Leaving footprints, not scars: a qualitative pilot study of Hispanic mothers’ willingness to communicate with dependent children about an advanced cancer diagnosis

Background: Prognostic disclosure to patients with advanced cancer facilitates treatment decisions and goals of care discussions. However, the perspectives of patients, families and physicians differ in this regard across different cultures. Non-disclosure of cancer diagnosis or prognosis is commonly observed in family-centric cultures such as India. Aim: To assess the prevalence of and factors associated with cancer patients’ awareness of advanced disease status; and its with quality of life and psychological distress. Methods: Patients for this cross-sectional questionnaire-based survey were recruited from oncology and palliative medicine clinics at a tertiary cancer hospital in India from January 2017 to June 2018. Patients aged ≥ 21 years, aware of cancer diagnosis and receiving oncology treatment for Stage IV solid cancer were included in the study after obtaining written informed consent. Results: Two hundred patients were enrolled, of which 146 (73%) were not aware of the stage of their malignancy and 9 (4.5%) believed that their disease was at stage I, II or III. Those who were aware of their advanced cancer stage had more years of education (9.9 years vs 8.1 years, p = .05) and had poorer spiritual wellbeing in the faith domain (adjusted difference −1.6, 95% confidence interval −3.1 to −0.1, p = .03) compared to those who were unaware. Conclusion: It is recommended that future studies may explore prognostic understanding in Indian patients according to their socio-cultural, spiritual and educational background.

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Pilot Study to Observe Changes in Independence in Everyday Life through Intensive Wheelchair Mobility Training in Wheelchair-Dependent Children

10.1055/s-0041-1739705 ◽

2021 ◽

Author(s):

Lieske van der Stam ◽

Fabienne Kühne ◽

Angela M. Kaindl

Keyword(s):

Pilot Study ◽

Everyday Life ◽

Dependent Children ◽

Mobility Training

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Shifting Palliative Care Paradigm in Primary Care From Better Death to Better End-of-Life : A Swiss Pilot Study

10.21203/rs.3.rs-153919/v1 ◽

2021 ◽

Author(s):

Johanna Sommer ◽

Christopher Chung ◽

Dagmar M. Haller ◽

Sophie Pautex

Keyword(s):

Quality Of Life ◽

Primary Care ◽

Palliative Care ◽

Pilot Study ◽

End Of Life ◽

Cancer Patients ◽

Advanced Cancer ◽

Communication Skills ◽

Advanced Cancer Patients

Abstract Background: Patients suffering from advanced cancer often loose contact with their primary care physician (PCP) during oncologic treatment and palliative care is introduced very late.The aim of this pilot study was to test the feasibility and procedures for a randomized trial of an intervention to teach PCPs a palliative care approach and communication skills to improve advanced cancer patients’ quality of life. Methods: Observational pilot study in 5 steps. 1) Recruitment of PCPs. 2) Intervention: training on palliative care competencies and communication skills addressing end-of-life issues.3) Recruitment of advanced cancer patients by PCPs. 4) Patients follow-up by PCPs, and assessment of their quality of life by a research assistant 5) Feedback from PCPs using a semi-structured focus group and three individual interviews with qualitative deductive theme analysis.Results: 8 PCPs were trained. PCPs failed to recruit patients for fear of imposing additional loads on their patients. PCPs changed their approach of advanced cancer patients. They became more conscious of their role and responsibility during oncologic treatments and felt empowered to take a more active role picking up patient’s cues and addressing advance directives. They developed interprofessional collaborations for advance care planning. Overall, they discovered the role to help patients to make decisions for a better end-of-life.Conclusions: PCPs failed to recruit advanced cancer patients, but reported a change in paradigm about palliative care. They moved from a focus on helping patients to die better, to a new role helping patients to define the conditions for a better end-of-life.Trial registration : The ethics committee of the canton of Geneva approved the study (2018-00077 Pilot Study) in accordance with the Declaration of Helsinki

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Methylphenidate for fatigue in advanced cancer: A prospective open-label pilot study

American Journal of Hospice and Palliative Medicine® ◽

10.1177/104990910101800310 ◽

2001 ◽

Vol 18 (3) ◽

pp. 187-192 ◽

Cited By ~ 91

Author(s):

Nabeel Sarhill ◽

Declan Walsh ◽

Kristine A. Nelson ◽

Jade Homsi ◽

Susan LeGrand ◽

...

Keyword(s):

Pilot Study ◽

Advanced Cancer ◽

Open Label

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Gene Expression Correlation for Cancer Diagnosis: A Pilot Study

BioMed Research International ◽

10.1155/2014/253804 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 8

Author(s):

Binbing Ling ◽

Lifeng Chen ◽

Qiang Liu ◽

Jian Yang

Keyword(s):

Pilot Study ◽

Cancer Progression ◽

Cancer Diagnosis ◽

Early Cancer ◽

Correlation Coefficients ◽

Gene Expressions ◽

Clinical Biomarkers ◽

Biomolecular Networks ◽

Early Cancer Diagnosis ◽

Novel Strategy

Poor prognosis for late-stage, high-grade, and recurrent cancers has been motivating cancer researchers to search for more efficient biomarkers to identify the onset of cancer. Recent advances in constructing and dynamically analyzing biomolecular networks for different types of cancer have provided a promising novel strategy to detect tumorigenesis and metastasis. The observation of different biomolecular networks associated with normal and cancerous states led us to hypothesize that correlations for gene expressions could serve as valid indicators of early cancer development. In this pilot study, we tested our hypothesis by examining whether the mRNA expressions of three randomly selected cancer-related genesPIK3C3,PIM3, andPTENwere correlated during cancer progression and the correlation coefficients could be used for cancer diagnosis. Strong correlations(0.68≤r≤1.0)were observed betweenPIK3C3andPIM3in breast cancer, betweenPIK3C3andPTENin breast and ovary cancers, and betweenPIM3andPTENin breast, kidney, liver, and thyroid cancers during disease progression, implicating that the correlations for cancer network gene expressions could serve as a supplement to current clinical biomarkers, such as cancer antigens, for early cancer diagnosis.

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