Impact of measuring quality of life in oncology practice: A prospective study.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21663-e21663
Author(s):  
Cecilia Castillo ◽  
Ana Laura Alfonzo ◽  
Natalia Camejo ◽  
Andrea Schiavone ◽  
Mariana Diaz ◽  
...  

e21663 Background: To assess the impact of incorporating systematic quality of life measurements in oncology practice on the quality of care and well-being of patients; to assess physician's level of satisfaction with this instrument and detectable changes in clinical practice Methods: In a prospective study, 67 patients (pts) diagnosed with cancer, undergoing cancer-specific treatments, were randomized into a intervention and control group. In the intervention group , pts had regular completion of touch-screen health-related quality of life (HRQL) questionnaires (European Organization for Research and Treatment of Cancer–Core Quality of Life Questionnaire version 3.0, and Hospital Anxiety and Depression Scale) and feedback of results to physician and then were followed up with a phone call where HRQL was measured by the Functional Assessment of Cancer Therapy–General questionnaire (FACT-G). In the control group, pts were regular followed with a phone call to answer FACT-G questionnaire. Physicians completed a visit-specific questionnaire after each visit of pts from intervention group. Results: 58 pts were included, 36 in the intervention group and 22 in the control group. Median age was 59 years. The results of the patient-reported data were found to be very useful to quite useful by 87.5% of physicians (14/16), and 56.3% of them considered that there was no difference in the length of visits. Completing the HRQL questionnaires on a touch screen was easy to very easy for 97.1% of patients, and 97.1% found that important questions were asked and that they would be willing to complete the questionnaires. FACT-G scores and subscale scores were higher in the intervention group, but differences were not statistically significant (76.44 v 72.60; p 0.388). Conclusions: HRQL assessments had a positive impact on physician-patient communication. It made it possible to learn how cancer and its treatments affected pts not only physically, but also on functional and psychological states and social relationships. They helped us improve therapeutic interventions and specialist referrals, thus achieving positive changes in the well-being and satisfaction of pts.

2004 ◽  
Vol 22 (4) ◽  
pp. 714-724 ◽  
Author(s):  
Galina Velikova ◽  
Laura Booth ◽  
Adam B. Smith ◽  
Paul M. Brown ◽  
Pamela Lynch ◽  
...  

Purpose To examine the effects on process of care and patient well-being, of the regular collection and use of health-related quality-of-life (HRQL) data in oncology practice. Patients and Methods In a prospective study with repeated measures involving 28 oncologists, 286 cancer patients were randomly assigned to either the intervention group (regular completion of European Organization for Research and Treatment of Cancer-Core Quality of Life Questionnaire version 3.0, and Hospital Anxiety and Depression Scale on touch-screen computers in clinic and feedback of results to physicians); attention-control group (completion of questionnaires, but no feedback); or control group (no HRQL measurement in clinic before encounters). Primary outcomes were patient HRQL over time, measured by the Functional Assessment of Cancer Therapy-General questionnaire, physician-patient communication, and clinical management, measured by content analysis of tape-recorded encounters. Analysis employed mixed-effects modeling and multiple regression. Results Patients in the intervention and attention-control groups had better HRQL than the control group (P = .006 and P = .01, respectively), but the intervention and attention-control groups were not significantly different (P = .80). A positive effect on emotional well-being was associated with feedback of data (P = .008), but not with instrument completion (P = .12). A larger proportion of intervention patients showed clinically meaningful improvement in HRQL. More frequent discussion of chronic nonspecific symptoms (P = .03) was found in the intervention group, without prolonging encounters. There was no detectable effect on patient management (P = .60). In the intervention patients, HRQL improvement was associated with explicit use of HRQL data (P = .016), discussion of pain, and role function (P = .046). Conclusion Routine assessment of cancer patients' HRQL had an impact on physician-patient communication and resulted in benefits for some patients, who had better HRQL and emotional functioning.


Author(s):  
Romina Nemecek ◽  
Patrick Huber ◽  
Sophie Schur ◽  
Eva Masel ◽  
Stefanie Porkert ◽  
...  

Patients with advanced cancer have a substantial symptom burden, which deteriorates their quality of life. Palliative care improves well-being of patients and their family caregivers. Within the scope of a controlled pilot study, a user-friendly telepresence system is developed, which enables patients and family caregivers to send a direct request to a palliative care team. Additionally, a specially tailored database is developed, which contains up to date patient information. Twenty patients with advanced non-small cell lung cancer are consecutively assigned in a control and an intervention group. The intervention group receives the telemedically augmented care, whereas the control group receives standard care. The primary goal of this chapter is to determine the usability and feasibility; the secondary goal is the assessment of the intervention's impact on quality of life and the number of unscheduled hospital admissions. To sum up, telemedically supported ambulatory palliative care may synergistically help to improve safety and quality of life.


2007 ◽  
Vol 25 (28) ◽  
pp. 4387-4395 ◽  
Author(s):  
Alyson B. Moadel ◽  
Chirag Shah ◽  
Judith Wylie-Rosett ◽  
Melanie S. Harris ◽  
Sapana R. Patel ◽  
...  

Purpose This study examines the impact of yoga, including physical poses, breathing, and meditation exercises, on quality of life (QOL), fatigue, distressed mood, and spiritual well-being among a multiethnic sample of breast cancer patients. Patients and Methods One hundred twenty-eight patients (42% African American, 31% Hispanic) recruited from an urban cancer center were randomly assigned (2:1 ratio) to a 12-week yoga intervention (n = 84) or a 12-week waitlist control group (n = 44). Changes in QOL (eg, Functional Assessment of Cancer Therapy) from before random assignment (T1) to the 3-month follow-up (T3) were examined; predictors of adherence were also assessed. Nearly half of all patients were receiving medical treatment. Results Regression analyses indicated that the control group had a greater decrease in social well-being compared with the intervention group after controlling for baseline social well-being and covariates (P < .0001). Secondary analyses of 71 patients not receiving chemotherapy during the intervention period indicated favorable outcomes for the intervention group compared with the control group in overall QOL (P < .008), emotional well-being (P < .015), social well-being (P < .004), spiritual well-being (P < .009), and distressed mood (P < .031). Sixty-nine percent of intervention participants attended classes (mean number of classes attended by active class participants = 7.00 ± 3.80), with lower adherence associated with increased fatigue (P < .001), radiotherapy (P < .0001), younger age (P < .008), and no antiestrogen therapy (P < .02). Conclusion Despite limited adherence, this intent-to-treat analysis suggests that yoga is associated with beneficial effects on social functioning among a medically diverse sample of breast cancer survivors. Among patients not receiving chemotherapy, yoga appears to enhance emotional well-being and mood and may serve to buffer deterioration in both overall and specific domains of QOL.


2012 ◽  
Vol 25 (1) ◽  
pp. 128-139 ◽  
Author(s):  
Linda Clare ◽  
Rhiannon Whitaker ◽  
Robert T Woods ◽  
Catherine Quinn ◽  
Hannah Jelley ◽  
...  

ABSTRACTBackground: The extent to which care home residents with severe dementia show awareness is influenced by the extent to which the environment provides opportunities for engagement and by the way in which care staff interact with them. We aimed to establish whether training care staff to observe and identify signs of awareness in residents with severe dementia resulted in improved quality of life for residents.Methods: In this pilot cluster randomized trial, care staff in four homes (n = 32) received training and supervision and carried out structured observations of residents using the AwareCare measure (n = 32) over an eight-week period, while staff in four control homes (n = 33) had no training with regard to their residents (n = 33) and no contact with the research team. The primary outcome was resident quality of life. Secondary outcomes were resident well-being, behavior and cognition, staff attitudes and well-being, and care practices in the home.Results: Following intervention, residents in the intervention group had significantly better quality of life as rated by family members than those in the control group, but care staff ratings of quality of life did not differ. There were no other significant between-group differences. Staff participating in the intervention identified benefits in terms of their understanding of residents’ needs.Conclusions: Staff were able to use the observational measure effectively and relatives of residents in the intervention homes perceived an improvement in their quality of life.


2017 ◽  
pp. 1228-1246
Author(s):  
Romina Nemecek ◽  
Patrick Huber ◽  
Sophie Schur ◽  
Eva Masel ◽  
Stefanie Porkert ◽  
...  

Patients with advanced cancer have a substantial symptom burden, which deteriorates their quality of life. Palliative care improves well-being of patients and their family caregivers. Within the scope of a controlled pilot study, a user-friendly telepresence system is developed, which enables patients and family caregivers to send a direct request to a palliative care team. Additionally, a specially tailored database is developed, which contains up to date patient information. Twenty patients with advanced non-small cell lung cancer are consecutively assigned in a control and an intervention group. The intervention group receives the telemedically augmented care, whereas the control group receives standard care. The primary goal of this chapter is to determine the usability and feasibility; the secondary goal is the assessment of the intervention's impact on quality of life and the number of unscheduled hospital admissions. To sum up, telemedically supported ambulatory palliative care may synergistically help to improve safety and quality of life.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 546-547
Author(s):  
Miranda McPhillips ◽  
Darina Petrovsky ◽  
Subhash Aryal ◽  
Nancy Hodgson

Abstract We conducted a two-arm RCT with dyads of 200 persons living at home with dementia (PLWD) who reported sleep disruption and family caregivers. Components of the Healthy Patterns intervention included: 1) assessing PLWD functional status, preferences and interests; 2) educating caregivers on environmental cues to promote activity and sleep; and 3) training caregivers in timed morning, afternoon, and evening activities. Outcomes included: PLWD quality of life, sleep, and neuropsychiatric symptoms. Sleep-wake patterns were assessed using wrist actigraphy and proxy-reported measures. The main intervention effects were tested using ANCOVA. The average age of participants was 73.4 years, 67% were female, 80% were African American/Black). At 4 weeks, the intervention group demonstrated less sleep-related impairment (p = 0.0031) and reported higher quality of life than the control group (p = 0.0074). These results provide new fundamental knowledge regarding the effects of timing activity on sleep and well-being.


2016 ◽  
pp. 183-199
Author(s):  
Romina Nemecek ◽  
Patrick Huber ◽  
Sophie Schur ◽  
Eva Masel ◽  
Stefanie Porkert ◽  
...  

Patients with advanced cancer have a substantial symptom burden, which deteriorates their quality of life. Palliative care improves well-being of patients and their family caregivers. Within the scope of a controlled pilot study, a user-friendly telepresence system is developed, which enables patients and family caregivers to send a direct request to a palliative care team. Additionally, a specially tailored database is developed, which contains up to date patient information. Twenty patients with advanced non-small cell lung cancer are consecutively assigned in a control and an intervention group. The intervention group receives the telemedically augmented care, whereas the control group receives standard care. The primary goal of this chapter is to determine the usability and feasibility; the secondary goal is the assessment of the intervention's impact on quality of life and the number of unscheduled hospital admissions. To sum up, telemedically supported ambulatory palliative care may synergistically help to improve safety and quality of life.


2018 ◽  
Vol 33 (2) ◽  
pp. 221-231
Author(s):  
Renske Kruizinga ◽  
Michael Scherer-Rath ◽  
Johannes BAM Schilderman ◽  
Iris D Hartog ◽  
Jacoba PM Van Der Loos ◽  
...  

Background: Diagnosis and treatment of incurable cancer as a life-changing experience evokes difficult existential questions. Aim: A structured reflection could improve patients’ quality of life and spiritual well-being. We developed an interview model on life events and ultimate life goals and performed a randomized controlled trial to evaluate the effect thereof on quality of life and spiritual well-being. Design: The intervention group had two consultations with a spiritual counselor. The control group received care as usual. EORTC QLQ-C15-PAL and the FACIT-sp were administered at baseline and 2 and 4 months after baseline. Linear mixed model analysis was performed to test between-group differences over time. Participants: Adult patients with incurable cancer and a life expectancy ⩾6 months were randomized in a 1:1 ratio to the intervention or control group. Results: A total of 153 patients from six different hospitals were included: 77 in the intervention group and 76 in the control group. Quality of life and spiritual well-being did not significantly change over time between groups. The experience of Meaning/Peace was found to significantly influence quality of life ( β = 0.52, adj. R2 = 0.26) and satisfaction with life ( β = 0.61, adj. R2 = 0.37). Conclusion: Although our newly developed interview model was well perceived by patients, we were not able to demonstrate a significant difference in quality of life and spiritual well-being between groups. Future interventions by spiritual counselors aimed at improving quality of life, and spiritual well-being should focus on the provision of sources of meaning and peace.


2021 ◽  
Vol 10 (3) ◽  
pp. 104-107
Author(s):  
Anusheh Haghighi ◽  
Maryam Dibadin ◽  
Alireza Farahani ◽  
Mohammad Amin Abbasi ◽  
Mohsen Arabi

Background: The present study aimed at evaluating the effect of weekly phone calls on treatment outcomes and quality of life among a group of Iranian patients with rheumatoid arthritis (RA). Materials and Methods: In this randomized clinical trial study, 60 patients aged 15-85 with RA were randomly assigned to intervention and control groups. The intervention group, in addition to a monthly assessment on a weekly basis, received a full 3-month follow-up telephone conversation in order to follow the correct and regular use of the drug and respond to the patients’ questions. The control group was only evaluated routinely. Finally, the severity of the disease activity (based on DAS-28) and the quality of life (based on the SF-12 questionnaire) were evaluated after three months. Results: After three months from the onset of intervention, a significant reduction was observed in the number of tender joints, mean erythrocyte sedimentation rate (ESR), and total score of DAS-28 in the intervention group compared to the control group. In addition, after three months of treatment, the quality of life for the intervention group improved significantly more than that of the control group. Conclusion: A weekly phone call with the patients suffering from RA with the purpose to guide the therapeutic process and respond to the patients’ questions could positively improve the severity of the disease along with the quality of life among the patients.


Author(s):  
Shefaly Shorey ◽  
Ee Heok Kua ◽  
Wilson Tam ◽  
Valerie Chan ◽  
Yong Shian Goh ◽  
...  

In Singapore, many older adults suffer from subsyndromal depression and/or subsyndromal anxiety, which can negatively impact their physical and mental well-being if left untreated. Due to the general public’s reluctance to seek psychological help and the low psychiatrist-to-population ratio in Singapore, this study aims to examine the preliminary efficacy, perceptions, and acceptability of a trained volunteer-led community-based intervention on community-dwelling older adults. Twenty-one participants (control: n = 11; intervention: n = 10) completed the randomized pilot study. A mixed-methods approach (questionnaires, semistructured interviews, examining blood samples, intervention fidelity) was adopted. No significant differences were found between the intervention and the control groups in depression, anxiety, life satisfaction, friendship, and quality of life. However, there was a positive change in quality-of-life scores from baseline to 6 months in the intervention group. The control group had significantly higher cortisol levels and lower annexin-A1 levels at 6 months, while the intervention group did not. Three themes emerged from the interviews: (1) impact of the intervention on older adults’ well-being, (2) attitudes toward intervention, and (3) a way forward. However, intervention efficacy could not be established due to small sample size caused by the coronavirus pandemic. Future randomized controlled trials should evaluate volunteer-led, technology-based psychosocial interventions to support these older adults.


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