Patient-caregiver concordance in symptom assessment and improvement in outcomes for patients undergoing cancer chemotherapy

2010 ◽  
Vol 6 (1) ◽  
pp. 46-56 ◽  
Author(s):  
Maria J. Silveira ◽  
Charles W. Given ◽  
Barbara Given ◽  
Ann Marie Rosland ◽  
John D. Piette
Keyword(s):  
Cancer Patients ◽  
Symptom Severity ◽  
Secondary Analysis ◽  
Symptom Burden ◽  
Symptom Assessment ◽  
Positive Effects ◽  
Cognitive Behavioural ◽  
Symptom Frequency ◽  
Over Time

Objective: To measure the agreement between cancer patients’ and family caregivers’ perceptions of the patients’ symptom severity, and the association between changes in caregiver accuracy and changes in outcomes. Methods: Secondary analysis of baseline and 10-week follow-up data from 142 cancer patient/caregiver dyads. Patient/caregiver agreement about symptom burden was measured for the 8 most prevalent symptoms and overall. Bivariate analyses examined the patient and caregiver characteristics associated with caregivers who were overestimators, underestimators or accurate at baseline. We tested the relationship between change in caregiver accuracy and both caregiver behaviour (e.g. use of information, hours spent caregiving) and patient outcomes (e.g. total symptom severity and frequency). Results: At baseline, caregivers overestimated the severity of 17 out of 18 symptoms; 50% predicted mean symptom severity accurately. Accuracy worsened over time for 51%, stayed the same for 36%, and improved for 13%. While not statistically significant, caregivers whose accuracy improved over time had patients who reported greater declines in: symptom severity, number of symptoms, symptom interference, total symptom frequency and depression. In addition, these caregivers experienced greater reductions in their use of information and hours helping the patient. Discussion: Caregivers typically over-estimate cancer patients’ symptom burden and accuracy does not improve over time. Improving caregiver accuracy may boost the positive effects of cognitive behavioural interventions designed to improve cancer patients’ quality of life.

scholarly journals Tobacco use in the Myeloproliferative neoplasms: symptom burden, patient opinions, and care

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sarah F. Christensen ◽  
Robyn M. Scherber ◽  
Gina L. Mazza ◽  
Amylou C. Dueck ◽  
Nana Brochmann ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Tobacco Use ◽  
Myeloproliferative Neoplasms ◽  
Myeloproliferative Neoplasm ◽  
Symptom Burden ◽  
Symptom Assessment ◽  
Cross Sectional ◽  
Former Smokers ◽  
Never Smokers

Abstract Background Patients with Philadelphia-negative Myeloproliferative Neoplasms (MPN) suffer from numerous symptoms and decreased quality of life. Smoking is associated with an increased symptom burden in several malignancies. The aim of this study was to analyze the association between smoking and MPN-related symptom burden and explore MPN patients’ opinions on smoking. Methods A total of 435 patients with MPN participated in a cross-sectional internet-based survey developed by the Mayo Clinic and the Myeloproliferative Neoplasm Quality of Life Group. Patients reported their demographics, disease characteristics, tobacco use, and opinions on tobacco use. In addition, MPN-related symptoms were reported via the validated 10-item version of the Myeloproliferative Neoplasms Symptom Assessment Form. Results Current/former smokers reported worse fatigue (mean severity 5.6 vs. 5.0, p = 0.02) and inactivity (mean severity 4.0 vs. 3.4, p = 0.03) than never smokers. Moreover, current/former smokers more frequently experienced early satiety (68.5% vs. 58.3%, p = 0.03), inactivity (79.9% vs. 71.1%, p = 0.04), and concentration difficulties (82.1% vs. 73.1%, p = 0.04). Although not significant, a higher total symptom burden was observed for current/former smokers (mean 30.4 vs. 27.0, p = 0.07). Accordingly, overall quality of life was significantly better among never smokers than current/former smokers (mean 3.5 vs. 3.9, p = 0.03). Only 43.2% of the current/former smokers reported having discussed tobacco use with their physician, and 17.5% did not believe smoking increased the risk of thrombosis. Conclusion The current study suggests that smoking may be associated with increased prevalence and severity of MPN symptoms and underscores the need to enhance patient education and address tobacco use in the care of MPN patients.

scholarly journals Patient-reported quality of care and pain severity in cancer

2014 ◽  
Vol 13 (4) ◽  
pp. 875-884 ◽  
Author(s):  
Kathryn A. Martinez ◽  
Claire F. Snyder ◽  
Jennifer L. Malin ◽  
Sydney M. Dy
Keyword(s):  
Quality Of Care ◽  
Cancer Patients ◽  
Nursing Care ◽  
Care Coordination ◽  
Symptom Burden ◽  
Care Quality ◽  
Pain Severity ◽  
Physician Communication ◽  
Patient Reported

AbstractObjective:Despite treatment availability, many cancer patients experience severe pain. Although patient assessments of care are increasingly employed to evaluate quality of care, little is known about its association with cancer symptom burden. The objective of our study was to examine the association between patient-reported quality of care and pain severity in a nationally representative cohort of cancer patients.Method:Quality of care was measured in three domains: physician communication, care coordination/responsiveness, and nursing care. Quality scores were dichotomized as optimal versus nonoptimal. Pain was measured on a scale of 0 (least) to 100 (worst). We utilized multivariable linear regression to examine the association between patient-reported quality of care and pain severity.Results:The analytic sample included 2,746 individuals. Fifty and 54% of patients, respectively, rated physician communication and care coordination/responsiveness as nonoptimal; 28% rated nursing care as nonoptimal. In adjusted models, rating physician communication as nonoptimal (versus optimal) was associated with a 1.8-point higher pain severity (p = 0.018), and rating care coordination/responsiveness as nonoptimal was associated with a 2.2-point higher pain severity (p = 0.006).Significance of results:Patient-reported quality of care was significantly associated with pain severity, although the differences were small. Interventions targeting physician communication and care coordination/responsiveness may result in improved pain control for some patients.

Value of caregiver ratings in evaluating the quality of life of patients with cancer.

1997 ◽  
Vol 15 (3) ◽  
pp. 1206-1217 ◽  
Author(s):  
K C Sneeuw ◽  
N K Aaronson ◽  
M A Sprangers ◽  
S B Detmar ◽  
L D Wever ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Informal Caregivers ◽  
Self Report ◽  
Sources Of Information ◽  
Individual Patient Level ◽  
Populations At Risk ◽  
Changes Over Time ◽  
Over Time

PURPOSE To evaluate the usefulness of caregiver ratings of cancer patients' quality of life (QL), we examined the following: (1) the comparability of responses to a brief standardized QL questionnaire provided by patients, physicians, and informal caregivers; and (2) the relative validity of these ratings. METHODS The study sample included cancer patients receiving chemotherapy, their treating physicians, and significant others involved closely in the (informal) care of the patients. During an early phase of treatment and 3 months later, patients and caregivers completed independently the COOP/WONCA charts, covering seven QL domains. At baseline, all sources of information were available for 295 of 320 participating patients (92%). Complete follow-up data were obtained for 189 patient-caregiver triads. RESULTS Comparison of mean scores on the COOP/WONCA charts revealed close agreement between patient and caregiver ratings. At the individual patient level, exact or global agreement was observed in the majority of cases (73% to 91%). Corrected for chance agreement, moderate intraclass correlations (ICC) were noted (0.32 to 0.72). Patient, physician, and informal caregiver COOP/WONCA scores were all responsive to changes over time in specific QL domains, but differed in their relative performance. Relative to the patients, the physicians were more efficient in detecting changes over time in physical fitness and overall health, but less so in relation to social function and pain. CONCLUSION For studies among patient populations at risk of deteriorating self-report capabilities, physicians and informal caregivers can be useful as alternative or complementary sources of information on cancer patients' QL.

scholarly journals Does smoking abstinence predict cancer patients' quality of life over time?

2019 ◽  
Vol 28 (8) ◽  
pp. 1702-1711 ◽  
Author(s):  
Úrsula Martínez ◽  
Karen O. Brandon ◽  
Steven K. Sutton ◽  
Thomas H. Brandon ◽  
Vani N. Simmons
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Smoking Abstinence ◽  
Over Time

Fatigue, quality of life, and cognitive functions in metastatic kidney cancer patients with antiangiogenic treatment.

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 328-328 ◽  
Author(s):  
S. Noal ◽  
M. Lange ◽  
B. J. Escudier ◽  
E. Sevin ◽  
S. Dauchy ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Working Memory ◽  
Episodic Memory ◽  
Executive Functions ◽  
Cancer Patients ◽  
Cognitive Functions ◽  
Well Being ◽  
Anxiety And Depression ◽  
Over Time

328 Background: Fatigue is commonly reported by patients under anti-angiogenic therapies, with sometimes cognitive complains. However, few studies have explored these problems. A longitudinal multicentric prospective study is ongoing in France on fatigue, cognitive functions, quality of life (QoL), anxiety and depression among metastatic kidney cancer patients receiving anti-angiogenic therapies. Objectives: The main objective is to assess fatigue. Secondary objectives are to assess cognitive functions, QoL, anxiety, and depression. Methods: Assessments are made at baseline, at 3 and 6 months. Evaluations were made by: autoquestionnaire MFI-20 to assess fatigue, FACT-G and FKSI to assess QoL, Spielberger's and Beck's questionnaires to assess respectively anxiety and depression. Cognitive functions were assessed by a neuropsychologist with the Working Memory Index (WAIS-III), Grober and Buschke test, Rey Complexe Figure test, verbal fluency and Trail Making test, exploring respectively working memory, episodic memory and executive functions. Preliminary results are presented. Results: 35 patients were enrolled, and 20 of them had the second assessment at 3 months. Most of patients received sunitinib (51%), others received bevacizumab and interferon, or sorafenib. At baseline, 45% of patients expressed general fatigue and 50% at 3 months (p=0.04). Other domains of fatigue (physical, mental, reduced activity and motivation) did not change over time. At baseline, few patients had cognitive disorders (working memory 6%; executive functions 0%; episodic memory 11%), with no decline at 3 months. However, there was an impairment of QoL in FKSI score (p=0.01) and of FACT-G physical well-being (p=0.01). No differences were found in social, emotional or functional well-being. There was no difference on depression nor on anxiety over time. Conclusions: Fatigue significantly increased during the first 3 months of anti-angiogenic treatment, with no impact on cognitive functions but a decline of QoL. These preliminary findings need to be confirmed by further follow-up and more patients. Final results will be provided with 120 patients. No significant financial relationships to disclose.

Implementation of the VA Symptom Assessment Scale (VSAS): Five-year experience.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e23120-e23120
Author(s):  
Daphne Ruth Friedman ◽  
Vikas Patil ◽  
Kelli Marie Rasmussen ◽  
Brian C Sauer ◽  
Michael J. Kelley ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Symptom Assessment ◽  
Assessment Scale ◽  
Veterans Health ◽  
Health Administration ◽  
Clinical Tool ◽  
Patient Reported ◽  
Symptom Assessment Scale

e23120 Background: Cancer patients experience symptoms which may precede diagnosis, occur during therapy, and persist into survivorship. Symptom assessments and patient reported outcomes have been shown to improve quality of life and extend survival in cancer patients. The Veterans Administration Symptom Assessment Scale (VSAS) is a clinical tool to document cancer-related symptoms. Here, we report VSAS adoption in five Veterans Health Administration (VHA) hematology-oncology sites during a five-year period. Methods: Data was collected from the Corporate Data Warehouse (CDW): VSAS data, date of birth, gender, race, ethnicity, vital status, year of cancer diagnosis, ICD-O-3, VHA facility, and clinic stop codes. Descriptive analyses of patient demographics, disease characteristics, and VSAS utilization was performed. VSAS is comprised of 13 symptoms, rated on a 0 to 10 scale. A VSAS visit was defined as the date the VSAS was administered to a patient. Results: From January 2013 through June 2018, there were 41,917 instances of VSAS administered to 9,409 unique patients at five VHA facilities: 8,512 (90.5%) were male; 5,241 (56%) were non-Hispanic White, 3,743 (40%) were Black, and 297 (3%) were other racial categories or not available. The median age at the first VSAS visit was 67 years. In patients whose oncologic diagnosis was recorded by a cancer registrar (4,536), the most common diagnoses were prostate cancer, lung cancer (all histologies), colon cancer, and multiple myeloma. The number of VSAS administrations increased annually, from 866 in 2013 to 12,775 in 2017, which may be attributed to increased adoption of VSAS across and within VHA facilities. Individual patients completed the VSAS 1-57 times (median 2). At the five VHA facilities utilizing VSAS in 2017, VSAS was administered at 56% of hematology-oncology clinic visits. Conclusions: VSAS is a tool to measure and document patient symptom burden, and has been successfully adopted in the last five years at select VHA facilities. Expanded use of VSAS throughout the VHA is an important step in improving the quality of life and extending survival of veterans with cancer and blood disorders.

P147 Quality of life (QOL) and symptom burden (SB) in breast cancer patients across the continuum

The Breast ◽  
2015 ◽  
Vol 24 ◽  
pp. S75-S76
Author(s):  
S. Verma ◽  
J. Hamer ◽  
C. Ecclestone ◽  
A. Leahey ◽  
L. Zhang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Cancer Patients ◽  
Symptom Burden ◽  
Breast Cancer Patients ◽  
The Continuum

scholarly journals Quality of Life Among Long-Term Survivors of Non-Hodgkin Lymphoma: A Follow-Up Study

2013 ◽  
Vol 31 (2) ◽  
pp. 272-279 ◽  
Author(s):  
Sophia K. Smith ◽  
Deborah K. Mayer ◽  
Sheryl Zimmerman ◽  
Christianna S. Williams ◽  
Habtamu Benecha ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Social Support ◽  
Hodgkin Lymphoma ◽  
Symptom Burden ◽  
Non Hodgkin Lymphoma ◽  
The Impact ◽  
Long Term Survivors ◽  
Over Time

Purpose Little is known about change in quality of life (QOL) among long-term cancer survivors. We examined change over time in QOL among long-term survivors of non-Hodgkin lymphoma and identified demographic, clinical, and psychosocial risk factors for poor outcomes. Methods Surveys were mailed to 682 lymphoma survivors who participated in a study 5 years earlier, when on average they were 10.4 years postdiagnosis. Standardized measures of QOL, perceptions of the impact of cancer, symptoms, medical history, and demographic variables were reported at both time points and examined using linear regression modeling to identify predictors of QOL over time. Results A total of 566 individuals participated (83% response rate) who were a mean of 15.3 years postdiagnosis; 52% were women, and 87% were white. One third of participants (32%) reported persistently high or improved QOL, yet a notable proportion (42%) reported persistently low or worsening QOL since the earlier survey. Participants who received only biologic systemic therapy reported improvement in physical health despite the passage of time. Older age, more comorbidity, and more or increasing negative and decreasing positive perceptions of cancer's impact were independent predictors of poor QOL. Lymphoma symptom burden, less social support, and having received a transplantation were related to negative perceptions of cancer's impact. Conclusion Moderate to severe symptom burden, limited social support, or having received a transplantation should alert the clinician to potential need for supportive services. Perceptions of cancer's impact are associated with QOL cross-sectionally and longitudinally; modifying these perceptions may thus provide a strategy for improving QOL.

scholarly journals The Effectiveness of a Men-only Supportive Expressive Therapy Group Intervention for Psychosocial Health Outcomes in Gastrointestinal Cancer Patients: A 6-month longitudinal study

2021 ◽  
Author(s):  
Devesh Oberoi ◽  
Celestina Martopullo ◽  
Barry D. Bultz ◽  
Linda Ellen Carlson
Keyword(s):  
Quality Of Life ◽  
Health Outcomes ◽  
Cancer Treatment ◽  
Cancer Patients ◽  
Gastrointestinal Cancer ◽  
Psychosocial Health ◽  
Mood States ◽  
Gi Cancer ◽  
Over Time

Abstract Background: An increasing number of gastrointestinal cancer (GI) patients suffer from the side effects of cancer treatment that can affect their psychosocial health outcomes such as mood states and quality of life. Despite its demonstrated usefulness in female cancer patients, the Supportive Expressive Group Therapy (SEGT) has not been tested in male cancer patients. The current study sought to examine the longitudinal effects of a professionally-led, men-only supportive-expressive group therapy (SEGT) on mood states, coping, and quality of life (QoL) in male GI cancer patients. Methods: Male GI cancer patients (n=31), at different stages of cancer treatment, were recruited from an ongoing men-only biweekly GI cancer SEGT. Data were collected at baseline (before or near the beginning of group attendance) and at three months and six months follow-up. All outcomes were patient-reported and included demographic data as well as the validated questionnaires: Profile of Mood States (POMS) for mood states, Functional Assessment of Cancer Therapy-General (FACT-G) for QoL, and Ways of Coping-cancer version (WOC) for coping. Linear mixed models were used to examine the change in the outcomes over time. Effect sizes were estimated using Cohen’s d. Results: The Anxiety (p=.04; d=0.70), Depression (p=.03; d=0.93) and Anger (p=.04; d=1.28) subscales of the POMS decreased between baseline and six months. Participants also reported improvements in coping through Distancing (distancing oneself from negative thoughts, being more accepting of the situation, and looking for positives) of the WOC (p=.04; d=0.4) between baseline and six months. There was no change in any of the FACT subscales (QoL) over time. Conclusions: This is the first study to investigate the effects of a SEGT intervention in male cancer patients. Participation in the intervention was associated with improved mood states and coping in male GI cancer patients; however, there was no change in measures of QoL.

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