Differences in practice and preferences associated with truth-telling to cancer patients

2020 ◽  
pp. 096973302094575
Author(s):  
Jing Wu ◽  
Yan Wang ◽  
Xiaodong Jiao ◽  
Jingting Wang ◽  
Xuchun Ye ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Medical Staff ◽  
Family Members ◽  
Mainland China ◽  
Disease Diagnosis ◽  
Negative Effects ◽  
Truth Telling ◽  
Chi Square ◽  
Patients With Cancer ◽  
Significant Difference

Background: Doctors should disclose the diagnosis to patients according to the principle of autonomy. However, not disclosing the diagnosis and prognosis to cancer patients remains common in mainland China. Objective: The study explored the experiences and attitudes of patients with cancer, family members, and the medical staff in truth-telling. Research design: A quantitative survey with three closed-ended questionnaires was conducted. Participants: In all, 137 patients with cancer, 134 family members caring for cancer cases, and 54 medical staff were surveyed. Descriptive statistics were used to summarize all characteristics, and the chi-square test was performed to analyze group differences in attitudes toward cancer disclosure. Ethical considerations: This study was approved by the Committee on Ethics of Biomedicine Research, at the Second Military Medical University (HJEC-2018-YF-001). Informed consent was obtained from all participants prior to study commencement. Findings: A total of 59.8% of patients were informed about their diagnosis within 1 week, and 19.7% inferred theirs. The medical staff preferred to prioritize family members in informing about patient diagnosis while 77.4% of patients preferred to be told the whole truth at the time of initial diagnosis. More patients than family members and medical staff wanted the patients to be informed about the diagnosis ( p < 0.001). A significant difference was found between the patients and family members regarding who should tell the patients. Discussion: The willingness of patients in knowing the truth was underestimated by their family members as well as the medical staff. Guessing the truth indirectly may exert negative effects on the patients, and not telling the truth is inappropriate in patients who want to be informed. Conclusion: Disclosure of a cancer diagnosis is a complex process involving medical practice, as well as a range of cultural, ethical, and legal factors. The medical staff should first assess each patient’s willingness in truth-telling and inform about disease diagnosis with respect. Emotional support and comfort from family members are encouraged. Anyone in the patient’s care team, especially nurses, could be integrated in the process of truth-telling.

scholarly journals EFFECT OF RADIOTHERAPY ON RENAL FUNCTION IN CERVICAL CANCER PATIENTS TREATED AT A COMPREHENSIVE CANCER CENTRE IN NIGERIA

2021 ◽  
Vol 2 (1) ◽  
pp. 47-55
Author(s):  
S. A. Otene ◽  
M. A. Usman
Keyword(s):  
Cervical Cancer ◽  
Renal Function ◽  
Cancer Patients ◽  
Data Extraction ◽  
University Teaching ◽  
Negative Effects ◽  
Chi Square ◽  
Ex Post ◽  
Study Results ◽  
Significant Difference

Cervical cancer (CC) has been identified as a leading cause of cancer-related death of women in Nigeria. Unfortunately, treatment for CC induces renal function injury due to nephrotoxicity of commonly used cytotoxic medications and radiotherapy. The aim of this study was to determine whether radiotherapy consistently impairs the renal function of cervical cancer patients after treatment as claimed by literature. The study was an ex post facto research, for retrospective evaluation of documented information on 220 cervical cancer patients treated in the Department of Radiotherapy, Usman Danfodiyo University Teaching Hospital (UDUTH), Sokoto, Nigeria. The study covered a six-year period from January, 2010 to December, 2015. Data were obtained from the patients’ case notes using a semi-structured data extraction form. Independent t-test and chi-square statistics were used to obtain and interpret results from the analysis of the data. The study hypothesis one states that there would be both positive and negative effects of radiotherapy on the renal function of patients with cervical cancer. But no significant difference was found regarding the effect of radiotherapy on renal function of the patients with cervical cancer at χ2 (1, N=220) = .284, P = 288. Hypothesis two states that there was no statistically significant difference in the Glomerular Filtration Rate (GFR) of the patients, measured before and after treatment (t (219) = -0.66, P> 0.5). Extrapolating from the study results revealed that radiotherapy does not only cause renal function impairment, but also enhances renal function among patients with cervical cancer. The study however recommends that there should be a constant monitoring of the GFR for every patient with cervical cancer underdoing radiotherapy.

Truth-Telling to Terminal Stage Cancer Patients in India: A Study of the General Denial to Disclosure

2021 ◽  
pp. 003022282110327
Author(s):  
Souvik Mondal
Keyword(s):  
Cancer Patients ◽  
Urban Areas ◽  
Family Members ◽  
Public Hospitals ◽  
Truth Telling ◽  
Full Disclosure ◽  
Terminal Stage ◽  
Rural And Urban Areas ◽  
Rural And Urban ◽  
Private And Public

Telling the truth to the terminal-stage cancer patients differs socio-culturally based on the priorities assigned to patients’ autonomy and the principles of beneficence and non-maleficence. After conducting in-depth interviews with 108 terminal-stage adult cancer patients, 306 family members, and 25 physicians, in private and public hospitals in both rural and urban areas, in the state of West Bengal, India it has been found that even though 85.60% of the patients prefer full disclosure, only 22.03% are actually informed. Though demographic characteristics, like age, gender, education etc., have marginal influences over the pattern of truth-telling, the main factor behind non-disclosure is the family members’ preference for principles of beneficence and non-maleficence over patient autonomy. Hence, only 9.32% of those 118 patients’ family members have agreed to full disclosure. Physicians comply with this culture of non-disclosure as family, in India, is the centre of decision-making and acts as the primary unit of care.

scholarly journals Adverse reactions of targeted therapy in cancer patients: a retrospective study of hospital medical data in China

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ruofei Du ◽  
Xin Wang ◽  
Lixia Ma ◽  
Leon M. Larcher ◽  
Han Tang ◽  
...  
Keyword(s):  
Targeted Therapy ◽  
Cancer Patients ◽  
Adverse Reactions ◽  
Cox Regression ◽  
Target Therapy ◽  
Skin Damage ◽  
Data Set ◽  
Patients With Cancer ◽  
Number Of Patients ◽  
Significant Difference

Abstract Background The adverse reactions (ADRs) of targeted therapy were closely associated with treatment response, clinical outcome, quality of life (QoL) of patients with cancer. However, few studies presented the correlation between ADRs of targeted therapy and treatment effects among cancer patients. This study was to explore the characteristics of ADRs with targeted therapy and the prognosis of cancer patients based on the clinical data. Methods A retrospective secondary data analysis was conducted within an ADR data set including 2703 patients with targeted therapy from three Henan medical centers of China between January 2018 and December 2019. The significance was evaluated with chi-square test between groups with or without ADRs. Univariate and multivariate logistic regression with backward stepwise method were applied to assess the difference of pathological characteristics in patients with cancer. Using the univariate Cox regression method, the actuarial probability of overall survival was performed to compare the clinical outcomes between these two groups. Results A total of 485 patients were enrolled in this study. Of all patients, 61.0% (n = 296) occurred ADRs including skin damage, fatigue, mucosal damage, hypertension and gastrointestinal discomfort as the top 5 complications during the target therapy. And 62.1% of ADRs were mild to moderate, more than half of the ADRs occurred within one month, 68.6% ADRs lasted more than one month. Older patients (P = 0.022) and patients with lower education level (P = 0.036), more than 2 comorbidities (P = 0.021), longer medication time (P = 0.022), drug combination (P = 0.033) and intravenous administration (P = 0.019) were more likely to have ADRs. Those with ADRs were more likely to stop taking (P = 0.000), change (P = 0.000), adjust (P = 0.000), or not take the medicine on time (P = 0.000). The number of patients with recurrence (P = 0.000) and metastasis (P = 0.006) were statistically significant difference between ADRs and non-ADRs group. And the patients were significantly poor prognosis in ADRs groups compared with non-ADRs group. Conclusion The high incidence of ADRs would affect the treatment and prognosis of patients with cancer. We should pay more attention to these ADRs and develop effective management strategies.

scholarly journals The Effect of the Covid-19 Free Operation Path Protocol on the Incidence of Lung Complications in Postoperative Elective Patients at dr. Moewardi Hospital Surakarta

2021 ◽  
Vol 5 (11) ◽  
pp. 1030-1036
Author(s):  
Galih Aktama ◽  
Henky Agung Nugroho ◽  
Muhammad David Perdana Putra
Keyword(s):  
Cancer Patients ◽  
Elective Surgery ◽  
Pulmonary Complications ◽  
P Value ◽  
Chi Square ◽  
Elective Surgical Procedures ◽  
Significant Difference ◽  
Before And After ◽  
Chi Square Test ◽  
Elective Patients

The pandemic that began in late 2019, COVID-19, affects all patients, including cancer patients. Patients with cancer that continues to spread and  there is no other effective alternative treatment must undergo surgery so that cancer does not get worse. Given this problem, many health care centers have developed a protocol system in the form of a COVID-19-free surgical route. This study is a retrospective cohort study comparing the incidence of pulmonary complications in patients undergoing elective cancer surgery at dr. Moewardi Surakarta before and during the COVID-19 pandemic. The study sample was adult patients  aged ≥ 18 years which underwent elective surgical procedures with the aim of curative cancer starting before COVID-19 (March 2019-February 2020) until the time the COVID-19 pandemic emerged (March 2020 - February 2021). The data obtained were 768 patients. Of these patients, 384 were classified as having a COVID19-free operation route during the pandemic, and 384 others underwent elective surgery in the pre-pandemic period. Based on the Chi-Square test, a p-value of 0.850 was obtained (P>0.05) which shows that there is significant difference between cases of pulmonary complications in surgical patients before and after the pandemic who were carried out through the COVID-19-free protocol route. In conclusion, there is no significant change in effect of the covid-19 free operation path protocol on the incidence of lung complications in postoperative elective patients at dr. Moewardi Hospital Surakarta, although this patented and mandatory protocol can reduce cancer patients’ morbidity and mortality who undergoing elective surgery during a pandemic.

scholarly journals SPATIAL DISTRUBITON OF CHILDREN TREATED BY CANCER IN ZONGULDAK, TURKEY

2016 ◽  
Vol XLI-B8 ◽  
pp. 231-236
Author(s):  
Aysel Topan ◽  
Dilek Bayram ◽  
Mustafa Özendi ◽  
Ali Cam ◽  
Cam Öztürk ◽  
...  
Keyword(s):  
Disease Diagnosis ◽  
Study Data ◽  
Expert Advice ◽  
Chi Square ◽  
Epidemiological Aspect ◽  
Distribution Maps ◽  
Significant Difference ◽  
Chi Square Test ◽  
Collection Form ◽  
Nonhodgkin Lymphoma

This research is focused on the examination of child cancer cases in Zonguldak (Turkey) descriptively in epidemiological aspect thanks to GIS. Universe of the study is composed of 60 children between 0-19 years old, treated in Children Oncology Clinic of Health Application and Research Center in BEU. Whole universe was reached without selecting a sample in the study. Data were collected by using a form prepared by obtaining expert advice and they were applied to children and their parents at study dates. Results were expressed as percentages. Chi-Square test was used in intergroup comparisons, results were assessed within 95% confidence interval and p&lt;0.05 was considered as statistically significant. Variables that were used in the study were assessed, recorded in prepared data collection form and distribution maps were produced. When disease diagnosis of the children participated in the study were evaluated, it was observed that 33.3% (n=20) were being treated for ALL, 13.3% (n=8) for Medullablastoma and 11.7% (n=7) for Hodgkin-nonHodgkin Lymphoma. It was detected that 31.7% (n=19) were in Ereğli, 31.7% (n=19) were in Central district and 18.3% (n=11) were in Çaycuma, when the places where children were living were evaluated. Statistically significant difference was found (p=0.016) comparing disease diagnosis with living place, and overall distribution map of the number of cancer cases was produced in this context. This is the first research subjecting the distribution of cancer cases for Zonguldak province.

Stress Encountered by Significant others of Cancer Patients Receiving Chemotherapy

1987 ◽  
Vol 17 (2) ◽  
pp. 151-167 ◽  
Author(s):  
Kay Hart
Keyword(s):  
Cancer Patients ◽  
Family Members ◽  
Significant Others ◽  
Stressful Events ◽  
Previous Experience ◽  
Stressful Event ◽  
Exploratory Research ◽  
Structured Interviews ◽  
Coping Responses ◽  
Significant Difference

This study was directed toward identifying and describing the perceived stress and coping responses of family and nonfamily significant others of cancer patients receiving chemotherapy. Identification of the similarities and differences among the responses given by family and nonfamily significant others was one of the primary purposes of this research. Using an exploratory research design, the investigator conducted structured interviews with one family and one nonfamily significant other identified in earlier interviews with twenty-five cancer patients receiving chemotherapy in ambulatory care settings. Significant others were asked to identify stressful events related to treatment factors, relationship factors, and perception of the patient's condition. Reported coping responses to events perceived as stressful were categorized into those behaviors that reduced or eliminated the stressful event or those that altered the appraisal of the event without changing the event itself. Statistical analyses revealed 1) no significant difference between the level of stress was expressed by family and nonfamily significant others; 2) significantly higher levels of stress were reported by female family members when compared to male family members; 3) significant others who had previous experience coping with cancer of a loved one reported higher levels of stress than persons without previous experience; 4) nonfamily members reported significantly higher levels of stress when the cancer patient lived with family; and 5) no relationship was demonstrated between level of stress and time since diagnosis of cancer.

Care for Imminently Dying Cancer Patients: Family Members' Experiences and Recommendations

2010 ◽  
Vol 28 (1) ◽  
pp. 142-148 ◽  
Author(s):  
Takuya Shinjo ◽  
Tatsuya Morita ◽  
Kei Hirai ◽  
Mitsunori Miyashita ◽  
Kazuki Sato ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Emotional Distress ◽  
Medical Staff ◽  
Family Members ◽  
Nationwide Survey ◽  
Cross Sectional ◽  
Dying Patients ◽  
The Family ◽  
High Level ◽  
Bereaved Family

Purpose The aim of this study was to clarify the level of emotional distress experienced by bereaved family members and the perceived necessity for improvement in the care for imminently dying patients and to explore possible causes of distress and alleviating measures. Methods A cross-sectional nationwide survey was performed in 2007 of bereaved families of cancer patients at 95 palliative care units across Japan. Results Questionnaires were sent to 670 families, and 76% responded. Families reported their experiences as very distressing in 45% of cases. Regarding care, 1.2% of respondents believed that a lot of improvement was needed, compared with 58% who believed no improvement was needed. Determinants of high-level distress were a younger patient age, being a spouse, and overhearing conversations between the medical staff outside the room at the time of the patient's death; those reporting high-level necessity of improvement were less likely to have encountered attempts to ensure the patient's comfort, received less family coaching on how to care for the patient, and felt that insufficient time was allowed for the family to grieve after the patient's death. Conclusion A considerable number of families experienced severe emotional distress when their family member died. Thus, we propose that a desirable care concept for imminently dying cancer patients should include relief of patient suffering, family advisement on how to care for the patient, allowance of enough time for the family to grieve, and ensuring that family members cannot overhear medical staff conversations at the time of the patient's death.

scholarly journals INVESTIGATING THE EFFECT OF REFLEXOLOGY IN INTENSITY OF PAIN AND ANXIETY AMONG PATIENTS SUFFERING FROM METASTATIC CANCER IN ADULTS’ HEMATOLOGY WARD

2018 ◽  
Vol 11 (6) ◽  
pp. 401 ◽  
Author(s):  
Simin Jahani ◽  
Fatemeh Salari ◽  
Nasrin Elahi ◽  
Bahman Cheraghian
Keyword(s):  
Cancer Patients ◽  
Metastatic Cancer ◽  
Test Group ◽  
Control Group ◽  
Anxiety Management ◽  
Patients With Cancer ◽  
Significant Difference ◽  
Before And After ◽  
The Mean ◽  
And Control

Objective: Findings suggest dissatisfaction of half of the cancer patients regarding pain and anxiety management. This study aimed to determine the effect of reflexology on the intensity of pain and anxiety among patients with metastatic cancer hospitalized inadulthematology ward.  Methods: In this study, the samples were selected from adult hematology ward in Baghaei 2 hospital in Ahwaz, Iran, according to the inclusion criteria. They were then assigned into treatment and control groups. In the treatment group, reflexology protocol was performed following manual reflexology method by Fr Josef Eugster based on Ingham method on the patient’s bed. In the control group, sole touching was used as the placebo. Reflexology was performed for three days, 30 min per day. Spielberger questionnaire were provided to the samples and completed in the first and third days, and Spielberger questionnaire was provided to the samples and completed. The data obtained from this study were then analyzed by SPSS 20.Results: The two groups did not show a significant difference in terms of demographic characteristics (p>0.05). Based on the obtained results, it was found that in the test group, there was a significant difference between the mean intensity of pain before and after the treatment across all 3 days as well as the mean anxiety of the 1st and 3rd days (p<0.05). However, in the control group, there was no significant difference in terms of mean pain intensity before and after the treatment across 3 days (p>0.05). No significant difference was observed between the mean anxiety of the 1st and 3rd days either (p>0.05).Conclusion: Considering the findings of this research, it can be concluded that reflexology has a positive effect on mitigating the intensity of pain and anxiety in metastatic cancer patients. Therefore, it is recommended that nurses employed in cancer centers benefit from the findings of this research to further help patients with cancer. It is also suggested that further research be conducted on the effect of reflexology on the pain and anxiety of other patients.

A case-control study examining the role of recent chemotherapy in causing Clostridium difficile infection among cancer patients

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 19563-19563
Author(s):  
P. Thapaliya ◽  
A. Donato ◽  
K. Curl
Keyword(s):  
Cancer Patients ◽  
Case Control Study ◽  
Case Control ◽  
Hospitalized Patients ◽  
Retrospective Case ◽  
Chi Square ◽  
Patients With Cancer ◽  
Toxin Assay ◽  
Chemotherapy Agents ◽  
Control Study

19563 Background: Clostridium difficle infection is a major cause of morbidity and mortality in hospitalized patients. The recent use of cancer chemotherapy agents is a frequently cited risk factor but there is a paucity of evidence to this regard. Objective: To determine if an association exists between C. difficile infection requiring hospitalization and recent chemotherapy in patients with cancer. Design: A retrospective case control study. Setting: Community Teaching Hospital Participants: 357 cancer patients admitted with diarrhea or developed diarrhea during their hospital stay that were tested for C. difficile diarrhea via toxin assay over a 2 year period. Outcome Measurements: C. difficile infection using tests for toxin A and or B in stool. Results: Eighty-nine cases had stool positive for C. difficile toxin whereas 267 controls were negative. 30/89 (33%) cases and 90/268 (33%) controls were found to have chemotherapy in the six weeks before collection of stool for toxin assay (Odds Ratio (OR) 1.09, p=1.0 using Pearson Chi square). Factors associated with infection on logistic regression analysis included recent antibiotic usage (OR 1.99, 95% CI 1.01- 3.93),hospitalization in preceding 2 wks with OR 4.1 (95%CI 2.39–7.05) and institutionalization with OR 2.13 (95 % CI 1.03–4.39). Conclusions: C .difficile infection in cancer patients is more likely in recently institutionalized or hospitalized patients who have received recent antibiotics, but not patients with recent chemotherapy. No significant financial relationships to disclose.

Anticoagulation in cancer patients in hospice

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e20509-e20509
Author(s):  
H. M. Holmes ◽  
K. T. Bain ◽  
R. Luo ◽  
A. Zalpour ◽  
E. Bruera ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Patient Characteristics ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Length Of Service ◽  
Chi Square ◽  
Patients With Cancer ◽  
Hospice Patients ◽  
The Mean ◽  
The Impact

e20509 Background: Low-molecular weight heparin (LMWH) is preferred over warfarin in patients with thromboembolic disease and active cancer, but no guidelines exist in hospice. Although warfarin may be less safe in hospice patients, hospices may prefer to provide warfarin due to lower cost and less invasiveness compared to LMWHs. We sought to identify disparities in the use of warfarin vs. LMWHs in cancer patients enrolled in hospice. Methods: We analyzed a dataset from a national pharmacy provider for more than 800 hospices. We identified patients with a terminal diagnosis of cancer who were enrolled and died in hospice in 2006 and who were prescribed warfarin or LMWH. Patient characteristics included age, gender, race, cancer diagnosis, length of hospice service, and number of comorbidities. For descriptive comparisons, the Kruskal-Wallis test was used for continuous variables, and the Chi-square test was used for categorical variables. Results: Of 54,764 patients with cancer admitted and deceased in 2006, 3874 (7.1%) were prescribed warfarin, and 1137 (2.1%) were prescribed LMWH. Patients prescribed warfarin (n=576) or enoxaparin (n=5) for treatment of atrial arrhythmias were excluded. The mean age was 70.6 years for warfarin and 64.8 years for LMWH (p<0.0001). The mean and median lengths of service, respectively, were 43.6 days and 23.0 days for warfarin and 35.0 and 18.0 days for LMWH, (p<0.0001). There were no differences for gender, and a higher proportion of white patients were prescribed warfarin. Patients prescribed warfarin had an average of 2.1 comorbid conditions, versus 1.6 conditions for LMWH (p<0.0001). Cancer diagnoses were significantly different between the two groups, with a higher proportion of patients with lung and prostate cancer taking warfarin. Conclusions: Patients prescribed warfarin were older, had more comorbidities, and a longer length of service than patients prescribed LMWHs. Further research is needed to determine the impact of anticoagulation on outcomes, especially cost and quality of life, for cancer patients in hospice. This study raises the need to establish guidelines for the appropriateness of anticoagulation in hospice patients with cancer. No significant financial relationships to disclose.

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