Evaluation of the psychosocial needs of cancer survivors.

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 207-207
Author(s):  
Smitha Pabbathi ◽  
Ariana Abid ◽  
Kanan Mehta ◽  
Dinorah Tyson Martinez ◽  
Carrie Hall ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Sleep Disturbances ◽  
Assessment Tool ◽  
High Stress ◽  
Retrospective Chart Review ◽  
Fear Of Recurrence ◽  
Psychosocial Needs ◽  
Psychosocial Effects ◽  
Patients Âgés ◽  
Distress Score

207 Background: Even after enduring successful treatment of their cancer, the late physical and psychosocial effects of treatment often continue to haunt as many as 50% of survivors. Furthermore, the needs of cancer survivors differ from those undergoing active treatment. However, there is a lack of comprehensive assessment for providers caring for survivors. Therefore, there is a need for one tool to assess the physical and psychosocial needs as well as evaluate their severity when initially establishing care in general survivorship clinic. In this study, we determine the most commonly identified of these needs as well as the degree to which they impact overall health of this population. Methods: A retrospective chart review of 220 patient records from the past six years in General Survivorship Clinic using Moffitt Cancer Center’s EHR was performed. All patients (ages 18-85 years) diagnosed with cancer without evidence of current disease and who had complete Clinical Needs Assessment Tool for Cancer Survivors (CNAT-CS) were eligible for inclusion. The CNAT- CS is a questionnaire of 36 items on which survivors identify as “not a concern”, “is a concern but I am managing”, or “I need help”. Results: A majority (65.5%) was female and white (81.3%); African Americans made up 11.4%. The mean age was 57.6 (SD = 11.3). Subjects had survived a variety of types of cancer with more than half (57%) having breast cancer. Their mean distress score was 2.75 (SD = 2.86). Fear of recurrence was the concern most often identified (56%), followed by feeling of high stress (50%), sleep disturbances (49%) and memory/ attention difficulties (40%). Highest scores were found on items about fear of the cancer returning (Mean = 0.71; SD = .55), information needed for follow-up care (mean = .64; SD = .59), stress in my life (mean = .60; SD = .65) and trouble with my memory/attention (mean = 0.52; SD = .69). Conclusions: These results indicate a relatively low mean distress score from the distress thermometer. Areas identified most frequently as a concern also tended to be the areas with the highest mean scores. Although almost 20% of survivors were in minority groups, ethnic minorities were underrepresented in this sample. Thus, future studies should focus on increasing the representativeness of the sample.

scholarly journals Improving Stress Management and Sleep Hygiene in Intelligent Homes

Sensors ◽  
2021 ◽  
Vol 21 (7) ◽  
pp. 2398
Author(s):  
Asterios Leonidis ◽  
Maria Korozi ◽  
Eirini Sykianaki ◽  
Eleni Tsolakou ◽  
Vasilios Kouroumalis ◽  
...  
Keyword(s):  
Sleep Disturbances ◽  
Contextual Information ◽  
High Stress ◽  
Sleep Hygiene ◽  
Poor Sleep ◽  
Health Issues ◽  
Time Data ◽  
Intelligent Home ◽  
And Control

High stress levels and sleep deprivation may cause several mental or physical health issues, such as depression, impaired memory, decreased motivation, obesity, etc. The COVID-19 pandemic has produced unprecedented changes in our lives, generating significant stress, and worries about health, social isolation, employment, and finances. To this end, nowadays more than ever, it is crucial to deliver solutions that can help people to manage and control their stress, as well as to reduce sleep disturbances, so as to improve their health and overall quality of life. Technology, and in particular Ambient Intelligence Environments, can help towards that direction, when considering that they are able to understand the needs of their users, identify their behavior, learn their preferences, and act and react in their interest. This work presents two systems that have been designed and developed in the context of an Intelligent Home, namely CaLmi and HypnOS, which aim to assist users that struggle with stress and poor sleep quality, respectively. Both of the systems rely on real-time data collected by wearable devices, as well as contextual information retrieved from the ambient facilities of the Intelligent Home, so as to offer appropriate pervasive relaxation programs (CaLmi) or provide personalized insights regarding sleep hygiene (HypnOS) to the residents. This article will describe the design process that was followed, the functionality of both systems, the results of the user studies that were conducted for the evaluation of their end-user applications, and a discussion about future plans.

106 Frailty Assessment in the Burn Population: A Single Center Retrospective Review

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S71-S72
Author(s):  
Erin Wolf Horrell ◽  
Ronnie Mubang ◽  
Sarah A Folliard ◽  
Robel Beyene ◽  
Stephen Gondek ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Level Of Care ◽  
Post Discharge ◽  
Patients Âgés ◽  
Injury Characteristics ◽  
Frail Patients ◽  
Discharge Care ◽  
Patients Experience

Abstract Introduction Burn morbidity and mortality increases with advancing age. Frailty is characterized by reduced homeostatic reserves and is associated with an increased biological age compared to chronological age. Our primary aim was to determine whether frailty as assessed on admission would be predictive of outcomes in the burn population. Methods We conducted a single institution 7-month retrospective chart review of all admitted acute burn patients ages 45 and older. Patient and injury characteristics were collected and compared using standard statistical analysis. Frailty scores were assessed upon admission using the FRAIL Scale. Results Eighty-five patients met inclusion criteria and were able to complete the FRAIL assessment. Patient and injury characteristics are listed in Table 1. Mean burn size was 6.7%TBSA (95%CI 4.9–8.4%). 34 patients (40%) were classified as robust (FRAIL score 0), 26(30.6%) as pre-frail (FRAIL score 1-Patients in the pre-frail/frail cohort received more palliative care consultations (p=.096) and had a longer length of stay (3.3d vs 7.55d p = .002), while prefrail patients had a similar LOS to frail patients (7.46 vs 7.64d p =.938). Patients in the pre-frail/frail cohort were also more likely to be discharged to a higher level of care than they were admitted from(p=.032) with prefrail patients experience an escalation in level of care more frequently than frail patients. The distribution by age by half-decade ranges is in Figure 1. By age 55–59, the majority of patients were prefrail or frail. Conclusions We demonstrated that frailty as assessed by the FRAIL score was predictive of increased length of stay and an escalation in post discharge care. In addition, patients characterized as pre-frail experience outcomes similar to frail patients and should be managed as such. Given the prevalence of frailty and prefrailty in the younger group of patients, we advocate for routine frailty screening beginning at age 55.

scholarly journals Factors Associated with Meeting the Psychosocial Needs of Cancer Survivors in Nova Scotia, Canada

2020 ◽  
Vol 28 (1) ◽  
pp. 13-25
Author(s):  
Soleil Chahine ◽  
Gordon Walsh ◽  
Robin Urquhart
Keyword(s):  
Primary Care ◽  
Nova Scotia ◽  
Cancer Survivors ◽  
Sociodemographic Factors ◽  
Patient Navigator ◽  
Care Providers ◽  
Psychosocial Needs ◽  
Factors Associated ◽  
Follow Up Care

Purpose: The purpose of this study is to describe the psychosocial needs of cancer survivors and examine whether sociodemographic factors and health care providers accessed are associated with needs being met. Methods: All Nova Scotia survivors meeting specific inclusion and exclusion criteria are identified from the Nova Scotia Cancer Registry and sent an 83-item survey to assess psychosocial concerns and whether and how their needs were met. Descriptive statistics (frequencies, percentages) and Chi-square analyses are used to examine associations between sociodemographic and provider factors and outcomes. Results: Anxiety and fear of recurrence, depression, and changes in sexual intimacy are major areas of concern for survivors. Various sociodemographic factors, such as immigration status, education, employment, and internet use, are associated with reported psychosocial health and having one’s needs met. Having both a specialist and primary care provider in charge of follow-up care is associated with a significantly (p < 0.05) higher degree of psychosocial and informational needs met compared to only one physician or no follow-up physician in charge. Accessing a patient navigator also is significantly associated with a higher degree of needs met. Conclusions: Our study identifies the most prevalent psychosocial needs of cancer survivors and the factors associated with having a higher degree of needs met, including certain sociodemographic factors, follow-up care by both a primary care practitioner and specialist, and accessing a patient navigator.

Hypothalamic-Pituitary and Other Endocrine Surveillance Among Childhood Cancer Survivors

2021 ◽  
Author(s):  
Laura van Iersel ◽  
Renee L Mulder ◽  
Christian Denzer ◽  
Laurie E Cohen ◽  
Helen A Spoudeas ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Childhood Cancer ◽  
Healthcare Providers ◽  
Clinical History ◽  
Childhood Cancer Survivors ◽  
Adolescent And Young Adult ◽  
Endocrine Disorders ◽  
Psychosocial Effects ◽  
Increased Risk ◽  
International Experts

Abstract Endocrine disorders in survivors of childhood, adolescent, and young adult (CAYA) cancers are associated with substantial adverse physical and psychosocial effects. To improve appropriate and timely endocrine screening and referral to a specialist, the International Late Effects of Childhood Cancer Guideline Harmonization Group (IGHG) aims to develop evidence and expert consensus-based guidelines for healthcare providers that harmonize recommendations for surveillance of endocrine disorders in CAYA cancer survivors. Existing IGHG surveillance recommendations for premature ovarian insufficiency, gonadotoxicity in males, fertility preservation, and thyroid cancer are summarized. For hypothalamic-pituitary (HP) dysfunction, new surveillance recommendations were formulated by a guideline panel consisting of 42 interdisciplinary international experts. A systematic literature search was performed in MEDLINE (through PubMed) for clinically relevant questions concerning HP dysfunction. Literature was screened for eligibility. Recommendations were formulated by drawing conclusions from quality assessment of all evidence, considering the potential benefits of early detection and appropriate management. Healthcare providers should be aware that CAYA cancer survivors have an increased risk for endocrine disorders, including HP dysfunction. Regular surveillance with clinical history, anthropomorphic measures, physical examination, and laboratory measurements is recommended in at-risk survivors. When endocrine disorders are suspected, healthcare providers should proceed with timely referrals to specialized services. These international evidence-based recommendations for surveillance of endocrine disorders in CAYA cancer survivors inform healthcare providers and highlight the need for long-term endocrine follow-up care in subgroups of survivors and elucidate opportunities for further research.

Psychological aspects in the problems of infertility among the population of various countries.

2021 ◽  
pp. 61-69
Author(s):  
I. A. Tliashinova ◽  
◽  
E. N. Mingazova ◽  
Keyword(s):  
Psychological Stress ◽  
Psychological Health ◽  
Sleep Disturbances ◽  
Stressful Life Events ◽  
Assessment Tool ◽  
Reproductive Function ◽  
Fertility Treatment ◽  
Cognitive Behavioral Group Therapy ◽  
Male Reproductive Function ◽  
The Relationship

The problem of infertility in the 21st century has become extremely important for public health in various countries, affecting the birth rate of the population and the number of humanity. Infertility, affecting approximately 8–12% of the world’s population, is associated with factors such as unwillingness to conceive, the age of the female partner, the number of diseases that affect fertility, etc. Questions of the influence of psychological problems, often regarded as the causes of idiopathic infertility, such as stress, depression, sleep disturbances, are of particular interest to researchers. A review of works on the potential impact of stress and depression on reproductive function showed not only a definite relationship, but also the difficulty of determining causal relationships due to the lack of a single assessment tool. P u r p o s e o f t h e s t u d y : to review foreign scientific literature containing information on the role of psychological factors in the formation of reproductive health disorders of the population, including infertility. M a t e r i a l s a n d m e t h o d s : bibliographic, information and analytical methods and the method of comparative analysis were used. R e s u l t s . Mental health issues are often viewed as the causes of female and male infertility. To improve the quality of life of patients with infertility, it is necessary to address the issues of a causal relationship between psychological health and infertility, psychological health when using IVF and ways to solve the problem of psychologically induced infertility. The risk of developing depression and the relationship of a higher degree of anxiety with clinical pregnancy after IVF are shown. Due to the inaccurate data on the relationship between psychological stress and a decrease in male reproductive function, psychological stress is considered in studies as a risk factor for erectile function and ejaculation in men against the background of a high level of stressful life events, compared with women. Findings. Research has proven the effectiveness of psychological support and cognitive-behavioral group therapy in fertility treatment programs, including interventions accompanying IVF. Studies of psychological ways of correcting depression and positive IVF results have shown the importance of programs for influencing the mental state of couples undergoing treatment for infertility reasons.

Psychosocial Screening Among Youth Seeking Weight Management Treatment

2017 ◽  
Vol 57 (3) ◽  
pp. 277-284 ◽  
Author(s):  
Megan B. Ratcliff ◽  
Perry A. Catlin ◽  
James L. Peugh ◽  
Robert M. Siegel ◽  
Shelley Kirk ◽  
...  
Keyword(s):  
At Risk ◽  
Weight Management ◽  
Retrospective Chart Review ◽  
Self Report ◽  
Risk Scores ◽  
Symptom Checklist ◽  
Patients Âgés ◽  
Pediatric Symptom Checklist ◽  
Obese Youth ◽  
Caregiver Report

The objectives of this study were to identify rates of, and factors associated with, “at-risk” scores on a brief psychosocial screener among overweight/obese youth seeking weight management treatment, as well as concordance between youth and caregiver reports. A retrospective chart review of 1443 consecutive patients ages 4 to 18 years and their caregivers was conducted. Almost 1 in 4 youth with overweight/obesity presented with psychosocial symptoms in the at-risk range for significant mental health issues based on caregiver report on the Pediatric Symptom Checklist (PSC) and 1 in 6 based on youth self-report on the Youth Pediatric Symptom Checklist (Y-PSC). Concordance between caregiver and youth was fair (agreement 24% to 40%). Higher scores were associated with male sex and older age on the PSC and with indication of depressive disorder in the electronic medical record on the Y-PSC. Conducting a brief psychosocial screen in comprehensive weight management programs is feasible and clinically indicated.

scholarly journals Concerns and Quality of Life of Cancer Survivors Across the Survivorship Trajectory: A Singapore Perspective

2019 ◽  
Author(s):  
Gek Phin Chua ◽  
Quan Sing Ng ◽  
Hiang Khoon Tan ◽  
Whee Sze Ong
Keyword(s):  
Quality Of Life ◽  
Cancer Survivors ◽  
Cancer Treatment ◽  
Cancer Survivorship ◽  
Recurrence Risk ◽  
Term Treatment ◽  
Fear Of Recurrence ◽  
Long Term Treatment

Abstract Background The aim of this study is to determine the main concerns of survivors at various stages of the cancer survivorship of the cancer survivorship trajectory and to assess whether these concerns have any effect on their quality of life (QOL). The overall goal was to use the insights from the study to guide practice on patient care. Methods A cross-sectional survey of 1107 cancer survivors diagnosed with colorectal, breast, lung, gynaecological, prostate or liver cancers from a cancer centre in Singapore. Eligible patients self-completed a questionnaire adapted from the Mayo Clinic Cancer Centre’s Cancer Survivors Survey of Needs. Results The top 5 concerns among all survivors were cancer treatment and recurrence risk (51%), followed by long-term treatment effects (49%), fear of recurrence (47%), financial concerns (37%) and fatigue (37%). Cancer treatment and recurrence risk, long-term treatment effects and fear of recurrence were amongst the top concerns across the survivorship trajectory. Mean QOL was 7.3 on a scale of 0 – 10. Completed treatment patients had higher QOL score than the newly diagnosed and on treatment patients and the patients dealing with recurrence or second cancer patients. Predictors for QOL included the economic status and housing type of patients and whether patients were concerned with pain and fatigue Conclusion This study confirms that cancer survivors in Singapore face multiple challenges and had various concerns at various stages of cancer survivorship, some of which negatively affect their QOL It is critical to design patient care delivery that appropriately address the various concerns of cancer survivors in order for them to cope and improve their QOL.

scholarly journals Anticoagulant Utilization and Direct Oral Anticoagulant Prescribing in Patients with Nonvalvular Atrial Fibrillation

2019 ◽  
Vol 72 (6) ◽  
Author(s):  
Priscilla Shum ◽  
Gordon Klammer ◽  
Dale Toews ◽  
Arden Barry
Keyword(s):  
Atrial Fibrillation ◽  
Oral Anticoagulant ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Renal Dialysis ◽  
Retrospective Chart Review ◽  
Patient Characteristics ◽  
Nonvalvular Atrial Fibrillation ◽  
Patients Âgés ◽  
Fibrillation Auriculaire

ABSTRACTBackground: Direct oral anticoagulants (DOACs) are indicated for prevention of stroke and embolism in patients with nonvalvular atrial fibrillation (NVAF). These agents have been shown to be non-inferior to warfarin in terms of efficacy and safety. However, their uptake in practice has been variable, and prescribed dosages may be inconsistent with manufacturer recommendations.Objectives: To evaluate patterns of oral anticoagulant use in patients with NVAF, including determination of patient characteristics associated with the prescribing of warfarin or DOACs and whether prescribed dosages of DOACs were concordant with manufacturer recommendations.Methods: This retrospective chart review was conducted from April to September 2017 at Abbotsford Regional Hospital, Abbotsford, British Columbia. Patients at least 18 years of age with NVAF and CHADS-65 score of 1 or higher were included. Patients with contraindications to oral anticoagulants, those with reversible atrial fibrillation, and those undergoing renal dialysis were excluded. The dosage of DOACs was categorized as too low, too high, or correct in relation to manufacturer recommendations for the Canadian product. Results: A total of 120 patients were included. At discharge, 83 (69%) of the patients had a prescription for DOAC, 25 (21%) had a prescription for warfarin, and 12 (10%) had no prescription for an oral anticoagulant. There were no statistically significant differences between the warfarin and DOAC groups with respect to patient characteristics. Among the 56 patients for whom a full DOAC dose was indicated, 7 (13%) received a dose that was too low. Among the 23 patients for whom a full DOAC dose was not indicated, 4 (17%) received a dose that was too high. Conclusions: At the study hospital, most patients with NVAF and CHADS-65 score of at least 1 had a discharge prescription for DOAC. Patient characteristics appeared to be similar between the warfarin and DOAC groups. For a notable proportion of patients who received a DOAC, the dosage was incorrect. Appropriate prescribing of oral anticoagulants could be further improved by education for prescribers and involvement of hospital pharmacists.RÉSUMÉContexte : Les anticoagulants oraux directs (AOD) sont indiqués pour prévenir les AVC et les embolies parmi les patients atteints de fibrillation auriculaire non valvulaire (FANV). Il a été démontré que l’efficacité et l’innocuité de ces agents n’étaient pas inférieures à la warfarine. Cependant, leur adoption dans la pratique est inégale, et les doses prescrites peuvent être contraires aux recommandations des fabricants.Objectifs : Évaluation des habitudes d’utilisation des anticoagulants oraux pour les patients atteints de FANV, y compris la définition des caractéristiques des patients associées à la prescription de la warfarine ou des AOD, ainsi que de la conformité des doses prescrites de ces derniers aux recommandations des fabricants.Méthodes : Cet examen rétrospectif des dossiers a été mené d’avril à septembre 2017 à l’Hôpital régional d’Abbotsford à Abbotsford, en Colombie-Britannique. Des patients âgés d’au moins 18 ans, atteints de FANV et ayant un score CHADS-65 d’au moins 1, ont été inclus dans l’étude. Les patients présentant une contre-indication aux anticoagulants oraux, ceux atteints de fibrillation auriculaire réversible et ceux soumis à une dialyse rénale en ont été exclus. La dose d’AOD destinés au marché canadien a été catégorisée comme trop faible, trop élevée ou correcte par rapport aux recommandations du fabricant.Résultats : Cent-vingt patients au total ont participé à l’étude. Au moment du congé, 83 (69 %) d’entre eux avaient une prescription d’AOD, 25 (21 %) avaient une prescription de warfarine et 12 (10 %) n’avaient pas de prescription d’anticoagulant oral. En ce qui concerne les caractéristiques des patients, il n’y avait aucune différence statistique notable entre les groupes ayant reçu une prescription de warfarine et ceux ayant reçu une prescription d’AOD. Des 56 patients qui avaient reçu une indication de dose complète d’AOD, sept (13 %) ont reçu une dose trop faible. Des 23 patients qui n’avaient pas reçu d’indication de dose complète d’AOD, quatre (17 %) ont reçu une dose trop élevée.Conclusions : À l’hôpital où s’est déroulée l’étude, la plupart des patients atteints de FANV et ceux ayant un score CHADS-65 d’au moins 1 recevaient une prescription d’AOD au moment du congé. Les caractéris-tiques des patients semblaient similaires entre les groupes ayant reçu une prescription de warfarine et ceux ayant reçu une prescription d’AOD. La dose d’AOD reçue par une proportion notable de patients était incorrecte. La prescription appropriée d’anticoagulants oraux pourrait encore être améliorée si on sensibilisait les prescripteurs avec la collaboration des pharmaciens d’hôpitaux.   

scholarly journals 1053 Sleep Duration And Timing Associated With History Of Breast Prostate And Skin Cancer: Data From A Nationally-representative Sample

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A400-A400
Author(s):  
B Piro ◽  
S Garland ◽  
P Jean-Pierre ◽  
B Gonzalez ◽  
A Seixas ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prostate Cancer ◽  
Skin Cancer ◽  
Cancer Survivors ◽  
Sleep Duration ◽  
Sleep Disturbances ◽  
Sleep Problems ◽  
Cancer Type ◽  
Cancer Data ◽  
History Of

Abstract Introduction Sleep disturbances are a common problem among cancer survivors. Also, cancer patients can have altered circadian rhythms and these changes can continue to affect the patient long after the conclusion of their treatment. This analysis aims to investigate how the sleep and wake times of cancer survivors differ from the rest of the population, depending on the type of cancer. Methods Data from the 2015-2016 National Health and Nutrition Examination Survey were used. Population-weighted data on N=5,581 individuals provided complete data. History of breast, prostate, and skin cancer (melanoma or other) was self-reported. Sleep duration was self-reported in half-hour increments, and typical bedtime and waketime was self-reported. Covariates included age, sex, and race/ethnicity. Weighted linear regressions with sleep duration, bedtime and waketime were examined, with each cancer type as predictor. Results Prevalence was 1.7% for prostate cancer, 1.5% for breast cancer, 2.3% for non-melanoma skin cancer, and 0.8% for melanoma. In adjusted analyses, prostate cancer was associated with an additional 26.5 minutes of average total sleep (95%CI 2.2,50.9, p=0.03), a 23.1 bedtime minutes earlier (95%CI -40.4,-5.8, p=0.009), and no difference in waketime. Breast cancer was associated with a bedtime that was 41.1 minutes later (95%CI 10.3,72.0, p=0.009) and a waketime that was 48.7 minutes later (95%CI 12.5,84.9, p=0.008), but no difference in sleep duration. No statistically significant effects were seen for either type of skin cancer, melanoma or non-melanoma. Conclusion Prostate cancer was associated with an earlier bedtime and associated increased sleep time. Breast cancer, on the other hand, was associated with a phase delay of the sleep period but no change in sleep duration. Skin cancer was not associated with differences in sleep duration or timing. These findings may have implications for not only treatment of sleep problems in different types of cancer, but also possible circadian mechanisms. Support Dr. Grandner is supported by R01MD011600

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