scholarly journals Fatigue in Advanced Cancer Patients: Congruence Between Patients and Their Informal Caregivers About Patients' Fatigue Severity During Cancer Treatment With Palliative Intent and Predictors of Agreement

2016 ◽  
Vol 52 (3) ◽  
pp. 336-344 ◽  
Author(s):  
Hanneke Poort ◽  
Marlies E.W.J. Peters ◽  
Marieke F.M. Gielissen ◽  
Constans A.H.H.V.M. Verhagen ◽  
Gijs Bleijenberg ◽  
...  
Author(s):  
Lynn A. Flint ◽  
Eric Widera

This randomized, crossover study examined advanced cancer patients’ perceptions of physician compassion when delivering a less optimistic versus more optimistic message. Patients with advanced cancer viewed two videos, each depicting actors portraying a physician and a patient discussing cancer treatment options. In one video, the physician delivers a less optimistic message and in the other, the physician delivers a more optimistic message. Participants rated their perceptions of physician compassion after viewing each video. They perceived the physician with the more optimistic message as more compassionate than the physician with the less optimistic message. The chapter describes the basics of the study, briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Tao Wang ◽  
Alex Molassiotis ◽  
Betty Pui Man Chung ◽  
Si-Lin Zheng ◽  
Hou-Qiang Huang ◽  
...  

Abstract Background Studies in the West have demonstrated that appropriate informational support is a vital component of cancer care, with positive effects on both patients and their informal caregivers. Since little is known about the information needs of advanced cancer patients and informal caregivers in China, where ‘silence as virtue’ is much more valued and the communication style is less open, this study was therefore conducted to elaborate the information needs of advanced cancer patients and informal caregivers as well as to explore their perceptions and experiences regarding their unmet information needs in the Chinese context. Methods This sub-study of a previous cross-sectional survey utilized a qualitative descriptive study design. The approach involved semi-structured interviews that followed an interview guide to collect data. Eligible participants were the advanced cancer patients and informal caregivers who had participated in the previous cross-sectional survey and reported unmet information needs. Each interview was audio-recorded and transcribed verbatim. Descriptive content analysis was used to analyze the data. Results Seventeen advanced cancer patients and 15 informal caregivers with unmet information needs participated in the semi-structured interviews, with ages ranging from 32 to 63 years old for patients and from 32 to 70 for informal caregivers. Four categories were extracted from the interviews with the patients and caregivers: (1) types of unmet information needs; (2) reasons for information needs not being met; (3) preferences for the provision of information; and (4) meaning and role of information. Each category had two to four sub-categories for both the patients and the caregivers, which were similar but not completely the same. Conclusion The findings indicated that the provision of appropriate information could promote informed decision-making and greater satisfaction with treatment options, reductions in psychological disturbances, and enhanced confidence and ability in self-management and capacity in caregiving. Moreover, information on Traditional Chinese Medicine and food therapy should be increased, particularly for patients at the follow-up stage, while the amount of information on prognosis should be flexible as it could increase patients’ and caregivers’ psychological burden. Healthcare professionals were the most preferred information provider, although their heavy workload resulted in time constraints. In this case, they should provide information to patients and caregivers together as a ‘whole unit.’ At the same time, the value of separate conversations should also be recognized as some caregivers preferred to conceal unpleasant information from the patient.


2011 ◽  
Vol 6 (2) ◽  
pp. 237-245 ◽  
Author(s):  
Kazue Komura ◽  
Mitsunori Miyashita ◽  
Yoshiyuki Kizawa ◽  
Shohei Kawagoe ◽  
Nobuya Akizuki ◽  
...  

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e17541-e17541
Author(s):  
Stephen John Clarke ◽  
Cindy Tan

e17541 Background: Nutritional status impacts on the outcomes of cancer treatment ( http://www.cancer.gov/cancertopics/pdq/supportivecare/nutrition/ HealthProfessional ). Nutrition is a concern of cancer patients. Many centres lack the resources to undertake formal nutritional assessments on cancer patients. Inflammatory markers have been shown to correlate with nutritional status and cancer treatment outcomes. The NLR is the ratio of the neutrophil and lymphocyte counts in a full blood count (FBC). Our aim was to determine if the NLR can be used to identify cancer patients needing nutritional assessment and intervention. Methods: A prospective observational study evaluated sequential new patients attending a cancer centre. All were assessed for nutritional status using the patient generated scored global assessment (PGSGA) tool and categorized as A (well nourished), or B/C (malnourished). A FBC was done in the week prior to treatment. Receiver operation characteristic (ROC) curves were used to determine optimal cut-points for NLR to predict malnutrition. Results: 234 patients were enrolled - 112 had advanced cancer. The median age was 60 years (range 25-83), 108 (46%) were male and 101 (43%) were malnourished at baseline. The mean NLR was higher in malnourished patients (4.1 vs 2.5 – p<0.001), however this was due to differences in advanced cancer patients. The optimal cut point for NLR in all patients to predict malnutrition was 5.0 (4.3 in advanced patients). In advanced patients, an NLR ≥4.3 had a sensitivity and specificity for malnutrition of 42.2% (95% CI 30.1-54.3) and 97.9% (95% CI 88.9-99.9), respectively, producing a positive predictive value of 0.96 (95% CI-0.82-1.00). Thus, NLR while strongly correlated with malnutrition is not sensitive enough alone to be used to identify malnourished cancer patients. However, as >98% of patients with a raised NLR had malnutrition, the NLR could be used to triage patients for nutritional assessment and thereby reduce the workload for clinical dieticians. Conclusions: The NLR is a useful indicator of nutritional status, which when elevated is specific for malnutrition. A low NLR should be reassuring in regard to nutritional status in advanced cancer patients.


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