas C. Calderon J. Fontcuberta Boj C. Font R. Lecumberri M. Monreal A. J. Muñoz Martín R. Otero A. Rubio P. Ruiz-Artacho C. Suarez Fernández E. Colome P. Pérez Segura 《Clinical & translational oncology》2017,19(8):997-1009
Introduction
Decision-making in cancer-related venous thromboembolism (VTE) is often founded on scant lines of evidence and weak recommendations. The aim of this work is to evaluate the percentage of agreement surrounding a series of statements about complex, clinically relevant, and highly uncertain aspects to formulate explicit action guidelines.Materials and methods
Opinions were based on a structured questionnaire with appropriate scores and were agreed upon using a Delphi method. Questions were selected based on a list of recommendations with low evidence from the Spanish Society of Oncology Clinical Guideline for Thrombosis. The questionnaire was completed in two iterations by a multidisciplinary panel of experts in thrombosis.Results
Of the 123 statements analyzed, the panel concurred on 22 (17%) and another 81 (65%) were agreed on by qualified majority, including important aspects of long-term and prolonged anticoagulation, major bleeding and rethrombosis management, treatment in special situations, catheter-related thrombosis and thromboprophylaxis. Among them, the panelists agreed the incidental events should be equated to symptomatic ones, long-term and extended use of full-dose low-molecular weight heparin, and concluded that the Khorana score is not sensitive enough to uphold an effective thromboprophylaxis strategy.Conclusion
Though the level of consensus varied depending on the scenario presented, overall, the iterative process achieved broad agreement as to the general treatment principles of cancer-associated VTE. Clinical validation of these statements in genuine practice conditions would be useful.6.
Caterina Calderon Pere Joan Ferrando Urbano Lorenzo-Seva Oliver Higuera Teresa Ramon y Cajal Jacobo Rogado Margarida Mut-Lloret Alejandra Rodriguez-Capote Carlos Jara Paula Jimenez-Fonseca 《Journal of pain and symptom management》2019,57(4):828-834
Objectives
Decisional regret is an indicator of satisfaction with the treatment decision and can help to identify those patients who need more support and evaluate the efficacy of decision support interventions. The objectives of this study are, 1) to evaluate the psychometric properties of the Decision Regret Scale and 2) to analyze the moderating effect of psychological distress on functional status and regret in patients with cancer following adjuvancy.Methods
A prospective, multicenter cohort of 403 patients who completed the Decision Regret Scale (DRS), Health-Related Quality of Life (EORTC QLQ-C30), and Brief Symptom Inventory (BSI). The evaluation was conducted six months after receiving adjuvant treatment in patients with resected cancer.Results
After treatment, most participants (51.9%) experienced no decision regret; 33.7% felt mild regret, and 14.4% exhibited high levels of regret. The Spanish version of the DRS demonstrated satisfactory properties: it had a strong, clear unidimensional factorial structure with substantial loadings. Decisional regret was related with lower scores on functional, symptom, and quality of life scales, and higher levels of psychological distress (all P = 0.001). Psychological distress was found to have a moderating effect on the relationship between functional state and decision regret.Conclusions
The Spanish version of the DRS is a reliable, valid tool to evaluate regret and post-decisional quality in clinical practice and further highlights the potential clinical implications of psychological distress for the relation between physical status and regret. 相似文献7.
P. Jimenez-Fonseca C. Calderon A. Carmona-Bayonas M. M. Muñoz R. Hernández M. Mut Lloret I. Ghanem C. Beato D. Cacho Lavín A. Ivars Rubio R. Carrión C. Jara 《Clinical & translational oncology》2018,20(11):1392-1399
Purpose
The aim of this study was to analyze differences in physician and patient satisfaction in shared decision-making (SDM); patients’ emotional distress, and coping in subjects with resected, non-metastatic cancer.Methods
602 patients from 14 hospitals in Spain were surveyed. Information was collected regarding physician and patient satisfaction with SDM, participants’ emotional distress and coping, as well as patient sociodemographic and clinical characteristics by means of specific, validated questionnaires.Results
Overall, 11% of physicians and 19% of patients were dissatisfied with SDM; 22% of patients presented hopelessness or anxious preoccupation as coping strategies, and 56% presented emotional distress. By gender, female patients showed a higher prevalence of dissatisfaction with SDM (23 vs 14%), anxious preoccupation (26 vs 17%), and emotional distress (63 vs 44%) than males. Hopelessness was more prevalent in individuals with stage III disease than those with stages I–II (28 vs 18%).Conclusion
Physicians must be mindful of the importance of emotional support and individual characteristics when communicating treatment options, benefits, and adverse effects of each alternative to oncological patients.8.
M. M. Muñoz-Sánchez C. Calderon P. Jimenez-Fonseca M. C. Soriano-Rodríguez C. Jara T. García-García C. Beato J. Rogado B. Castelo R. Hernández M. Mangas-Izquierdo A. Carmona-Bayonas 《Clinical & translational oncology》2018,20(12):1604-1611
Purpose
Despite the burgeoning geriatric population with cancer and the importance of understanding how age may be related to mental adjustment and quality of life so far, differences in coping strategies and psychological harm between the elderly and adults are hardly being taken into account to modify the approach to this population. The aim of this prospective study is to describe the differences in psychological characteristics between older and adult cancer patients and examine dissimilarities in their psychological evolution during adjuvant chemotherapy.Methods
Adults (18–69 years old) and older patients (≥?70) with newly diagnosed non-metastatic resected cancer admitted to receive adjuvant chemotherapy were recruited. Patients completed the following questionnaires: mini-mental adjustment to cancer, brief symptom inventory, shared decision-making questionnaire–patient’s version, multidimensional scale of perceived social support, EORTC quality-of-life instrument, life orientation test-revised, and satisfaction with life scale.Results
500 cancer patients (394 adults and 106 older) were evaluated. The impact of the diagnosis was less negative among older patients, with no differences in coping strategies, quality of life, or search for support. Regarding psychological changes from the beginning to the end of the adjuvant treatment, both age groups reported more somatic symptoms, increased psychological difficulty, reduced coping strategies, and a significant decrease in quality of life at the end of postoperative chemotherapy.Conclusion
Although there were clear psychological differences between adults and senior cancer patients, their evolution during adjuvant chemotherapy was similar, with deterioration in quality of life and coping. This negative psychological impact of adjuvant chemotherapy should be taken into account when considering interventions.9.